WEBVTT 00:00:00.309 --> 00:00:02.609 You're listening to the PG Pinecast, 00:00:02.709 --> 00:00:04.389 where smart people in healthcare come to 00:00:04.429 --> 00:00:05.110 make noise. 00:00:05.129 --> 00:00:09.951 Here's your host, Jimmy McKay. 00:00:09.971 --> 00:00:11.451 Big thanks to Sarah Health, 00:00:11.471 --> 00:00:13.271 the remote care platform helping clinics 00:00:13.330 --> 00:00:15.651 boost revenue without having to add staff 00:00:15.832 --> 00:00:17.911 or four thousand post-it notes. 00:00:18.192 --> 00:00:18.371 See, 00:00:18.472 --> 00:00:20.332 Sarah automates daily patient check ins 00:00:20.772 --> 00:00:23.073 through simple text message reminders, 00:00:23.092 --> 00:00:25.172 which means no app, no lost passwords, 00:00:25.213 --> 00:00:25.733 no logins. 00:00:26.574 --> 00:00:28.814 This way, clinics improve follow through. 00:00:29.500 --> 00:00:32.103 They meet RTM requirements and get 00:00:32.143 --> 00:00:33.945 reimbursed for the care they're already 00:00:34.005 --> 00:00:35.948 delivering between visits. 00:00:36.228 --> 00:00:37.770 Learn more at sarahealth.com. 00:00:37.810 --> 00:00:40.593 That's S-A-R-A health.com. 00:00:41.194 --> 00:00:42.676 In healthcare, 00:00:42.695 --> 00:00:44.237 clinicians often feel like they're stuck 00:00:44.258 --> 00:00:44.718 in the middle. 00:00:44.959 --> 00:00:46.801 Call between doing the right thing for 00:00:46.841 --> 00:00:47.301 patients 00:00:48.381 --> 00:00:49.142 And hitting numbers, 00:00:49.182 --> 00:00:50.783 the business needs to survive. 00:00:51.222 --> 00:00:53.283 But what if those two goals were never 00:00:53.344 --> 00:00:54.444 supposed to compete? 00:00:54.463 --> 00:00:55.384 What if they weren't supposed to be 00:00:55.463 --> 00:00:55.905 separate? 00:00:56.265 --> 00:00:59.165 Today's guest has spent a career helping 00:00:59.265 --> 00:01:01.887 rehab teams and clinicians stop fighting 00:01:01.926 --> 00:01:04.808 the business side of healthcare and start 00:01:04.867 --> 00:01:05.748 understanding it. 00:01:06.207 --> 00:01:08.129 She's trained thousands of clinicians 00:01:08.149 --> 00:01:09.709 across the country to translate 00:01:09.769 --> 00:01:11.530 complicated clinical challenges... 00:01:12.391 --> 00:01:15.352 into practical systems that actually work 00:01:15.712 --> 00:01:17.293 in real clinics it's got to be real 00:01:17.873 --> 00:01:20.774 uh she's part speech language pathologist 00:01:20.853 --> 00:01:22.993 part pretend pt and ot but we're all 00:01:23.013 --> 00:01:25.774 cousins part educator and part strategy 00:01:25.793 --> 00:01:27.614 leader let's welcome back to the show 00:01:27.655 --> 00:01:29.275 katie holterman katie welcome back to the 00:01:29.295 --> 00:01:33.115 program thank you uh what's nice in theory 00:01:33.516 --> 00:01:35.615 may not be practical and what's practical 00:01:35.676 --> 00:01:39.117 may not feel nice so the tensions 00:01:40.236 --> 00:01:42.037 that clinicians feel between quality care 00:01:42.058 --> 00:01:44.200 and productivity expectations, 00:01:44.742 --> 00:01:46.082 they're real. 00:01:46.183 --> 00:01:48.266 So clinicians often say they feel like 00:01:48.365 --> 00:01:51.049 business pressures conflict with patient 00:01:51.088 --> 00:01:51.450 care. 00:01:52.191 --> 00:01:53.691 Let's start with where. 00:01:53.772 --> 00:01:56.075 Where does that tension actually come 00:01:56.135 --> 00:01:56.335 from? 00:01:57.108 --> 00:01:59.790 I think the tension comes from clinicians 00:01:59.849 --> 00:02:02.692 not understanding that business is 00:02:02.733 --> 00:02:06.256 business and that it's okay to know that 00:02:06.335 --> 00:02:08.076 you are actually working for a business, 00:02:09.198 --> 00:02:12.381 that it's okay to know that money makes 00:02:12.401 --> 00:02:14.082 the world go round, right? 00:02:14.223 --> 00:02:18.787 And it has to be a component of 00:02:18.806 --> 00:02:19.567 the conversation, 00:02:19.867 --> 00:02:21.949 but that as long as that conversation is 00:02:22.050 --> 00:02:24.632 led with clinical eyes and clinical words, 00:02:26.311 --> 00:02:28.234 the fiscal piece will follow it and it 00:02:28.253 --> 00:02:29.936 just will be a good thing. 00:02:30.657 --> 00:02:31.578 I mean, this is why 00:02:33.201 --> 00:02:35.383 nursery rhymes or fairy tales or fairy 00:02:35.402 --> 00:02:38.183 tales because it's a story that teaches a 00:02:38.243 --> 00:02:38.623 lesson. 00:02:39.544 --> 00:02:41.324 This is why schoolhouse rocks. 00:02:41.504 --> 00:02:42.905 This is how a bill becomes a bill. 00:02:43.145 --> 00:02:44.645 You can be mad when things aren't your 00:02:44.686 --> 00:02:47.347 way, but when you begin to understand, 00:02:47.606 --> 00:02:48.747 hey, there's a process. 00:02:48.907 --> 00:02:50.087 If you want the outcome, 00:02:50.568 --> 00:02:51.948 let's go back to the beginning and see 00:02:51.967 --> 00:02:54.049 how this thing changes. 00:02:54.408 --> 00:02:56.229 I think it's probably on the syllabus. 00:02:56.270 --> 00:02:57.210 In fact, I know it is. 00:02:57.449 --> 00:02:58.789 It must be mentioned somewhere, 00:02:59.191 --> 00:03:00.131 but it's probably different 00:03:01.348 --> 00:03:04.248 program to program in terms of, hey, 00:03:04.269 --> 00:03:05.489 you're going into healthcare. 00:03:05.808 --> 00:03:07.468 And then there's like seven subtitles 00:03:07.788 --> 00:03:08.049 layer. 00:03:08.409 --> 00:03:10.349 Healthcare is a business. 00:03:10.729 --> 00:03:12.629 It's probably one of the businesses. 00:03:12.669 --> 00:03:14.570 There are others like it where it's driven 00:03:14.610 --> 00:03:15.510 by this mission, 00:03:15.991 --> 00:03:16.770 but it's still a business. 00:03:16.811 --> 00:03:17.912 If you'd like to get paid to do 00:03:17.931 --> 00:03:18.171 this, 00:03:18.572 --> 00:03:20.372 there needs to be some sort of financial 00:03:20.412 --> 00:03:22.973 exchange in order to keep the lights on 00:03:23.112 --> 00:03:24.592 and pay for the people involved. 00:03:24.733 --> 00:03:25.853 who actually provide the care. 00:03:25.893 --> 00:03:27.954 Larry Benz in a recent episode even said 00:03:28.653 --> 00:03:29.734 in a health care organization, 00:03:29.854 --> 00:03:31.354 your assets wear shoes. 00:03:31.375 --> 00:03:32.435 Your assets are the people. 00:03:32.495 --> 00:03:33.775 I know you might have machines or 00:03:33.835 --> 00:03:34.216 anything, 00:03:34.816 --> 00:03:36.295 but even if you're a hospital with MRI 00:03:36.336 --> 00:03:37.997 machines and helicopters and ambulances, 00:03:38.516 --> 00:03:40.417 really your most important asset, nothing, 00:03:40.776 --> 00:03:43.737 nothing moves unless you have people. 00:03:43.798 --> 00:03:44.377 Exactly. 00:03:44.397 --> 00:03:46.998 And here's the problem. 00:03:49.060 --> 00:03:51.439 I think the core of it before the 00:03:51.479 --> 00:03:53.860 person becomes the employee in 00:03:54.366 --> 00:03:56.127 PT, OT and speech, 00:03:57.108 --> 00:04:00.270 they're the student and the student isn't 00:04:00.330 --> 00:04:02.532 taught business. 00:04:03.193 --> 00:04:09.139 They're not taught that their product is 00:04:09.218 --> 00:04:11.920 what they're selling or they're not taught 00:04:12.001 --> 00:04:13.522 the financial aspect of it. 00:04:13.603 --> 00:04:15.743 So we go into this business thinking, 00:04:16.785 --> 00:04:17.225 okay, well, 00:04:17.264 --> 00:04:18.564 everything else is going to make the 00:04:18.625 --> 00:04:18.845 money. 00:04:18.865 --> 00:04:21.045 We're just going to treat. 00:04:21.326 --> 00:04:21.545 Right. 00:04:22.846 --> 00:04:24.706 You are a service, right? 00:04:24.786 --> 00:04:27.867 Ritz-Carlton doesn't really sell beds. 00:04:28.067 --> 00:04:29.968 They sell the experience, 00:04:30.127 --> 00:04:32.127 everything from the moment you pull up to 00:04:32.187 --> 00:04:32.927 when you leave, 00:04:32.968 --> 00:04:34.028 if there's a mint on the pillow. 00:04:35.588 --> 00:04:37.389 And I've heard of healthcare organizations 00:04:37.449 --> 00:04:39.069 bringing in, quite literally, 00:04:39.509 --> 00:04:40.470 the Ritz-Carlton's 00:04:41.538 --> 00:04:45.887 sort of management or experience school to 00:04:46.028 --> 00:04:46.810 understand 00:04:47.793 --> 00:04:50.053 you're providing experience, right? 00:04:50.113 --> 00:04:52.415 So your framework sort of starts with 00:04:52.454 --> 00:04:55.495 defining non-negotiables. 00:04:55.636 --> 00:04:58.718 And I like those because as creative or 00:04:58.778 --> 00:05:01.478 as free as we can be in how 00:05:01.499 --> 00:05:02.559 we treat, right? 00:05:02.579 --> 00:05:03.920 There should be some non-negotiables. 00:05:04.259 --> 00:05:05.500 In order to be really creative, 00:05:05.540 --> 00:05:06.641 to think outside the box, 00:05:06.920 --> 00:05:08.002 there's got to be a box. 00:05:08.141 --> 00:05:09.843 So your non-negotiables are a box. 00:05:09.923 --> 00:05:10.903 And I like those things. 00:05:10.963 --> 00:05:12.124 Exactly. 00:05:12.303 --> 00:05:13.584 What does that look like in a real 00:05:13.624 --> 00:05:14.944 clinic, your non-negotiables? 00:05:15.307 --> 00:05:15.607 Yeah, 00:05:15.706 --> 00:05:17.146 so I think of these as like clinical 00:05:17.166 --> 00:05:19.567 guardrails, right? 00:05:20.548 --> 00:05:23.329 What is that box that you're not going 00:05:23.348 --> 00:05:23.988 to go out of, 00:05:25.569 --> 00:05:26.649 but you can play within it? 00:05:27.269 --> 00:05:31.389 So what is the max number of patients 00:05:31.870 --> 00:05:34.130 or people per therapist? 00:05:34.271 --> 00:05:35.550 What does that look like? 00:05:35.810 --> 00:05:38.372 And when it starts to go outside that 00:05:38.411 --> 00:05:40.432 box or outside that guardrail, 00:05:40.971 --> 00:05:42.372 then you know you're getting a little bit 00:05:42.473 --> 00:05:43.612 into more of that 00:05:45.480 --> 00:05:48.483 sticky place of is that really a business 00:05:49.584 --> 00:05:52.485 motivated decision versus your clinical 00:05:52.505 --> 00:05:54.168 guardrail of this is patient care. 00:05:54.968 --> 00:06:00.232 So that's an example of just I think 00:06:00.271 --> 00:06:01.773 staffing is a really good one. 00:06:02.233 --> 00:06:03.754 What does your staffing look like? 00:06:05.375 --> 00:06:08.158 And is it that you're trying to have 00:06:08.418 --> 00:06:10.600 X number of staff for, you know, 00:06:10.639 --> 00:06:12.401 this day versus this day? 00:06:12.480 --> 00:06:15.663 And does that make clinical sense because 00:06:15.702 --> 00:06:17.283 of the patient makeup that you have in 00:06:17.303 --> 00:06:17.725 that day? 00:06:17.805 --> 00:06:19.526 So clinical guardrails, I think, 00:06:19.545 --> 00:06:23.067 are really important from a documentation 00:06:23.129 --> 00:06:23.709 standpoint. 00:06:23.728 --> 00:06:23.949 You know, 00:06:23.988 --> 00:06:26.011 what is your clinical guardrail there? 00:06:26.790 --> 00:06:28.052 And then obviously from a billing 00:06:28.072 --> 00:06:30.192 standpoint, you know, from CPT codes, 00:06:31.213 --> 00:06:32.295 you know, what does that look like? 00:06:33.920 --> 00:06:34.221 Of course, 00:06:34.300 --> 00:06:35.422 I come at everything from the lens of 00:06:35.461 --> 00:06:36.581 the guy who used to work at a 00:06:36.601 --> 00:06:37.122 radio station, 00:06:37.141 --> 00:06:38.382 but there's so many parallels, 00:06:38.601 --> 00:06:40.223 and we were taught the difference between 00:06:40.302 --> 00:06:41.223 policy and law. 00:06:41.822 --> 00:06:42.523 Now, first of all, 00:06:42.983 --> 00:06:44.124 you can't violate the law. 00:06:44.423 --> 00:06:45.064 You can't do it. 00:06:45.363 --> 00:06:46.283 I mean, you can, and people do, 00:06:46.303 --> 00:06:47.024 but you're going to get caught. 00:06:47.103 --> 00:06:47.884 Just pretend like you're going to get 00:06:47.925 --> 00:06:48.105 caught. 00:06:48.125 --> 00:06:48.785 Don't do it, right? 00:06:49.045 --> 00:06:50.125 So there was the FCC. 00:06:51.204 --> 00:06:53.105 Don't break any of their rules. 00:06:54.428 --> 00:06:55.329 I don't care what you're doing. 00:06:55.370 --> 00:06:55.730 Don't do it. 00:06:55.990 --> 00:06:57.610 Then there was policy and that's set by 00:06:57.630 --> 00:06:58.190 the company. 00:06:58.471 --> 00:07:00.252 We don't do these things. 00:07:01.093 --> 00:07:01.812 And that's like, Hey, 00:07:01.833 --> 00:07:02.874 if you want to work here, 00:07:03.274 --> 00:07:04.134 you can't break these laws. 00:07:04.153 --> 00:07:06.295 We, these rules, sorry, not laws rules. 00:07:06.675 --> 00:07:08.776 Cause we'll fire you for that. 00:07:08.817 --> 00:07:10.257 That's outside of our bounds. 00:07:10.757 --> 00:07:13.860 And the funny part was in radio, 00:07:14.019 --> 00:07:15.860 it's much like it was so it's funny 00:07:15.901 --> 00:07:17.201 to come to healthcare and be like, 00:07:17.240 --> 00:07:18.101 Oh my gosh, this is, 00:07:18.141 --> 00:07:19.702 and I'm sure it's other, you know, 00:07:19.802 --> 00:07:21.264 professions too. 00:07:21.363 --> 00:07:23.584 Everybody on the air, we made the thing. 00:07:24.946 --> 00:07:26.927 We made the funny commercials and we made 00:07:26.966 --> 00:07:27.427 the whatever. 00:07:27.447 --> 00:07:29.428 We picked the music and we talked, right? 00:07:29.668 --> 00:07:30.529 We were the clinicians. 00:07:30.949 --> 00:07:31.971 We were the product. 00:07:33.190 --> 00:07:35.552 And we would look at sales and management 00:07:35.653 --> 00:07:37.894 as sort of always wanting to butt heads. 00:07:38.735 --> 00:07:40.855 And the minute I sort of realized that 00:07:40.896 --> 00:07:43.798 without them, we can't do what we do. 00:07:44.057 --> 00:07:45.158 And without us, they can't do. 00:07:45.478 --> 00:07:46.759 We are in the same boat. 00:07:46.819 --> 00:07:47.920 We are tied together. 00:07:48.560 --> 00:07:49.122 So instead, 00:07:49.201 --> 00:07:50.601 I sort of pulled a Bruce Lee move 00:07:50.622 --> 00:07:51.783 and it was only because I had smart 00:07:51.843 --> 00:07:52.684 bosses around me. 00:07:54.264 --> 00:07:55.144 be water. 00:07:55.165 --> 00:07:56.427 The goal is to get along, 00:07:56.468 --> 00:07:57.028 to go along, 00:07:57.129 --> 00:08:01.134 but I made sure to sort of hold 00:08:01.175 --> 00:08:01.995 fast to, well, 00:08:02.536 --> 00:08:03.778 I understand why you're trying to do that, 00:08:03.798 --> 00:08:05.721 but that's asking me to violate some of 00:08:05.742 --> 00:08:07.745 the things that keep our brand a brand. 00:08:08.600 --> 00:08:10.401 Which if we do an exception now, 00:08:10.862 --> 00:08:12.322 what's the stop of six months from now 00:08:12.343 --> 00:08:12.802 for doing that? 00:08:12.822 --> 00:08:14.124 If we eventually do it now, 00:08:14.204 --> 00:08:16.064 no one's listening and now you can't sell 00:08:16.105 --> 00:08:16.524 anything. 00:08:16.845 --> 00:08:17.745 And I feel like it's the same for 00:08:17.786 --> 00:08:18.225 clinicians. 00:08:18.245 --> 00:08:19.987 It's like, well, if we make exceptions, 00:08:20.266 --> 00:08:21.528 I understand why you're telling me that, 00:08:21.548 --> 00:08:23.709 but I can't do it because I've also 00:08:23.728 --> 00:08:24.488 got a license. 00:08:24.709 --> 00:08:26.430 I didn't have a license in broadcasting. 00:08:26.449 --> 00:08:27.310 You didn't have to have one. 00:08:27.571 --> 00:08:30.031 You lose that in healthcare, you're done. 00:08:30.271 --> 00:08:32.613 So that should be also be your guiding 00:08:32.653 --> 00:08:32.893 light. 00:08:33.192 --> 00:08:33.433 Yeah. 00:08:33.494 --> 00:08:36.294 And also, you know, the, 00:08:36.315 --> 00:08:38.115 when you start making the exceptions, 00:08:39.437 --> 00:08:42.298 it's easy to lose sight of when that 00:08:42.339 --> 00:08:45.221 exception then becomes the norm, right? 00:08:45.240 --> 00:08:46.721 The slippery slope idea, right? 00:08:46.782 --> 00:08:46.902 Yeah. 00:08:47.042 --> 00:08:48.462 You make that exception once, 00:08:48.523 --> 00:08:49.423 then you make it again. 00:08:49.543 --> 00:08:51.985 And then it's, well, was it really, 00:08:52.206 --> 00:08:53.486 was that really within our clinical 00:08:53.506 --> 00:08:53.986 guardrail? 00:08:54.067 --> 00:08:55.107 Right, right, right. 00:08:55.128 --> 00:08:55.988 Did I make that up? 00:08:56.048 --> 00:08:58.870 So it's important to really keep and take 00:08:58.909 --> 00:08:59.410 hold of that. 00:08:59.831 --> 00:09:00.571 Right. 00:09:00.591 --> 00:09:01.552 So this, 00:09:03.393 --> 00:09:05.235 I think everything I just sort of heard 00:09:05.254 --> 00:09:06.235 or a lot of what I just heard 00:09:06.274 --> 00:09:06.775 sounds like, 00:09:07.589 --> 00:09:11.131 understanding what you do and where you 00:09:11.192 --> 00:09:11.513 fit. 00:09:12.133 --> 00:09:14.434 And this is understanding the physics of 00:09:14.455 --> 00:09:15.897 the environment. 00:09:15.976 --> 00:09:16.557 Yes. 00:09:16.576 --> 00:09:18.538 Given a blank check and all the time 00:09:18.558 --> 00:09:19.019 in the world, 00:09:19.059 --> 00:09:20.240 you would treat people differently. 00:09:21.393 --> 00:09:22.854 But we do not have a blank check 00:09:23.134 --> 00:09:25.515 and unlimited time in this environment. 00:09:25.556 --> 00:09:26.336 That just is not. 00:09:27.336 --> 00:09:29.577 So we have to understanding the other 00:09:29.658 --> 00:09:31.298 side, management, 00:09:31.339 --> 00:09:33.000 if you're a clinician or clinicians, 00:09:33.039 --> 00:09:33.720 if you're management, 00:09:33.921 --> 00:09:36.802 because sometimes management are former 00:09:36.822 --> 00:09:37.783 clinicians like yourself. 00:09:38.363 --> 00:09:39.403 Sometimes you're not. 00:09:40.083 --> 00:09:42.325 So sometimes more understanding is 00:09:42.586 --> 00:09:43.785 typically always better, right? 00:09:43.826 --> 00:09:46.587 Like understanding is either confirming 00:09:46.607 --> 00:09:47.808 what you already knew or teaching you 00:09:47.849 --> 00:09:48.308 something new. 00:09:48.808 --> 00:09:49.349 Exactly. 00:09:49.668 --> 00:09:50.168 Exactly. 00:09:50.370 --> 00:09:51.370 And you, you, 00:09:52.730 --> 00:09:55.750 I think that that understanding and it 00:09:55.791 --> 00:09:57.371 goes a long way because then you can 00:09:57.652 --> 00:09:59.451 speak the language for the other person 00:09:59.491 --> 00:09:59.812 too. 00:09:59.851 --> 00:10:01.452 Like when you're all on the same page, 00:10:01.513 --> 00:10:04.374 it just makes the, the, 00:10:04.494 --> 00:10:05.494 it makes everything easier. 00:10:05.974 --> 00:10:07.315 And so that starts with communication, 00:10:07.375 --> 00:10:08.975 clear, clear communication. 00:10:09.195 --> 00:10:09.596 Yep. 00:10:09.635 --> 00:10:09.836 You, 00:10:09.875 --> 00:10:12.255 you say if something matters clinically, 00:10:12.515 --> 00:10:14.116 it should be measured. 00:10:14.793 --> 00:10:15.293 Yes. 00:10:15.332 --> 00:10:17.413 What are the most important metrics then 00:10:17.793 --> 00:10:19.533 that clinics should actually track? 00:10:19.573 --> 00:10:21.475 Because in twenty twenty six and beyond, 00:10:21.514 --> 00:10:21.774 believe me, 00:10:21.995 --> 00:10:24.316 we could track the list of things we 00:10:24.355 --> 00:10:26.115 can track is only listen. 00:10:26.135 --> 00:10:27.657 You can actually hear it getting longer as 00:10:27.677 --> 00:10:28.116 we speak. 00:10:28.697 --> 00:10:30.518 But what are the most important metrics? 00:10:30.557 --> 00:10:33.038 Because we can't have a million KPIs. 00:10:33.099 --> 00:10:34.119 It makes them not key. 00:10:34.178 --> 00:10:35.879 That's what K and KPI means, right? 00:10:36.659 --> 00:10:38.340 So what are what are the most important 00:10:38.360 --> 00:10:39.941 metrics that you think clinics should 00:10:40.100 --> 00:10:40.860 actually track? 00:10:41.211 --> 00:10:43.452 Yeah, well, before I answer that, 00:10:43.493 --> 00:10:45.673 I think what you just said is so 00:10:45.714 --> 00:10:47.215 important that it deserves to be kind of 00:10:47.254 --> 00:10:47.794 said again. 00:10:49.315 --> 00:10:50.556 Everything can't be important. 00:10:51.115 --> 00:10:52.236 Can't be. 00:10:52.336 --> 00:10:53.716 And if you're measuring it, 00:10:54.076 --> 00:10:55.018 for goodness sake, 00:10:55.177 --> 00:10:56.899 ensure that there's like a compelling and 00:10:56.938 --> 00:10:58.938 real story behind it, right? 00:10:59.639 --> 00:11:00.539 It has to matter. 00:11:00.960 --> 00:11:04.522 So what matters for clinical care and why? 00:11:05.121 --> 00:11:07.283 And the why part is the important part. 00:11:08.157 --> 00:11:09.719 because then that will help you figure 00:11:09.798 --> 00:11:11.299 out, is it really important to measure? 00:11:11.441 --> 00:11:14.344 So for example, frequency, right? 00:11:14.543 --> 00:11:18.528 How frequent are we seeing patients per 00:11:18.567 --> 00:11:18.889 week? 00:11:19.369 --> 00:11:20.931 That's a metric that everybody seems to 00:11:20.990 --> 00:11:22.331 want to measure. 00:11:22.432 --> 00:11:24.674 Are we seeing them three times a week? 00:11:24.715 --> 00:11:26.135 Is that appropriate? 00:11:26.953 --> 00:11:27.673 Well, why? 00:11:28.154 --> 00:11:29.154 Why is that appropriate? 00:11:29.475 --> 00:11:30.916 It may be appropriate for one type of 00:11:30.956 --> 00:11:32.017 patient and not for another. 00:11:32.057 --> 00:11:33.677 So it really doesn't make sense and we 00:11:33.697 --> 00:11:35.097 can kind of throw that away if we 00:11:35.118 --> 00:11:36.359 don't have the why behind it. 00:11:38.279 --> 00:11:39.500 Number of visits, right? 00:11:39.561 --> 00:11:41.581 That's gonna be something that people are 00:11:41.601 --> 00:11:42.501 going to measure. 00:11:42.782 --> 00:11:44.322 But again, why? 00:11:44.823 --> 00:11:46.845 What's the magic number and do we have 00:11:46.865 --> 00:11:50.285 a story behind that that gives us reason 00:11:50.346 --> 00:11:52.788 as to why we need to measure that? 00:11:54.089 --> 00:11:54.969 And then outcomes. 00:11:55.028 --> 00:11:55.208 Right. 00:11:55.249 --> 00:11:56.129 In this day and age, 00:11:56.169 --> 00:11:58.410 we're moving towards value based care. 00:11:58.750 --> 00:11:59.991 Actually, scratch that. 00:12:00.211 --> 00:12:04.355 We are in value based care. 00:12:04.455 --> 00:12:06.956 And so outcomes are of utmost importance. 00:12:08.076 --> 00:12:11.178 But if we don't if we're just measuring 00:12:11.278 --> 00:12:12.940 outcomes because we think we're supposed 00:12:12.960 --> 00:12:15.461 to measure this assessment, 00:12:15.522 --> 00:12:19.124 this this this measure that CMS says we 00:12:19.183 --> 00:12:19.884 have to measure. 00:12:21.285 --> 00:12:21.645 Okay, 00:12:22.025 --> 00:12:24.647 that does make sense because it fits into 00:12:25.307 --> 00:12:27.606 the value-based care model. 00:12:28.807 --> 00:12:30.008 But at the heart of it, 00:12:30.268 --> 00:12:33.508 what's going to say that your clinic is 00:12:33.687 --> 00:12:34.967 the best clinic out there? 00:12:35.989 --> 00:12:36.729 Is it, you know, 00:12:37.068 --> 00:12:38.408 I come from the geriatric world. 00:12:38.469 --> 00:12:40.528 So a lot of times we would measure, 00:12:40.548 --> 00:12:42.169 you know, something around falls. 00:12:42.590 --> 00:12:44.090 We would measure, you know, 00:12:44.850 --> 00:12:46.870 is the patient at risk for falling? 00:12:48.250 --> 00:12:48.551 Okay. 00:12:50.384 --> 00:12:52.027 What's the number of times they've fallen 00:12:52.047 --> 00:12:52.586 in the year? 00:12:53.008 --> 00:12:54.850 That's one measure that we can, you know, 00:12:54.889 --> 00:12:56.191 that that might matter. 00:12:57.192 --> 00:12:59.975 And then insurance companies may pay us 00:13:00.394 --> 00:13:01.716 more if 00:13:02.748 --> 00:13:04.469 their patient is not falling as much, 00:13:04.509 --> 00:13:06.029 if their patient is not at risk for 00:13:06.070 --> 00:13:06.471 falling. 00:13:07.030 --> 00:13:08.412 But wouldn't it be great if we had 00:13:08.652 --> 00:13:10.192 a better measure of, well, 00:13:10.232 --> 00:13:11.793 what's the number of times that they 00:13:11.854 --> 00:13:14.416 engaged in something or didn't engage in 00:13:14.495 --> 00:13:16.317 something because they had a fear of 00:13:16.378 --> 00:13:18.519 falling or didn't have a fear of falling? 00:13:19.240 --> 00:13:22.442 And it's because I had PT and it 00:13:22.481 --> 00:13:23.543 made a difference. 00:13:23.982 --> 00:13:24.163 Well, 00:13:24.222 --> 00:13:27.144 now we have a domino effect of all 00:13:27.184 --> 00:13:29.287 of the things that that can potentially 00:13:29.527 --> 00:13:30.067 impact. 00:13:32.037 --> 00:13:33.298 including, again, 00:13:33.418 --> 00:13:35.019 payment from insurance companies. 00:13:35.058 --> 00:13:36.299 So I think there's a number of things 00:13:36.320 --> 00:13:37.981 that we need to look at measuring. 00:13:38.142 --> 00:13:39.363 But more importantly, 00:13:39.982 --> 00:13:41.484 why are we measuring it? 00:13:41.504 --> 00:13:42.845 What is the story behind it? 00:13:42.884 --> 00:13:43.725 What is the purpose? 00:13:43.745 --> 00:13:45.606 And I was taught that early in my 00:13:45.967 --> 00:13:46.388 career. 00:13:46.408 --> 00:13:47.469 It doesn't really matter what my career 00:13:47.568 --> 00:13:47.708 is. 00:13:47.749 --> 00:13:49.049 The advice was still good. 00:13:49.490 --> 00:13:52.552 Number one, a great boss said, she said, 00:13:53.533 --> 00:13:53.833 figure, 00:13:53.974 --> 00:13:57.076 understand at least the basics of every 00:13:57.135 --> 00:13:57.996 job in this company. 00:13:59.235 --> 00:14:00.275 even if you're not going to do it. 00:14:00.855 --> 00:14:03.418 So go out, ask, volunteer. 00:14:03.577 --> 00:14:04.859 I came in as a broadcaster, 00:14:04.879 --> 00:14:06.159 but I was going out when I didn't 00:14:06.200 --> 00:14:07.821 have to to help set up events because 00:14:07.860 --> 00:14:08.240 I was like, 00:14:09.761 --> 00:14:10.842 I'm going to need to send these people 00:14:10.923 --> 00:14:11.023 out. 00:14:11.043 --> 00:14:11.943 I want to know what I'm sending them 00:14:11.984 --> 00:14:14.426 to when it's raining or snowing or when 00:14:14.466 --> 00:14:15.326 I give them no notice. 00:14:15.385 --> 00:14:16.966 When someone turns to me and says, well, 00:14:16.986 --> 00:14:18.168 it takes four hours to do that. 00:14:18.187 --> 00:14:18.528 I'm like, oh, 00:14:18.567 --> 00:14:19.349 we can do that in an hour and 00:14:19.369 --> 00:14:20.649 a half. 00:14:20.950 --> 00:14:23.292 Or I know I'm sending you to something 00:14:23.412 --> 00:14:23.731 awful. 00:14:23.851 --> 00:14:25.452 I'm going to give you more help. 00:14:25.552 --> 00:14:27.774 But understanding what the actual job 00:14:28.961 --> 00:14:30.682 entails why you're doing it. 00:14:31.384 --> 00:14:32.965 And then at some point that why might 00:14:32.985 --> 00:14:34.946 have changed and now you don't need to 00:14:34.966 --> 00:14:35.986 do that anymore. 00:14:36.027 --> 00:14:36.908 So why are we doing it? 00:14:37.307 --> 00:14:38.668 There seems to be no reason. 00:14:38.908 --> 00:14:40.250 I guess we can discontinue that. 00:14:40.629 --> 00:14:42.351 So understanding the why is everything 00:14:42.392 --> 00:14:43.331 I've heard so far. 00:14:43.432 --> 00:14:44.793 Yes, a hundred percent. 00:14:44.873 --> 00:14:45.014 Yeah. 00:14:45.793 --> 00:14:47.754 I do want to thank Empower EMR. 00:14:48.096 --> 00:14:49.356 If your clinic is stuck in an EMR, 00:14:49.376 --> 00:14:49.937 it slows you down. 00:14:49.956 --> 00:14:51.118 Empower gives you speed, 00:14:51.158 --> 00:14:51.878 cleaner workflows, 00:14:52.298 --> 00:14:54.200 and documentation tools built specifically 00:14:54.240 --> 00:14:54.860 for rehab. 00:14:55.120 --> 00:14:56.581 Better notes, faster documentation, 00:14:56.621 --> 00:14:57.722 smoother clinic operations. 00:14:57.783 --> 00:15:00.264 Learn more at empoweremr.com. 00:15:00.283 --> 00:15:01.725 That is empoweremr.com. 00:15:01.745 --> 00:15:03.086 I mean, even EMRs, 00:15:03.105 --> 00:15:05.008 they have access to so many things. 00:15:05.028 --> 00:15:06.107 So you can measure. 00:15:07.078 --> 00:15:09.020 But if you're not asking upstream what 00:15:09.061 --> 00:15:10.361 you're looking for or what you want to 00:15:10.402 --> 00:15:10.662 measure, 00:15:10.682 --> 00:15:11.822 you're not going to get that good data 00:15:12.182 --> 00:15:12.763 downstream. 00:15:13.063 --> 00:15:15.205 So let's move forward in this timeline. 00:15:15.446 --> 00:15:16.947 Once metrics exist, 00:15:17.846 --> 00:15:19.328 the real challenge now is getting 00:15:19.349 --> 00:15:22.091 clinicians to care about them. 00:15:22.931 --> 00:15:24.633 This just feels like it's a feedback loop. 00:15:24.873 --> 00:15:28.014 How do you suggest we create buy-in or 00:15:28.034 --> 00:15:29.416 what have you seen work, 00:15:29.537 --> 00:15:31.837 not only in theory, but in practice, 00:15:31.898 --> 00:15:32.519 in reality? 00:15:33.828 --> 00:15:34.528 make it visible, 00:15:34.948 --> 00:15:39.610 make the frontline clinician be able to 00:15:39.730 --> 00:15:42.070 see what those metrics are. 00:15:42.529 --> 00:15:42.791 Again, 00:15:43.971 --> 00:15:45.091 they know the metric and they know the 00:15:45.130 --> 00:15:45.711 why behind it. 00:15:48.432 --> 00:15:49.152 Once you get past that, 00:15:49.192 --> 00:15:51.251 it's kind of an easy slope to kind 00:15:51.292 --> 00:15:52.131 of glide down. 00:15:52.532 --> 00:15:53.711 But if they don't see it, 00:15:54.832 --> 00:15:57.052 then they're not going to have it 00:15:57.552 --> 00:15:59.452 constantly in their workflow, 00:15:59.513 --> 00:16:02.193 in their reminder, in their daily life. 00:16:03.802 --> 00:16:07.004 But making it visible is one thing. 00:16:07.985 --> 00:16:09.927 How are they interpreting it and are they 00:16:09.966 --> 00:16:11.528 interpreting the metric correctly? 00:16:11.668 --> 00:16:13.450 So make it visible, 00:16:13.909 --> 00:16:17.591 make it a part of conversation so that 00:16:17.792 --> 00:16:20.854 they understand what the metric is telling 00:16:20.874 --> 00:16:23.796 them and again, what that story is. 00:16:25.677 --> 00:16:29.100 I think who who talks about the metrics 00:16:29.820 --> 00:16:31.522 and what they say about them are 00:16:32.541 --> 00:16:34.322 as important as the metrics themselves. 00:16:34.361 --> 00:16:35.142 So in other words, 00:16:35.861 --> 00:16:38.163 clinic owner talks about a metric that 00:16:38.182 --> 00:16:40.004 they're, you know, let's just say it's, 00:16:40.163 --> 00:16:41.825 you know, revenue per day. 00:16:43.304 --> 00:16:45.306 A clinic owner talking about that and just 00:16:45.346 --> 00:16:46.946 saying, okay, our revenue per day is this, 00:16:46.985 --> 00:16:48.886 and here's the number and walks away. 00:16:49.567 --> 00:16:51.727 Frontline clinician does not care about 00:16:51.788 --> 00:16:51.947 that. 00:16:52.248 --> 00:16:53.349 It's tone deaf. 00:16:54.229 --> 00:16:55.490 But if you talk about it in the 00:16:55.529 --> 00:16:57.409 way of here's our revenue per day, 00:16:57.470 --> 00:16:59.870 and here's how we got to that number. 00:17:00.591 --> 00:17:03.113 And it was X number of units. 00:17:04.532 --> 00:17:06.233 And this is the CPT code that you 00:17:06.413 --> 00:17:06.773 used. 00:17:07.174 --> 00:17:08.894 And let's talk about your documentation. 00:17:08.914 --> 00:17:10.776 And does your documentation reflect what 00:17:10.816 --> 00:17:11.336 you did? 00:17:12.997 --> 00:17:15.337 Is that the right CPT code for what 00:17:15.377 --> 00:17:15.678 you did? 00:17:15.698 --> 00:17:17.419 And if it is, great, perfect. 00:17:17.459 --> 00:17:18.138 If it's not, 00:17:18.219 --> 00:17:19.599 maybe we need to change that. 00:17:20.880 --> 00:17:22.300 That's a clinical discussion. 00:17:22.967 --> 00:17:25.749 That turns that whole clinician's mind 00:17:25.788 --> 00:17:27.170 frame, 00:17:27.509 --> 00:17:30.352 mindset from here's a number and walk 00:17:30.392 --> 00:17:30.852 away. 00:17:31.612 --> 00:17:32.893 Here's what you did. 00:17:33.574 --> 00:17:34.773 I'd love to know more about it. 00:17:35.255 --> 00:17:37.996 Let's have a conversation about that. 00:17:38.036 --> 00:17:39.636 But the more they see that in front 00:17:39.676 --> 00:17:41.939 of their face and hear that information, 00:17:42.713 --> 00:17:44.535 at least that's a conversation they're 00:17:44.555 --> 00:17:46.416 willing to have them i think yeah 00:17:47.356 --> 00:17:50.358 clinicians are not stupid i mean they can 00:17:50.378 --> 00:17:52.901 understand this the thing is if but but 00:17:52.980 --> 00:17:54.342 you can't understand something that hasn't 00:17:54.362 --> 00:17:55.583 been put in front of you or you're 00:17:55.603 --> 00:17:57.544 not discussed or it's it's it's been 00:17:57.584 --> 00:18:00.906 hidden from you this is why revenue per 00:18:00.946 --> 00:18:02.667 day in your clinic matters and you're like 00:18:02.708 --> 00:18:04.068 why so you can buy another boat it's 00:18:04.088 --> 00:18:05.329 like no because if we if this stays 00:18:05.390 --> 00:18:06.711 low for too long we close 00:18:07.861 --> 00:18:09.502 And then we provide no care to anyone. 00:18:10.163 --> 00:18:11.884 Or if we can figure out a way 00:18:11.924 --> 00:18:15.748 to clinically improve care or find more 00:18:15.788 --> 00:18:19.291 people to help, we raise that number. 00:18:19.332 --> 00:18:20.932 We can hire another clinician or we can 00:18:20.972 --> 00:18:22.294 expand to another thing or we can give 00:18:22.335 --> 00:18:23.035 you a raise. 00:18:23.455 --> 00:18:24.997 I don't think clinicians want, 00:18:25.678 --> 00:18:26.397 for the most part, 00:18:26.878 --> 00:18:27.819 to produce more 00:18:29.076 --> 00:18:30.076 just to get a raise, 00:18:30.116 --> 00:18:31.096 and I don't think you should. 00:18:31.817 --> 00:18:34.960 But if you understand that doing a few 00:18:34.980 --> 00:18:37.142 more butterfly, you know, 00:18:37.682 --> 00:18:40.364 the butterfly flaps its wings, right? 00:18:40.483 --> 00:18:42.565 The butterfly effect, what that does, 00:18:43.086 --> 00:18:44.727 the tail shouldn't wag the dog, 00:18:44.826 --> 00:18:46.347 but the dog should wag the tail. 00:18:46.407 --> 00:18:48.308 Like, that's why we got into this. 00:18:48.609 --> 00:18:49.109 It's really funny, 00:18:49.150 --> 00:18:49.970 especially in healthcare. 00:18:49.990 --> 00:18:51.211 I say we have the Peace Corps gene. 00:18:52.491 --> 00:18:54.012 Many people, and rightfully so, 00:18:54.032 --> 00:18:54.874 would like to be paid more. 00:18:56.035 --> 00:18:57.055 But they would also like to give a 00:18:57.095 --> 00:18:59.596 lot of things away for free or included. 00:19:00.655 --> 00:19:02.215 And those two things don't math. 00:19:03.537 --> 00:19:04.096 Those two things, 00:19:05.396 --> 00:19:06.477 they don't work together. 00:19:09.397 --> 00:19:10.998 I'd love to see how that works. 00:19:11.038 --> 00:19:14.679 But you've said dashboards and scorecards 00:19:15.138 --> 00:19:15.499 matter. 00:19:15.679 --> 00:19:17.219 I sort of like that second one too. 00:19:17.839 --> 00:19:19.880 Only if people actually see them, right? 00:19:19.960 --> 00:19:21.619 An invisible scorecard that I'm getting 00:19:21.660 --> 00:19:22.320 graded on. 00:19:22.421 --> 00:19:23.701 Even in higher education, 00:19:23.721 --> 00:19:24.381 there's a rubric. 00:19:25.260 --> 00:19:27.221 I know how much percent of my grade 00:19:27.261 --> 00:19:27.803 or anything. 00:19:27.863 --> 00:19:29.123 A lot of times I think you're right 00:19:29.163 --> 00:19:30.003 where it's not visible. 00:19:30.304 --> 00:19:33.685 So what is good visibility look like in 00:19:33.705 --> 00:19:34.026 the clinic? 00:19:34.046 --> 00:19:35.586 Because I imagine too much might be 00:19:35.646 --> 00:19:36.287 paralyzing. 00:19:36.807 --> 00:19:37.527 Absolutely. 00:19:37.708 --> 00:19:38.048 Yeah. 00:19:38.147 --> 00:19:42.130 I think it's this balance, right? 00:19:42.150 --> 00:19:45.211 Where you don't want so many numbers 00:19:45.230 --> 00:19:49.012 coming at people and so many different 00:19:49.053 --> 00:19:51.413 scorecards and different dashboards and, 00:19:51.595 --> 00:19:51.855 you know, 00:19:53.003 --> 00:19:54.527 different numbers that mean different 00:19:54.547 --> 00:19:56.391 things in different ways because then it 00:19:56.431 --> 00:19:57.372 becomes white noise. 00:19:58.934 --> 00:20:03.063 But invisible metrics 00:20:04.053 --> 00:20:05.374 die quick, 00:20:05.534 --> 00:20:07.775 make the actual metric die even quicker. 00:20:07.835 --> 00:20:09.395 So it's a balance. 00:20:09.496 --> 00:20:13.817 I think that scorecards are important from 00:20:13.978 --> 00:20:16.659 how the clinician is doing themselves. 00:20:16.719 --> 00:20:17.839 Everybody wants to do well. 00:20:18.079 --> 00:20:20.961 Nobody gets into this field to say, 00:20:21.121 --> 00:20:22.461 I want to be a really can I 00:20:22.481 --> 00:20:22.981 swear on here? 00:20:23.521 --> 00:20:23.781 Sure. 00:20:24.221 --> 00:20:25.542 I want to be a really shitty clinician. 00:20:25.702 --> 00:20:26.663 No one says that. 00:20:30.692 --> 00:20:32.594 People want to take pride in the work 00:20:32.614 --> 00:20:33.354 that they do. 00:20:33.534 --> 00:20:35.055 So a scorecard is a great way to 00:20:35.134 --> 00:20:35.654 do that. 00:20:36.155 --> 00:20:37.936 And this goes back to outcomes. 00:20:38.416 --> 00:20:39.978 Nobody wants to go in and being like, 00:20:40.057 --> 00:20:41.598 I'm gonna give mediocre therapy today. 00:20:41.618 --> 00:20:44.540 And maybe this knee injury is gonna get 00:20:44.560 --> 00:20:45.461 better by itself. 00:20:45.520 --> 00:20:47.041 Maybe I'm gonna help it a little bit. 00:20:47.363 --> 00:20:47.542 No, 00:20:47.603 --> 00:20:49.763 people want their patients to walk out the 00:20:49.804 --> 00:20:51.345 door and go, oh my gosh, 00:20:51.984 --> 00:20:53.946 Katie did a fantastic job. 00:20:54.106 --> 00:20:55.487 I'm gonna refer her to all of my 00:20:55.567 --> 00:20:56.107 friends. 00:20:57.352 --> 00:20:58.773 that makes us feel good. 00:20:59.013 --> 00:21:01.757 And so that kind of a scorecard and 00:21:01.777 --> 00:21:04.220 visibility from our outcomes perspective 00:21:04.359 --> 00:21:07.544 and our cash business perspective, 00:21:08.065 --> 00:21:10.567 that all paints the picture of how good 00:21:10.607 --> 00:21:12.730 of a clinician you are at the end 00:21:12.750 --> 00:21:13.050 of the day. 00:21:13.642 --> 00:21:14.481 With a good scorecard, 00:21:14.501 --> 00:21:17.663 imagine we both understand what the number 00:21:17.743 --> 00:21:19.324 means and how it changes. 00:21:20.104 --> 00:21:21.204 If you're giving me a C and I'm 00:21:21.244 --> 00:21:21.365 like, 00:21:21.384 --> 00:21:22.505 but I don't know how I make the 00:21:22.545 --> 00:21:24.145 C a B, that's not fair. 00:21:24.786 --> 00:21:26.926 And then understanding how it lines up 00:21:27.366 --> 00:21:28.267 with the big picture. 00:21:28.307 --> 00:21:29.928 How does this move the entire boat 00:21:30.488 --> 00:21:30.928 forward? 00:21:31.327 --> 00:21:32.868 So this is just an alignment of good 00:21:32.929 --> 00:21:33.568 expectations. 00:21:33.909 --> 00:21:35.349 I mean, most things that... 00:21:36.174 --> 00:21:36.394 you know, 00:21:36.434 --> 00:21:39.656 devolve into stress or disagreement. 00:21:40.357 --> 00:21:43.960 If you rewind, it's because of missed. 00:21:43.980 --> 00:21:44.720 I said that, 00:21:45.181 --> 00:21:46.181 but that's not what I meant. 00:21:46.300 --> 00:21:47.241 Or I you said that, 00:21:47.261 --> 00:21:49.143 but I heard this or I don't understand. 00:21:49.983 --> 00:21:52.384 Sometimes it is as simple as a simple 00:21:52.424 --> 00:21:54.685 but not easy as understanding what those 00:21:54.727 --> 00:21:56.387 expectations really are and making sure 00:21:56.407 --> 00:21:56.948 they're aligned. 00:21:57.438 --> 00:21:58.438 Yeah, absolutely. 00:21:58.718 --> 00:21:59.618 And words matter. 00:22:00.199 --> 00:22:02.740 The way you say things and explain things 00:22:03.000 --> 00:22:03.779 do matter. 00:22:03.819 --> 00:22:05.060 And I'm a big believer in that. 00:22:05.101 --> 00:22:06.361 I think because I'm an SLP, 00:22:06.881 --> 00:22:09.481 I definitely always go with the, you know, 00:22:09.501 --> 00:22:11.083 choose your words carefully on how you 00:22:11.143 --> 00:22:11.823 explain things. 00:22:11.843 --> 00:22:12.604 Correct. 00:22:12.663 --> 00:22:12.903 Yeah. 00:22:13.564 --> 00:22:14.263 I said that, 00:22:14.304 --> 00:22:15.404 but this is what I heard or I 00:22:15.464 --> 00:22:16.045 thought that. 00:22:16.734 --> 00:22:17.095 Right. 00:22:17.214 --> 00:22:18.016 Is what this meant. 00:22:18.375 --> 00:22:19.557 Right. 00:22:19.997 --> 00:22:20.196 Katie, 00:22:20.217 --> 00:22:21.998 your hot take is that it's okay to 00:22:22.038 --> 00:22:24.878 give up a little clinical autonomy. 00:22:24.939 --> 00:22:25.819 What do you mean by that? 00:22:25.859 --> 00:22:26.559 I like that. 00:22:27.340 --> 00:22:28.461 Sounds scandalous. 00:22:28.480 --> 00:22:28.861 Gosh, 00:22:29.721 --> 00:22:31.942 you people hate to hear this usually. 00:22:33.263 --> 00:22:35.805 If I had a dime for every time 00:22:35.884 --> 00:22:36.244 I heard, 00:22:36.325 --> 00:22:38.205 you can't tell me I can only do 00:22:38.247 --> 00:22:39.047 this assessment. 00:22:39.987 --> 00:22:41.488 My clinical judgment is this. 00:22:41.969 --> 00:22:43.449 I'd be a very rich person. 00:22:43.648 --> 00:22:44.170 Yeah. 00:22:45.494 --> 00:22:47.695 And I don't mean this that, you know, 00:22:47.796 --> 00:22:48.096 yes, 00:22:48.415 --> 00:22:51.836 we're taking away all clinical autonomy. 00:22:51.936 --> 00:22:53.417 No one should think for themselves. 00:22:53.438 --> 00:22:54.417 That's not what I mean. 00:22:55.557 --> 00:22:59.339 But standardization is what makes things 00:22:59.460 --> 00:23:01.240 flow easily. 00:23:01.519 --> 00:23:04.901 It's what helps produce these numbers that 00:23:04.941 --> 00:23:06.241 we can actually measure. 00:23:07.221 --> 00:23:09.843 and produces scorecards that we can talk 00:23:09.883 --> 00:23:10.202 about. 00:23:10.323 --> 00:23:14.564 So it is okay to have some standardization 00:23:14.683 --> 00:23:15.263 in place, 00:23:15.625 --> 00:23:18.766 whether that is everybody has to use this 00:23:18.905 --> 00:23:21.506 assessment so that we level the playing 00:23:21.546 --> 00:23:23.146 field on measurement. 00:23:24.122 --> 00:23:26.823 You can use other assessments and that's 00:23:26.843 --> 00:23:28.624 where your clinical autonomy comes in. 00:23:29.443 --> 00:23:31.065 But if you want to set a standard 00:23:31.085 --> 00:23:32.645 for your clinic to say, OK, 00:23:32.685 --> 00:23:35.186 but everybody has to at least at a 00:23:35.346 --> 00:23:39.249 minimum use X, Y, Z, that's OK. 00:23:39.328 --> 00:23:41.210 It's not taking away anybody's clinical 00:23:41.250 --> 00:23:41.569 judgment. 00:23:41.589 --> 00:23:43.490 It's not saying you're going to be a 00:23:43.530 --> 00:23:44.951 cookie cutter PT. 00:23:45.471 --> 00:23:49.032 It's saying I'm going to make sure that 00:23:49.432 --> 00:23:50.513 at the very minimum, 00:23:51.034 --> 00:23:52.855 this is the standardization of workflow. 00:23:54.045 --> 00:23:55.925 And it produces a better product. 00:23:55.986 --> 00:23:56.346 Understood. 00:23:56.625 --> 00:23:56.846 Yeah. 00:23:57.105 --> 00:23:57.346 All right. 00:23:57.746 --> 00:23:58.226 I can see that. 00:23:59.247 --> 00:24:00.606 Last thing I'll ask before we do a 00:24:00.646 --> 00:24:02.867 parting shot is where do leaders usually 00:24:02.928 --> 00:24:06.068 lose their team in this sort of 00:24:06.108 --> 00:24:06.808 discussion? 00:24:07.309 --> 00:24:07.670 Right. 00:24:07.710 --> 00:24:10.151 So we just I feel like we just 00:24:10.191 --> 00:24:10.730 talked about. 00:24:11.730 --> 00:24:12.490 metrics, 00:24:12.791 --> 00:24:14.753 but brought it back to words and 00:24:14.854 --> 00:24:15.796 understanding. 00:24:16.296 --> 00:24:19.299 So where in this process do leaders 00:24:19.421 --> 00:24:23.385 usually lose their team in this? 00:24:23.425 --> 00:24:24.086 Two places. 00:24:24.948 --> 00:24:27.652 When they don't talk about the why and 00:24:27.711 --> 00:24:28.133 when they 00:24:29.412 --> 00:24:31.896 only have that business hat on and forget 00:24:31.936 --> 00:24:33.820 that that frontline clinician doesn't give 00:24:33.861 --> 00:24:35.584 a rat's ass about the business and i 00:24:35.624 --> 00:24:37.227 don't mean that that they you know we've 00:24:37.267 --> 00:24:38.769 talked about they need to give them you 00:24:38.789 --> 00:24:40.553 know they need to care about the business 00:24:40.573 --> 00:24:41.555 they need to understand it 00:24:42.486 --> 00:24:43.626 But at the end of the day, 00:24:44.448 --> 00:24:47.450 they want to know what is in it 00:24:47.470 --> 00:24:51.212 for them as a clinician and why we 00:24:51.313 --> 00:24:53.035 are doing what we're doing. 00:24:53.115 --> 00:24:54.375 So like, for example, 00:24:54.955 --> 00:24:57.499 good documentation protects revenue. 00:24:58.138 --> 00:25:00.221 That's just a fact. 00:25:01.701 --> 00:25:03.923 But talking to the clinician about how 00:25:03.962 --> 00:25:05.944 good documentation protects their license 00:25:06.025 --> 00:25:09.188 and keeps them out of jail is actually 00:25:09.229 --> 00:25:09.868 going to help. 00:25:10.189 --> 00:25:11.471 It's going to do the but what about 00:25:11.550 --> 00:25:12.991 me factor. 00:25:14.394 --> 00:25:15.835 And remembering that clinicians aren't 00:25:15.875 --> 00:25:16.915 taught about business. 00:25:17.215 --> 00:25:18.557 So, you know, 00:25:18.798 --> 00:25:20.380 we need to talk about it frequently 00:25:20.740 --> 00:25:21.980 because they aren't, 00:25:22.201 --> 00:25:23.663 it's not in their daily routine. 00:25:24.383 --> 00:25:25.084 thought process. 00:25:25.505 --> 00:25:28.130 But if we talk to them again as 00:25:28.150 --> 00:25:30.654 a clinician and how it relates to clinical 00:25:30.835 --> 00:25:31.435 care, 00:25:32.136 --> 00:25:35.022 it's going to take that clinician and that 00:25:35.083 --> 00:25:36.045 business a long way. 00:25:36.604 --> 00:25:40.244 Yeah, words matter from an SLP. 00:25:40.444 --> 00:25:42.144 Parting Shot is brought to you by our 00:25:42.164 --> 00:25:43.365 friends at US Physical Therapy. 00:25:43.405 --> 00:25:46.967 Today's show is brought to you by USPH, 00:25:47.406 --> 00:25:49.106 partners with clinic owners who want to 00:25:49.126 --> 00:25:50.508 grow without losing their identity. 00:25:50.548 --> 00:25:51.988 You stay local and in control while 00:25:52.008 --> 00:25:53.448 getting the support and resources of a 00:25:53.508 --> 00:25:54.189 national network. 00:25:54.249 --> 00:25:57.950 Learn more at usphpartnership.com or find 00:25:57.990 --> 00:25:59.470 out at usph.com. 00:26:00.490 --> 00:26:02.250 I'm going to pitch you a question for 00:26:02.270 --> 00:26:04.332 the parting shot instead of letting you or 00:26:04.372 --> 00:26:06.532 making you sort of go from scratch. 00:26:06.933 --> 00:26:08.054 Here's your parting shot question. 00:26:09.194 --> 00:26:12.256 If rehabilitation is going to survive, 00:26:12.797 --> 00:26:15.657 right, as a whole, PTOT speech, 00:26:15.678 --> 00:26:16.458 whatever you want to call it, 00:26:16.498 --> 00:26:17.419 rehab is going to survive, 00:26:17.719 --> 00:26:19.920 the shift that we're already in to 00:26:19.960 --> 00:26:20.721 value-based care, 00:26:21.280 --> 00:26:24.061 what's one mindset the clinicians need to 00:26:24.102 --> 00:26:25.442 change right now? 00:26:29.481 --> 00:26:34.604 Gosh, your parting shots always kill me. 00:26:36.384 --> 00:26:43.186 I would say that without good clinical 00:26:43.207 --> 00:26:47.449 care and without showing evidence of what 00:26:47.509 --> 00:26:48.568 that looks like, 00:26:50.369 --> 00:26:51.750 there's no point in actually even 00:26:51.790 --> 00:26:52.290 providing it. 00:26:54.030 --> 00:26:55.711 So making sure that you, you know, 00:26:55.731 --> 00:26:57.352 showing the evidence behind showing the 00:26:57.392 --> 00:26:57.612 work. 00:26:57.872 --> 00:27:00.232 Like I, I have a, a. 00:27:00.252 --> 00:27:03.654 Fifteen year old son who is complaining to 00:27:03.694 --> 00:27:05.615 me every day that he has to show 00:27:05.654 --> 00:27:07.855 his work and in his, you know, 00:27:07.895 --> 00:27:09.557 homework that he's doing for math and for 00:27:10.237 --> 00:27:10.777 LA and all that. 00:27:11.778 --> 00:27:11.978 Mom, 00:27:12.018 --> 00:27:12.958 why do I have to show my work? 00:27:13.837 --> 00:27:14.739 Because at the end of the day, 00:27:14.778 --> 00:27:15.798 that's what you're getting graded on. 00:27:15.838 --> 00:27:16.558 It's not the output. 00:27:16.598 --> 00:27:17.880 It's actually the work that you've put in. 00:27:18.279 --> 00:27:19.480 And so outcomes are the same way. 00:27:19.500 --> 00:27:20.580 It's a great analogy. 00:27:21.020 --> 00:27:21.661 Uh, Katie Holderman, 00:27:21.701 --> 00:27:22.781 thanks for coming on here and talking 00:27:22.801 --> 00:27:23.122 about this. 00:27:23.182 --> 00:27:23.741 Much appreciated. 00:27:27.260 --> 00:27:27.641 Absolutely. 00:27:27.661 --> 00:27:28.280 Thanks for having me. 00:27:28.300 --> 00:27:28.942 That's it for this one. 00:27:28.961 --> 00:27:30.442 We're just getting warmed up. 00:27:30.903 --> 00:27:31.784 Smash follow, 00:27:31.844 --> 00:27:33.665 send it to a friend or crank up 00:27:33.705 --> 00:27:34.707 the next episode. 00:27:35.207 --> 00:27:36.228 Want to go deeper? 00:27:36.387 --> 00:27:40.612 Hit us at pgpiecast.com or find us on 00:27:40.672 --> 00:27:43.233 YouTube and socials at pgpiecast. 00:27:43.634 --> 00:27:45.915 And legally, none of this was advice. 00:27:45.976 --> 00:27:47.698 It's for entertainment purposes only. 00:27:49.398 --> 00:27:51.260 See, Keith, we read the script. 00:27:51.560 --> 00:27:52.201 Happy now.