WEBVTT 00:00:00.660 --> 00:00:02.621 You're listening to the PT Pinecast, 00:00:02.741 --> 00:00:04.761 where smart people in healthcare come to 00:00:04.801 --> 00:00:05.663 make noise. 00:00:05.783 --> 00:00:07.423 Here's your host, Jimmy McKay. 00:00:07.442 --> 00:00:10.185 All right. 00:00:10.224 --> 00:00:12.566 Some people in physical therapy chase 00:00:13.086 --> 00:00:14.147 efficiency. 00:00:15.039 --> 00:00:16.460 Others chase compliance. 00:00:16.740 --> 00:00:18.963 And most clinics are stuck somewhere in 00:00:18.983 --> 00:00:20.824 the middle, just going around in circles, 00:00:21.083 --> 00:00:21.724 chasing something, 00:00:22.045 --> 00:00:23.946 trying to treat patients well while 00:00:23.966 --> 00:00:26.306 surviving productivity expectations, 00:00:27.207 --> 00:00:28.268 documentation pressure, 00:00:28.728 --> 00:00:31.150 and reimbursement changes that seem to 00:00:31.170 --> 00:00:34.072 shift every year or every, I don't know, 00:00:40.697 --> 00:00:43.459 What if the systems inside healthcare 00:00:43.899 --> 00:00:46.921 actually protected the clinicians instead 00:00:46.942 --> 00:00:47.883 of burning them out? 00:00:48.823 --> 00:00:50.966 What if compliance wasn't something 00:00:51.026 --> 00:00:51.826 therapists feared, 00:00:52.286 --> 00:00:54.668 but something that gave them confidence 00:00:55.713 --> 00:00:57.174 What if business strategy didn't dilute 00:00:57.195 --> 00:00:58.075 clinical care at all, 00:00:58.115 --> 00:00:59.595 but actually strengthened it? 00:01:00.176 --> 00:01:02.697 Today's guest has built a career right at 00:01:02.756 --> 00:01:04.638 that intersection that I just described. 00:01:05.138 --> 00:01:06.998 She's helped organizations translate 00:01:07.039 --> 00:01:09.560 clinical excellence into systems that 00:01:10.221 --> 00:01:10.501 work. 00:01:11.260 --> 00:01:12.941 turning compliance into clarity, 00:01:13.081 --> 00:01:16.224 education into something people actually 00:01:16.603 --> 00:01:16.905 use. 00:01:17.245 --> 00:01:17.984 Who would have thought? 00:01:18.566 --> 00:01:20.287 And how about turning strategy into tools 00:01:20.587 --> 00:01:23.608 that help therapists survive modern 00:01:23.649 --> 00:01:24.129 healthcare? 00:01:24.569 --> 00:01:26.911 She believes it's something simple but 00:01:27.031 --> 00:01:27.691 powerful. 00:01:27.971 --> 00:01:30.873 Clinical decisions should guide financial 00:01:30.893 --> 00:01:33.575 decisions, not the other way around. 00:01:33.614 --> 00:01:34.435 And if you do what's right for the 00:01:34.474 --> 00:01:36.656 patient, the money will follow. 00:01:37.177 --> 00:01:38.798 Let's bring in Katie Holterman. 00:01:38.957 --> 00:01:40.159 How'd we do on the intro, Katie? 00:01:40.605 --> 00:01:41.746 I think pretty good. 00:01:41.966 --> 00:01:42.727 I think pretty good. 00:01:42.787 --> 00:01:44.248 I like to wear a lot of hats. 00:01:44.668 --> 00:01:46.049 So as you can see, 00:01:46.088 --> 00:01:47.689 they kind of go on and off and 00:01:47.950 --> 00:01:49.671 depending on the lens that I'm looking at 00:01:49.712 --> 00:01:50.432 and things like that. 00:01:51.093 --> 00:01:52.132 But that's good, right? 00:01:52.192 --> 00:01:55.454 Because I don't think I talked about silos 00:01:55.715 --> 00:01:58.277 more in my life until I became a 00:01:58.316 --> 00:01:59.638 physical therapy student and then 00:01:59.677 --> 00:02:00.237 graduated. 00:02:00.918 --> 00:02:02.359 I don't know that there were silos in 00:02:02.379 --> 00:02:03.500 my previous life, 00:02:03.900 --> 00:02:05.701 but I definitely recognize them. 00:02:05.962 --> 00:02:06.882 And you're talking about... 00:02:07.829 --> 00:02:10.271 being able to sit atop the silos and 00:02:10.312 --> 00:02:11.554 see what's going on in each and saying, 00:02:11.894 --> 00:02:13.596 Hey, you're over here trying to fix this, 00:02:13.695 --> 00:02:14.697 but you're doing it this way. 00:02:14.717 --> 00:02:15.698 If you just changed it, 00:02:15.937 --> 00:02:17.218 it would solve your problem in this 00:02:17.258 --> 00:02:17.639 problem. 00:02:17.719 --> 00:02:21.163 And that feels like actual efficiency. 00:02:21.263 --> 00:02:21.903 Exactly. 00:02:22.163 --> 00:02:22.623 Exactly. 00:02:22.723 --> 00:02:24.145 And being able to kind of look at 00:02:24.566 --> 00:02:27.068 through different lens lenses and jump 00:02:27.109 --> 00:02:29.670 around without jumping in, 00:02:30.072 --> 00:02:31.812 but jumping around and, 00:02:32.114 --> 00:02:32.213 and 00:02:33.694 --> 00:02:36.355 pulling what is needed out of each bucket, 00:02:36.376 --> 00:02:37.656 so to speak. 00:02:37.716 --> 00:02:37.855 Yeah. 00:02:37.936 --> 00:02:38.356 Right now, 00:02:38.417 --> 00:02:39.776 it might feel like in healthcare and 00:02:39.836 --> 00:02:42.877 probably warranted that clinicians are 00:02:42.937 --> 00:02:43.919 where the rubber meets the road. 00:02:43.938 --> 00:02:44.899 I mean, we have to be, right? 00:02:44.959 --> 00:02:45.979 We are a service. 00:02:46.019 --> 00:02:47.539 We provide a service, right? 00:02:47.580 --> 00:02:49.020 That is what we do in healthcare. 00:02:49.060 --> 00:02:49.860 We provide care. 00:02:50.161 --> 00:02:51.061 Care is a service. 00:02:51.480 --> 00:02:52.961 And it often feels like where the rubber 00:02:52.981 --> 00:02:56.242 meets the road or where the brake pads 00:02:56.383 --> 00:02:56.802 are, right? 00:02:56.823 --> 00:02:58.082 That's where the most friction is. 00:02:58.323 --> 00:02:59.204 Unfortunately, that's where our 00:02:59.924 --> 00:03:01.104 our humans are who want to give the 00:03:01.145 --> 00:03:01.425 most. 00:03:01.746 --> 00:03:03.788 So you talk a lot about building systems 00:03:04.247 --> 00:03:06.950 that actually protect clinicians instead 00:03:06.991 --> 00:03:07.871 of burning them out. 00:03:08.711 --> 00:03:11.054 What does that look like or what could 00:03:11.074 --> 00:03:13.556 that look like in reality in a clinic? 00:03:13.637 --> 00:03:16.900 How can you give me examples of situations 00:03:16.939 --> 00:03:18.882 where we're actually able to protect those 00:03:18.921 --> 00:03:20.543 people instead of using them as the thing 00:03:20.562 --> 00:03:22.444 that we stop the car with? 00:03:22.544 --> 00:03:22.925 Exactly. 00:03:22.944 --> 00:03:23.064 Well, 00:03:23.085 --> 00:03:24.447 I think the first thing that you said 00:03:24.467 --> 00:03:25.788 was really important is that 00:03:26.804 --> 00:03:30.686 we have a service right but it's our 00:03:30.746 --> 00:03:33.467 product correct clinicians don't want to 00:03:33.507 --> 00:03:36.429 think that they have a product clinicians 00:03:36.709 --> 00:03:41.350 are touchy-feely and loving and want to do 00:03:41.371 --> 00:03:43.532 the great thing and a product is stingy 00:03:43.693 --> 00:03:47.655 and tangible and not um not something that 00:03:47.675 --> 00:03:50.056 people want to grab onto but when you 00:03:50.075 --> 00:03:51.415 start to realize that your service is a 00:03:51.475 --> 00:03:51.937 product 00:03:52.995 --> 00:03:54.399 That's kind of the first system that you 00:03:54.419 --> 00:03:56.264 put into place is that understanding 00:03:56.304 --> 00:03:56.604 piece. 00:03:57.798 --> 00:04:01.100 That in and itself is a system that 00:04:01.161 --> 00:04:01.540 works, 00:04:01.901 --> 00:04:05.304 just having that clarity of everything. 00:04:05.465 --> 00:04:09.147 That to me is strategy number one. 00:04:09.207 --> 00:04:11.710 Then when we go forward and say, okay, 00:04:11.770 --> 00:04:13.411 now what systems can we put into place 00:04:13.450 --> 00:04:16.494 to protect the clinician as far as from 00:04:16.533 --> 00:04:17.593 a compliance perspective, 00:04:17.653 --> 00:04:20.516 making sure that we are doing something 00:04:20.557 --> 00:04:22.699 that is compliant and doing it well 00:04:23.238 --> 00:04:25.461 without having to jump through seventeen 00:04:25.560 --> 00:04:26.601 hoops to do it. 00:04:28.538 --> 00:04:30.343 That's a slam dunk if we can do 00:04:30.382 --> 00:04:30.684 that, 00:04:30.744 --> 00:04:33.149 where we just put something in place and 00:04:33.209 --> 00:04:37.237 have checks and balances that are already 00:04:37.398 --> 00:04:39.281 in the workflow for the clinician. 00:04:39.843 --> 00:04:40.964 Why don't we do this? 00:04:41.024 --> 00:04:41.646 Let's start with there. 00:04:41.665 --> 00:04:42.747 I'll give an example. 00:04:43.206 --> 00:04:44.668 I bought a bike off eBay because one 00:04:44.689 --> 00:04:45.970 day I was going to be a triathlete 00:04:46.250 --> 00:04:47.372 and I was riding on that bike. 00:04:47.391 --> 00:04:48.151 That was my bike. 00:04:48.572 --> 00:04:50.213 And eventually after two or three years, 00:04:50.894 --> 00:04:52.076 someone looked at me riding that bike. 00:04:52.096 --> 00:04:53.076 It was one of those bikes where you 00:04:53.096 --> 00:04:54.177 sort of like lay down like you're super 00:04:54.197 --> 00:04:54.678 fast, you know, 00:04:54.699 --> 00:04:55.459 the hands in front of you. 00:04:55.980 --> 00:04:56.880 And someone said, hey, 00:04:57.401 --> 00:04:58.983 why do you sort of curl your wrists 00:04:59.083 --> 00:04:59.182 in? 00:05:00.083 --> 00:05:00.523 And I'm like, well, 00:05:00.543 --> 00:05:02.024 the handlebars are this long and my arms 00:05:02.064 --> 00:05:02.324 are longer. 00:05:02.345 --> 00:05:03.084 And they go, you know, 00:05:03.105 --> 00:05:04.105 there's a screw right there. 00:05:04.125 --> 00:05:04.646 You loosen that, 00:05:04.687 --> 00:05:06.247 those things telescope out. 00:05:06.528 --> 00:05:07.968 You could have them go longer. 00:05:08.589 --> 00:05:11.192 I adapted to the bike instead of, 00:05:11.291 --> 00:05:12.012 because I didn't know, 00:05:12.173 --> 00:05:12.833 I didn't know any better. 00:05:13.353 --> 00:05:14.555 I could have the bike adapt to me 00:05:14.595 --> 00:05:16.055 and I wouldn't have cocked my wrists for 00:05:16.096 --> 00:05:16.735 two and a half years. 00:05:16.857 --> 00:05:17.817 Now that's the only way I can ride, 00:05:17.857 --> 00:05:18.177 by the way. 00:05:19.237 --> 00:05:22.401 So let's start with why doesn't that 00:05:22.440 --> 00:05:22.841 happen? 00:05:23.201 --> 00:05:23.341 Like, 00:05:23.841 --> 00:05:26.163 why do we build systems that actually we 00:05:26.363 --> 00:05:28.946 ask the clinician to adapt to instead 00:05:28.985 --> 00:05:29.086 of... 00:05:29.947 --> 00:05:31.187 making more sense the other way around? 00:05:31.968 --> 00:05:33.189 I think there's a number of reasons. 00:05:33.329 --> 00:05:37.572 I think our EMR systems are failing us, 00:05:40.254 --> 00:05:42.596 but it's not the system itself. 00:05:42.677 --> 00:05:45.399 It's how we exactly what you're saying, 00:05:45.439 --> 00:05:48.141 how we aren't using the tools within the 00:05:48.221 --> 00:05:50.903 EMR systems to help 00:05:51.583 --> 00:05:53.004 them adapt to what we need. 00:05:53.345 --> 00:05:53.584 Now, 00:05:53.964 --> 00:05:56.247 I'll put the EMR companies aside because 00:05:56.766 --> 00:05:57.968 there's so many of them. 00:05:58.468 --> 00:05:59.790 They all have their limitations. 00:05:59.990 --> 00:06:01.130 They all have their benefits. 00:06:01.571 --> 00:06:02.752 One is not better than the other. 00:06:04.834 --> 00:06:05.435 I take that back. 00:06:05.454 --> 00:06:06.495 There are some that are better than the 00:06:06.514 --> 00:06:06.675 other. 00:06:08.685 --> 00:06:11.208 But I guess they're different tools and 00:06:11.307 --> 00:06:13.250 some of them are better in this situation 00:06:13.290 --> 00:06:13.990 versus that. 00:06:14.391 --> 00:06:14.992 Exactly. 00:06:15.172 --> 00:06:15.673 Exactly. 00:06:15.952 --> 00:06:17.595 I mean, here's an example. 00:06:17.694 --> 00:06:21.158 So I my I'm an SLP by trade. 00:06:21.317 --> 00:06:23.259 I just play a really good PT on 00:06:23.279 --> 00:06:23.680 TV. 00:06:23.761 --> 00:06:27.504 So that's, you know, but that being said, 00:06:27.925 --> 00:06:30.047 so many of the EMR systems are built 00:06:30.447 --> 00:06:31.247 for PT and OT. 00:06:32.242 --> 00:06:35.783 So being an SLP in that world where 00:06:35.843 --> 00:06:36.483 you're, you know, 00:06:36.502 --> 00:06:38.524 if you're an SLP in a rehab clinic 00:06:38.584 --> 00:06:39.444 or something like that, 00:06:39.564 --> 00:06:43.165 you have to fit your exactly a circle 00:06:43.225 --> 00:06:47.507 into a square anyway on daily life because 00:06:47.567 --> 00:06:48.906 clinics are set up for PT. 00:06:48.927 --> 00:06:51.507 Clinics are just that's, you know, 00:06:51.887 --> 00:06:53.809 SLP is the odd man out anyway. 00:06:54.629 --> 00:06:56.689 Then you have a documentation system 00:06:56.709 --> 00:06:57.889 that's either built for PT 00:06:58.985 --> 00:07:02.670 or built for skilled nursing or built for, 00:07:02.949 --> 00:07:03.831 you know, this place. 00:07:04.031 --> 00:07:07.095 And so you're already two or three steps 00:07:07.134 --> 00:07:09.637 behind in trying to make your 00:07:09.677 --> 00:07:13.461 documentation effective, efficient, 00:07:13.862 --> 00:07:14.644 compliant, 00:07:15.319 --> 00:07:16.661 you're working against that. 00:07:16.740 --> 00:07:18.523 So the more that you can work with 00:07:18.562 --> 00:07:21.045 the EMR systems to make sure that, 00:07:21.125 --> 00:07:21.365 you know, 00:07:21.545 --> 00:07:23.487 if there is any flexibility in what you 00:07:23.507 --> 00:07:26.752 can do to not have clinicians working 00:07:26.812 --> 00:07:29.074 against that day after day and minute 00:07:29.093 --> 00:07:31.257 after minute, that's going to be key. 00:07:32.418 --> 00:07:34.940 And then the other piece is sometimes, 00:07:34.980 --> 00:07:35.240 you know, 00:07:35.321 --> 00:07:36.562 clinicians get into their 00:07:38.617 --> 00:07:43.882 patterns of treatment that are great 00:07:43.923 --> 00:07:44.584 clinically, 00:07:45.045 --> 00:07:46.505 but then make it ten times harder for 00:07:46.545 --> 00:07:48.908 them to document or for them to audit 00:07:48.928 --> 00:07:52.492 their own documentation rather than, 00:07:52.552 --> 00:07:53.492 again, like you were saying, 00:07:54.434 --> 00:07:56.355 adapt to the bike or have the bike 00:07:56.375 --> 00:07:56.997 adapt to you. 00:07:57.416 --> 00:07:59.079 Sometimes you need to kind of give a 00:07:59.119 --> 00:07:59.879 little to get a little. 00:08:00.379 --> 00:08:01.358 Understood. 00:08:01.418 --> 00:08:02.279 And it seems like, 00:08:03.180 --> 00:08:04.240 because we should follow the money, 00:08:05.000 --> 00:08:05.480 and you said, 00:08:05.880 --> 00:08:07.242 make it good and the money will follow. 00:08:08.141 --> 00:08:08.942 It seems like, 00:08:09.122 --> 00:08:10.202 and I don't have a number to this, 00:08:10.903 --> 00:08:13.043 but if my day felt better or easier, 00:08:13.264 --> 00:08:13.824 or if I wanted to, 00:08:14.004 --> 00:08:15.425 if I was spending more time doing the 00:08:15.466 --> 00:08:15.725 thing, 00:08:15.906 --> 00:08:18.367 being the SLP or the PT or the 00:08:18.427 --> 00:08:20.947 OT, the clinic, the hospital, 00:08:21.007 --> 00:08:24.028 anything would probably have happier, 00:08:24.069 --> 00:08:26.050 more productive therapists who stuck 00:08:26.069 --> 00:08:26.730 around longer. 00:08:26.829 --> 00:08:28.110 And we know those things cost money. 00:08:28.624 --> 00:08:29.343 Absolutely. 00:08:29.783 --> 00:08:33.544 The money for hiring and rehiring and 00:08:33.585 --> 00:08:35.865 training, it is bananas. 00:08:36.005 --> 00:08:39.166 It is so expensive. 00:08:39.326 --> 00:08:40.767 It's an entire industrial complex. 00:08:41.147 --> 00:08:42.767 Yes, completely. 00:08:43.386 --> 00:08:46.727 And the problem is, 00:08:47.748 --> 00:08:51.129 if you look at just a general evaluation 00:08:51.149 --> 00:08:51.828 that you have to write, 00:08:52.673 --> 00:08:56.135 There are sometimes seventeen steps, 00:08:56.676 --> 00:08:58.476 clicks, buttons, 00:08:59.477 --> 00:09:02.100 boxes that you need to fill in. 00:09:02.519 --> 00:09:04.941 And if you click this and then you 00:09:05.081 --> 00:09:05.662 make an error, 00:09:05.701 --> 00:09:07.342 you have to go back three times. 00:09:08.462 --> 00:09:10.825 If we can save clinicians three steps, 00:09:11.325 --> 00:09:14.506 five steps, that's a huge difference, too. 00:09:15.147 --> 00:09:16.548 But clinicians sometimes don't like to 00:09:16.567 --> 00:09:17.489 think outside the box. 00:09:18.481 --> 00:09:21.143 And so if we can use education to 00:09:21.263 --> 00:09:23.644 help them problem solve in the moment, 00:09:24.764 --> 00:09:27.785 that's going to help them in the long 00:09:27.826 --> 00:09:28.385 run anyway. 00:09:28.466 --> 00:09:29.807 And again, to your point, 00:09:30.366 --> 00:09:31.248 save the burnout, 00:09:31.288 --> 00:09:33.328 save the frustration that they're feeling 00:09:33.788 --> 00:09:35.490 and keep the clinician and keep them 00:09:35.529 --> 00:09:35.909 happy. 00:09:36.529 --> 00:09:38.711 A lot of therapists might hear the word 00:09:38.750 --> 00:09:40.932 efficiency and immediately think it means 00:09:41.772 --> 00:09:44.573 cutting corners or I'm sure a lot of 00:09:44.614 --> 00:09:46.453 things and emotions jump into someone's 00:09:46.474 --> 00:09:47.554 head when they hear efficiency. 00:09:48.815 --> 00:09:50.576 How can clinics become more efficient 00:09:50.676 --> 00:09:53.717 without compromising clinical standards, 00:09:53.738 --> 00:09:55.238 without cutting those corners, 00:09:55.258 --> 00:09:56.499 without putting the team in? 00:09:56.519 --> 00:09:59.399 So how can they do that? 00:09:59.559 --> 00:10:01.041 I think a couple of different ways. 00:10:01.942 --> 00:10:02.961 It's not a bad word. 00:10:03.081 --> 00:10:05.263 And people do think I always say the 00:10:05.283 --> 00:10:06.144 word productivity. 00:10:07.346 --> 00:10:08.106 Oh my gosh, 00:10:08.246 --> 00:10:09.668 you say that word in front of a 00:10:09.707 --> 00:10:11.368 bunch of clinicians and you think that I 00:10:11.408 --> 00:10:13.528 just had the mouth of a sailor, 00:10:13.589 --> 00:10:14.729 which I do, 00:10:14.869 --> 00:10:17.330 but I don't use it on a daily 00:10:17.470 --> 00:10:19.110 basis at work. 00:10:20.530 --> 00:10:24.091 But it has become this terrible word. 00:10:24.591 --> 00:10:27.732 I think taking that terribleness out of it 00:10:27.773 --> 00:10:29.572 is step one. 00:10:29.613 --> 00:10:32.734 Before you even put into practice any tips 00:10:32.774 --> 00:10:34.193 or tricks or things like that, 00:10:35.355 --> 00:10:35.855 you need to 00:10:36.327 --> 00:10:38.568 to get on the same page with a 00:10:38.609 --> 00:10:41.089 clinician and understand why efficiency, 00:10:41.129 --> 00:10:41.629 productivity, 00:10:41.668 --> 00:10:43.090 whatever word you want to use, 00:10:44.049 --> 00:10:45.309 isn't a terrible thing. 00:10:45.671 --> 00:10:48.010 It is a thing that the rest of 00:10:48.071 --> 00:10:52.292 the world uses as they measure success. 00:10:52.631 --> 00:10:54.352 It may not be called productivity, 00:10:55.827 --> 00:10:57.609 but yeah, there's a hundred words for it. 00:10:57.629 --> 00:10:57.808 Right. 00:10:57.970 --> 00:10:58.590 Exactly. 00:10:58.710 --> 00:11:00.431 It's, it's your, your product, 00:11:00.451 --> 00:11:03.013 your service, your, your efficiency, your, 00:11:03.452 --> 00:11:05.355 your success. 00:11:05.414 --> 00:11:05.615 I mean, 00:11:05.634 --> 00:11:07.375 some industries just call it your measure 00:11:07.416 --> 00:11:07.996 of success. 00:11:08.397 --> 00:11:09.557 That is what it is. 00:11:10.097 --> 00:11:12.200 So I think that's number one is kind 00:11:12.240 --> 00:11:14.000 of having laying that groundwork for, 00:11:14.221 --> 00:11:15.942 for clinicians to say, you know, 00:11:15.981 --> 00:11:16.962 this is the expectation. 00:11:17.023 --> 00:11:17.764 It's not all bad. 00:11:17.823 --> 00:11:19.024 Let's get on the same page on how 00:11:19.043 --> 00:11:19.945 we can make that work. 00:11:21.125 --> 00:11:22.427 It's not cutting corners. 00:11:22.787 --> 00:11:24.788 And here's why it's not cutting corners 00:11:24.869 --> 00:11:25.349 because you, 00:11:26.027 --> 00:11:32.870 If you are doing a session and making 00:11:33.431 --> 00:11:35.231 the patient at the center of it, 00:11:36.692 --> 00:11:39.414 if you are consistently talking to them 00:11:39.434 --> 00:11:40.134 about their goals, 00:11:40.174 --> 00:11:41.696 consistently talking to them about what's 00:11:41.716 --> 00:11:42.756 going to work the best, 00:11:43.476 --> 00:11:46.519 consistently asking their feedback, 00:11:47.599 --> 00:11:49.880 that is going to make the session run 00:11:49.941 --> 00:11:51.961 more efficiently already. 00:11:52.315 --> 00:11:53.475 because you're already putting the patient 00:11:53.514 --> 00:11:54.596 at the center of it and you're not 00:11:54.635 --> 00:11:56.255 putting a lot of fluff in that you 00:11:56.296 --> 00:11:58.517 feel as a clinician is better than what 00:11:58.537 --> 00:11:59.476 the patient feels. 00:12:00.456 --> 00:12:02.158 So I think by starting with the patient's 00:12:02.398 --> 00:12:02.898 ears, 00:12:03.697 --> 00:12:05.719 that's the first step in becoming an 00:12:05.739 --> 00:12:07.419 efficient clinician. 00:12:07.860 --> 00:12:10.701 I have observed tens of thousands of 00:12:10.760 --> 00:12:12.880 sessions, maybe an exaggeration, 00:12:13.120 --> 00:12:16.442 but a lot of sessions where I've watched 00:12:16.481 --> 00:12:18.302 clinicians go. 00:12:19.183 --> 00:12:25.350 Talk, do, put patients doing X, Y, Z. 00:12:25.571 --> 00:12:27.472 Not once asking the patient, 00:12:28.494 --> 00:12:29.495 does this work for you? 00:12:30.797 --> 00:12:32.238 How is this going to help you in 00:12:32.258 --> 00:12:33.078 your daily life? 00:12:33.539 --> 00:12:35.261 And if they would have started with those 00:12:35.322 --> 00:12:36.663 questions from the get-go, 00:12:37.203 --> 00:12:38.485 their sessions would have been ten times 00:12:38.544 --> 00:12:39.046 more efficient. 00:12:40.370 --> 00:12:43.652 efficiency and quality are not enemies. 00:12:43.731 --> 00:12:44.893 That is something that I took away from 00:12:44.913 --> 00:12:45.832 a lot of things that I read that 00:12:45.852 --> 00:12:45.993 you, 00:12:46.153 --> 00:12:47.293 that you had said that those things are 00:12:47.413 --> 00:12:48.514 not enemies. 00:12:48.735 --> 00:12:50.936 And if you understand that and we can 00:12:50.975 --> 00:12:54.038 adapt the system to work towards that, 00:12:54.918 --> 00:12:56.399 everybody sort of wins. 00:12:56.418 --> 00:12:57.299 The clinician has a better, 00:12:57.919 --> 00:12:59.500 has a better feeling when they walk out 00:12:59.520 --> 00:13:00.782 at five o'clock or whatever time they're 00:13:00.802 --> 00:13:02.202 leaving and the patient has a better 00:13:02.243 --> 00:13:03.984 experience and they want to come back and 00:13:05.287 --> 00:13:06.287 Efficiency and quality, 00:13:06.947 --> 00:13:08.028 they're not enemies. 00:13:08.087 --> 00:13:09.187 You've also said something that might 00:13:09.207 --> 00:13:09.927 surprise people. 00:13:10.469 --> 00:13:12.408 Compliance is also not the enemy. 00:13:12.428 --> 00:13:12.928 I mean, geez, 00:13:13.269 --> 00:13:14.590 if you see a meeting with compliance 00:13:14.610 --> 00:13:15.889 department on your schedule pop up, 00:13:15.929 --> 00:13:17.791 I'm sure heart rates generally rise. 00:13:17.811 --> 00:13:20.351 But why do so many clinicians see it 00:13:20.392 --> 00:13:20.751 that way, 00:13:20.772 --> 00:13:22.292 that compliance might be the enemy? 00:13:22.572 --> 00:13:23.993 And what are they getting wrong? 00:13:25.253 --> 00:13:27.833 I think that the word compliance stirs up 00:13:29.654 --> 00:13:32.275 scary images out of compliance. 00:13:33.659 --> 00:13:35.600 I mean, you can hear you're in compliance, 00:13:35.620 --> 00:13:37.062 but most of the time... Yeah, 00:13:37.101 --> 00:13:38.403 no one calls a meeting to tell you 00:13:38.643 --> 00:13:39.203 you're in compliance. 00:13:39.224 --> 00:13:40.423 You're in compliance, exactly. 00:13:41.024 --> 00:13:43.385 No one will say to you... 00:13:44.947 --> 00:13:45.567 A perfect example, 00:13:45.587 --> 00:13:46.868 I just had this this morning. 00:13:47.708 --> 00:13:49.009 I'm never going to tell my son, 00:13:49.549 --> 00:13:51.571 you're making your bed correctly. 00:13:51.591 --> 00:13:52.491 Right. 00:13:52.511 --> 00:13:53.513 I'm going to yell at him that he's 00:13:53.552 --> 00:13:55.614 making his bed incorrectly because he's 00:13:55.653 --> 00:13:57.095 throwing the sheets on and it's driving me 00:13:57.134 --> 00:13:57.855 crazy and he's got... 00:13:59.238 --> 00:14:02.841 We never say you're in compliance, 00:14:02.900 --> 00:14:04.041 you're doing a great job. 00:14:04.361 --> 00:14:06.163 We say you're out of compliance and here's 00:14:06.202 --> 00:14:06.623 why. 00:14:08.244 --> 00:14:10.105 We say that to help, 00:14:10.505 --> 00:14:12.966 but people hear I'm out of compliance and 00:14:12.986 --> 00:14:13.927 this is a scary thing. 00:14:14.008 --> 00:14:14.187 Now, 00:14:14.408 --> 00:14:15.609 it is a scary thing because if you're 00:14:15.629 --> 00:14:17.210 out of compliance, it costs money. 00:14:18.130 --> 00:14:19.251 And we don't want that. 00:14:20.893 --> 00:14:22.913 But I think that if people understood that 00:14:22.974 --> 00:14:25.375 compliance is a support system, 00:14:26.096 --> 00:14:28.357 that we can, you know, by... 00:14:28.927 --> 00:14:31.149 a compliance department or making sure 00:14:31.168 --> 00:14:33.889 that you're in compliance, again, 00:14:33.948 --> 00:14:35.769 it's making your job a little bit easier 00:14:35.809 --> 00:14:37.330 in the end because you don't have to 00:14:37.370 --> 00:14:39.870 do any rework. 00:14:40.250 --> 00:14:41.951 That's a supportive nature that every 00:14:41.971 --> 00:14:43.912 compliance department wants to hold true. 00:14:43.951 --> 00:14:44.091 Yeah. 00:14:45.653 --> 00:14:47.673 It's a tool that protects you and the 00:14:47.692 --> 00:14:48.873 clinics and the care. 00:14:49.734 --> 00:14:50.494 Use it as such. 00:14:50.634 --> 00:14:51.614 I used to have a meeting once a 00:14:51.653 --> 00:14:53.075 week in radio with my boss where we 00:14:53.174 --> 00:14:54.034 literally mean this 00:14:54.912 --> 00:14:56.552 this went down like nails, 00:14:56.591 --> 00:14:59.352 which was we listened to a tape of 00:14:59.513 --> 00:15:01.253 me. 00:15:01.293 --> 00:15:02.453 Fast forward and play, 00:15:02.514 --> 00:15:04.134 and we'd sit there in silence and listen 00:15:04.173 --> 00:15:04.573 to me. 00:15:05.153 --> 00:15:06.554 And I'm a pretty extroverted guy, 00:15:07.174 --> 00:15:08.235 but I started sweating. 00:15:08.674 --> 00:15:09.955 And that was a knot in your stomach 00:15:10.134 --> 00:15:12.216 until my boss eventually, I think, 00:15:12.275 --> 00:15:13.975 saw me squirming in the seat and said, 00:15:14.556 --> 00:15:15.236 hey, just so you know, 00:15:15.616 --> 00:15:18.537 this is to work on, not penalize. 00:15:19.378 --> 00:15:20.577 And the minute I started looking at it 00:15:20.597 --> 00:15:21.018 like that, 00:15:22.003 --> 00:15:23.384 I actually looked forward to it and it's 00:15:23.423 --> 00:15:25.004 probably where I got the best ROI in 00:15:25.065 --> 00:15:28.245 terms of improvement, 00:15:28.947 --> 00:15:30.506 but it needs to be framed that way. 00:15:30.868 --> 00:15:33.408 Or myself included, if you see compliance, 00:15:34.428 --> 00:15:36.590 your heart rate goes up and now you're 00:15:36.649 --> 00:15:37.890 automatically playing defense, 00:15:37.931 --> 00:15:39.032 I guess is what I'm getting at. 00:15:39.371 --> 00:15:40.692 Yes, exactly. 00:15:40.893 --> 00:15:44.794 And the thing is that you do have 00:15:44.855 --> 00:15:47.216 to kind of play defense all the time 00:15:47.336 --> 00:15:49.116 to be in compliance 00:15:50.030 --> 00:15:51.152 Because you have to be thinking 00:15:51.192 --> 00:15:51.932 defensively. 00:15:52.693 --> 00:15:52.813 Sure. 00:15:52.833 --> 00:15:54.095 Understanding what game you're playing. 00:15:54.655 --> 00:15:55.456 Exactly. 00:15:55.697 --> 00:15:57.278 And it doesn't have to be that you 00:15:57.418 --> 00:15:57.698 are. 00:15:58.080 --> 00:15:58.860 There's a difference between. 00:16:00.621 --> 00:16:04.486 Between kind of being on the defense and 00:16:04.807 --> 00:16:06.969 being in defense of what you're doing. 00:16:07.269 --> 00:16:07.990 Yeah. 00:16:08.070 --> 00:16:10.212 And I think that that's something that 00:16:10.253 --> 00:16:11.914 people need to to kind of. 00:16:12.736 --> 00:16:14.017 recognize within themselves. 00:16:14.457 --> 00:16:16.577 I have everybody ask three questions of 00:16:16.597 --> 00:16:20.639 their documentation whenever they're 00:16:20.678 --> 00:16:22.399 trying to assess their documentation or 00:16:22.419 --> 00:16:24.740 when I'm trying to get them in practice 00:16:24.961 --> 00:16:25.961 as they're documenting. 00:16:26.020 --> 00:16:26.780 Three questions. 00:16:27.441 --> 00:16:28.701 Would I defend this in court? 00:16:30.101 --> 00:16:30.721 How easily? 00:16:31.523 --> 00:16:33.523 Would another clinician know exactly what 00:16:33.543 --> 00:16:34.783 to do next? 00:16:35.283 --> 00:16:35.663 Clarity. 00:16:36.144 --> 00:16:38.264 And then did I clearly connect treatment 00:16:38.304 --> 00:16:38.725 to function? 00:16:39.864 --> 00:16:40.965 And if people are going to answer those 00:16:41.004 --> 00:16:42.346 three questions, I always say, 00:16:42.767 --> 00:16:44.008 you don't have to worry about compliance. 00:16:44.408 --> 00:16:44.607 I mean, 00:16:45.149 --> 00:16:46.610 obviously from technical sides and things 00:16:46.649 --> 00:16:47.190 like that you do, 00:16:47.230 --> 00:16:48.772 but from a documentation perspective, 00:16:49.192 --> 00:16:50.893 you can answer those three questions you 00:16:50.932 --> 00:16:51.394 haven't made. 00:16:52.134 --> 00:16:53.956 And if you can simplify it like that, 00:16:54.135 --> 00:16:55.397 I think people feel like, okay, 00:16:55.417 --> 00:16:56.238 those are three questions. 00:16:56.337 --> 00:16:56.938 I can do that. 00:16:56.958 --> 00:16:58.539 I can make sure that happens. 00:16:59.760 --> 00:17:03.144 Very, very rarely is the answer, 00:17:03.224 --> 00:17:04.545 make it more complicated, right? 00:17:05.213 --> 00:17:05.753 Exactly. 00:17:05.773 --> 00:17:06.934 So I think what you're saying there is, 00:17:07.415 --> 00:17:08.316 I need to see, 00:17:08.355 --> 00:17:09.757 can you answer these three? 00:17:09.957 --> 00:17:11.077 Let's simplify it. 00:17:11.178 --> 00:17:12.318 Now you can do that a hundred different 00:17:12.358 --> 00:17:12.838 ways. 00:17:13.200 --> 00:17:14.140 Right. 00:17:14.319 --> 00:17:15.681 I forget where the study was, 00:17:15.721 --> 00:17:17.722 but someone ran an analysis on thousands 00:17:17.742 --> 00:17:18.522 of treatment notes. 00:17:19.483 --> 00:17:20.964 And we'll say that insurance, 00:17:20.984 --> 00:17:21.746 I'm using air quotes here, 00:17:21.806 --> 00:17:23.646 insurance requires too much documentation. 00:17:23.727 --> 00:17:25.407 And the analysis showed that we actually 00:17:25.548 --> 00:17:26.489 over-documented. 00:17:27.320 --> 00:17:28.301 I could see that. 00:17:28.321 --> 00:17:30.683 Because we probably weren't focused on 00:17:30.703 --> 00:17:32.184 what the actual goal was. 00:17:32.244 --> 00:17:34.487 We hear documentation and some people, 00:17:34.507 --> 00:17:35.228 myself included, 00:17:35.448 --> 00:17:38.451 heard write down as much as you can. 00:17:39.673 --> 00:17:40.673 And if you want to talk to a 00:17:40.733 --> 00:17:41.114 lawyer, 00:17:41.213 --> 00:17:42.494 the lawyer will tell you if you're ever 00:17:42.535 --> 00:17:43.115 on the stand, 00:17:43.135 --> 00:17:44.517 you answer the question asked, 00:17:44.896 --> 00:17:47.660 not a word more. 00:17:47.700 --> 00:17:48.680 More is not better. 00:17:48.800 --> 00:17:49.621 Better is better. 00:17:49.861 --> 00:17:52.083 And simpler is the goal. 00:17:52.182 --> 00:17:53.243 The goal should be those three. 00:17:53.304 --> 00:17:54.164 Do those three things again. 00:17:54.565 --> 00:17:55.226 Let me see if I can do it. 00:17:56.346 --> 00:17:57.186 Can you answer this? 00:17:57.207 --> 00:17:58.387 Would you feel comfortable answering this 00:17:58.407 --> 00:17:58.749 in court? 00:17:59.229 --> 00:17:59.628 Correct. 00:17:59.849 --> 00:18:02.451 If another therapist read your note cold, 00:18:03.011 --> 00:18:04.493 could they understand it is clear. 00:18:04.933 --> 00:18:05.575 Yeah. 00:18:05.674 --> 00:18:06.275 And then the third one, 00:18:06.315 --> 00:18:08.517 can you connect what you're doing to a 00:18:08.557 --> 00:18:08.777 goal? 00:18:09.278 --> 00:18:09.738 Exactly. 00:18:10.219 --> 00:18:11.279 Is there a purpose for this? 00:18:11.759 --> 00:18:12.760 Why the heck are you doing it? 00:18:12.840 --> 00:18:13.961 Because if you can't do that, 00:18:14.001 --> 00:18:14.843 then you shouldn't have done it. 00:18:15.222 --> 00:18:18.326 And I think that where people get into 00:18:18.365 --> 00:18:18.586 this 00:18:20.928 --> 00:18:22.950 doing too much or doing more than they 00:18:22.990 --> 00:18:25.471 need to or feeling like it's complicated 00:18:25.811 --> 00:18:28.074 is because we do state the phrase of, 00:18:28.173 --> 00:18:29.234 if you didn't document it, 00:18:29.255 --> 00:18:31.857 you didn't do it, which is true, 00:18:32.498 --> 00:18:35.441 but there's a way to document it to 00:18:35.701 --> 00:18:36.981 answer those three questions and be done. 00:18:37.442 --> 00:18:38.022 Efficiently. 00:18:38.563 --> 00:18:39.284 Exactly. 00:18:39.403 --> 00:18:40.944 See, I came to PT again, 00:18:41.025 --> 00:18:41.806 a second career. 00:18:42.346 --> 00:18:43.287 Yes, I worked in radio. 00:18:44.300 --> 00:18:45.741 before that i had a degree in journalism 00:18:46.502 --> 00:18:48.003 and it was so weird going through 00:18:48.463 --> 00:18:50.164 undergrad because i took my journalism 00:18:50.204 --> 00:18:52.826 classes and i took my core classes english 00:18:53.067 --> 00:18:55.308 science whatever and there in those 00:18:55.348 --> 00:18:58.290 courses the general classes i had to write 00:18:58.310 --> 00:19:01.854 an eight-page paper the goal was length 00:19:02.493 --> 00:19:04.836 where in my journalism classes my goal was 00:19:05.016 --> 00:19:06.857 clarity and the best 00:19:07.946 --> 00:19:09.647 was can you get the most information 00:19:09.688 --> 00:19:13.250 transmitted through words or sounds in the 00:19:13.351 --> 00:19:15.413 fewest amount of words? 00:19:15.472 --> 00:19:17.554 So it was very funny to jump back 00:19:17.574 --> 00:19:19.655 and forth between those classes because in 00:19:19.915 --> 00:19:21.076 one, I was playing one game, 00:19:21.096 --> 00:19:23.739 which was answer the question in eight 00:19:23.759 --> 00:19:24.638 pages or more. 00:19:25.460 --> 00:19:26.980 And the other was you have a thousand 00:19:27.020 --> 00:19:27.961 words, no more. 00:19:28.021 --> 00:19:29.942 You cannot use a thousand and one. 00:19:30.483 --> 00:19:33.086 So my brain did not brain very well. 00:19:33.465 --> 00:19:35.587 So I come to PT where when I'm 00:19:35.627 --> 00:19:37.209 learning documentation, I'm saying, well, 00:19:38.330 --> 00:19:40.332 I remember having a CI just walking by 00:19:40.352 --> 00:19:42.011 my computer, not reading, 00:19:42.372 --> 00:19:44.292 seeing physically how many words were 00:19:44.313 --> 00:19:45.432 there and being like, it needs more. 00:19:45.913 --> 00:19:46.692 And I'm like, why? 00:19:46.792 --> 00:19:47.512 And she's like, just, 00:19:47.633 --> 00:19:48.473 I can tell from here. 00:19:48.493 --> 00:19:49.153 And I'm like, 00:19:49.193 --> 00:19:50.354 but you don't know the words. 00:19:50.413 --> 00:19:51.914 What if I picked better words? 00:19:52.335 --> 00:19:54.095 What if they answered Katie's three, 00:19:54.375 --> 00:19:55.295 Katie's big three? 00:19:56.635 --> 00:19:57.816 I feel like I feel, 00:19:57.855 --> 00:19:58.516 and the answer was always, 00:19:58.635 --> 00:20:01.317 I feel I don't want to have this. 00:20:01.356 --> 00:20:02.457 Not when I hit submit, 00:20:02.557 --> 00:20:04.337 I feel like the more is better. 00:20:04.417 --> 00:20:05.317 And I understand that. 00:20:05.753 --> 00:20:06.013 Yeah. 00:20:06.334 --> 00:20:06.575 Yeah. 00:20:06.894 --> 00:20:08.155 And then take it a step further. 00:20:08.195 --> 00:20:08.476 Right. 00:20:08.675 --> 00:20:09.737 Think about your settings. 00:20:09.936 --> 00:20:12.417 So I've started in acute care, acute care. 00:20:12.498 --> 00:20:14.219 You write and I'm old. 00:20:14.318 --> 00:20:16.140 So I started, you know, way back when, 00:20:16.160 --> 00:20:17.520 when we still had paper charts and all 00:20:17.540 --> 00:20:17.801 that. 00:20:20.182 --> 00:20:22.503 You wrote four sentences and that was it. 00:20:22.523 --> 00:20:25.906 I mean, your note was simple, but. 00:20:27.342 --> 00:20:29.403 You switch to a different setting. 00:20:29.423 --> 00:20:30.762 And if you're not writing a book, 00:20:31.503 --> 00:20:33.564 that wasn't acceptable in that setting. 00:20:33.963 --> 00:20:35.724 So to me, 00:20:36.025 --> 00:20:39.185 those three questions kind of came out of, 00:20:39.645 --> 00:20:41.487 I need to find that happy medium for 00:20:41.527 --> 00:20:43.248 myself as a documenter. 00:20:43.268 --> 00:20:43.968 Yeah. 00:20:44.750 --> 00:20:46.491 And then when I got into more of, 00:20:46.531 --> 00:20:46.872 you know, 00:20:48.054 --> 00:20:49.836 overseeing clinical services and making 00:20:49.875 --> 00:20:51.356 sure that the clinical product was good 00:20:51.376 --> 00:20:52.397 and it was compliant, 00:20:52.719 --> 00:20:54.980 then those three questions really helped 00:20:55.020 --> 00:20:57.743 serve in an educational framework when I'm 00:20:57.824 --> 00:20:58.904 educating clinicians. 00:20:59.486 --> 00:21:01.127 It's just when you can simplify it there. 00:21:01.147 --> 00:21:02.088 I remember learning research, 00:21:02.128 --> 00:21:02.689 my professor. 00:21:03.815 --> 00:21:04.935 oversimplified it. 00:21:05.016 --> 00:21:06.576 He was like, Jimmy, just what? 00:21:06.896 --> 00:21:07.336 So what? 00:21:07.416 --> 00:21:07.837 Now what? 00:21:08.057 --> 00:21:11.019 I'm like, oh, I can do that. 00:21:11.339 --> 00:21:13.800 My brain can't brain holding ten different 00:21:13.820 --> 00:21:15.201 things while I'm reading something. 00:21:15.603 --> 00:21:15.982 But if it's like, 00:21:16.042 --> 00:21:16.782 what are we talking about? 00:21:16.803 --> 00:21:17.304 Can you explain? 00:21:17.344 --> 00:21:18.044 And when you're done reading this, 00:21:18.064 --> 00:21:19.025 can you explain what happened? 00:21:19.184 --> 00:21:19.384 Yeah. 00:21:20.005 --> 00:21:21.185 Can you explain why it mattered? 00:21:21.226 --> 00:21:21.586 So what? 00:21:21.726 --> 00:21:21.946 Yeah. 00:21:22.446 --> 00:21:23.448 Can you explain now what? 00:21:23.548 --> 00:21:24.028 Now where should we go? 00:21:24.048 --> 00:21:24.127 Okay. 00:21:24.147 --> 00:21:25.068 What are you going to do with this? 00:21:25.229 --> 00:21:25.509 Oh, yeah. 00:21:25.808 --> 00:21:26.009 Great. 00:21:26.048 --> 00:21:26.288 Do that. 00:21:26.670 --> 00:21:28.750 And then research became fun after that. 00:21:30.167 --> 00:21:30.828 A hundred percent. 00:21:30.848 --> 00:21:31.750 A hundred percent. 00:21:31.950 --> 00:21:34.353 You simplify it down and you think it's 00:21:34.432 --> 00:21:37.837 not that hard if I just think of 00:21:37.897 --> 00:21:38.618 the end goal. 00:21:38.939 --> 00:21:39.259 Yeah. 00:21:39.358 --> 00:21:39.539 Yeah. 00:21:40.099 --> 00:21:41.241 Do you want to say thanks to U.S. 00:21:41.281 --> 00:21:43.344 Physical Therapy, USPH, 00:21:43.464 --> 00:21:44.986 a national network of clinics focused on 00:21:45.006 --> 00:21:45.846 developing clinicians? 00:21:46.548 --> 00:21:47.108 Not burning them out. 00:21:47.528 --> 00:21:49.049 They offer leadership tracks, mentorship, 00:21:49.089 --> 00:21:51.092 and the stability PTs need to build long 00:21:51.112 --> 00:21:53.294 careers in the profession while still 00:21:53.354 --> 00:21:54.315 practicing locally. 00:21:54.454 --> 00:21:56.737 USPH.com, that's USPH.com. 00:21:56.876 --> 00:21:58.479 And our friends at Empower EMR, 00:21:58.939 --> 00:22:00.721 built specifically for physical therapists 00:22:00.740 --> 00:22:01.521 who are tired of... 00:22:02.102 --> 00:22:03.061 doing everything we're talking about. 00:22:03.261 --> 00:22:04.883 Documentation, slowing them down. 00:22:05.242 --> 00:22:07.223 Empower focuses on speed, clean workflows, 00:22:07.243 --> 00:22:09.364 and documentation tools PTs actually ask 00:22:09.384 --> 00:22:09.584 for. 00:22:09.884 --> 00:22:10.444 Faster notes, 00:22:10.464 --> 00:22:11.545 smoother clinical operations, 00:22:11.944 --> 00:22:13.726 and support that doesn't disappear when 00:22:13.746 --> 00:22:14.185 you need help. 00:22:14.226 --> 00:22:16.185 Find them online at Empower, E-M-R. 00:22:16.506 --> 00:22:20.387 That is Empower, E-M-R.com. 00:22:20.428 --> 00:22:20.587 Katie, 00:22:20.607 --> 00:22:22.087 your hot take is that most continuing 00:22:22.127 --> 00:22:24.328 education is a waste of time. 00:22:24.409 --> 00:22:25.409 I love hot takes. 00:22:25.888 --> 00:22:26.848 That's gonna make some people 00:22:26.969 --> 00:22:30.770 uncomfortable because going with this more 00:22:30.931 --> 00:22:31.431 is better. 00:22:32.568 --> 00:22:34.651 More continuation is better than less in 00:22:34.750 --> 00:22:35.411 continuation. 00:22:35.671 --> 00:22:38.232 So what's broken about continuation right 00:22:38.313 --> 00:22:40.255 now in your view? 00:22:40.315 --> 00:22:42.797 So continuing education to me, 00:22:42.876 --> 00:22:45.699 and I am a nerd that loves to 00:22:45.939 --> 00:22:48.421 have continuing education more and more 00:22:48.441 --> 00:22:48.780 and more. 00:22:49.721 --> 00:22:51.063 In American Speech and Hearing 00:22:51.083 --> 00:22:51.544 Association, 00:22:51.564 --> 00:22:52.924 we have something called the ACE Award, 00:22:52.944 --> 00:22:55.826 which is the achievement for continuing 00:22:55.846 --> 00:22:56.386 education. 00:22:56.626 --> 00:22:58.368 So it's clinicians who get 00:22:59.602 --> 00:23:00.942 X number of CEUs per year. 00:23:01.143 --> 00:23:02.502 I have like eighteen of these things. 00:23:03.824 --> 00:23:04.243 Yeah, I love it. 00:23:04.263 --> 00:23:05.023 I love it. 00:23:05.104 --> 00:23:07.125 All of it's a waste of time because 00:23:09.865 --> 00:23:11.105 because at the end of the day, 00:23:11.747 --> 00:23:13.346 I'm going to say ninety five percent of 00:23:13.386 --> 00:23:15.887 the continuing education courses that you 00:23:15.907 --> 00:23:17.969 sit through, you sit through them, 00:23:18.608 --> 00:23:21.630 you think you learn something and you 00:23:21.670 --> 00:23:23.050 cannot apply it the next day. 00:23:24.438 --> 00:23:28.138 And if we're going to make true continuing 00:23:28.219 --> 00:23:30.440 education worthwhile for our clinicians, 00:23:30.480 --> 00:23:33.079 because every clinician discipline has a 00:23:33.160 --> 00:23:35.240 certain number that they need to adhere 00:23:35.280 --> 00:23:35.621 to, 00:23:36.641 --> 00:23:38.701 make it something that's going to be 00:23:38.961 --> 00:23:41.823 applicable the minute you walk out that 00:23:41.863 --> 00:23:42.123 door. 00:23:42.222 --> 00:23:44.202 And I think ninety five percent of our 00:23:44.282 --> 00:23:46.364 CEU courses missed the mark on this. 00:23:46.673 --> 00:23:48.193 So how do you spot a good one 00:23:48.275 --> 00:23:50.436 before you plunk down money and give up 00:23:50.457 --> 00:23:50.876 a weekend? 00:23:50.916 --> 00:23:51.778 How do you, what do you, 00:23:51.837 --> 00:23:52.659 what's your big, you know, 00:23:52.679 --> 00:23:54.019 you've got a big three or a litmus 00:23:54.039 --> 00:23:55.060 test or a, you know, 00:23:55.381 --> 00:23:56.923 how do you spot those ones that the 00:23:56.962 --> 00:23:57.824 juice is going to be worth? 00:23:58.384 --> 00:23:59.164 Yeah. 00:23:59.224 --> 00:23:59.724 Yeah. 00:24:00.006 --> 00:24:00.125 Um, 00:24:00.385 --> 00:24:02.347 it's a great question and I wish I 00:24:02.367 --> 00:24:03.989 had the direct answer to it because I 00:24:04.029 --> 00:24:04.910 haven't figured that out. 00:24:04.930 --> 00:24:06.652 Let's put it this way. 00:24:06.932 --> 00:24:08.192 What besides like, you know, 00:24:08.253 --> 00:24:09.074 people love that phrase, right? 00:24:09.134 --> 00:24:10.115 Monday morning applicable. 00:24:10.154 --> 00:24:10.776 Can I use this? 00:24:11.576 --> 00:24:11.737 Um, 00:24:12.958 --> 00:24:14.618 don't have to name it you can but 00:24:14.699 --> 00:24:16.098 what's one that you took that you were 00:24:16.118 --> 00:24:18.460 like gosh this was great like for every 00:24:18.500 --> 00:24:21.040 minute i was in class i got value 00:24:21.521 --> 00:24:23.821 and then why like what about it was 00:24:23.862 --> 00:24:28.064 so great so i i don't know that 00:24:28.104 --> 00:24:29.785 i'm going to answer that question exactly 00:24:29.825 --> 00:24:32.365 just because of the way that i think 00:24:32.405 --> 00:24:35.146 it depends on what your interest is or 00:24:35.186 --> 00:24:36.827 what you're you know what you are doing 00:24:36.867 --> 00:24:37.448 on a day-to-day 00:24:37.946 --> 00:24:40.627 But I think the thing that gets me 00:24:41.248 --> 00:24:47.189 about the continuing ed pieces are each 00:24:47.229 --> 00:24:49.509 discipline has certain requirements for 00:24:49.689 --> 00:24:52.069 topics or certain hours or things like 00:24:52.109 --> 00:24:52.390 that. 00:24:53.170 --> 00:24:55.711 And I don't even necessarily subscribe to 00:24:55.730 --> 00:24:57.391 the Monday morning applicable. 00:24:58.250 --> 00:24:59.990 I want it something that you're going to 00:25:00.030 --> 00:25:02.652 walk away and say, I got it. 00:25:03.251 --> 00:25:04.573 and it's going to stick with me. 00:25:04.633 --> 00:25:06.094 Maybe I won't use it Monday morning, 00:25:06.134 --> 00:25:07.914 but I can use it two weeks from 00:25:07.954 --> 00:25:10.636 now because I remember it so much. 00:25:10.917 --> 00:25:14.880 The problem is we have these instructors 00:25:14.920 --> 00:25:18.323 who either are talking research 00:25:18.863 --> 00:25:21.243 and aren't able to kind of apply this 00:25:21.463 --> 00:25:23.404 or we we have data that's not really 00:25:23.444 --> 00:25:25.666 telling a story or you're just not 00:25:25.707 --> 00:25:27.207 connecting with the audience so as an 00:25:27.366 --> 00:25:30.709 educator my my big thing is i need 00:25:31.288 --> 00:25:32.930 to to come with a presentation i need 00:25:32.950 --> 00:25:36.092 to come with a slide deck great but 00:25:36.132 --> 00:25:38.732 if my audience and i'm looking out and 00:25:38.833 --> 00:25:41.954 half of them are at a different spot 00:25:41.994 --> 00:25:44.256 in their career or a different wanting a 00:25:44.296 --> 00:25:46.676 different thing than i've originally had 00:25:47.978 --> 00:25:48.458 prepared 00:25:49.423 --> 00:25:50.423 I got to be ready to throw that 00:25:50.463 --> 00:25:51.744 PowerPoint out the window and say, 00:25:51.765 --> 00:25:54.326 let's just have a chat, you know? 00:25:54.666 --> 00:25:56.647 And I think that's where most of these 00:25:57.249 --> 00:25:57.828 courses, 00:25:57.868 --> 00:25:59.750 because they are such strict guidelines 00:25:59.851 --> 00:26:00.872 on, you know, what, 00:26:01.971 --> 00:26:04.193 what the course has to meet and the 00:26:04.233 --> 00:26:07.016 objectives people are held to their 00:26:07.056 --> 00:26:07.777 PowerPoints. 00:26:09.243 --> 00:26:10.044 But at the end of the day, 00:26:10.064 --> 00:26:12.444 if you just have to have a conversation 00:26:12.484 --> 00:26:14.006 or pivot and tell a story, 00:26:14.685 --> 00:26:16.386 that's going to actually help the 00:26:16.446 --> 00:26:17.886 participant. 00:26:18.567 --> 00:26:19.407 Know your audience. 00:26:20.387 --> 00:26:21.008 Recognize. 00:26:21.048 --> 00:26:21.888 I've said this before. 00:26:22.088 --> 00:26:24.890 I could be the world's greatest third 00:26:24.910 --> 00:26:25.470 grade teacher. 00:26:25.529 --> 00:26:27.191 I could rip through a third grade syllabus 00:26:27.230 --> 00:26:28.111 in like three weeks. 00:26:28.131 --> 00:26:28.730 We'd be done. 00:26:29.511 --> 00:26:29.951 Move along. 00:26:29.971 --> 00:26:30.432 Now, 00:26:30.471 --> 00:26:31.893 the third graders would have no idea what 00:26:31.932 --> 00:26:32.492 I just said. 00:26:32.932 --> 00:26:34.634 And one percent of them would have learned 00:26:34.953 --> 00:26:35.354 any of it. 00:26:36.380 --> 00:26:38.420 The goal isn't to have communicated. 00:26:38.500 --> 00:26:40.300 The goal is to have achieved 00:26:40.480 --> 00:26:41.240 understanding. 00:26:41.740 --> 00:26:44.381 And I always use a third grade analogy 00:26:44.401 --> 00:26:45.161 because it's so odd. 00:26:45.221 --> 00:26:45.942 Of course, 00:26:45.981 --> 00:26:47.221 you're going to get third graders and you 00:26:47.241 --> 00:26:48.301 get at thirty of them and they're going 00:26:48.321 --> 00:26:50.582 to be there for every topic. 00:26:50.981 --> 00:26:52.163 Some are going to be more or less 00:26:52.202 --> 00:26:54.663 knowledgeable or more or less excited 00:26:54.682 --> 00:26:56.002 about learning or, you know. 00:26:56.702 --> 00:26:58.344 And then when we have adults, we like, 00:26:58.463 --> 00:26:59.463 well, no, you're all adults. 00:26:59.483 --> 00:27:01.344 You need your you should all be exactly 00:27:01.364 --> 00:27:02.324 the same and you should. 00:27:02.763 --> 00:27:04.125 No, no, no, no. 00:27:04.144 --> 00:27:05.125 That's I'm sorry. 00:27:05.164 --> 00:27:06.045 That's not how it works. 00:27:06.505 --> 00:27:07.886 Exactly, exactly. 00:27:08.067 --> 00:27:09.667 And everyone's at different points in 00:27:09.688 --> 00:27:10.409 their career, 00:27:10.788 --> 00:27:12.711 different points in their interests. 00:27:12.750 --> 00:27:13.011 You know, 00:27:13.071 --> 00:27:14.653 some people are going to sit through an 00:27:14.772 --> 00:27:17.836 ethics class that's required by the 00:27:17.856 --> 00:27:18.436 discipline. 00:27:19.018 --> 00:27:21.559 And you have maybe three who are actually 00:27:21.619 --> 00:27:23.942 factually interested in ethics. 00:27:24.971 --> 00:27:29.199 or have an ethical dilemma that they may 00:27:29.219 --> 00:27:31.442 have had that they can pull from the 00:27:31.501 --> 00:27:33.925 experience that the instructor is talking 00:27:33.945 --> 00:27:36.229 about and the others are sitting in the 00:27:36.249 --> 00:27:36.690 room going, 00:27:36.829 --> 00:27:38.291 I just need to get this continuing 00:27:38.352 --> 00:27:39.673 education credit. 00:27:39.713 --> 00:27:40.414 There's different reasons. 00:27:40.935 --> 00:27:41.256 Yeah. 00:27:41.336 --> 00:27:43.157 And so you need to be able to 00:27:43.998 --> 00:27:46.500 manage to the listener and change what 00:27:46.519 --> 00:27:48.520 you're talking about based on what they 00:27:48.621 --> 00:27:49.761 need in that moment. 00:27:50.501 --> 00:27:51.282 And I think a lot of that, 00:27:51.742 --> 00:27:53.584 the continuing ed is just, you know, 00:27:53.663 --> 00:27:55.325 unfortunately can be a waste of time if 00:27:55.345 --> 00:27:57.307 you're not able to pivot as an instructor. 00:27:57.826 --> 00:27:58.567 Well, you mentioned pivot. 00:27:58.647 --> 00:28:00.429 Healthcare used to reward volume. 00:28:00.669 --> 00:28:00.848 I mean, 00:28:00.868 --> 00:28:02.210 a lot of places it still does. 00:28:02.529 --> 00:28:04.651 But things now are shifting towards value, 00:28:04.671 --> 00:28:05.551 which is good value. 00:28:07.102 --> 00:28:08.702 But if there's a theme that I think 00:28:08.742 --> 00:28:10.244 I've picked up from our conversation right 00:28:10.285 --> 00:28:10.464 now, 00:28:10.605 --> 00:28:12.987 it's understand what game you're playing. 00:28:13.047 --> 00:28:14.928 Understand what tools you have and what 00:28:15.048 --> 00:28:16.869 good is for this situation. 00:28:17.430 --> 00:28:19.652 So what does that actually mean for the 00:28:19.672 --> 00:28:21.834 way that therapists, PTs, OTs, 00:28:22.153 --> 00:28:23.115 we're all sort of cousins, 00:28:23.414 --> 00:28:24.316 practice day to day? 00:28:24.395 --> 00:28:27.298 This shift away from volume and towards 00:28:27.417 --> 00:28:27.898 value. 00:28:28.019 --> 00:28:31.260 A lot of conversations with this VBC 00:28:31.300 --> 00:28:31.801 coming up. 00:28:32.261 --> 00:28:32.642 Right. 00:28:32.721 --> 00:28:34.203 What will that change? 00:28:34.344 --> 00:28:34.624 Right. 00:28:34.683 --> 00:28:36.565 So how does that actually play out for 00:28:36.825 --> 00:28:38.707 for for everybody? 00:28:38.886 --> 00:28:39.267 Yeah. 00:28:39.366 --> 00:28:42.910 So I think the I think people need 00:28:42.930 --> 00:28:45.711 to understand that outcomes, 00:28:46.512 --> 00:28:47.773 which used to be just kind of like 00:28:47.814 --> 00:28:50.015 this word that we heard in the background. 00:28:50.154 --> 00:28:50.435 Right. 00:28:51.661 --> 00:28:53.001 outcomes are going to be the driver. 00:28:53.262 --> 00:28:55.064 If they aren't already in your clinic, 00:28:55.265 --> 00:28:56.986 they are going to be your driver. 00:28:57.205 --> 00:28:59.788 It is how well did you see that 00:28:59.828 --> 00:29:00.169 patient? 00:29:00.229 --> 00:29:02.211 How well did you get that patient back 00:29:02.250 --> 00:29:03.271 to their goal? 00:29:04.854 --> 00:29:06.454 How quickly did you do it? 00:29:06.715 --> 00:29:08.376 How efficiently did you do it? 00:29:09.919 --> 00:29:11.319 And how did you do it at the 00:29:11.339 --> 00:29:11.700 end of the day? 00:29:11.820 --> 00:29:12.340 What worked? 00:29:12.500 --> 00:29:13.241 What didn't work? 00:29:13.923 --> 00:29:14.823 And I think 00:29:15.723 --> 00:29:17.365 that going back to what we were talking 00:29:17.385 --> 00:29:18.326 about originally, you know, 00:29:18.667 --> 00:29:19.788 listening to the patients, 00:29:20.048 --> 00:29:24.654 stopping everything and stopping what you 00:29:24.694 --> 00:29:27.478 think your what's the word, 00:29:27.557 --> 00:29:28.398 what you think your 00:29:30.717 --> 00:29:32.478 goal is going to be or your treatment 00:29:32.498 --> 00:29:34.259 plan or your idea in your head when 00:29:34.278 --> 00:29:37.181 you walk into that session put that aside 00:29:37.641 --> 00:29:39.741 listen to the patient and ask you know 00:29:39.862 --> 00:29:42.304 ask the questions that's going to help 00:29:42.324 --> 00:29:44.704 with value-based care but it is the 00:29:44.805 --> 00:29:46.266 outcomes are really what's going to drive 00:29:46.306 --> 00:29:48.847 it and clinicians need to understand that 00:29:49.228 --> 00:29:51.469 i don't think they do yeah it's it's 00:29:51.749 --> 00:29:53.450 it's playing a slightly different uh well 00:29:53.829 --> 00:29:55.070 playing the same game but now the 00:29:55.290 --> 00:29:57.712 scoreboard is a little bit it might be 00:29:57.752 --> 00:29:58.133 different 00:29:58.472 --> 00:30:00.394 yeah i had i had a great former 00:30:00.434 --> 00:30:04.178 sales director who would start like these 00:30:04.258 --> 00:30:05.878 meetings with clients or whatever and he 00:30:05.898 --> 00:30:07.000 would start the certain way i remember 00:30:07.019 --> 00:30:09.040 like after ten times hearing him just 00:30:09.060 --> 00:30:10.502 being like why are you saying that and 00:30:10.522 --> 00:30:11.963 he and he sat me down he said 00:30:12.644 --> 00:30:13.825 i want to understand what their version of 00:30:13.865 --> 00:30:14.244 good is 00:30:14.986 --> 00:30:18.307 Because if I'm playing ice hockey, 00:30:18.828 --> 00:30:21.130 but I'm being judged on figure skating, 00:30:21.769 --> 00:30:23.151 I'm never going to win. 00:30:23.330 --> 00:30:25.472 I just scored nine goals, right? 00:30:25.492 --> 00:30:27.034 But you didn't do any triple lutzes. 00:30:29.315 --> 00:30:31.436 And so it's just speaking two different 00:30:31.477 --> 00:30:31.977 languages. 00:30:32.217 --> 00:30:34.097 So when I start with clients or companies, 00:30:34.578 --> 00:30:35.419 or even if someone just says, 00:30:35.538 --> 00:30:36.400 I want to pick your brain. 00:30:36.460 --> 00:30:37.259 And I'm, you know, 00:30:37.401 --> 00:30:38.760 what are we solving for here? 00:30:38.922 --> 00:30:40.843 Like, what does good look like? 00:30:41.242 --> 00:30:42.263 Yeah. 00:30:42.344 --> 00:30:43.846 And it makes them often, 00:30:43.865 --> 00:30:45.487 it makes them stop and think they don't 00:30:45.507 --> 00:30:46.448 have a clear answer right away. 00:30:46.627 --> 00:30:47.328 That's good. 00:30:48.390 --> 00:30:49.651 They know the answer, 00:30:49.671 --> 00:30:52.153 but they haven't maybe asked or they don't 00:30:52.173 --> 00:30:53.255 know how to put it in a sentence. 00:30:53.734 --> 00:30:54.695 That's step one. 00:30:55.217 --> 00:30:55.376 Right. 00:30:55.757 --> 00:30:56.958 What does good look like? 00:30:58.058 --> 00:30:59.560 And scale this for me. 00:30:59.760 --> 00:31:02.042 Is this a five hundred dollar problem, 00:31:02.423 --> 00:31:04.265 a fifty thousand dollar problem or a half 00:31:04.285 --> 00:31:05.405 a million dollar problem? 00:31:06.262 --> 00:31:07.625 Cause I don't like asking like in what 00:31:07.785 --> 00:31:07.944 I do, 00:31:07.964 --> 00:31:10.709 I don't like asking what's your budget. 00:31:11.049 --> 00:31:12.490 That's an objective question. 00:31:12.951 --> 00:31:13.952 What I'll do is like, what, 00:31:15.663 --> 00:31:17.704 What changes for your organization if we 00:31:17.765 --> 00:31:18.305 fix this? 00:31:18.664 --> 00:31:19.786 If we fix this right? 00:31:20.227 --> 00:31:21.508 And I'm purpose and like, 00:31:21.827 --> 00:31:23.088 I haven't told you what we're going to 00:31:23.108 --> 00:31:24.329 fix because I don't know what the problem 00:31:24.349 --> 00:31:24.490 is yet. 00:31:24.670 --> 00:31:26.332 But if we do, what changes? 00:31:26.852 --> 00:31:28.693 And that shows me the level of intensity. 00:31:29.273 --> 00:31:29.394 Like, 00:31:29.413 --> 00:31:31.215 is this a one phone call and done? 00:31:31.516 --> 00:31:32.497 What do you think it is? 00:31:33.076 --> 00:31:34.298 I want you to fix our entire social 00:31:34.337 --> 00:31:35.538 media strategy in the next hour. 00:31:35.818 --> 00:31:39.142 My man, that's not going to happen. 00:31:39.521 --> 00:31:40.123 Let's get on. 00:31:40.663 --> 00:31:41.144 I was taught. 00:31:41.183 --> 00:31:42.545 Have you ever heard of the arc triangle? 00:31:43.323 --> 00:31:43.864 Yeah. 00:31:43.884 --> 00:31:45.625 Affinity, reality, communication, 00:31:45.724 --> 00:31:47.605 and then that's the goal. 00:31:47.826 --> 00:31:48.946 You have to have those three things to 00:31:48.987 --> 00:31:51.169 achieve understanding, right? 00:31:52.750 --> 00:31:53.990 We are not in the same reality. 00:31:54.030 --> 00:31:55.451 If you think I'm going to overhaul an 00:31:55.471 --> 00:31:56.972 entire system in the next forty eight 00:31:57.032 --> 00:31:58.114 minutes, not going to happen. 00:31:58.394 --> 00:32:00.016 So let's get on the same page there. 00:32:00.076 --> 00:32:01.297 Right. 00:32:02.451 --> 00:32:04.354 But these types of conversations need to 00:32:04.374 --> 00:32:04.634 be had. 00:32:04.755 --> 00:32:06.596 A lot of times I feel like productivity 00:32:06.656 --> 00:32:08.199 or efficiency or standards are, 00:32:09.180 --> 00:32:10.561 this is the number you need to hit. 00:32:11.303 --> 00:32:12.384 Without telling clinicians, 00:32:12.904 --> 00:32:14.646 how do I affect that number? 00:32:15.968 --> 00:32:16.949 How do I do better? 00:32:16.989 --> 00:32:18.611 What are the runs or goals or triple 00:32:18.631 --> 00:32:18.991 let'ses? 00:32:19.383 --> 00:32:20.163 Well, and here's the thing. 00:32:20.263 --> 00:32:22.984 I think also it's not just the, 00:32:23.005 --> 00:32:24.026 you know, how do I do it? 00:32:24.266 --> 00:32:24.965 I always say, you know, 00:32:24.986 --> 00:32:27.426 teach the why before the what. 00:32:27.607 --> 00:32:29.608 Ask the why before the what. 00:32:29.628 --> 00:32:31.609 Don't ask what the end result's going to 00:32:31.630 --> 00:32:31.750 be. 00:32:31.910 --> 00:32:34.530 Ask, you know, why are we doing it? 00:32:34.711 --> 00:32:35.912 Then you get to the how, 00:32:35.932 --> 00:32:36.853 then you get to the what. 00:32:36.932 --> 00:32:38.834 But if you don't have the why and 00:32:38.854 --> 00:32:40.434 the clinician doesn't understand the why, 00:32:42.891 --> 00:32:45.073 then you're losing before you've even 00:32:45.093 --> 00:32:45.252 started. 00:32:45.272 --> 00:32:47.134 You're creating mini MacGyvers though. 00:32:47.295 --> 00:32:48.855 Otherwise, it's just following SOP. 00:32:48.875 --> 00:32:50.557 If I understand the why and then I 00:32:50.596 --> 00:32:51.877 get something unusual, 00:32:52.038 --> 00:32:53.339 I can figure out a way to make 00:32:53.380 --> 00:32:54.559 this work because I understand where 00:32:54.580 --> 00:32:55.421 the... Just listen, 00:32:55.461 --> 00:32:57.222 tell me to get to Times Square. 00:32:57.242 --> 00:32:58.903 You don't have to tell me what route 00:32:58.923 --> 00:32:59.364 to take. 00:32:59.625 --> 00:33:00.806 But if the goal is get to Times 00:33:00.846 --> 00:33:03.007 Square by noon, I'll figure it out. 00:33:03.047 --> 00:33:03.807 Don't worry about it. 00:33:04.147 --> 00:33:05.930 But if it's follow these steps, 00:33:06.009 --> 00:33:07.151 as soon as I get to five and 00:33:07.171 --> 00:33:08.050 there's a traffic jam, 00:33:08.392 --> 00:33:10.053 I don't know what to do. 00:33:10.133 --> 00:33:11.134 I'm not empowered... 00:33:12.188 --> 00:33:13.648 with a goal to know why, 00:33:14.269 --> 00:33:16.592 or I don't know what kind of tools 00:33:16.612 --> 00:33:17.272 I'm allowed to do. 00:33:17.313 --> 00:33:18.874 There's a story that's pretty famous. 00:33:19.493 --> 00:33:22.537 The Zappos.com, the online shoe retailer, 00:33:23.258 --> 00:33:25.339 the guy who launched it realized they kept 00:33:25.880 --> 00:33:28.182 being a bottleneck in customer service. 00:33:29.123 --> 00:33:31.005 And he realizes because every customer 00:33:31.045 --> 00:33:32.486 service problem went through him as the 00:33:32.526 --> 00:33:33.006 CEO. 00:33:33.267 --> 00:33:34.007 So finally, he just said, 00:33:34.146 --> 00:33:36.368 if the problem requires a solution that's 00:33:36.388 --> 00:33:38.010 a thousand dollars or less, 00:33:39.713 --> 00:33:41.595 whatever action you think is best take it 00:33:42.115 --> 00:33:44.257 up to a thousand dollars and just explain 00:33:44.477 --> 00:33:46.538 what i did this because this and this 00:33:46.878 --> 00:33:47.818 and then i'll look at it and go 00:33:47.858 --> 00:33:49.299 yeah you got it and if there's one 00:33:49.319 --> 00:33:50.800 that's like hey man that didn't let's 00:33:50.840 --> 00:33:52.863 let's review this case and their amount of 00:33:52.923 --> 00:33:54.864 complaints went down and their time to 00:33:54.923 --> 00:33:57.346 solve uh problems went down and their 00:33:57.405 --> 00:34:00.948 costs went down of course they did you 00:34:00.968 --> 00:34:02.548 understood the why the goal was to make 00:34:02.568 --> 00:34:05.371 happy people yep understood got it less 00:34:05.391 --> 00:34:06.951 than a thousand dollars most of the time 00:34:06.991 --> 00:34:08.092 it was probably like a twenty eight dollar 00:34:08.112 --> 00:34:08.293 fix 00:34:09.425 --> 00:34:09.905 Exactly. 00:34:10.186 --> 00:34:11.226 And they were empowered. 00:34:11.527 --> 00:34:12.547 So they did it. 00:34:12.567 --> 00:34:13.327 They did it better. 00:34:13.527 --> 00:34:14.547 They did it more efficiently. 00:34:14.847 --> 00:34:15.329 Correct. 00:34:16.369 --> 00:34:18.210 And that's exactly how we have to treat 00:34:18.269 --> 00:34:20.791 our clinicians and ensure that our 00:34:20.811 --> 00:34:22.092 clinicians understand that, 00:34:22.652 --> 00:34:24.393 the empowerment, the why, 00:34:25.552 --> 00:34:26.813 and the simplicity of it all. 00:34:27.193 --> 00:34:29.375 Yeah, I agree. 00:34:29.394 --> 00:34:31.856 We'll bring you back for an episode that's 00:34:31.896 --> 00:34:33.396 really on a six-step playbook, right? 00:34:33.436 --> 00:34:34.416 So how about we'll tease, 00:34:34.436 --> 00:34:35.697 let's call it front tease, everybody. 00:34:36.737 --> 00:34:38.458 We'll bring you back for the six-step 00:34:38.478 --> 00:34:38.798 playbook. 00:34:38.818 --> 00:34:40.460 If a clinic owner or rehab director wanted 00:34:40.480 --> 00:34:42.882 to create systems that protect clinicians, 00:34:43.842 --> 00:34:45.103 we'll bring you back for a full episode 00:34:45.123 --> 00:34:46.523 on six because I feel like asking you 00:34:46.543 --> 00:34:49.686 that, it's two episodes in one. 00:34:50.387 --> 00:34:51.427 So we'll separate that. 00:34:51.467 --> 00:34:52.268 So that'll be the second one. 00:34:52.588 --> 00:34:55.130 So we'll skip to the parting shot right 00:34:55.170 --> 00:34:57.371 now. 00:34:57.431 --> 00:34:58.532 This is the parting shot. 00:34:59.092 --> 00:35:00.472 One last mic drop moment. 00:35:01.173 --> 00:35:01.974 No pressure. 00:35:02.414 --> 00:35:04.516 Just your legacy on the line. 00:35:05.878 --> 00:35:06.099 All right, 00:35:06.119 --> 00:35:07.139 there's your parting shot brought to you 00:35:07.159 --> 00:35:08.480 by our friends at Sarah Health. 00:35:08.940 --> 00:35:10.300 They help clinics stay connected with 00:35:10.360 --> 00:35:12.862 patients between visits using automated 00:35:13.043 --> 00:35:14.903 text message check-ins. 00:35:15.224 --> 00:35:19.485 Text message that support RTM codes. 00:35:19.666 --> 00:35:20.186 Text message. 00:35:20.387 --> 00:35:22.387 That means there's no app or login or 00:35:22.427 --> 00:35:24.548 thing to forget or password to re-op every 00:35:25.248 --> 00:35:25.889 text messages. 00:35:26.650 --> 00:35:28.070 It's one of the easiest ways clinics can 00:35:28.090 --> 00:35:29.492 improve outcomes while unlocking new 00:35:29.532 --> 00:35:31.313 reimbursable care outside the clinic. 00:35:31.474 --> 00:35:35.336 Visit sarahhealth.com, S-A-R-A health.com. 00:35:35.817 --> 00:35:36.717 So you have two choices. 00:35:37.137 --> 00:35:38.699 You can pick your own parting shot and 00:35:38.719 --> 00:35:39.239 just do it, 00:35:39.780 --> 00:35:41.282 or I can give you a prompt. 00:35:42.061 --> 00:35:44.664 Which one do you want? 00:35:44.704 --> 00:35:45.985 I'm feeling spicy today. 00:35:46.005 --> 00:35:47.367 Let's do a prompt because I... 00:35:48.525 --> 00:35:48.907 All right. 00:35:48.947 --> 00:35:51.190 So if therapists feel like efficiency 00:35:51.309 --> 00:35:53.052 always means cutting corners, 00:35:53.733 --> 00:35:54.793 you say that's wrong. 00:35:55.235 --> 00:35:56.757 What would you have them do? 00:35:56.777 --> 00:35:58.659 What's the first step, 00:35:59.219 --> 00:36:00.842 like an action that they should take? 00:36:00.862 --> 00:36:02.182 If a clinician's listening, like, okay, 00:36:02.222 --> 00:36:02.664 I agree with her. 00:36:02.704 --> 00:36:03.605 I'd love that to happen. 00:36:03.905 --> 00:36:05.246 But what do I do about it here 00:36:05.266 --> 00:36:07.610 in my clinic where Katie's not my boss? 00:36:08.971 --> 00:36:10.411 Hmm. 00:36:10.893 --> 00:36:12.273 And they're feeling like they have to cut 00:36:12.313 --> 00:36:12.755 corners. 00:36:13.114 --> 00:36:13.956 Or they're just feeling like, 00:36:14.255 --> 00:36:16.257 here I have this metric that I'm measured 00:36:16.297 --> 00:36:16.639 to. 00:36:17.500 --> 00:36:18.079 What do I do? 00:36:18.099 --> 00:36:20.001 Do I talk to my boss and ask 00:36:20.021 --> 00:36:21.043 them to walk me through it? 00:36:21.222 --> 00:36:22.644 I feel like the answer is always people, 00:36:22.704 --> 00:36:23.005 right? 00:36:23.925 --> 00:36:24.346 Yes. 00:36:24.706 --> 00:36:27.650 I would say if they don't even know 00:36:27.670 --> 00:36:30.492 where to start, first step to do is... 00:36:31.833 --> 00:36:33.554 is ask the question. 00:36:34.916 --> 00:36:35.177 Ask, 00:36:36.358 --> 00:36:38.380 what is the main goal for me to 00:36:38.420 --> 00:36:38.599 meet? 00:36:38.920 --> 00:36:41.782 Is it more visits per week? 00:36:42.282 --> 00:36:44.625 Is it better use of my time? 00:36:44.744 --> 00:36:45.905 Is it better outcomes? 00:36:46.085 --> 00:36:47.367 Is it better documentation? 00:36:47.467 --> 00:36:52.711 What is it that's going to make me 00:36:52.911 --> 00:36:56.594 a next level clinician or make me able 00:36:56.655 --> 00:36:59.418 to meet that goal in a more efficient 00:36:59.458 --> 00:36:59.617 way? 00:36:59.922 --> 00:37:01.284 Because you can do a lot of them, 00:37:01.364 --> 00:37:02.063 but I would say like, 00:37:02.184 --> 00:37:04.945 which lever has the most leverage? 00:37:05.306 --> 00:37:05.885 Right. 00:37:05.945 --> 00:37:07.067 I have twenty choices. 00:37:08.248 --> 00:37:09.108 I can't pull all twenty, 00:37:09.307 --> 00:37:11.068 but which one should I pull first or 00:37:11.108 --> 00:37:16.032 most often or sooner to get that number 00:37:16.072 --> 00:37:16.853 to move? 00:37:18.393 --> 00:37:20.574 And to what it just sounds like you're 00:37:20.594 --> 00:37:20.795 saying, 00:37:20.835 --> 00:37:21.936 understand what the North Star really 00:37:21.976 --> 00:37:22.155 means, 00:37:22.215 --> 00:37:24.336 what is good in this situation look like? 00:37:24.641 --> 00:37:26.563 A hundred percent because it could look a 00:37:26.603 --> 00:37:28.385 million different ways for different 00:37:28.425 --> 00:37:28.784 people, 00:37:29.306 --> 00:37:32.947 but every person has the first lever to 00:37:33.068 --> 00:37:35.190 try and then they may need to try 00:37:35.230 --> 00:37:35.851 different ones. 00:37:36.170 --> 00:37:36.490 Yeah. 00:37:36.570 --> 00:37:37.791 Or the first one works perfectly. 00:37:38.052 --> 00:37:38.952 Yeah. 00:37:38.972 --> 00:37:39.152 Katie, 00:37:39.172 --> 00:37:40.193 if someone was going to reach out to 00:37:40.213 --> 00:37:41.175 you, what's the best place? 00:37:41.195 --> 00:37:42.596 Is it the old LinkedIn? 00:37:42.675 --> 00:37:45.418 LinkedIn is the best place to reach me. 00:37:45.438 --> 00:37:48.760 I get messages all the time and I'll 00:37:49.460 --> 00:37:50.282 be sure to respond. 00:37:50.302 --> 00:37:50.762 All right. 00:37:50.782 --> 00:37:51.563 We'll bring you back. 00:37:51.702 --> 00:37:52.724 Katie, appreciate the time. 00:37:52.744 --> 00:37:53.583 Thanks for talking with us. 00:37:53.824 --> 00:37:54.204 Thank you. 00:37:56.465 --> 00:37:57.545 That's it for this one. 00:37:58.005 --> 00:37:59.505 We're just getting warmed up. 00:37:59.945 --> 00:38:01.847 Smash follow, send it to a friend, 00:38:02.067 --> 00:38:03.726 or crank up the next episode. 00:38:04.246 --> 00:38:05.208 Want to go deeper? 00:38:05.628 --> 00:38:07.768 Hit us at pgpinecast.com. 00:38:08.989 --> 00:38:11.010 Or find us on YouTube and socials at 00:38:11.030 --> 00:38:12.250 pgpinecast. 00:38:12.670 --> 00:38:14.951 And legally, none of this was advice. 00:38:15.010 --> 00:38:16.670 It's for entertainment purposes only. 00:38:16.690 --> 00:38:18.391 Bullshit! 00:38:18.431 --> 00:38:19.012 See, Keith? 00:38:19.231 --> 00:38:20.293 We read the script. 00:38:20.592 --> 00:38:21.233 Happy now?