Broadcasting way too early from three
separate Wi-Fi connections.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
All right.
Good morning here on PT Breakfast Club.
We got the, we got the,
I call it the drunk mariachi band sound
effect in the background.
That's the music.
He's Tony Meritato.
I'm Jimmy McKay.
Dave Kittle.
He's probably, he's probably coming along.
He's probably, he's probably in traffic.
He lives in New York City.
He's probably,
he's probably caught in traffic.
We've got some interesting,
we got some interesting topics today,
but I was just telling Tony before we
went live.
Playing golf this weekend,
which I do two point three times per
year,
it's usually in direct proportion to how
many of my friends are getting married.
That's like more friends getting married
that year, more golf, less friends,
less golf.
We had talked earlier about like a
business model where if you've got someone
who's older and they still want to golf,
do you hire the physical therapist to play
the round of golf with them?
Yeah.
And I don't know if I've ever seen
that was I feel like a year ago.
I don't know if I've seen anybody do
that yet.
Still a viable idea.
And I feel like we're getting closer.
I feel like a year ago was ten
years ago in terms of acceptance time for
a topic like that.
So switch out golf, fishing, hiking,
biking,
like Dave in the park having a catch.
Switch out whatever activity you want.
This all originated from Ryan Pineda,
the YouTuber who was like, hey,
I've never played golf.
I want to start playing golf,
but I want to optimize my time.
People want to come consult with me.
I'm going to charge, I don't remember,
two, three thousand dollars.
We'll do a round of golf.
I'll put together a foursome.
And that kind of inspired me to think
like, yeah, you know,
there's so many adults who aren't
confident, don't feel safe,
are concerned about falling on the golf
course.
You, the physical therapist,
make them go out there safely.
You help keep them out of trouble.
You stop the problem before it happens.
And you get to play around the golf.
But, you know,
we could be anything fishing and other
stuff that I mentioned.
You charge a premium rate for it because
these individuals wouldn't be able to do
it without you anyway.
Yeah.
And you put it maybe a small group
or you do one on one.
It doesn't matter.
This we talked about going to baseball
games like this is something that you're
right.
I have not seen it happen.
I have not seen it gain traction.
I think we're just too busy.
Yeah, we're too busy.
We don't get off the hamster wheel.
And because of that,
we never give it a chance to grow
roots.
Let me, let me,
let me push back on you.
What would you have to charge?
Because golf takes three, four hours.
What, you know, what, and you're,
so you're not working in your,
how many P I think that's where people
hesitate for a half a day of not
being in the clinic.
Oh my God.
But how many of these clients would you
have to find and play a round of
golf or be with them on a round
of golf per month to exceed that?
So how would you work backwards from...
Because I think this is a big hesitation.
I think people are with you so far.
And then I was helping someone yesterday
write a one pager for a sponsorship.
Same thing.
And she literally said,
my finger is hovering above the enter
button.
And I said, I think I gave her,
I'll find the actual text conversation.
But I said, what do you worry about?
If they say no,
you're going to have exactly the same
amount of money you have now.
And if they say yes,
you're going to have a whole lot more.
And this person had asked three times for
a one pager to be sent to them.
So this is a weird relationship with
money.
How would you work backwards to price
this?
And if you're just joining,
as we say good morning to Dave,
if you're going to have a physical
therapist follow you on the golf course,
I feel like this is something concierge
pain relief could have on the menu.
So walk me backwards how you guys would
price this.
This is where you go back to the
same kind of three pricing methodologies.
You either price it based on what other
people are selling a similar service for,
which nobody is selling this service,
or you go to like Titleist or TPI
guys, you know,
and see what they're charging.
You do it based on your cost.
Well,
if I would be in the clinic making,
you know, a hundred,
a hundred and fifty an hour,
I'm going to be out of the clinic
for six to eight hours.
What is the cost of that?
Or you price it based on value.
What is it worth to the individual?
Somebody who hasn't golfed in three or
four years because they've had
Parkinson's, they've been falling,
they're unsafe, they're uncomfortable.
You know,
is it worth a twenty five hundred dollar
a day?
Absolutely.
And then you say, OK, well,
everybody can't afford that.
No, they cannot.
Everybody can't afford to live in New York
and they shouldn't be able to if you
can't afford it.
I can't afford everything either.
You offer it to the people who can
afford it.
And, you know,
either of those three pricing
methodologies, it does not matter.
Just get it out there.
Is this something you think you could sell
in New York City, Dave?
I'm going to answer what I think.
I'm going to say, yeah, I would say,
yeah.
You might be on mute there, Dave.
Hang on.
Give me some more context because I was
coming in late and adjusting my AirPods
here.
We talked a while ago about a physical
therapist accompanying you on a round of
golf.
So they would be there for all the
things.
Listen,
you can take lessons from a pro on
the range and then go out and play
golf.
Or you can have that person in your
back pocket and say,
I want to speed up my...
improvement education and i'm willing to
pay a premium for that now i've got
this person's eyes on me for eighteen
holes when i'm actually out there not on
the range which is usually perfect
conditions
So this is you pitching us this type
of an offer,
or this is Tony's idea in terms of
presenting it to...
Tony had brought it up a while ago,
and I was just saying, hey,
I feel like that was a year or
two ago that we heard about that.
And then I hope and pray that someone
steals it and does it,
and then I see them.
The biggest compliment, I think,
for what we do here on a live
stream,
and I don't want to speak for you
guys, but for me,
Is a year from now, someone's like, yeah,
man, July, twenty twenty six.
I watched this episode and I listened to
it three times in my car and I
quit.
You know,
I decided that day I would then begin
building my thing.
And then a year later,
they DM us and they go,
this started with you guys.
Like and it's not because of us.
It's just the fact that we're shooting our
mouths off with ideas.
So I'm hoping to see the concierge golf
PT somewhere.
Yeah.
I mean, and there's a,
there's a bunch of, uh,
PTs doing this in terms of just like
golf focused.
Um, my, a couple of initial thoughts,
one would be,
it would be a good front end offer.
It could also be a good backend offer.
So for us, like we have more,
you know, sixty, seventy,
eighty year old retired professionals who
want to get back to golf where
The initial offer is just like the first
visit evaluation, right?
Like home visit and they're banged up.
They got discharged from a hospital.
They have significant back pain,
something different, right?
And then it's like,
so it's the evaluation.
Then it's like the plan of care.
And then getting back to golf might be
like the second or third goal.
like the one guy who i posted on
social media it's kind of like getting
back to putting in his living room that
was like one goal and then it was
then it was getting back to the golf
simulator for like an hour rental but he's
not gripping and ripping for a full hour
right so it was like a dynamic stretch
and he took his time and all that
then it was like okay golf simulator
multiple times and
being obsessed with the data and like,
okay, I'm hitting it further.
I'm making some progress.
Right.
Then, then it could be like, Hey,
we also have this offer,
which is X amount of dollars for a
doc, your,
your doctor of physical therapy to
accompany you to the nine holes of golf.
And then eventually maybe a full round of
golf.
Right.
So for us,
the way it fits in is we just
haven't advertised upfront.
So for us,
it's almost like more of a backend offer,
but I think that also,
can be lost, right?
Like, so it's,
I'm sure Tony would have better ideas in
terms of like,
why not also put it in the front
and then it might motivate those types of
people to want to work with us.
and maybe you know maybe tony can give
some other ideas in terms of like let's
say it was like someone that had a
knee replacement they sold that they still
might need tony and his his plan of
care and his rehab and then maybe the
golf is somewhere during the plan of care
but it's a it's a separate event it's
a separate dollar amount it's a separate
purchase separate from the uh covered
service of physical therapy
You don't call it a front-end offer or
a back-end offer.
You call it the front nine and the
back nine.
Listen, it's got to have a name, guys.
It's got to have a name.
That's what you do.
But guys,
no one would pay for something like this.
No one would – oh,
would you look at that.
Have you guys ever heard of these
services?
No.
I just Googled catty girls.
Oh,
this is what they do during the day?
This is what they do during the day.
You can rent fitness models to be caddies
for your foursome.
People don't pay for stuff like this.
Now, the biggest mistake of this,
and I do not get an affiliate code,
it's the caddy girls from the
caddygirls.com.
How are you not playing off of that
girl, Alex, and just calling,
call me caddy?
But no one would pay for something like
this.
And yet organizations like this exist
because they're like people,
they will not pay for it if you
do not let them swipe a credit card
and give them an offer.
You have a hundred percent zero, sorry,
a hundred percent chance of getting zero
dollars,
which is the wrong side of the math
equation to be on.
So I'm still waiting for this.
I did find that I have to reschedule
with the guy.
He is a physical therapist online only for
people who are in dental.
So dentists and a lot of, he said,
more hygienists.
He's like,
talk about niche within a niche.
Just healthcare providers, just dentists,
really just for hygienists.
He's like, they're banged up, man.
And this is their livelihood.
So that's what he does.
Okay.
Tony's making deals.
I want to talk about the Instagram story
that you shared with the trainer.
where he was teaching older adults how to
fall or how not to fall,
but exactly why.
He essentially,
like if I had to talk to a
PT,
I would say it looked like he was
walking through like an LSVT big prep
course, but he's a trainer, right?
So Tony, tell me about that video.
Real quick, before we do,
Dave's a hundred percent right.
My patients say, don't buy green bananas.
Like they know they don't have enough time
to like get stronger,
improve your mobility,
work on your fitness,
do all of these things,
then start putting, then start chipping,
then start like, they're like, no,
let's just go out and play.
Let's just get out there,
go out and hit the ball.
Even if it goes ten yards and dribbles
into a ditch.
Don't buy green bananas.
So morbid.
Yeah, I've been following,
there's two kind of channels I've been
following on Instagram.
I'm sure there's a thousand more behind
them.
These are not physical therapists.
I don't know exactly.
One says RN,
so I don't know if he's a nurse,
but two guys,
they've got a bunch of geriatrics and
they're working on falling.
I actually shared a video and maybe this
is why it came up in my algorithm.
where I was doing like forward rolls and
fall recovery,
I call it instead of prevention.
And then I saw these guys and I'm
like, first,
where do they find these are like, sixty,
seventy,
eighty year old adults who are willing to.
Yeah.
simulate falling, fall on mats,
fall on carpet,
like sit down and lay back.
I can't get a single person in my
clinic without like begging them to even
sit on the ground.
So first,
I don't know how they handle the
liability.
I don't know where they find the
individuals willing to challenge
themselves and do this.
But yeah, hey,
they're not physical therapists.
They're not licensed PTs.
So then my question is, okay,
if we know that this exists because it's
there on social media, must be true.
Must be true.
if i'm the physical therapist evaluating
somebody and i make the determination okay
this person needs to do some work on
fall recovery and falling there's a
resource out there that self-pay that
allows them to do this at a pretty
good level like they're doing good stuff
am i committing fraud by continuing to
bill insurance for doing that same thing
myself
That's number one.
Am I committing fraud because I'm not
putting this person out to somebody else
who can do it, not billing insurance?
Why are more physical therapists not doing
it themselves?
Like,
this is obviously something that we could
do, something that many want to do.
And then where else do you want to
go with it, Jimmy?
yeah is it and is it is it
effective i mean it looks like it would
be effective for like the human right in
terms of like balance and reaction and all
that strength mobility i don't know it
hasn't been studied there's no
peer-reviewed double-blind placebo studies
to determine whether it's effective to
practice getting on the floor but my
assumption is yes it's probably effective
Yeah, Adam Paris,
I don't know if he's watching,
but he had a post this morning and
this was on my brain already.
And he was drawing a straight line
between, listen,
thousands of PTE students sat for the NPTE
this week,
but the license doesn't certify you've
mastered the profession.
So again,
it's like a license question because the
license exists to protect the public.
So is this guy without a license scary?
Is he harmful?
Is the license the moat?
Right.
It's the thing we hide behind that we
say, well,
nothing can cross this and let's defend
the moat.
Are we defending the wrong thing?
Is the license just a receipt that you
hang on the wall and say,
I'm accountable when this gets
complicated?
Since I think I think the trainer,
what if this guy was actually what if
he read more studies and more textbooks
than any PT?
Let's have a hypothetical.
but no license.
Is he still not as good?
Is he still not good?
I just think we're defending the wrong
thing all the time.
I think we're not paying attention to the
right thing.
I think that leads into the burnout
discussion,
which is you're paying attention to the
wrong thing.
You're not seeing.
So I started a series on my Instagram
where I'm finding,
and I DM'd Dave because I wanted you
to be on too,
where I want to find people who are
like, I didn't like doing this.
So instead of just quitting and, oh,
I'll be mad at this personal trainer who's
doing the thing that I'm supposedly
getting sixty bucks a visit for,
you're just like, I did the thing.
I just think the thing is different.
There could be a thousand different
things.
I did one video with Sean,
Steven Burkhart,
who started Snow Beast Performance.
He just packed up his stuff in a
car, drove to Vermont,
stood in the corner of a CrossFit studio
treating people.
And now all he does, he decided,
all I want to do is treat people
who ski and snowboard.
And where do I go to do that?
Vermont.
but I don't know anybody.
I don't have an MBA and there's no
funding.
There's no PE backing.
He's like, I don't care.
I just did it.
You can do that.
I feel like these people are small.
It's not a story of thirteen locations.
He's got four people,
but he employs four people doing exactly
what they want all day, every day.
You can do that.
You don't have to just leave and sell
Pokemon cards or sell shoulder courses.
Neither are bad,
but you don't have to leave clinical care
and do that.
I think you guys are an example of
that.
So that's totally this going.
You don't have to leave.
And that personal trainer that's doing the
balance reaction type of dynamic stuff
with older adults, they if they like it,
they are safe.
If he's safe, if they enjoy it,
if they feel benefit and they continue to
pay him or any company or personal trainer
like that out of pocket.
that's just the market, right?
There's,
there's nothing that holds that individual
back from doing it.
As long as I guess they're not saying
that it's physical therapy and they're
just like a,
a personal trainer that's not licensed.
So that, you know,
in a way maybe it's some competition,
but it's also like, Hey,
that's the market.
And if they're doing like,
obviously he's doing social media videos
and that's how Tony caught it and shared
it with us.
So like,
learn from it how can you you know
model it or or maybe mimic it a
little bit yes and then but but but
don't complain about it don't come into a
facebook group a physical therapy facebook
group and say this is wrong and all
that it's like that trainer is getting
after it he's create he or she is
creating a following a community of people
that like it that benefit from it and
they're like oh wow like i'm going to
just keep paying this person because they
No,
they're not a licensed physical therapist.
No,
they're not a healthcare provider or a
doctor or physician or whatever,
but they feel better.
They feel more empowered.
They like it.
They want to continue.
There's some socialization or community.
Yeah.
So like that's, that's just competition.
That's,
this is no different than like the stretch
labs.
Right.
You have to ask the question,
are you mad they're doing it or mad
they're doing it better than you?
Which one is it?
Because you know you're mad they're doing
it better than you.
I'll give you two parallels.
Let's imagine you owned a taxi medallion.
And for people outside of, I don't know,
major cities,
I don't know if this is a thing,
you used to buy a medallion,
which is a license to drive taxis.
And they were like a million dollars.
I'm sure they're more now.
I remember growing up as a kid,
it's a million dollars.
Imagine you bought a medallion and then a
year later, Uber starts.
You'd be offended.
That's just life, folks.
That's business and life.
You'd be offended.
And your neighbors would be mad for you.
They would be.
They'd be mad for you while they're
calling an Uber.
They'd be outraged for you.
And you have to adapt and respond and
suck it up and not blame anyone else
and just take action.
And maybe you sell it.
Maybe you buy other cars and you become
like a mini Uber.
Right.
I was going to say a host,
not a host, like a, you know,
have a fleet of Ubers or cars or
car service or whatever.
Like imagine you owned a hotel and you
put a bajillion dollars in your life
savings to a hotel.
And then all of a sudden I can
rent someone's living room.
Are you mad?
Yes.
What would you do if you owned a
hotel and,
And Airbnb rolled into your town.
I know what you do.
You go attract customers that would not
like me,
customers that don't want an Airbnb.
I told you guys on the show before,
went to San Francisco.
There's a dog running around the host.
We were below and the host was upstairs
and the dog was running around at eleven
p.m., twelve midnight.
I'm never going back to Airbnbs.
So the host tries to find more people
like me online and advertise to me online
because I want the certainty of a hotel
room with a front desk person and a
gym.
And typically it's quiet.
Most of the time it's quieter.
I want certainty.
So you find customers that want the
certainty and the reliability and not the
curve balls that come with an Airbnb.
And there are so many stories.
Yep.
If I were the marketing guy for,
I don't know, Hilton,
I would hire a third-party marketing
company.
I would hire them.
Never run an ad for Hilton.
Never do that.
You're going to go start ten Instagram
accounts.
And the only way you get content is
you go to Reddit and look for Airbnb
fails.
And you make funny videos.
So you put out...
You make sure you shine a light on
all the disasters.
Hilton never shares it.
There's no connection to it.
You just make sure their stories get
shared.
Or you double down on what you're good
at.
Right.
Dave mentioned the gym.
I don't know many Airbnbs that have a
gym with there.
So if you want that, go there.
We're for this.
I mean, this is Grey Poupon, man.
Am I dating myself with the Grey Poupon?
Understand that above this line is us and
below this line is everybody else.
Do that.
There were some great commercials where
they were, I don't remember exactly,
but basically like comparing you go to a
hotel, you have, you know,
the service that cleans your room,
makes your bed,
like everything is taken care of.
You have all of these guarantees.
You go to an Airbnb and you have
to clean the house.
You're not allowed to use the shower.
That's another thing.
It irritates me beyond belief.
I got to clean your house.
Are you kidding me?
I'd rather pay extra so that I pay
extra for the hotel.
And because they employ someone who cleans
the room and flips the room and changes
the sheets and all that.
Yes.
The thing is,
how do we do that in physical therapy
the right way?
Because what I see in physical therapy is,
come to me, a cash pay provider,
because you get one-on-one service.
Come to me, a cash pay provider,
because I'm not controlled by insurance.
I don't think the physical therapy
profession has figured out how to make the
comparisons correctly yet,
but the hospitality figured it out.
Yeah.
So a couple of things that we kind
of lean on or or complaints that we
hear from other people when they call in
when they've tried.
Medicare Part B home visits and or busy
in network offices is that they'll say
things, Tony, like I didn't like that.
I was treated simultaneously with two,
three, four other people at the same time.
I wanted I want more attention from my
physical therapist.
If it's home visits,
sometimes they send other therapists and
it's not the same therapist and the
patient doesn't know who's even coming or
showing up.
There's less continuity.
Especially from VNS,
which is like a Medicare Part A service,
like after you're discharged and you get
home visits and the patient complains that
uh the therapist says i'll be there today
between nine a.m and three thirty p.m like
the cable guy and then the therapist calls
ten minutes before the visit and i was
like hey i'm i'm ten fifty minutes away
like can you can can we do it
in like fifteen minutes you good with that
and they're like no i had like i'm
just doing something else or like
literally one of our therapists,
my private therapist is here that I'm
paying out of pocket for.
So now it's not a good time because
we schedule on time,
but the system is different.
Those are some of the things that we've
heard.
And maybe we haven't done a lot of
messaging or marketing on Instagram about
it,
but we definitely discuss those points on
the phone, like one-on-one.
Does that make sense?
Yeah.
I do like the fact that Dave just
said,
I would pay more to have someone else
clean the room.
That's a hotel.
Like that's no, no, I,
that's what I mean.
Yes.
It's like, yes, it's cheaper.
Although now if you go to Airbnb, it's,
it's not the same.
It's like the same.
Yeah.
So if you're,
if you're going to line me up the
same cost,
Unless it's like a house on Lake Como
or something, then we're talking.
But that's the more VRBO.
Like Airbnb is trying to be a hotel.
VRBO is trying to be a house on
Lake Como or a Skyline apartment in New
York City.
I wanted to know what Rory Sutherland
would do.
And if you don't know the audience who
Rory Sutherland is, look him up.
I feel like he could read a bedtime
story.
He could read the phone book and I'd
be terribly interested just the way he
talks.
Not just his accent, like his pacing.
I asked my Jarvis,
what would you do to position one-on-one
care better than just one-on-one or not
constrained by insurance?
I think we agree.
You're trying to create a problem that I
don't know if the patient knows exists.
They're like, I don't know.
I have insurance.
That's a good thing.
I think you're talking past each other.
So here's some positioning lines that...
ai rory thinks it would say you're not
buying more care you're buying fewer
handoffs that's a real friction people
don't like that we have a hard enough
time in twenty twenty six making a
connection with one human and i gotta meet
someone and i've known for two or three
weeks and then i got this other person
and i gotta meet and i don't like
that and that's icky we barely want to
talk to each other i'd rather just text
so i do like the line we're not
you're not buying more care
You're buying fewer handoffs.
I do like that.
The expensive version is the one you quit
after three visits.
Why start the sixty dollar a session one?
Do it three times.
Get nothing and leave.
But this is what a ton of patients
do across the country.
Now, less,
way less often at Tony's because at Tony's
practice,
there's like the community and they know
him or they know other people.
They know the other patients there.
And Tony kind of has that whole,
you know, cheers effect, like the tribe,
the community, there's socialization.
But that one staff from WebPT from the
last eight, ten, whatever years is like,
I think it's like approximately, you know,
three visits and then drop off like on
average across the country over,
over like a crazy large data set.
Yeah.
Like Larry Ben said, he's like, I mean,
he's had large data sets.
He's like the valley of three.
Right.
And so it's like, why is that?
If it's not just like certain clinics or
certain certain like it's not just
Confluent and it's not just ATI,
it's not just Athletico.
It's across the entire country.
And in my opinion,
it's if you don't have the socialization
and the community that Tony has built.
And if it's really,
if you don't have that,
it's super transactional.
It's low dollar amount, right?
Just a copay.
It's your copay.
So it's low dollar amount.
And most of the time,
probably lower value, unfortunately.
Right.
So people don't or the therapist is so
busy with with patients that they have the
inability to lay out a clear plan.
Hey,
we're doing this for this reason or we're
doing these things to relate to your goal
that you care about.
And it's just so you can't do all
that if you're a therapist treating
fifteen to thirty patients a day.
Rory Sutherland,
another line you're paying.
This is like a British line, though,
but he's British.
So you have to say you're paying for
the absence of nonsense.
That only works if you've had nonsense,
though.
I think most I think people understand
nonsense, though, and they can go,
you know, doctor's office.
I showed up on time and they were
forty two minutes late.
Right.
Good morning, Wilbur.
Good morning, Teresa.
As you watch the live stream,
some other lines that he had cash.
P.T.
is what people thought P.T.
was going to be before they experienced
the system.
Like,
I like how we were like and you
can hear it.
Who says that?
This is Rory Sutherland.
If he got hired by me and gave
me lines,
most people don't want premium care.
They want care that doesn't make them feel
like a stranger every Tuesday.
Like that,
that gives you a nipple twist of an
emotion,
not just we're better date me because the
other guy's a douche bag that makes you
look like a douche bag.
But there are some outpatient in network
physical therapy practices across the
country where if I'm the therapist for
Jimmy and
and i'm sick today they just allow jimmy
to still show up and they're like hey
jimmy your therapist is tony today and
jimmy's like oh like i kind of feel
blindsided like maybe in some places if if
the vibe is communicated up front
Like if the first visit for Jimmy,
he's introduced to Dave and he's
introduced to Tony and he's introduced to
the other therapist.
I've been in an environment like that.
Now it's a team approach,
but there's other practices that are like,
we would never call Jimmy the patient
who's going to be coming in today and
give him a heads up.
It's going to be a different therapist.
Cause we don't want them to lay cancel.
Right.
If you know that that's going to happen.
Yeah.
Why not lean into that and introduce Dave
as the quarterback,
but also you've got to introduce the wide
receivers and the tight ends and the
running backs and be like, listen,
main guy,
we're also going to spread the ball around
because we do that here.
And then there's no missed expectation.
That was expected from the start.
I don't know that I've ever heard anybody
do that.
All right,
Tony's got to leave a little bit early.
I want him to jump in and fill
this a little bit because I want to
get his feedback.
I'm just listening.
I'm absorbing.
I'm learning.
This is how I learn.
No, we want to hear,
we want to hear from you because you
have built like a magic community that
other practices,
I feel like across the country are just
way more transactional and don't have the
stickiness or the retention.
I could do that because I got small.
That's the only reason why I could do
that.
When we were five locations across two
states, I couldn't do it.
I would have to implement the systems.
I would have to have the protocols.
It would have to be machine run.
I just told you guys off air.
I was like, look,
three patients showed up early.
We've got three patients out there
already.
I need to jump off to go help
my PTA.
Like we can do this because we are
small and we can control things.
But if I had to force therapists to
follow protocols and guidelines,
I couldn't do it.
Oh, he's so busy.
His internet cut out.
He's like, Nope, sorry.
There is, there is,
we can hear you Tony.
I'm back.
I'll wrap it up with this.
Um, you know, you,
you have to know what it is that
you're trying to sell.
I don't sell physical therapy.
I sell an experience.
I'll catch you guys next week.
All right, man.
All right, Tony.
It's all psychology, right?
Picture your supermarket, Dave.
What's the name of the supermarket you go
to in the city?
What's the brand?
Met Fresh.
When you walk in,
which way do you turn?
I go straight.
But then you're going to walk around the
store.
Then eventually left.
So you're the outlier because there's
research that shows that retail stores and
supermarkets,
they want you to walk counterclockwise.
So you walk in and usually produce and
fruit are to the right and you will
do the left.
You walk in straight and the produce is
either in front of you and then to
the right.
And then it is a left,
which would be counterclockwise.
So yeah.
No, that's strange, though,
because it's usually counterclockwise.
It's usually to the right and going
counterclockwise.
Usually.
But what I'm getting at is, like,
human beings are big, dumb animals.
And there is... I forget the number,
and I'll Google it in a second.
If you're at a dinner party and there's
two of you talking and then a third...
and then a fourth.
There's a number of people,
and no one taught you this,
but there's a number of people when the
group splits into two.
It's too big for one conversation.
It needs to be two.
You've been there.
You've been on the sideline and you're
watching,
and then all of a sudden you just
turn to the person next to you,
or you make eye contact with someone that
you want, and you two break off.
What I'm getting at is, Tony said,
the only reason I'm able to do this
is because I got small.
Every PE organization wants to scale Tony
to five hundred locations and you can't.
And it's not a systems thing.
It's a human being brain thing because
we're big dumb animals.
That's the answer.
Like there's a point when you'd have too
many therapists,
although you don't scale your scaling
relationship.
So you really are a concierge pain relief.
You are.
not scaling.
You're one-on-one-ing at scale.
Do you know what I mean?
You're trying to have more one-on-ones,
not five hundred people come in to the
machine.
I think the PE organizations,
and there's the data to back it because
everybody keeps doing it and striking out.
When you remove the thing that makes you
special and then fail and then get shocked
that you lost money doing it,
how many times do we have to touch
that stove before it doesn't work?
I don't know.
I think, I mean,
I want to be partnering or eventually
buying,
more so partnering with other PTs that are
self-pay, like cash pay practices,
and have a portfolio of them across the
country because then they're like still
part owners.
Right.
And we share all the best practices.
We share what's working with marketing or
admins, whatever it is,
that type of stuff.
But still having the patient, the clients,
pay for
whatever like the premium rate is out of
pocket.
That's actually, that's that.
Yes.
It's like, you need the right therapist.
Like you need the right human, right?
I'm, I'm,
I'm interviewing therapists right now.
And any,
like the first step is a fifteen minute
phone, phone call,
like a fifteen minute phone call
introduction.
And I almost, like that fifteen minutes,
I'm getting like obviously more reps at
it.
So it's like,
I can,
I pretty much have a good gut of
like, who's like, hell yeah.
All right.
The right fit or a great fit within
minutes.
And it's like, it's either that,
or it's like, ah,
like they're probably not or like some
once in a while, it's like,
they're definitely not, you know?
So, but there's a lot of those therapists,
but that's, that's part of it.
I don't,
I don't want to get off topic,
but like, yes, yes, yes.
You need the therapist,
but also the separate topic is,
When someone's paying something out of
pocket,
all of a sudden they take it more
seriously and they're more likely to get
results,
meaning the patient paying for the
service,
which is completely a disconnect from all
the in-network practices across the
country where, yes,
I know premiums are higher, co-pays,
co-insurances are higher.
But in general, like, come on,
you're paying forty dollars a visit,
twenty dollars a visit to use your
in-network P.T.,
services at whatever practice across the
country, you don't take it as seriously.
Come on.
It is what it is.
The more I pay for something,
the more I take it seriously.
It's fact.
I want to go back to the other
thing that I think you're saying,
which is you might not be able to
verbalize or write an...
Let's say you had to write an SOP,
a standard operating procedure,
and you were going to hand off hiring.
That would be hard, I assume, for you.
I'm picturing... At this time.
At this time, yeah.
But I think it always should be hard.
I mean,
it's pretty crucial to know who to let
in.
I think it's most of your business.
Outside of systems and what tools you use,
I think you are mostly people.
That's what you are.
You're not even... The product is there,
but without the people...
That's why Marcus Limone will say,
people process product.
Processes all your tools and how you're
doing it.
The order.
A machine that you can run.
But part of that is... It's vibe.
This is all I was in radio.
Again, I said...
I sat there in the radio studio.
I had a lot of time to think.
If I was going to open another radio
station in my market that was going to
go after and play the same music,
what would I do?
I know what I would do.
I would I would have an intern sit
there and listen to my competitor.
Like if I was coming in as the
new guy,
I would go to the legacy established radio
station.
I would have an intern write down all
fifteen songs they played last hour and I
would play the next hour.
I'm playing the exact same music.
Right.
But now we're even.
They have a head start.
It's the difference is what you do between
the songs.
you're providing physical therapy.
Let's just say, like,
you can only do so many things.
You can only be so creative with the
body, right?
It's everything else.
That's the differentiator.
But if you asked me to write down
how I find a new DJ, broadcaster,
I'd be like,
I want to meet him and I'm going
to smell him and lick him and,
you know,
like all the other things besides just let
me see your resume or how do you
pronounce the word Foo Fighters?
Like, that's not it.
It's everything else that you can't do
physically
yep and you have this has to be
it's like brain or gut this is sort
of a gut thing and i don't know
the answer but you know you don't know
what's right but you sure as hell know
what's wrong or you should be and that's
when you know you have your finger on
it yeah and and one of the things
i'm like i definitely i i don't know
if it's like it's not like the best
uh approach but like at least for us
is it's still the the old adage of
like
hiring someone who you would want to have
a beer with or have a coffee with
like me, meaning like,
and it doesn't mean we're going to be
friends.
It doesn't mean like we're going to like
hang out, but it means like you,
you can't like,
you have to at least like,
like have some affinity for this therapist
or this person you're hiring.
Like you have to like them.
They have to be likable.
It can't be like you go home and
you tell your spouse like, Oh my God,
I had a coffee or a beer with
so-and-so and it was terrible.
They were talking about themselves the
whole time or like,
It like, there was no, uh,
there was a disconnect.
There was no communication or there was,
we didn't,
we weren't on the same page with,
I don't know,
they were bringing up politics and I
didn't want to talk about whatever,
whatever it is.
Right.
So for me, it's like,
I take my therapist out for meals and
stuff and coffees and all that.
And like, you have to, you have to,
they have to be likable.
And if you like them,
then most likely your ideal client and
patient will like them.
The fact that you actually used a not
often used word affinity.
That is the word.
It doesn't mean you need to be in
love with him and you want to be
the best friend.
So have you ever heard of the arc?
This is the arc triangle.
I think this is from the dude from
Dianetics.
I think this is L. Ron Hubbard.
Oh, no.
I think it was all about like spaceship
or something, right?
Yeah.
Dude, wild stuff.
Wild.
Scientology is wild.
It is a cult.
Doesn't mean he can't be right about some
stuff,
but this is his arc triangle and it
holds up.
And the three corners of the arc triangle,
ARC, what Dave said, affinity,
you have to have, you can't,
when the person walks in,
you can't be like, oh, this guy again.
You can't have that.
You have to have a modicum.
And I love that word because I never
use it.
Modicum of affinity.
Likeability, right?
So affinity, reality is next.
We have to be on the same page.
You couldn't hire someone that you like,
Dave, I'm guessing,
that is over here doing the weird thing
where they do the hand, the Reiki.
I'm guessing if you're like, hi,
I'm great.
You love me.
I'm a good guy.
You'd have a beer with me.
You'd play catch with me.
But I'm doing Reiki over here.
You're like, listen, I like you.
You're a good guy.
This ain't going to line up.
So I wish you well.
I don't hate you for it, but next.
Right.
And then communication.
You have to be able to transfer
information back and forth.
And if you can't.
So that's the arc triangle.
You have to have those three things to
achieve.
And that's the goal is understanding.
And you've been in situations.
I've been in situations.
We've all been in situations where one or
two or three of these things is out
of whack.
It just does not work.
It doesn't work.
So the fact that you said affinity,
I was like, yes.
I licked the foo, says Dr. Bo.
You just know.
And that's simple.
It's just not easy all the time.
There's a lot,
at least for me with like recruiting and
interviewing and hiring,
like there's a lot of things that are,
that's kind of like that,
where it could be like,
it could be the one,
it could be one thing,
but it's an immediate like disqualifier.
Like it could be, uh, or,
or it's like a cluster of things.
Like, let's say, um, for the,
either the zoom, the,
so it's a fifteen minute phone,
fifteen minute phone call is the first
step.
Then the next step is a sixteen minute
zoom video interview.
Next step after that is a sixty minute
in-person evaluation, mock evaluation,
skills assessment.
So they evaluate me as the fake patient.
They get a case.
If you're late to any of those,
That's like one thing.
So it's like, oh, maybe,
but also could be like life happen, right?
But then it's like if we meet in
person and you're, again, you know, Jimmy,
and some people know,
I have a certain type of style or
whatever.
So if you show up kind of disheveled
or you're not really clean shaven or you
look a little like you're hungover or your
shirt is untucked or what, then I'm like,
okay, well, so that's something.
And now I piece together the other time
that you might've been late.
So now it's like I'm clustering signals
around you.
Yeah, there's pattern recognition.
But some of those,
if those things are big enough,
that could just,
like one of those things could just
disqualify someone from our process right
now.
It's what my friend Mike Morrison has
called a knowledge scent.
It's like you're putting into the world,
like shows up.
It's usually never one thing unless the
one thing is catastrophic.
It's did this a little odd,
was late and didn't even apologize or try
to like communicate why, right?
There's that great scene from the Will
Smith movie, Pursuit of Happiness,
where he tries to get the job and
he gets the interview and then he shows
up covered in paint or something.
Yes.
I love that movie.
And he explains it perfectly.
When the boss was like,
what would you say to someone if you
were in my chair and someone dressed up
like you and was wearing a shirt?
And if I hired them.
But he was honest.
You know what I mean?
He was like, listen,
I'm trying to communicate.
I understand how this isn't good.
It was not on purpose.
It is not a sign of my respect
or lack thereof of you.
It is because life happened.
And that person was at least in the
movie, of course, able to go, okay, okay,
I get it.
Do you want to switch topics?
I have one specifically for you that I
don't know if you have data on.
You did your postcard thing a while ago.
Has it been long enough for you to
like have results or like?
Yeah, so we're still,
I probably spent close to four grand.
It's still negative, unfortunately.
So we got leads.
We got some people booking avals.
We did,
one lady booked an aval last week,
so paid the hundred and seventy five
bucks.
So it's like the fifty percent off
evaluation.
I had coached one of my therapists and
I was specifically for this aval.
I said she was wanting to work on
balance and maybe some chronic back pain,
whatever.
I said,
you're going to tell her we don't do
single follow-up visits.
So whatever her goal is,
you're going to attach a custom package,
whatever you think it's going to take to
help her achieve whatever this first goal
is.
Maybe it's the big goal.
Maybe it's step one of a goal that's
going to take three steps or whatever.
So therapists sold or pitched,
she agreed to like a five visit package,
which at three fifty a visit was seventeen
fifty.
That was that would have been after the
evaluation.
So she agrees to that.
And then like the next day changed their
minds.
So still we're still negative,
but at the same time,
we're hoping that these postcard assets
are, uh, on the, hopefully they're like,
they're like on the fridge.
They're on the bulletin board, the, the,
the cork board or in a drawer somewhere.
And we hope that those seeds grow into
a cash paying patients in the future.
But,
still negative.
And the company that I did the postcards
with, um, they are,
they're hounding me like crazy.
And I'm just like very direct.
And I'm like, Hey,
like maybe it's on data, right?
Yeah.
But like, they're like, Hey,
like when you want to run your next
campaign.
And I'm like, well, I got Lee,
I got a few leads, but like,
you know, it's not,
I mean, it was,
I think it was two or three,
I think it was like two or three
campaigns.
So I, you know,
I spent a couple thousand bucks and I'm
like, I needed,
if I spend that much with Google,
like I get more leads and I get
people to convert and pay.
So it's like,
of course I want to take some ownership.
Like maybe there's like,
it's part of the funnel and I got
to like optimize some of the steps.
Maybe it's the words,
maybe it's too many words.
Like maybe we need to redesign it.
But the company, I was just,
the company did the postcards.
I was kind of just like,
Yeah, I might revisit it,
but it's not my main priority.
And I was hoping that they would give
me some discount or something to run the
next campaign.
So I'm just holding out for right now.
I would put them on my side of
the table and go, help me understand.
We paid X, I got ten leads,
two converted.
Why would increasing this be
disproportionately good?
Because they have the data, right?
Because they gave you the QR code,
so they can see how many scans there
are.
Correct.
They should, they should,
they should have it.
Yeah.
They should be sitting there going, man,
this struck out.
We,
if we want to not lose him forever,
we need to sit on his side of
the table,
not try to sell him something again.
So here, here's the,
here's the challenge with these postcards,
right?
Is this relates to,
you remember when I was telling you guys
that I was sending out handwritten letters
or,
or printed letters and sign it and signing
the letters to practice owners to
potentially buy their practice, right?
So I had done that the past couple
of years and I heard other people online
doing it,
like where they were sending letters to
potential business owners to see if they
wanted to sell their business.
And a lot of those business owners will
not reply or respond until they get three
or four or five or six letters from
that company because they think it's a
scam or they don't take it seriously
upfront.
So now the company that does the
postcards,
they're kind of saying that they're kind
of like, well, you,
you kind of need more volume.
You need, you know, you need,
but it's like, I know I need, yes,
I agree.
I need more outbound.
Yes.
I need more volume of these postcards to
go out.
But at the same time,
like I'm outlaying money now.
And like,
I got to wait like so much longer
to get that money back.
So the risk is all on me.
Um, like what risk are you taking?
None basically, you know?
So it's like,
yes it is a long-term play no matter
what and yes you should only be doing
this if you have like an extra testing
like this this was literally a test
marketing budget i knew that like hey i
got this money uh it's a deduction you
know it's a tax write-off will boyd might
still be here live and he can confirm
that this would be a marketing tax
deduction expense hundred percent it's an
expense but it's also like i know that
like some people will keep these some
people like i think charles lockwood or
somebody online another pt in another
state said
Someone had this like of his,
like in their drawer.
And, you know,
six to nine months later after the mailer,
they called him.
Right.
So it'll, it'll convert.
It'll,
it'll eventually get us more calls and
leads, but it's like,
how many thousands of dollars?
Like,
do I need to do four or five,
six,
seven thousand dollars or something to
then, to then get it back?
you know in six to nine months like
what like it's not great for cash flow
you know what i mean it kind of
is like it's not in reality it's not
ideal it's not ideal now if it were
gangbusters then we would pour more money
into it right right and so we just
can't right now or it just doesn't make
sense to do it this is what i
really want and it hasn't happened for the
live stream is there are people out there
who've done
disproportionately stupid ideas.
And they've worked.
So one of those where we did this
crazy thing and it worked.
I think what works in Bangor,
Maine works in New York City to an
extent.
There's differences,
but there's more similarities than
differences.
There's some things that will never work
and some things that would.
Maybe we'll try to start poking in some
of the Facebook groups that we run.
I just want a big repository of ideas.
Because I think the thing that we sell
is great.
It's great.
No notes.
And I'm not here to change your clinical
anything.
No one wants that.
It's this outreach thing.
We used to call it a swipe file.
It's like when you had an idea,
but you couldn't do it now,
you put it in the drawer.
And then every once in a while,
you break the drawer out and you just
kind of comb through it.
And you're like, yeah,
that's a good timing for it now.
I think the answer right now,
three years ago,
is do everything with a QR code and
everything's digital.
And you give away a digital guide and
a PDF and a course and a video.
I think that's so saturated that the
answer now is analog.
Now you give them something stunningly
simple or stupid and you make it cute.
Realtors are good at this.
Like if you gave out corkscrews,
doesn't make any sense,
but draw a straight line between
corkscrews and whatever and be like,
if you want to be able to open
that great bottle of red five years from
now, we should start doing curls now.
I'm Dave.
Like, you know what I mean?
And then that stays in their drawer.
When they have that problem, you're there.
Yeah.
Because the problem used to be,
where the hell are all my phone numbers?
And a good pizzeria gave you a magnet.
And if you made it on their refrigerator,
game over.
You're calling that number when you have
pizza problem,
which is every Friday or every two weeks.
That magnet has great ROI.
So I would love to find out because
there's a million stories out there.
There's a million story in the Naked City
and this one is mine.
I think that it would be great to
collect those.
And I think most PTs when they hit
it are more than happy to share it
because you're not competing really with
the person across the country.
There's more of us that should be in
concert than should be in competition.
Right.
uh i gotta finish a few minutes early
but we are also looking to do revisit
meta ads so facebook ads and google i'm
sorry facebook ads and instagram ads great
and um yeah i'm gonna be speaking to
two different companies this week two of
the ones that you know of um and
uh yeah we'll we'll see and it's like
hey that's like maybe that'll be more
efficient or maybe that
is still a challenge because New Yorkers
are really skeptical and don't trust
service-based businesses.
Maybe that's your ad.
If I were writing copy,
like I was doing back in radio times
before AI kids,
we used to use a pencil.
The problem,
if you said the problem is my audience
is usually skeptical, I would open with,
I'm sure you're probably skeptical about
this.
It immediately disarms them.
And you don't have to say it verbatim,
but it needs to be said either literally
or implied.
This feels too good.
Like you've heard the ad.
A twenty twenty six Toyota Camry for less
than twenty six thousand.
That can't be right.
That immediately says this seems too good
to be true.
In fact, I'm going to keep talking,
though.
I don't know what our spin is on
that.
But whatever it is, you take the bullet.
You eight mile them.
You take the bullet out of their gun
first.
Everything that they would crap on you
for, you say it and you go,
this is true that we are more expensive.
We're more expensive than every other
clinic that you can Google.
Don't even bother Googling every other
clinic in Manhattan.
We're more expensive.
And then leave it open ended.
I like it.
There's probably a reason for that.
Because we wouldn't be in business if we
didn't get results for other people that
were paying out of pocket.
Then that's your next line.
And we've been in business for three
years.
How do you think that works?
And then your next line is,
if you have this, this, or this problem,
and you're in Manhattan,
we solve it and we come to your
house.
I don't know.
That's just how I would do it.
But I would pretty it up.
That's when you use AI.
Use humans for this.
You pretty it.
You smooth it and you sand it.
All right, let's do parting shots.
man, we, we bounced around all over, but,
um, I I'm,
I'm fine with continuing to focus,
at least for us focusing on the, uh,
premium out of pocket service delivery of
what we also call physical therapy,
even though we kind of think that the
offering or the overall system or
presentation is either similar or
different than the network practices.
But yeah, I just, it just, uh,
Someone paying out of pocket to work with
us, they take it more seriously.
They're more likely to get results faster.
And then the cash flow is just amazing.
And then also side note for us to
talk about in the next week or two,
probably hiring another therapist soon.
Might even hire two before the end of
the year.
So we're rocking.
So yeah, we got a lot going on.
And also another topic,
I'm speaking to a virtual assistant
company,
hiring two virtual assistants to do our
phone calls.
So that's a big lift for me as
well to kind of get the whole script
navigated and coach them and all that.
So yeah, a lot going on.
Good stuff.
I think if you took the transcript of
every episode that we've done in this live
stream and ran it through AI and said,
find like, what's the commonality?
I think it's this, for me anyway.
Just make sure you understand what game
you're playing.
Because if you're playing the I'm not
making enough money game,
And the answer you think is go get
more certifications.
You're not playing it right.
You're changing the color of your jersey.
That doesn't help you, right?
I need you to change what skates you're
wearing or I need you to leave that
game if you don't like it.
Understand what game you're playing.
Understand the rules so well you can bend
them and break them and not get caught.
It doesn't mean break the law.
I'm going to say that because otherwise
our lawyers will freak out.
What it means is understand the rules so
well, you know where the gaps are.
The story was Wayne Gretzky,
when he was a kid,
had the little whiteboard that coaches
would use in hockey and draw whatever.
He would follow with his finger on a
pen
where the puck was on the ice.
And then when he was done,
he didn't look at where the lines were.
He looked at where it wasn't.
And he goes,
I'm going to go hang out there.
When I have the puck,
I'm going to go where people aren't.
So he understood those.
That's why Wayne,
it's called Wayne Gretzky's office.
Nobody went behind the net.
Well, you can't score from back there,
but you know, it's really,
really easy to do from back there.
Pass to people that are open,
which is why he has the most assists.
Do you know the stat?
If Wayne Gretzky scored zero goals in his
career,
he would still have the most points scored
ever,
which means he has more assists than
everybody else has assists and goals.
Yes, he's a goal scorer.
Now he's not the leading goal scorer.
He's still the most assist leader and
pointer.
So Wayne just understood what game he was
playing.
All right,
we'll talk to you guys on Tuesday.
Have a great weekend.
Enjoy.
That's it.
We're out.
Boys, what the hell are you doing?
Follow Tony Meritato 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 Pinecast 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.