Broadcasting way too early from three
separate wifi connections.
It's PT breakfast club with Tony Meritato,
Dave Kittle and Jimmy McKay.
In the first rule food in the studio,
like running a little late this morning.
Uh, he's Tony Meritato.
I'm Jimmy McKay.
Dave Kittle will be showing up pretty
soon.
Uh,
beer league hockey game went late.
It's like,
but I'm wired when I get home.
Yeah.
Then I go to bed at like midnight
or one AM and I'm like, you know,
and then I wake up late and I'll
meet my breakfast at eight thirty on a
live stream.
So.
So is it wrapped in a burrito, eggs,
sausage?
Yeah.
I was telling Tony, yeah.
I am nothing if not predictable with a
lot of things, right?
Breakfast,
I don't like to think in the morning.
Steve Jobs talked about this and I
actually had a conversation about decision
fatigue.
Yeah.
And I thought it was like,
woo woo or like what decision fatigue.
Oh yeah.
But like Steve would always say that he
ate this or, you know,
did the same things that weren't important
so that when the important things
happened,
He had the bandwidth, you know,
like an executive,
your job is to make decisions.
So if you can reduce the number of
decisions, like I don't care about food.
Right.
Some people are foodies.
I eat because every seven,
eight hours I get real hungry and feel
like I'm going to die.
And then I eat stuff.
Like there's some things I like,
but I'm not one of those people who's
like, oh my gosh,
I have to try this and do whatever.
I sort of don't care.
So yeah.
So that's why I eat the exact same
thing every day for breakfast,
decision fatigue.
Dave, do you ever get decision fatigue,
especially now as a relatively new dad?
Good morning.
First comment, I was going to ask,
why is Jimmy in the Batcave right now?
It looks a little dark there.
Yeah, the lights are halfway on.
It's all good.
Decision fatigue.
Yeah.
I mean,
I feel like sometimes I will I think
I'm I think I'm no different than a
lot of prospective patients out there
where I'll delay making a decision because
I don't want to make the wrong decision.
One example is having more front desk
help,
like virtual assistants or someone
U.S.-based or abroad that's answering the
phone calls,
that's doing a lot of the callbacks.
I have a whole bunch of self-limiting
beliefs around it because I feel like I'm
the best one to do it.
And I feel like I have the best
ability to demonstrate, like,
authority and status over some of the big
personalities that call in.
Or it's, like,
the personalities of the patient's
assistant or, you know,
executive assistant or whatever.
So, like...
Just around that is one example.
And I have numerous examples.
And in general,
I would not have been able to get
to this point where I'm at right now
with full-time team members and all that
if I didn't take the reins and just...
make decisions and like kind of figure it
out later, reassess,
maybe I made the wrong decision,
no problem, go back and change it.
But when it mounts up to so many
decisions as a business owner,
there can be decision fatigue.
I mean,
I went through this with electronic
medical records.
I went through it with payroll software.
Eventually, like for me,
what helps is like, it's easier to say,
it's harder to do,
but it's so easy to say,
and what I would suggest anyone do,
You have to just pick a lane,
pick a path,
make a decision knowing that it might not
be the best therapist or the best software
or the best approach.
You realize like, oh, wow, this is wrong.
We talked about house cleaners here on the
show months ago.
And Tony said that they don't like,
you know,
they used to do it and then they
don't like it and why we were doing
it and all that.
And I didn't even tell you guys,
but since then we've gone through like
three or four different cleaners slash
cleaning companies.
Because the first person comes,
the business owner, with an assistant,
and that first time is amazing.
I'm like, oh, this is their model.
Their model is,
then they leave this assistant that's
barely trained for all the follow-up
visits.
Sounds similar to some of the physical
therapy out there.
Yeah.
uh and so then it's like okay well
they missed this they missed this they
missed this like let's give them another
shot they get another shot they missed
this they missed a bunch of stuff um
then we switch right so business for at
least for me is just like in a
never-ending onslaught of decisions so if
you're not okay with that if you're if
you are petrified of making any decision
you're probably not an entrepreneur you
hit two topics that i'd like to develop
One, I don't want to forget them.
One is talking about outsourcing,
like intake and outsourcing and that kind
of stuff.
I had a conversation with Joey Albritton
and I was telling him, I was like,
dude,
the clinic's blowing every number out of
the water.
We're doing better in a single location
than we have in ten years.
I'm like, you know why?
I said,
because I have my wife who's a licensed
physical therapist,
a far better physical therapist than me
doing front desk.
And I can absolutely tell you,
she is a thousand times more valuable to
the company doing front desk.
And when I say doing front desk,
that includes admissions,
answering the phone, making callbacks.
It also includes all of the billing,
pre-authorization,
calling insurance companies, follow-ups.
I need her brain operating that department
of the business.
I cannot outsource that to a company
overseas.
I can't outsource that to even a twenty
five dollar an hour person with a
bachelor's degree.
You need the clinical brain who can
identify a problem,
develop a solution for the problem,
systemize that solution,
prevent that problem from ever happening
again.
Right.
That is what we need at that position.
And because we got that in her clinical
mind,
A monkey can treat a patient.
I need her to do the creative aspect
of figuring out how to get paid.
So he was like,
in no world does it make sense to
pay a licensed therapist to be a
receptionist.
I said, well, heck,
it does in my world because for ten
years we've never made this much money and
had this much consistency and been this
busy without that person in that role.
Would she need to be a PT or
does she just have that mind?
No.
You just need that mind.
You just need curiosity, creativity,
analytics.
You need to be able to identify.
But PTs tend to have that kind of
brain.
That's what we do.
We do it in the clinic.
It's just if I let her do it
out there, we're not going to get paid.
If I have her do it in here,
we're going to get paid.
And so the second part that Dave brought
up,
the mistake that cleaning company made,
and it's the mistake that therapists make
all the time,
that cleaning company put their best foot
forward, got in the door,
blew you out of the water with how
amazing the experience was,
then filled it with somebody who can't
fulfill on the expectation they
established.
if i establish a lower expectation in the
clinic on day number one that is what
the patient has benchmarked as this is
what i'm gonna get and as long as
i continue to fulfill on that you know
seventy percent uh expectate awesome but
like and this is why
As the owner, as the founder, you know,
like if Dave goes out there and does
the first visit and just blows the patient
out of the water,
then brings in somebody who might be good,
just not as good as Dave.
It's never going to feel as good as
the first day when the patient had Dave.
We have to let those other clinicians who
are not owners,
who are not at the level that you're
at, go with it from day number one.
You don't forget it.
That was it.
That was the second.
The second was the fact that that cleaning
company made a mistake by doing so great
on the first day,
establishing the bar so high.
Right.
Outsourcing.
Right.
So Dave, we'll go to you.
You brought something up I didn't even
think about and never thought about.
A lot of times you might not even
be talking to the potential patient or
client on the first day.
You're talking about assistants or staff
members booking for those people.
So how do you go about...
doing this or is this is this bad
like do you set the bar with dave
and then when someone else shows up it
might not be good better or worse it's
just different well first of all i don't
like it i don't like it because i
want to i want to i want to
speak to the decision maker right right
now we're historically me my wife has done
callbacks before i've had other folks try
and help us do callbacks before
We're always going to be professional and
respectful with the third party.
Believe it or not, like,
there's families in New York City where,
whether it's remotely or in person,
they have an assistant, like,
for their life.
Like, for their, like,
doctor's appointments and, like,
booking travel and all that.
Like...
Some are remote.
Some are literally in person during the
physical therapy visits at the home,
which is just I mean, it's wild.
Like they're getting paid a full like
seventy, eighty,
whatever thousand dollar salary to be a
full time assistant.
It's like kind of it's kind of crazy.
But I would love to get to that.
I can't wait to get to that point.
So I don't I want to speak to
the decision maker.
I want to speak to the person that's
in pain because then I can ask the
consequence questions like, hey, so Tony,
you have this knee pain.
What if you do nothing?
What if nothing changes in six months?
Where might you be?
I want to ask the pain point challenge
and the consequence questions.
If I'm speaking to the assistant or the...
uh the executive assistant or something
like that it's unfortunately like they're
just going to pass along like the numbers
and the figures and how much we can
we cost it's it's not the full it's
not the full it's not the full like
it's not the full sales process because
I mean,
we can still ask all those things,
the same thing that we would do,
like what makes it better,
what makes it worse, like why now,
all that type of stuff.
But unfortunately,
like these assistants sometimes have very
overbearing,
strong personality type boss that they're
working for.
And they've been kind of trained and
trained
they've been geared to kind of just do
these like transactional phone calls.
And it's kind of hard sometimes to kind
of like break through the glass and kind
of like, like break through their,
their shell.
Cause they have a shell,
like an outer shell that's like tough
because they've developed that because
that's their job.
And they work with someone who is a
multimillionaire or,
or a billionaire or whatever.
So, um, but yeah, sometimes that, in fact,
um, we have a client right now.
That's why,
that's why I brought it up is we
have a client right now where the, the,
The family's assistant is remote living in
Colorado,
but she literally signed the paperwork,
sent sent the credit card information,
did all the phone calls,
did all the text messages and emails and
all the organizing of everything.
And I and we we haven't spoken to
the mother or father for the under
eighteen year old client.
So it's it's kind of like it's a
little wild, but it is what it is.
Yeah, I know some people I know.
I know several people who have that job.
They are the executive assistant.
And you hear the word assistant and you
automatically assume, well,
how much they bring to the table.
These people are running the show.
They can be running the show.
Right.
Like what they're able to do,
what you're actually able to do,
like sort of alluding to like I've never
met her.
Like, I'm pretty sure she exists.
But Tony says, you know, his wife.
Right.
what they're able to do is they're not
they're able to follow one two three four
five step directions but they're also able
to think when three goes sideways we throw
four and five out what is the actual
thing we're solving for okay that's gone
you know like the computer systems are
down what do we do they're able to
think four steps ahead that is a skill
that is a valuable skill because they
understand
Like the trains don't run when something
goes sideways and how do we keep things
together?
They are booking crazy expensive private
flight tickets and vacations and obviously
doctor's appointments because they're
calling us or physical therapy.
I think an average person would be like,
okay, are you the right provider?
Where is your office?
What date is the appointment?
Those are basics.
Good ones that I know and I've seen
them worked with are asking,
they're smart enough to know
They've been burned by the hot stove.
They've booked an appointment.
The boss or whoever they work for went
to it and was like, that doctor sucked.
How'd you vet them?
And they were like, vet them?
I thought I was supposed to get the
appointment book.
The smart ones go, got it.
When I'm called to question on why I
made decision A and not F,
I have to have good reasoning and those
things like, are you saving me time?
Clicking book, book, you know,
and selecting a time and date is not
saving the time picking the right provider
or the right, Oh, you,
you got me the right flight for the
cheapest price,
but I have a six hour layover in,
you know, in Iowa.
What are you doing?
Why don't you think about that?
They're paying you to think.
And you just brought up a good point,
which is sometimes historically we would
say to these assistants, uh, like, Hey,
hey hey tom um i know first of
all it sounds i know you have a
tough job we have a lot of clients
that have called in over the years where
they have an assistant or an ea or
uh uh executive assistant or whatever like
different um different like different
titles but like hey tom um first of
all i just want to let you know
that we have we've onboarded a lot of
uh high profile clients over the years
through their assistants and i just want
to let you know that
First of all, this is my direct number.
This is how you can reach us.
This is the easiest way.
And also,
we're going to try to set this up.
And I'm asking these questions to make
sure that it's the right fit for both
of us.
So I want to make sure that your
boss, this client,
is the right fit for us.
Not just are we the right fit for
you and your boss,
but I want to make sure that you're
the right fit for us.
So they're a little bit of status.
But at the same time,
we want to come back and say, hey,
Tom, by the way,
We've had a lot of these scenarios where
an assistant like you has booked for their
client.
And I wanna let you know that we
understand that you're sticking your neck
out here.
Like there is some risk and we don't
wanna,
we do not wanna make you look bad.
It is our focus that we're also gonna
try to get your boss,
the client better with the back pain or
whatever.
But at the same time, Tom,
We will not make you look bad.
I actually will be sending Dr. Andrew.
He's one of my most professional prompt
physical therapists.
He runs marathons.
He helps with back pain.
He can do all the things.
But also,
he knows how to manage your type of
boss, the person that you're describing,
like the strong personality, the ego,
the busy schedule, all of that.
He knows how to manage that.
He's confident and he's clear on the game
plan and also experienced in dealing with
this type of clientele.
And no matter what happens,
we're going to make sure that we over
communicate with you because you're
sticking your neck out here.
You're finding a...
random physical therapy practice on
Google.
I mean,
obviously a word of mouth referral is
best,
but sometimes they're finding us on Google
or something.
And so we will literally say, hey,
just want to let you know that we've
gone through this a million times before.
And we really focus on making sure that
you, whoever's reaching out,
the assistive,
will not look bad here we never want
you to look bad in fact we want
your boss to speak with you privately in
the coming days or weeks and say oh
my gosh i cannot believe that you found
this type of practice and they got a
doctor of physical therapy degree and they
come here for an hour and then the
obviously the self-pay figures like don't
even matter but it's really about wow that
you found a great person a great fit
a great company thank you so much we
want the we want the client to be
saying that to their assistant
That's our goal.
When you start talking to someone like
that, that is a pattern interrupt.
Like when you're on the call with an
EA and you're like, hey, listen,
we've done this before.
Let's make sure this is the right fit
so that your boss gets the right
experience.
What you've just said is I understand what
you're solving for.
I've seen and done this before.
Let's make sure I can solve your problem.
Not even your boss's problem yet.
It's now both of your problem.
And when someone hears that,
their defenses are way down.
It's two problems.
Yes.
It's two different problems.
Yes, correct.
It is.
I need to make sure my boss isn't
pissed off.
I need to make sure that we solve
my boss's problem.
You're going to handle my other problem.
You're going to handle my boss's problem.
My problem is finding the right provider.
then your problem is solving my boss's
shoulder issue but it's amazing how like
You can learn.
Can you learn that in school?
You probably can.
You can learn lots of things in school.
I didn't.
I learned a lot of the stuff that
I learned in my background on internships.
And I think I lucked out.
Or I don't even know what luck is
anymore.
But I worked for some really good people
who, when something happened,
explained to me what just happened.
And I was able to be like, oh,
that's what actually happened.
That's a lesson here.
That's valuable.
I need to remember this going forward.
So here's something I want to bring up.
And this is like,
it starts to get a little weird,
but talk it with Larry Benz.
He brings up these different things called
like paradoxes.
Like,
have you ever heard of like Jevons
paradox?
It's like these,
like these concepts and like economics or
psychology is usually where they are.
Jevons paradox is when something becomes
really cheap.
We don't actually use less of it.
We use more of it because it's cheap.
So like the example is like when coal
got efficient, we didn't ship less stuff.
And we're like, look at all that savings.
We shipped more stuff.
We actually took the savings and we're
like, well, screw the savings.
Look how great this is.
So I started looking around and when
people start beating the drum about
saving, saving, saving,
all of a sudden my brain put two
and two together.
And I'm like, hey,
when we start talking about AI scribes
saving hours and hours of time,
is that going to be the case?
Because I looked behind me and I said,
with all this technology that's come
around in my forty six years of being.
Yeah.
We still work as much, if not more.
So it's just changing what we might do
more, but it's not actually reduced.
The careful ones say it doesn't save like
four hours of time.
It saves four hours of documentation time
a week.
But you're also like the smart clinicians
go,
but you're going to put me to do
so.
I'm going to see more patients now.
And if you're okay with that,
then it's a win.
I just see all this,
like we're not using less AI because AI
may be more efficient.
I'm not just, well,
I'm done now and I'm going to leave.
No, we're just doing more and more.
You guys know the subtle art of not
giving a fuck, Mark Manson.
I read Mark Manson's email.
I read very few emails.
Seth Godin, Mark Manson,
and who's Five Bullet Friday?
Tim Ferriss.
That's about it.
And Mark Manson was talking about this.
He's like...
He's a really itchy brain guy.
He's like, in the last three months,
if I'm not using AI,
I feel like I'm falling behind.
And this is a guy who's probably at
the bleeding edge.
So relating it to practice,
Dave talks about the apps and the things
that he uses.
I still got to get the name of
that app that you use because that you
can watch...
like a replay of like a eval audio
audio audio only audio only okay got it
that's still really valuable like the
transcript you can ask it questions so i
guess the question is is the juice worth
the squeeze i mean it must be right
like with tony tony's affiliated with
hippo scribe so he's got to jump in
here first about uh ai scribes and all
that
Yeah, I agree with Jimmy.
I agree with the paradox,
the idea that the more time it saves,
the more we do other stuff,
we fill that time.
There's never a point in anyone's life
where you're actually doing nothing.
Even if you're recovering,
even if you're resting,
watching Netflix and chilling, whatever,
you're always going to fill that time with
something.
I brought the AI Scribe in, right?
I've been using it for years.
I will never function without an AI Scribe
in physical therapy.
But all that does is it allows me
to do more video content,
more other stuff.
I'm sitting here right now
I've got this box that came yesterday,
a new compression device that the company
upgraded and sent me.
Jimmy,
I still haven't seen your live selling
product stuff.
Where do you at, bro?
It's on Amazon Live.
I got to go find it.
I'm going to go watch it.
So, yeah, we totally just do more.
I mean, and that's human nature.
Like,
that is the way it's supposed to be.
What frustrates me the most is when I
do see somebody...
Who like, I don't know,
they don't create more.
They don't do more.
They have all these amazing tools.
Best time to ever be alive as a
human being in the history of the world.
And if you watch TikTok,
you would think we live in the worst
time to be alive.
I mean,
it's such a bizarre time right now.
I think if you brought in a psychologist,
and I will,
because I got a buddy who's a
psychologist,
and if I give him enough time,
he'll think about stuff like this.
Could the idea,
if people do honestly believe this is
crazy and this is the worst time ever...
Do you think it's the paralysis or the
abundance of all the things I could or
should be doing and that feels so heavy?
Because when you watch someone succeeding
and you're like, I'm so far behind.
I've been doing this.
I should be doing that.
Let me drop this and do that.
And some of those things are just not
possible.
You can't.
Comparison is the thief of joy.
And...
This is a comparison machine, right?
It's great if you want to figure out
something new.
It's horrible if you get stuck comparing
yourself to everybody else,
which is a simple,
that's a human nature thing.
Yeah.
Especially, you know, depending,
I was thinking on the way in this
morning,
You hear the saying,
you're the average of the five people you
spend the most time with.
Who are the people around you?
We should do an episode on what we
listen to, what we watch.
So I'm on this running program.
ChatGPT is my running coach.
I'm trying to bring my diastolic blood
pressure down.
I have not been able to do it
by myself without medication for three
years.
I want my diastolic.
My systolic is doing great.
My diastolic will not come down.
I'm trying all these different things.
So anyway, every run that I do,
I don't listen to music.
I listen to the All In podcast.
I listen to Peter Diamandis.
I listen to these business and technology
guys that get me so pumped,
get me more pumped than music gets me
pumped.
While I'm running that by the end of
my run,
not only do I have the endorphins of
the run,
but I feel so positive about the future
of society,
about how successful we can be,
about how easy it is in today's world
to get what you want.
And I'm just like, I just,
I feel bad for other people who maybe
don't have that resource available or
don't know it exists.
Yeah.
Quick translation is Tony goes on a run
and he gets the runner's high and then
he gets the entrepreneurship high.
I love it.
What do you listen to, Dave?
Not in my life could I listen to
a podcast while running.
Just couldn't do it.
So more so music.
But I have learned that when I go
out for like a four or five,
six mile run, historically,
I will run the first mile too fast.
Like I'm just bad at pacing myself.
So I will specifically put on an audio
book or a podcast in the beginning to
slow myself down.
to like take it easy.
And then if I need like a boost,
maybe I'll put on some, you know, fast,
uh, like, like rap,
hip hop or anything that's like house
music or even rock or whatever.
Um, but I have listened to like,
I remember specifically like Robert
Cialdini's persuasion.
Like I've listened to that running and I
mean, I don't know, Tony, like,
does it take away from the run?
Who cares?
Like you're out running.
Like at least for me, I don't know,
like maybe I'm running slower or whatever,
but, um,
I've listened to a ton of business and
marketing audio books and podcasts while
running.
Um, for me, I don't know.
You can't go wrong,
but typically I'll only listen to music if
I'm running or working out.
Otherwise any other time driving it's
audio books or, or podcasts, uh,
in the subway,
audio books and podcasts always learning.
Yeah.
Uh, you can't, you can't,
you can't increase your, you can't,
you're not really helping yourself by
listening to more music ever.
Like it's, it's not,
it's not producing any new thoughts,
new stimulation.
It's not, it's not, it's,
I don't think it,
I don't think it's going to help you,
your family, your income, your future.
No,
so I can't listen to someone speaking when
I'm running.
I and what I've found out is the
best music for me to listen to is
EDM, electronic music.
And the reason is there's not a whole
lot.
There's not a lot of lyrics typically.
And I begin having internal conversations
then.
Like that's when I sort of put things...
That's when I start drawing lines between
things that I've learned.
That's almost like when you're sleeping
and when you dream,
that's when you actually synthesize
everything as someone's thought.
But for the life of me,
there's no way I could listen to anything
words.
When I'm walking...
going somewhere, traveling,
that's when I listen to words, read books,
coffee shop, words, books,
all those different things.
I just want to clarify.
I'm saying that
by me listening to audio books and
podcasts,
it will make me more money versus
listening to music.
Okay, so you agree with that?
You agree with that, okay.
Yes and no,
because I put things together when I'm not
thinking,
like in the shower or the back seat.
So like I need to eat, listen,
read to words,
and then I need to like chew and
digest.
I need to zone out.
Like,
so I need to do both of those
things.
I need to synthesize.
and working out for me because i'm an
endurance guy right i just do one thing
slowly for a long time that's like my
skill um for me there's a lot of
time to chew and digest because you want
to i don't want to look at the
clock i'll turn the clock off i'm like
my i'll stop running when the machine says
stop running i said forty five minutes
i'll do forty five minutes um that's for
me is chew it like like breaking things
down i listen to chialdini's book for me
for some reason listening to books
isn't great podcast conversations are good
but i need to read the book we're
just wired everybody's wired there's no
right or wrong i wish i could listen
to books it's terribly efficient
for me,
I don't know if I do a lot
of the zoning out.
If I do,
I don't feel like that's my building time.
I don't feel like that's my critical
decision time.
I don't feel like that's when I'm
implementing something or making moves or
whatever.
Although I'm not saying the zoning out
is...
pointless i think it's important but i'm
saying you're saying you'll listen to the
edm and zone out and i'm saying uh
i i i'm not i feel like i'm
not constructive if i'm zoning out if that
makes sense right i feel like i am
constructing what i'm not thinking about
the problem or learning more again you can
only be like you know putting food in
the mouth or chewing and digesting one or
the other um
real quick yeah real quick kind of off
this topic i shared a post about using
chat gpt i said clinicians have a real
opportunity right now there's still enough
people who aren't on like any ai platform
consistently enough to understand how to
use it and how to extract value from
it me using chat gpt as my running
coach a couple big realizations for me
One is I put in,
I think I put in three objectives.
The primary objective being bring my
diastolic blood pressure down.
Secondary objective was increase my volume
so that I would be comfortably running ten
miles.
I was at about four to five.
And then number three was I'm stuck at
this body weight.
I have never weighed this much.
I understand the principles of nutrition
and thermodynamics and all that crap.
it's not working like I'm not getting my
body weight down I need my body weight
to come down but I said I don't
want to sacrifice diastolic reduction with
calorie burning so that's a third priority
um I took screenshots of all my running
analytics from the past month when I had
started put that in put my body weight
put my daily blood pressure numbers in and
it's an amazing running coach one of the
big realizations for me one was
just running too fast like its big push
was get your heart rate down heart rate
dictates pace you cannot exceed most of my
runs you cannot exceed one fifteen to one
twenty five heart rate to to focus on
that diastolic you know blood pressure
reduction i was like oh my gosh i
feel like i'm walking yeah what do i
do um and i finish these runs and
i'm like ah i'm dying to do more
but it's like no you cannot do more
you have to pace yourself
I think therapists have the opportunity
right now to say, hey, you, me,
and ChatGPT, we're going to work together.
Every time a patient walks in my door,
the first thing we should do is pull
up your ChatGPT, your Gemini, your Claude,
whatever you're going to use.
Let's put in your data together.
Let's see its analysis along with our
analysis.
And then between sessions,
This is going to be the third party.
This is going to be the coach that
walks you through every day.
I want you to tell it.
How did your knee feel?
How did your shoulder feel?
What did you do differently?
Find the patterns that are exacerbating
the symptoms.
And then let's identify those trends to
improve your outcome.
We should be doing that as a paid
service.
We should be incorporating that right now.
And I don't think me included,
I don't think any of us do.
Why not?
I don't know.
Because we're afraid.
We're the magician.
And if I show you that I'm using
a tool,
it takes away the magic of me being
like, there's an ace up my sleeve, right?
I don't think so.
I think it's just the friction of changing
to a new system.
It's the friction of incorporating
something different.
You need to create new wear patterns,
and that takes work.
That is mental fatigue that it's like I
can turn my brain off and go treat
ten hours of patients and not think a
single thought and be totally comfortable
with it.
But to bring in a new thing like
that, I don't know.
It just seems too powerful.
Like, again, I use Peloton.
I got a treadmill and I got a
bike.
props to Facebook marketplace.
And it constantly is looking at my data.
Like it's constantly like, Hey,
based on the last three weeks,
you should be running longer.
Like you said,
you're cause it asked me for my goals.
And I was like, you know,
increased distance or whatever.
Genius.
What's that?
genius yeah it's like based on this based
on this goal you're not getting there like
you said you wanted to be doing this
by this i used i've been using chat
gpt to say you want to talk about
a place i cannot focus and walk out
and have no idea what i just did
there is a supermarket so i'm like listen
i like five meals these are the only
five meals i like my goal is weight
loss and you know healthy eating
Give me five recipes and then tell me
what I need to buy.
Right.
The only next step would be I'm going
to give you the layout of my supermarket.
Tell me what to get in every single
aisle.
Have you guys seen this?
There's a shopping cart at one of the
two supermarkets I live near.
I log in with my little plus number,
my phone number to give me like,
you know, the nickel off of whatever.
I then scan items as it goes into
the shopping cart.
And then I just check out.
It knows what's in there.
Because it's got cameras,
it knows if I only scanned one peanut
butter and not two.
And it has like... It will weigh fruit.
It is wild.
And it knows, of course, that's cool.
So I'm like playing with it, really.
And then as I get on the paper
towel aisle,
I hear a ding and I go,
did I press something?
Did I touch something?
It's like, no,
brawny paper towels are fifty cent off.
And I'm like, how smart is that?
Because I don't buy brawny.
I usually buy this other one.
And now it's saying, ding,
I know exactly where you are.
If you're in the aisle,
I know what I generally know what your
problem is.
I'm going to nudge you towards me.
And it just seems like we're using it
to sell paper towels,
but not to help human beings become and
stay healthy.
Wild.
Yeah.
Changing topics.
I want to hear about Dave's vlog and
driving and recording and sharing
information.
What's been going on with that?
I was just cutting out.
I didn't hear it.
About your vlog.
You're driving and yapping.
Yes.
I'm just trying to test out new formats.
I think the immediate response was that
it's better or faster to get to,
I don't know.
Again, we're talking low views,
but faster to get to four hundred views
compared to other reels or whatever.
It certainly seems to be working.
This has been inspired by the GaryVee
videos where he was in the back of
you know, taxi cabs or,
or like whatever Ubers and things like
that.
Um, so my, I,
I pitched my wife on recording it because
we were going into, uh,
treat her at the office over the weekend.
Just like some plantar fasciitis type
stuff.
And there was like a,
a red light machine and a laser machine,
which we also have separate content on and
that's coming out soon.
But I was like, you know,
I was like, let's, you know,
Jimmy helped me with picking out the road
lapel mics.
So I was like, let's get,
let's get that on my, my collar.
And I said, Hey,
the easiest thing to my wife, Annie,
I was like, the easiest thing is like,
can we just use hit record?
I'm like,
we'll just go back and forth and we'll
have a conversation literally just like
this show.
and she's like no and i'm like all
right so hit record and i'm gonna
freestyle the way that i can that i
know took years to be able to do
because it's like totally not comfortable
at all but i was like all right
let's just i want it i want to
bang out this content i know i think
it'll be interesting um who wouldn't want
to see i don't know it's different see
a pt driving around you see buses and
taxi cabs and whatever it just
It's not anything groundbreaking,
but it's just a different format compared
to like, here's an exercise on, you know,
a hip mobilization or, you know,
a posture exercise or, you know,
a spinal manipulation that, you know,
a crack and pop that all the chiros
do just trying to be different.
That's all.
How are you picking what to talk about?
Is it whatever comes to mind?
Exactly.
So started talking about, um,
even in network, like what, like,
of course you want to use your network
insurance and blah, blah, blah.
It's not your fault.
And you know,
here's why we don't take it.
And talking about, um,
manual therapy versus I use chat GPT maybe
a couple of weeks ago on what,
and I think Tony has done this.
What are like the most provocative
polarizing topics in physical therapy?
And I posted some stuff about it.
So like one is, um,
cash pay or out of network versus in
network.
That's one topic.
Another topic is manual therapy versus
exercise only.
So I've, I've talked about that.
I've made other posts about it.
Um, but are you, are you keeping like,
are you like me where you'll just jot
down a few things in a note or
on a, or on a piece of paper?
And then when you hit record, you're like,
just right there off the dome,
off the cuff.
Yeah.
I'll do like notes just so I don't
forget about it.
So when I sit down and say,
I've got an hour to do this,
And I've been doing a lot.
I haven't done it recently,
but I was doing a lot of series
where I was like, I have an idea.
I'm like, okay,
let's pose six solutions to this one
problem and I'll just do them in a
row.
And the reason I like doing that is,
especially on Instagram,
that you can link...
one video to another.
So I sort of daisy chain the video
together and I made all the thumbnails the
same.
Like for one series,
it was black background, white text,
same text.
And it was like number seven, number six,
number five with the idea.
If you trip across one,
you're going to go up and down the
chain.
we were driving through manhattan and we
were using external i i i was using
external things to immediately come off
the cuff with a topic so we're on
we're on park ave we're turning left on
the fifty seventh street and it's traffic
even though it was uh sunday there's
traffic there's a traffic cop in the
middle of fifty seventh and park and he's
waving us through so i said to annie
i'm like hey hit record and you can
see the traffic cop right out my window
and i and i go all right so
you're recording okay so i'm driving here
through traffic
You just saw the traffic cop.
He's waving us through, right?
He's kind of he's guiding us through.
He's providing direction and support and
he's making sure everyone's safe and all
that.
No different than what my doctors of
physical therapy do.
We're like not just health coaches,
but we're going to guide someone through
how they navigate a new injury,
an old injury,
even if they tried everything,
even if they failed everything.
So I'm able to go a minute or
two completely off the cuff for something
that I just saw out the car window.
Then we're driving through.
You'd make a great radio.
That's it.
That was the job.
we're driving another block or two up at
the seventh street.
And then when you pass the, um,
is it the, the,
the Gucci store or whatever,
like the whole,
the whole building is the outside of like
a, uh, a Gucci or a Gucci bag,
like the whole, the whole building.
Right.
So I'll be,
every tourist is taking pictures of it.
So I say to my wife,
get your phone, start the video of,
of the building of like the suitcase, the,
the, the luxury suitcase building.
Right.
start recording and then pan it over to
me.
And I'm going to be like, yeah,
you know why Gucci and Prada,
like every single year they raise their
prices.
Why?
And I say, Annie, why,
why can they do that?
How are they able to do that every
single year?
If they can charge thousands of dollars
for, uh, for bag, for purses, for bags,
for luggage, whatever, like why,
How can they do it?
So she I'm pulling her in.
So she starts to listen off things.
And like the second thing she says is
like brand.
And I'm like, yes, brand.
Exactly.
And messaging and, you know,
status and perceived value.
Right.
And so we're going through that.
And then I'm like,
then I segue that right into like
perceived value of concierge physical
therapy, what we do out of pocket.
So I'm pulling stuff out from the
sidewalks and from.
out the window and immediately make I
think we only filmed like five I posted
two so far I think we felt I
think we felt like five uh or so
we did some like driving from Brooklyn
into the city into the into the tunnel
so um I'll just be doing more of
that just got to be on the road
and have someone uh recorded or whatever
but um it was fun for sure
What's the best exercise to do?
The one you're going to do.
What's the best type of content to create?
The one that you're going to continually
create that you see resonating with an
audience.
four hundred views is not a lot,
but if it's the right four hundred people,
it is a lot.
I've got a friend,
I helped launch a podcast, and she's like,
I'm hovering around three,
four hundred downloads an episode.
I'm like,
imagine you did this live at a bar
and three or four hundred people showed
up.
I need you to start,
and I call it,
I need you to un-Kardashian that number.
And understand that you're also talking...
This is a PTA.
This is a super narrow niche.
There's, what,
three hundred thousand PTs in the country?
I don't know how many PTAs,
but a lot less.
I'm like,
you have four hundred people listening to
you yammer on about PTA stuff for forty
minutes?
That's a lot.
I'm like,
how many people work for this company?
Less than that.
So I need you to understand that.
So four hundred views is sort of...
I know it's the beauty pageant metric.
It really is.
I mean...
There are podcasts that get more listens,
but I look at my number of...
It's called quality listens.
And what that means is when someone hits
play...
What percentage gets to the seventy five
percent mark?
So if a hundred people listen and I
have eighty percent quality play,
it means eighty out of one hundred at
least hit three quarters of however long
that episode is.
If it's ten minutes or sixty minutes,
that to me is actually more valuable.
It means I'm talking about the right
things to make people push play and stick
around.
Instagram stuff is just pushing play.
But you can look at some of the
data.
And I think I showed you, Tony,
if you use the edits app,
it'll get a lot more information.
And I think they want you to use
their editing app because they want you to
stop using like things like CapCut,
which is related to TikTok.
So it'll give you more information if you
use their apps.
But I mean, it's hard to do,
but get, you know,
four hundred is still four hundred.
It's still pretty good.
the thing that i thought was interesting
was i'm still not comfortable recording in
front of my wife recording in front of
my kids i i couldn't do what you
did in that video just because i'd feel
comfortable because because the the the i
i know that the benefit of getting this
recording
getting this recorded and getting it out
there.
And thank you to David.
David Rubin is supporting me immensely on
Instagram.
He's commenting, he's liking,
and he was loving those videos,
the one or two that I posted so
far.
So David,
thank you for the feedback there.
I just know that the benefit of getting
that out there
the way that I can speak briefly on,
on camera in,
in that type of a setting where there's,
there's like not that many people that are
doing video like that in New York city
in a car, like not that many, like.
Ten, twenty, fifty.
I mean,
like there's not that many people doing
it.
So I'm like, in terms of PT,
I I'm definitely the only PT that does
it in New York city in a car.
So it's like, it's,
it's going to be unique.
And,
I don't know if you stepped away from
the video, Tony or not,
but like my wife, I was like,
all right, can we just, yeah,
we can do it back and forth.
And she's like, no.
And I was like, well, hit record.
I'm just going to talk about anything.
Like,
and so we're just going to go from
there.
And like, yeah,
the first one was a little choppy.
And then it was like,
and I was just like right into it.
Literally just like the show.
So I think you could do it, Tony.
I totally think you could do it.
Yeah, it's like anything.
You just got to start doing it.
You got to either get mad enough,
frustrated enough, hungry enough, do it,
and you realize it's doable.
I agree with Jimmy, though.
Four hundred views doesn't tell me much.
It's how much did they view of the
total content.
If they're viewing more than fifty percent
is usually my metric.
Amazing.
Like most people are not going to view
more than fifty percent of it.
And then
shoot i had something that i was gonna
oh i shared a screenshot with you guys
maybe i posted it of the people also
ask version on facebook you know google
has people also ask on my facebook feed
and i wasn't sure if other people were
seeing it it's starting to show ai
generated questions which is basically
what google had forever as people also ask
So as a content creator,
now what you do is you put that
piece of content up,
you see what those are,
and then you start creating new videos to
answer those specific questions.
And it just,
it spider webs out into a whole,
you know,
vertical silo of content around the topic.
That's the concept of,
and it's a paid tool, answer the public.
Yeah.
Answer the public was like,
you put in a,
we've all seen like a color wheel, right?
Or a motion wheel.
You put a question,
usually it's better when a question goes
in the middle and then it'll have you
people also ask and it'll group it in
who, what, where, when, how.
And the idea there is like,
what would you put,
what would Dave's question in the middle
be?
Like,
Pain relief, New York City.
Where can I get pain relief in New
York City?
Or where can I get physical therapy?
Or where can I get concierge physical
therapy in New York City?
And then it'll have all the questions that
are sort of secondary to that.
You make sure you show up in as
many of those as possible.
And then I look at the world like
a giant Venn diagram, right?
This person knows this person,
this person, but it's also this question.
The person who's asked this question also
is asking this question.
If you can cover those things,
you sort of own,
you begin to own that category.
I think another great direction for Dave
is,
and this could be on the business side
or on the patient care side.
I don't do this nearly enough.
I was thinking this morning I need to
do it more.
Snap a screenshot of a Facebook post.
do a green screen on Instagram with the
image of the Facebook post behind you and
just answer the question.
Like there's so many Facebook posts out
there coming up with what do people want
to see?
That's the hardest part of what we do.
But you just snap that screenshot,
put it behind you.
You answer the question, you read it,
answer it.
green screen it it is a piece of
cake and you could crank out ten fifteen
twenty of those in no time and then
you just have that repository that you can
either schedule or just post when you need
to post them so i i i did
i did one here's one right here a
green screen this was maybe this was
a few weeks ago, maybe a month ago.
And then I went back in to try
to do more green screens.
And it took a while because I was
looking for it.
And I had to ask ChachiBT,
where is the green screen feature inside
of Instagram?
And they're like, well, update your app.
I updated the app.
It still wasn't there.
Long story short,
you have to download the new edits app.
And it's in there.
I was like, oh.
i it spent a week looking for the
green screen i'm typing a green screen by
instagram green screen instagram that's
weird i i i didn't download edits i
know about it i found the green screen
in instagram just regular instagram yeah i
don't know if it was taken away things
just changed and they always do and
there's probably a reason there there are
reasons for it um
but it also pisses me off when it
does.
But then you know what I do?
I learn the new way and I just
keep moving.
That's what we all do.
That's what they expect you to do.
Yeah.
All right, real quick.
I don't know if we have one last
topic.
We're closing the show.
Dave,
I was thinking about you this morning.
So my wife, huge baseball fan,
knows all of the Reds' stats and history
and all of this stuff.
I found a reel this morning of a
guy talking about old school baseball,
grabbed a bunch of old school baseball
clips.
He was like,
these guys used to hate each other.
When you were running a second base,
you would break up the double play by
knocking out the second baseman.
You'd run through the catcher,
blood fights, like all that stuff.
and now and it's hilarious because my wife
said she's like i don't like this new
baseball like these guys are all buddy
buddy so we have ellie de la cruz
and he's talking to the second baseman on
the other team and they're laughing and
joking and patting each other on the bat
on the butt totally different culture but
it kind of got me thinking about you
know modern physical therapy
I see the new creators coming out on
TikTok, on Instagram.
I was listening to a guy this morning.
He's talking about making twenty thousand
a month right out of school,
bought a lives in a van so that
he could put all his money into building,
you know,
his physical therapy practice and nothing
against him.
It's it's the culture,
the new culture of PT.
But like I am definitely old school PT
and I don't have any interest in joining
the new culture of physical therapy.
Two topics blended together.
When I play college baseball,
D two baseball in Philly,
I hated every other,
every single team that we played.
And then looking back on it,
I would remember certain guys names and I
would like,
try to like connect with them on LinkedIn.
And like, they wouldn't,
they don't answer like my DMS or whatever.
So I feel like that was a miss.
I feel like that was a miss on
future teams.
networking because future connections and
all that,
because I played against a ton of people
over the years.
Right.
Like travel ball,
Legion baseball in South Jersey,
college baseball, the summer leagues,
everything like that.
That's how I was always geared, though,
Tony,
kind of like that old school mentality
that like you don't even you don't even
talk to the other team when you're on
the field in the infield.
I played in my whole life when you're
on the infield and the other team hits
a home run.
You don't say to the guy rounding base,
you don't say, hey, good hit, good job,
nice thing.
You don't,
you scowl at them or you turn away.
You don't talk to them.
You don't say good hit, nice double,
nice triple, blah, blah, blah.
Nowadays, that is the case.
And I'll, you know,
younger guys say that to me.
I get on base and all good swing,
good hit this.
And it's kind of wild.
It's kind of different.
I think in the future could help you
just in terms of like the whole networking
thing.
But in terms of the competitiveness,
it is a different dynamic.
Right.
Hey, one more actionable marketing item.
I don't know if you guys,
did you see that post I made about
aquatic therapy in the home?
No.
So I referenced Sam Walton because if I've
got it right...
In their tub or hot tub or what?
Nope, nope.
If I got this right,
show me a note.
Didn't Sam Walton or the Walmart people go
up in a helicopter or an airplane and
look for where they were going to put
the next Walmart store?
He got his own pilot's license.
He got his own license and he would
fly his own little Cessna by himself.
Okay, so that got me thinking about it.
I was like, wait a minute.
I remember flying back home to Sarasota.
You'd look out the airplane window.
You'd see pools everywhere.
So I went on Zillow.
I typed in Sarasota, which by the way,
blew me away at how expensive houses are.
But anyway, and I was like, holy crap.
I switched it to satellite.
I saw all of the pools.
I was like,
if I was a mobile therapist and I
had any interest in aquatics, you know,
pool therapy,
This would develop my mailing list and I
would use Dave's format for a postcard.
And I would specifically target houses
with a pool.
preferably a million plus in value.
And I would just start direct mailing
these houses with in-home outpatient
physical therapy for aquatic therapy.
And that's how I would grow my list
for whatever it is that I wanted to
do.
And then that got me thinking about like,
okay, well,
what if I love dogs and I wanted
to include the owner's dog in the therapy
session,
I would figure out a way to find
out who owns a dog.
And I would start targeting those houses.
Maybe I buy the mailing list from
somewhere and I would market specifically
like pet and human, you know,
combined therapy sessions.
Let's include your dog.
Let's get the dog out for a walk.
Patients tell me all the time,
they're like,
I wish I could walk my dog.
I can't do it anymore.
Hey, guess what?
There's a solution for that.
And I think even a faster way,
instead of trying to find a mailing list
of people that have pools,
you just go to the local pool companies
and say, Hey,
we would love to collaborate with you.
All of our current clients that have
pools,
we would love to recommend you drop off
brochures.
We're going to be in their home treating
them.
And we're going to, you know, we can,
bring up like oh hey your pool oh
you're frustrated that you got to open
your pool close your pool clean your pool
all that why don't you use john's pool
cleaner or whatever and then also by the
way john's pool cleaner could you drop off
our business cards or our brochures
whatever when you do the pool cleanings
and whatever and and do a little
cross-pollination referral with that
company which is what i try to do
with that tub cut that tub cut cleaning
company
where it's like, hey,
that's our ideal client.
There's literally no competition.
It's two completely different services.
So whether it's a mobile therapist, Tony,
doing that with trying to find the million
dollar home plus with a pool,
you just go right to the pool company
and say, hey, let's try to collaborate.
Let's try to network together.
Let's share each other's marketing
materials with our current clients.
Try to get on, try to have them
share your information with their current
clients.
And then same type of thing.
You go to the, even in Brooklyn,
and I'm sure it's in Ohio and upstate
New York, everywhere else,
like all these mobile dog,
these mobile dog cleaners, groomers.
My cousin was a dog walker in Brooklyn
and was making six figures.
My cousin's husband.
Six figures.
I'll yes and these two ideas.
I think it was on the corner offense.
I think it was Chris Corner.
He was giving kudos to someone who figured
out a way to use AI that would
go to some satellite imagery,
and they were a blacktop company.
So they skipped,
do you need a new driveway?
The blacktop company was able to spot
anybody with a driveway more than a
thousand square feet,
and it would send them a quote.
Okay.
And it would say, your driveway,
because I scanned it from an aerial
photograph and figured out how to measure
and did it to scale.
I know how many square feet your driveway
is.
For me to do that,
it's this much money.
And they just kept repeating to those
people in their area.
They skipped anybody without a driveway.
So they kept hitting the people over and
over.
The old school way is when your guys
are out doing a driveway in Jimmy's
neighborhood is take thirty postcards and
go fifteen houses in either direction.
That's fine.
This guy was able to do it without
ever leaving his house.
And the cost of that is terribly low.
But I'm pretty sure the margin on a
blacktop and a driveway is pretty good.
The thing that I like about the satellite
more than the affiliation with the pool
company, like I love that idea.
The satellite gives me the geography.
And so for a mobile therapist,
like I would never be a mobile therapist
who took people from all over the city.
I would be a mobile therapist who took
people from a specific neighborhood that
like literally I could walk house to house
to house,
knock out ten visits in a day instead
of three visits in a day because of
commute time.
um that same chris corner did an episode
where they looked at google street view
and they used those images from google
street view to create landscaping mock-ups
so ai creates the landscaping mock-up but
that got me thinking what about all the
people if i was a therapist who did
home modifications you know i would be
looking at entryways i'd be looking at uh
different things like that that as a
therapist you would say oh we could
get a handrail here.
We can, you know,
change the entryway here.
We can make these upgrades,
even ramps and stuff,
accessibility devices that help patients.
All of that could be done from a
simple photo of the front of the house,
you know?
So, and you send them out a quote,
an estimate, Hey,
if you're going to age in place and
you're looking to stay safe in the home,
like this is what we do.
Yep.
all right i think we're good we had
such a completely random show today all
over the place also tony's back there he's
like taking care of business like uh
behind the scenes like over his shoulder
uh i don't know you're like checking a
patient at the front desk you're going
through here what's going on today
Real quick,
I scheduled a new patient that walked in
the schedule.
Like, who walks in the schedule?
Took a payment that would have been missed
that we would have had to then invoice
later.
Got three people on the schedule for next
week.
Like, yeah,
you just get it done while you're here.
All right, parting shots.
What do you got?
Dave, you go first.
I'll take the reflection of,
and I'm not saying we're any better than
anyone else out there,
but what we just did today on this
show of kind of bouncing all over
different topics.
Tony's in and out of the conversation.
He's jumping right back into it.
I don't think it's,
I'm not saying we need any credit.
I just think it's the ability to handle
different things coming at you or even
navigating different environments
differently.
None of this was planned.
We just we just smoothly go through it
because we've had the reps of going
through this show for two years and doing
other shows for many more years before
that.
So I don't know if there's if that's
a learning point.
I think that's just something that would
take time.
And it's not something that you can
necessarily replicate other than going
back to the very first thing,
which is don't overthink it.
Just do it.
You know, improve it.
Change it as you go.
I don't know what else to say other
than that.
Yeah,
the theme today was definitely just hidden
opportunities.
We talked about ChatGPT being a hidden
opportunity.
We talked about marketing and satellites
and so many creating content on the drive
that would have been wasted time that now
you're leveraging to grow your business.
There are so many hidden opportunities out
there.
You just got to pick one and go
with it.
I mean,
people in healthcare are very smart.
They're also...
They don't need any change very much,
which means if you do,
all of a sudden you're the top one
percent.
And be okay with failing twenty times
because that one success could lead you to
a lot of stuff that someone else is
not doing or not paying attention to.
All right, we're back on Tuesday.
What do you want Tuesday to be?
Do you want us to, what you suggested,
bring what we listened, like,
almost like when you walk into a bookshop
and the staff recommends a book,
a podcast.
Yeah, let's do a six-pack episode.
Two, two, and two.
What is the topic?
Book, podcast, blog?
Yeah, the voices in our brains.
Audio anything.
Voice in our brains sounds good.
Are you hearing voices?
Yes, I am.
See you back on Tuesday.
Have a good weekend.
That's it.
We're out.
Boys, what the hell are you doing?
Follow Tony Maritano on YouTube at Total
Therapy Solution.
Find Dave Kittle at
conciergepainrelief.com and on YouTube at
The Dave Kittle Show.
And follow Jimmy McKay at PT Podcasts on
YouTube, the socials,
and wherever you binge podcasts you
pretend are for CEUs.
And hey, just a reminder,
none of this was for advice.
This was for entertainment only.
Our lawyers say that counts.
Thanks, Keith.