Broadcasting way too early from three
separate Wi-Fi connections.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
how to be honest this one feels this
feel i heard something i think tony
maritato not even something you said
before we went live just the vibe you
said something about the profession not
existing i mean if that isn't a cold
open i don't know what is um do
we want to start with someone else's post
is that we want to start with are
you trying to find that one yeah i've
got it let me pull it up so
richard severn which i think probably most
people know
I'm going to put it on the screen.
This was posted on his personal profile,
the doctor of physical therapy students,
a bunch of different places.
And basically,
he's talking about the financial viability
of the profession, right?
He's like, I don't want to talk,
make it all about finances.
And there have been multiple therapists
and educators in the profession talking
about finance.
But he talks about challenges to the
financial viability of the profession,
clinical practice.
This generation of students is more aware
of their finances than ever before.
Talking about return on the investment,
putting academic PT programs under threat.
You talk to students.
You kind of have your finger on the
pulse.
Before I keep going,
what's been your experience?
I don't truthfully think PT students in
the programs are thinking about finances
at all.
but i think i think they're thinking about
it more than they did ten years ago
i do not do that is that funny
because i'm right or funny because i'm
wrong more more is relative right before
it was zero now it's one percent well
well all right let me it's it's hard
to measure but i don't think there was
much discussion there was zero ten years
ago and now there's some so that's a
thousand percent more right exactly uh
Yeah, I think I've said this before,
and this is not a knock on education,
but after eighth grade is ninth grade and
after ninth grade is tenth grade,
there's always a thing.
So there was always a thing to land
on.
That's how it was for me now.
the closer you got to the end of
high school,
the more your teachers were like,
you know, you need to do some stuff,
right?
You can't just show up and sit there
and then be moved along to the next
number.
Eventually,
like you're going to get the boot, right?
So I think that was sort of the
debt,
like the idea ten years ago when I
graduated from PT school, and again,
only ten years ago, was there's a job,
like you're going to work for it,
but there will be one.
And now some of those jobs,
you're underwater in terms of like
whatever you owe versus whatever it's
paying.
And that should be a wake-up call that
you need to do something different.
It doesn't necessarily need to be more.
I mean,
listen to a guy like Chris Corner and
he's like,
you don't need to necessarily just keep
working more hours, right?
There is that whole, I mean,
if I heard it,
if there's a cliche for the last ten
years, it's trade time for money.
Yeah, it's ability for money.
It's time for money, right?
But if you're in first gear and for
every spin of the pedals,
you're only getting one spin of the back
wheel, that's not good.
Figure out something else to do.
Maybe don't bail out of the profession
altogether before you look around and say,
well, what else do I like to do?
What am I good at?
What is no one else doing that a
bunch of people need to do?
Again,
still shocked that no one's also adding...
food service i thought your idea for like
like meal prepping with people who were
either homebound or just don't have the
time or like me i have lots of
time i don't like doing it and i
would pay someone to do that right i'm
not lazy i just i'd rather be outside
mowing the lawn or weed whacking than i
would cooking something and other people
are vice versa
So I think the fact that if you
don't know who Rich Severn is,
he might be one of the last people
to go out of the way,
in my opinion, to talk about finances.
This guy's all about clinical excellence.
He's in academia.
And the fact that he's doing this,
but he's also seeing this full circle
moment, I think.
Because at eleven fifty nine on the clock,
you have students and at twelve oh one,
you have academics and programs.
And now I think they're both
Touching each other, right?
I mean,
somebody had a stat the other day of
how many colleges there were in the
country and how many of them were
financially in trouble.
And the number wasn't good.
It was a significant amount.
I think Rich is looking at it from
the lens of like, well,
if these schools are in trouble,
who's going to be teaching the next
generation of PTs?
The answer might be no one.
And then what happens?
other professions absorb the things that
we did i think that's the route that
you were going and that's the route that's
sort of what i i didn't even read
rich's post i didn't see it but i've
listened to rich enough to go i think
i know where he's going rich isn't the
guy trying to get loaded he ain't the
guy trying to get rich rich ironically is
trying to just teach people and be happy
and be good so um i'm on a
diatribe here so oh uh my thing i
think students are more aware of it
And one step further,
I think the ones that are hyper aware
of it aren't making the decision to go
to PT school.
I think the ones that are actually
crunching the numbers and looking at them
and saying, this math, don't math.
We never hear from, I never meet them.
They never listened to this podcast
because they never make the decision.
They're gone.
Right.
Yeah.
And that's what it is.
You know,
basically what I'm taking away from his
post is if the financial situation in
clinical practice improves,
the value of the profession improves,
we attract more people.
And when I look at that, I mean,
it goes back to chicken or the egg.
Are we as a profession past the point
where maybe back in the day,
We were able to kind of bring people
in,
attract students who just want to help
people, right?
That's what we did.
Now it's not financially viable anymore to
just want to help people because the
people helping people need to buy a house,
need to buy a car,
need to raise their kids,
like do all of this stuff.
So all morning I was playing around with
AI and I was talking to AI.
I'm like,
how do you differentiate between the
healer physical therapist who wants hands
on the patient,
the therapist who wants an hour dedicated
to each individual,
make a fully customized treatment plan
versus somebody more in my world where I'm
like, look, we're all humans.
We need to walk or locomote.
We need to move through space,
however we do that.
We need to lift and push and pull
and carry.
I can develop a plan that pretty much
works everything.
I haven't taken a student for probably
almost ten years.
Since before COVID,
I haven't accepted any students.
Yesterday,
I talked to a local high school.
They're like, I've got this young girl.
She really wants to be a physical
therapist.
She's in her senior year of high school.
Can we do this arrangement?
I was like, yeah, we'll take her.
Because now we're kind of in a better
position to provide the student with what
I believe they need.
But with that,
one of the main things I'm going to
show this student is, look,
here's ten humans that all walked in with
different conditions, a back, a shoulder,
a knee, a hip or whatever.
They all have different histories.
They're all unique personalities.
They're all kind of snowflakes in their
own way.
But at the end of the day,
every single one of them will benefit from
doing these five things,
walking across the balance beam,
carrying a weight, you know,
resisting this motion, whatever it is.
And that's where I go back to him.
Like, first,
we have the identity issue of am I
the person who has to do the intervention
or am I the person who who now
analyzes the situation,
determines the plan of care and then lets
the technician
deliver the intervention,
not even a physical therapist assistant,
but an actual unlicensed tech that's been
trained by me.
And if we continue down the road as
a profession,
fostering the culture that nope everything
has to be done by the pt or
the pta nothing can be outsourced to the
technician working under the pt or the pta
i just think we we've passed that uh
replacement population growth where now
we're declining and at some point
correct at some point we're going to be
replaced and it's not so much that i'm
going to replace it's what i deliver is
going to be replaced okay this person
walks in they have shoulder pain they want
to reduce pain and improve function i
don't i'm not the only option to do
that i'm one option to do that and
if i can't do it at scale somebody
else is going to come in and do
it because these individuals need that
outcome
Funny part is this last weekend,
I was at like a prompt growth summit.
This brought a bunch of practice owners
in.
And my job for two of the sessions,
and you're gonna love this, was poke.
Ask a question until you got enough people
talking and then shut up,
which is harder for me to do,
but I did it.
And the only rule was we can talk
about the ideas that were there,
just like Graham sessions at that one
conference, just don't say who said what.
And the idea of PTAs or care extenders
were brought up and all these practice
owners, most of them were larger,
footprints all of them most of them were
in agreement that is a great idea in
fact if you're not doing it that math
don't math and these are the people who
are paying attention to their own math
they're not using hypothetical math
they're using their math in with their
payer mix in their state with their staff
their overhead their costs and they're all
saying yeah we we are doing this as
much as we possibly can and if not
we should be doing it more
Yeah.
So is it ego?
Is it I'm these these are the hands
of a healer?
Is it that is it we're taught that
we're the one don't let someone else do
the thing that's the magic.
But you and I think both agree that
these aren't magic.
It's you know,
it's supposed to be this and sort of
this like, I don't know.
I think it's a combination of, you know,
I go back to listening on TikTok,
this particular OT that I listen to a
lot,
who I completely disagree with all of her
perspectives.
I don't know her name,
and I wouldn't say it even if I
did.
What are her perspectives?
What is her stance?
Well, it's just back to...
Each individual needs a customized,
dedicated plan.
And we've got all of this knowledge in
our head, which we do.
They basically want the patient to get a
thousand dollar experience
But they refuse to allow the patient to
pay for it.
They expect the taxpayer in the community
to pay for it.
And they refuse to provide the service for
less money because they need to make
money.
So they want to get paid more.
They want non-patients to pay the bill for
them.
It's like they want all of these things
together.
And then this is where I really struggle
also.
i'm like where do you draw the line
between personal responsibility versus
this kind of victim mentality where she
she's like hey i was burnt out i
couldn't stay in the clinic i'm out of
patient care but i'm still an ot and
i want other ots to be more like
me well if everybody's like you nobody's
going to treat patients everybody's going
to teach people how to treat patients and
nobody's going to treat patients yeah
Um, so again,
that's not a sustainable profession.
Like I can't hire somebody like that.
That's why I've given up on hiring
clinicians.
I just can't do it.
Who would be perfect for you?
Like,
how would you describe the person who you
would love to have walk in and you'd
hire?
What, what, what, what are their,
what would their motive?
Like, what would their vibe be?
And what would they like?
What would the, what would drive them?
That's a great question.
I think a big part of it is
you don't have to do what I do.
You don't have to do it the way
I do it.
You can do your own thing.
But you have to have a passion for
putting the numbers together,
understanding the finances behind it,
making conscious decisions of, hey,
I'm willing to sacrifice more income
because I'm going to do what I want
to do versus I want to do what
I want to do and I want to
make a premium income.
Like Dave's not here today,
but Dave makes a premium income for what
he does.
I'm okay taking less money.
I take a lot less money for delivering
what I still believe is an outstanding
patient care experience, you know?
And so what I would look for in
an individual who potentially could join
the team would be somebody who they're,
they're a self-starter.
They think independently,
they know what they want to do.
They know what they want to achieve.
They understand the finances behind it.
They can,
they can find a middle ground between
making enough money to be comfortable,
achieving their financial goals,
and still delivering an experience that
the patient wants,
even if it's nothing like the experience
that I deliver.
But that person is doing it themselves,
and there's no reason for them to come
work for me.
If I worked for you or Dave,
I would have stayed in clinical practice
longer.
The reason I left was my brain don't
brain like some people were like, oh,
you're the angle of the force that you're
using on the tibia.
Jimmy, you're ten degrees off, buddy.
Like, what do you do?
And I just remember being like,
I don't know,
like I sort of felt like getting a
move.
Their leg was like more more.
That was eighty five percent of it.
So I felt like the places that I
worked were
way focused on the wrong thing.
And I kept looking at myself in the
mirror being like,
you are round peg in square hole world.
You got to get the hell out of
there.
Like,
I feel like more people need to talk
about that.
What you're talking about, which is...
And, you know,
my physical therapist assistant and I talk
about this.
We're like, it doesn't really matter.
It doesn't have to be that technical.
There are cases where it does need to
be that technical.
And that's where I think the value is.
Those therapists are working for
institutions where they're not being
monitored.
They're not, you know,
productivity standards aren't at a hundred
and twenty percent.
you can have three patients walking
working with a patient who had a stroke
and and all of that resource going into
that one individual because that
institution is making all their money
somewhere else yeah correct the overhead
is covered you could do nothing and the
overhead is covered right right but in my
my situation it's more like hey we just
need to move we need to work out
like the individual just needs a little
more fit now i will say real quick
So yesterday I had two situations where I
evaluated a patient,
I expected a specific outcome.
During the treatment,
I found new information that changed my
perspective on what this person actually
needed.
Hence, I changed what we were doing.
If I had delegated that out to a
technician that is not a therapist,
I don't think that would have been
necessarily identified.
It might have been identified two,
three sessions later after some of that
money had been wasted.
So again,
I'm still trying to find that balance
point where, yeah,
I can have a standardized protocol.
Everybody comes in.
They do the same ten things.
They're all going to get some level of
improvement,
but they're going to be people who need
more direct supervision,
more direct analysis.
i don't know where that point is yeah
but i go back to like all right
there are therapists who who have to go
and do legal depositions they've been
documenting for twenty years preparing for
the one time that they have to go
do a deposition that is a whole lot
of over documentation for the chance that
one time in twenty years i'm gonna get
called into a court of law
And like,
these are the kinds of things that I'm
like,
you don't over-treat everybody just
because occasionally there's going to be
one or two cases that do need more,
you know, let's go the other direction,
figure out a system where if there is
something, a red flag that pops up,
we can identify it.
Then that person goes to the specialist.
Not everybody goes to the specialist.
Right.
Yeah.
Horses, not zebras.
When does this break?
You brought something up very briefly that
I think actually tips the scales.
We don't have a problem right now,
or everybody tells me at least,
most of the time problem is not finding
patients.
Right.
But when there are less humans,
I imagine right now the biggest two
problems,
there's going to be three problems, right?
The biggest of the two or the three
right now are
Well,
I'm getting paid less for doing work.
I've got to figure out how to take
a hundred dollars,
but provide something for sixty dollars so
I can at least make forty.
Right.
So it's the economics.
We'll call it the number.
And then it's I need more people who
want to do the thing that brings in
the revenue.
It's not the patient's thing.
What happens when we throw the third
problem on there?
And I'm sure AI could map this out
with a bell curve of
Where the population dip is, right?
Because the end of the baby boom is
in their seventies.
I think my dad,
the end of the baby boom,
and he's seventy three.
So like, yeah, in ten years,
what's that kind of I mean,
is that going to be the thing that
really,
really puts the pressure on all of the
things that we're talking about now?
uh that's a good question yeah i i
think there's there's that but then you go
deeper and you're like okay well how much
is hinge and sword gonna take off our
plate you know for the individuals like
how are they gonna commoditize at scale
simple orthopedic cases that would have
come to a live physical therapist that
don't really need a live physical
therapist,
they would have taken care of that.
How is AI and technology gonna develop new
interventions?
I mean, AI in healthcare,
robotics in healthcare,
like I do think this is gonna have
a major impact where maybe we don't have
as many people who are gonna need the
services of human physical therapist.
Are we going to advance technology quicker
than the population of licensed PTs is
going to decline?
Who's going to get to the finish line
first?
I don't know.
Or is the educational system going to
change and adapt?
You know,
are they gonna change the culture of who
are we putting out into the profession?
Who are the students we're attracting?
Why is it that chiropractors tend to go
into private practice more than physical
therapists?
Is it because the educational programs of
chiropractic care are attracting more
entrepreneurial people?
Like they wanna help people,
I wanna help people.
They want to do it in different ways.
Why are so many chiropractors in private
practice where PTs, which is fine.
I am totally a proponent of, look,
just wipe out all outpatient orthopedic
from insurance based care.
If you want to do outpatient orthopedic,
go work for a hospital,
go work for an institution,
go work for a place that you can
focus on being the best therapist you can
be without doing marketing,
without answering calls,
without scheduling patients and accepting
copays.
Just go do that.
And then let's change the face of
outpatient private practice,
which
You weren't on the episode.
Dave and I were talking, I think,
with the PTs who are teaching personal
trainers how to do PT.
But yeah,
you and I talked about it because you
did Active Life interview.
And yeah,
like maybe that's the future of outpatient
ortho.
We just completely move away from
insurance,
completely move away from calling a PT.
We're still providing the same outcome.
And I think that's what's important.
Yeah, that's the question that, you know,
would a rose with any other name smell
sweet, right?
If I was licensed on Monday but dropped
my license on Tuesday and still did the
same thing on Wednesday,
is it still the same?
And the only difference is I can't bill
insurance,
which is probably one of the reasons why
people don't want to work for,
I'm not just going to say a hospital
system.
I don't think they're the big bad wolf
all the time anyway.
I don't want to be told what to
do.
I am an independent, autonomous thinker,
which I agree with.
But if you want more flexibility,
you got to take more risk, right?
If you want to hang your own shingle,
you have to be the one responsible for
doing all the things.
I had a post on LinkedIn that I
think it's one of the few times that
everybody agreed with me.
I said, if you own a private practice,
you are not in the physical therapy
business.
You are in the marketing and patient
attraction business.
You're in the customer experience
business.
You're in the human resources business.
When I got promoted in radio,
my boss sat me down and was like,
all right,
today's your first day and you're
officially in charge.
And then he said,
are you ready for someone on your staff
to come in your office and cry?
And I was like, no,
why would that ever be a thing?
And then three months later,
someone's crying because they needed a
weekend off because their grandma died.
And I was like,
I didn't realize I was in the people
taking care of their emotions business,
but I was.
My job was to manage people.
doesn't just mean like yell and tell them
what to do in fact it's the opposite
if i just treated them well i didn't
have to tell them to do anything um
getting a little off track but the the
idea there is yeah so your idea would
be outpatient physical therapy under
insurance let the hospitals have it
they're getting paid more for it anyway
everything else is cash is that what you
mean like we just take cash
Yes, that is exactly what I mean.
I wish I would have grabbed the
screenshot.
There was a physical therapist in one of
the Facebook groups who said,
I think it was a she,
she went to physical therapy at a
chiropractic-owned clinic.
clinic.
She saw a physical therapist.
The bill went through for like seven
hundred and fifty dollars.
The clinic got paid four hundred and
something dollars.
She's like first.
She said it was obscene to get paid
that much for an hour of physical therapy.
But what was she charged a copay?
I don't even.
Yeah, I don't know.
But she mad because she got screwed or
she like mad that someone else is getting
paid so much.
She got mad that somebody else was getting
paid so much and she was getting paid
so little when she was the physical
therapist, not the patient.
are you mad they're doing it?
Or are you mad that they're doing it
better than you?
And I think you know the answer to
that one.
What's the opposite of schadenfreude?
Schadenfreude is like the idea of you're
happy when you see someone trip and fall.
This is like someone's mad when someone's
doing well.
Dude,
take that dude to lunch and be like,
hey, how'd you do that?
What are you doing?
And it might just be a process issue
or a contract issue.
Instead of crapping on that person, like,
buy him dinner and be like, teach me,
teach me how, what are you doing?
What are you doing differently?
Because you're not competing as much with
that person as you think you are competing
against other time, gravity, skin cancer.
We're competing against all those things.
Those are the things that are actually
trying to kill us.
The dude down the street is just trying
to do the same thing as you.
I think that's, I believe that.
Well,
this goes back to the culture question.
Is it a societal change or shift?
Is it something within the universities
which tend to skew more liberal?
There are PTs right now who I'm trying
to walk this line where it's like, look,
somebody launched a business.
outside of healthcare,
grew this business to the highest
valuation ever for a business.
Now that business has lost thirty,
forty percent of its value from its peak.
And there are therapists celebrating that
this business,
which has lifted hundreds of people above
a million dollar valuation,
lifted thousands and thousands of people
out of poverty.
They're celebrating because they don't
like the person who started the business.
and so the business has lost value you
know like it's a them versus us it's
this whole thing that's pervasive through
politics through life through everything
now i could just be an an old
guy who's like oh back in my day
right but but i just i see this
we're not celebrating the success and you
say it all the time when the success
happens people want to tear down that
success unless it's happening to them and
then they're mad that it you know um
So I don't know.
Did you see the movie Air,
the Michael Jordan-like sort of biopic?
I did not.
Worth it.
Ben Affleck, Matt Damon.
a good movie.
It's a good movie,
even though you and I are old enough
to know the story, like, but even there,
and there is a scene, the scene,
the pivotal scene where Matt Damon is
like, I don't know,
like one of the agents for Nike, like,
and he's telling,
he's essentially pitching Michael Jordan
as the third or fourth best shoe.
Everybody is doing converse.
Nike is not a thing then.
And he's like,
you're gonna win championships.
The world is gonna build you up because
you're a great story.
You're this guy that was cut from his
high school team,
and then you won a championship in
college.
And he's like,
you're gonna reach the mountaintop.
And then they're gonna tear you down.
Because when they build you into something
that doesn't exist,
you they have to you they can't let
you exist like the the scene is so
fantastic because that's true with an
athlete an actor or actress a musician a
company these all have faces right like
all these companies have faces the first
time someone pointed that out who has more
instagram followers tim you know steve
jobs or ins or or apple and i
was like well obviously apple it's a
company no it's the it's the face
It's the face.
So yeah,
when you see someone down the street doing
better than you,
I forget who said it first,
but the success isn't cake.
If I got a big old slice,
our mentality is from when we're little.
I don't want that toy until my brother
touched it.
And then my brain doesn't need to be
taught.
One toy, if he has it,
I have zero toy, right?
That's not success, though.
It's just not.
It's the world's too big with too many
opportunities to be focused on that.
I mean,
Jerry breaks it out more than anybody,
I think, with that statistic.
And I don't even,
it's been said so many times,
I'm not even sure where the hell the
statistic came from,
but that ninety-two percent of people who
could use physical therapy don't even get
it.
So we're competing over the eight percent
instead of the ninety two percent.
Right.
I told that story about
When I ran the radio station,
we had a budget for this one day,
St.
Patrick's Day in Scranton.
And every year we pitched to get our
budget funded by the boss.
And eventually the boss said,
what do you want to do on St.
Patrick's Day?
And I said, nothing.
I wanted to take that money and spend
it in April, May, and June.
Because I saw you're all fighting over one
day's worth of attention for ten grand.
I'll just take my ten grand and I'll
go spend it where no one else is.
I'll go build...
on cheap,
cheap real estate and wait for the people
to eventually move there or give them a
reason to.
Girls gone wild, right?
Super bad, super horrible,
like VHS empire built on buying every ad
from eleven p.m.
to five a.m.
because it was cheap.
And that's when his audience was awake.
Right.
We keep trying to out PT each other.
The people who win will not.
They will figure out a strategy to reach
people
in a different way,
which is a good segue that I can
go to unless you have something else.
Yeah, go ahead.
So we got a listener voicemail.
Getting voicemails now.
Someone sent me one of those voice
messages in Instagram.
I'll get her name in a second.
But she was approached by a marketing
company who essentially gave her a pitch
and said, listen, X number of people...
It's a good pitch anyway.
They thought from her seat anyway.
X number of people are moving to your
area.
You own a clinic in this area.
here's five ways we can target those
people before they decide who their
physical therapist is now i think this is
a good strategy i don't know if it's
a good strategy for pt because i still
think pt is pretty reactive right like i
don't move into a town and go okay
i gotta find a doctor i gotta find
three good restaurants one place to have a
drink and who's my pt right like we
sort of look for pt
arguably too late, right?
Myself included.
I start thinking of who my PT is
when my elbow hurts or when my knee
hurts.
But I thought this strategy at least was
pretty good.
I'm not sure if I can make this
any larger.
Essentially, it was like saying,
target the new families before they begin
searching.
So I like the idea.
I just don't know if I love it
for PT.
And she was essentially asking us to sort
of critique this pitch.
I thought the image was designed pretty
well.
I'm sure if I was giving this image
a prompt, I'd say, great design,
lose fifty percent of the words, though.
Right.
Better keep the better where maybe seventy
percent of the words and just make the
other words bigger.
But essentially,
their pitch was be the first physical
therapy practice they discover.
OK,
let's let's say because it does say
families.
Let's say you're a peds practice.
with a kid who's going to need PT
forever, like you're in PT for life,
right?
That's a good point.
That's a good audience for that.
Yeah.
Second is they essentially say we serve
your community in a fifteen mile radius
around where this person is in Kansas.
So they're showing we understand how
people search for things.
We're going to put you in front of
them before they need before they need
care.
I'm trying to see what that estimated
verified new families every month.
If that number is right,
it's twenty six hundred new families in a
fifteen mile radius in Kansas.
I don't know.
I'm not good with math.
That seems like a lot.
But if that's right,
like if you got one percent of that,
if you're in front of one percent of
that, that would be good math.
So thoughts on this strategy and thoughts
on this strategy for a PT.
I mean, it's, I like it.
Let me start there.
I like it.
I can tell you candidly,
when I hear a patient who would
potentially fit into that category,
a patient who moves somewhere and like one
of the first things they want to do
is they want to find their PT,
I get a little bit uncomfortable inside.
Ooh, why?
Because to me,
now from a business owner perspective,
it's like, yes, cha-ching.
But from a therapist perspective,
I'm like, ooh, that's not my ideal client.
That's a little too dependent.
That's a little too needy.
That's the guy who starts texting you five
minutes after the date is over to be
like, hey, we had a great time.
That patient's too expensive.
Not too expensive, just too needy.
But that's going to be expensive for you
because like, hey man,
you're going to demand way too much of
my time and effort.
I'm never going to serve you.
You're always going to want more.
Right, right.
So, you know, from that, but hey,
there are therapists who love that patient
and that patient could be your lifetime
patient.
Lifetime value of that patient is going to
be incredibly high.
That patient is going to believe that you
are the healer that they've been looking
for and they're going to want to be
with you no matter what.
There's value in that,
just not value for me.
I like the idea of establishing yourself
early in the process.
I think the biggest barrier to this is
we don't have the margin and the budget
to afford to pay for that.
Yeah,
it's more than what we're going to make
on a typical outpatient orthopedic or
neuro case.
So that would be the challenge.
This is essentially what Dave is doing.
Instead of new families, he's targeting,
we should get an update.
The last update we have is that he
had a bunch of clicks and scans,
but nobody had followed through.
Maybe one person did a discovery visit.
He had done a postcard mailer.
The twist that I like, I mean,
I like the postcard mailer idea.
The twist that I loved was that each
card had a specific QR code,
like a trackable QR code.
That's obviously an app,
because if you had to sit there and
just make a new QR code,
that way you can see when was it
sent, what building, yada, yada.
But we also agreed, I think,
or I at least did, and say...
that card might sit in a drawer for
six, nine months,
a year before you're like, oh yeah, okay,
I'll make that decision.
So you don't know if you can attribute
it to that.
Yeah, I think you're right.
The margin isn't there,
but I think that marketing company was
doing an honest job at least in saying,
okay, let me think forward for you.
And if these people have already made
their decision,
the people that already live there.
And if there are twenty six hundred new
families coming in,
that's a lot per month.
Yeah.
It's in Kansas.
What is that?
I'm pulling it back up.
Then the other stuff that you look at,
like these are obviously very generic
stock photography images.
This is trying to sell whoever makes the
decision about marketing in the PT
business.
This is trying to sell that person.
I loved what you said about pediatrics
who...
you know,
have a condition that's going to need
lifetime care.
I don't see that here.
It's not.
Yeah.
So I don't know.
Let me see what her, um, focus was.
I didn't ask her for permission to share
her stuff.
I don't think she'd mind,
but board certified serving, uh,
area that unless, Oh,
mom and baby specialist.
So yeah, mom and baby specialist.
It doesn't come across in that message
though.
Right.
Like it doesn't look like that.
At least this pitch doesn't look like
that.
Because I was in peds.
I didn't understand that until I got in
peds.
And Amy, my mentor, was like,
these kids are going to be...
This is Tuesday at one o'clock until this
kid's eighteen.
Then they go somewhere else.
Or even a couple years past eighteen.
So that would be a good strategy for
this.
Because that involves a weekly need.
Your PT for typical outpatient ortho,
I don't think it would be
a great idea this would be a great
idea if you were a chain like you
said if you had the size and the
margin to do that if you had your
own marketing person this person you might
hire for digital seo or okay you be
mine i'll pay you two grand a month
to find me two families two patients that
come in that are that are quote in
the new family bucket i wonder too if
there was
Dr. Bo, coming in with the stat.
Kansas City Metro, largest in...
They're just outside of Kansas.
Kansas City?
Yeah, I think so.
Gained about eight thousand residents
total over four years.
Oh, yeah.
So there's no way it's two thousand a
month unless there is that much out.
I'm not good.
This is not my strong suit.
Maybe they're counting each person in the
house.
Oh, because it says three thousand.
Yeah, well, I don't know.
I think the thing said three thousand.
It doesn't matter.
But yes,
that number is important because you're
going to say,
how much did it cost me to get?
You need to know your customer acquisition
cost.
Your cash.
I'm guessing this was AI generated
regardless.
Looking at this,
which is pleasant to look at compared to,
I shared this one with you.
Yeah,
I've seen this now way too many times.
And again, I'm guilty of this.
My YouTube thumbnails look very AI
generated.
You know, we can jump on a trend,
but the trend's going to wear out.
It's going to burn out.
To me, this is part of the AI.
As soon as ChatGPT started getting better
or clawed with generating these kinds of
infographics, it got overutilized.
Yeah, yeah.
And so what are your thoughts when you
see something like this?
If you're the occupational therapist
sitting there, you know,
is this appealing to you?
No.
In fact, it would probably turn me off.
It was like, you couldn't...
This poster for the podcast listeners...
Put that back up.
This poster...
This is going to be great for the
podcast listeners.
This poster sounds...
Like a monster truck commercial.
Sunday, Sunday, Sunday, it's Gravedigger.
Like across the top.
Now hiring occupational therapists at
forty, forty, forty seven dollars a night.
Like this poster sounds like trash.
Like this to me is why people call
it slop.
Designing something with AI doesn't
necessarily make it slop.
It's when you can tell like you did
one prompt and this thing popped out and
it's trash, right?
So now the curtains don't match the
carpet, Tony.
Like if this is the classy,
if this is a place you want someone
who's great to work at, this don't match.
If this place is, you know,
smells like stale cigarettes and,
you know, old Budweiser cans, yeah,
this clinic looks fantastic.
And I'm not, you know,
trashing them except for this poster makes
you look like that.
I don't know who you are.
I don't have my glasses on.
I came and read where this person's from.
But yes, this this don't match.
I would say, though,
the opposite or not the opposite,
it's not completely opposite.
A YouTube thumbnail designed sort of
cartoony or caricature that's designed to
get to get an immediate emotion to watch
the video.
So I think you do need to balance
what you look like.
You can go too much.
where you're advertising with a flashy,
too loud, too sloppily designed thumbnail.
And then you click it and you're like,
this is a very thoughtful video.
I was expecting like someone screaming and
a lot of zoom in, zoom outs.
Where's the weird B-roll transitions and
stuff like that?
And it's not there.
So just match the curtains to the carpet,
right?
Like you gotta make sure these two things
match up or here's why.
you'll get the people that this poster
attracts and you'll be sitting there
going, advertising doesn't work.
Or the opposite is true.
You design something super classy and
classy people apply and then they get
there and they're like,
I don't wanna work here.
And you say, advertising doesn't work.
You're not matching the message to the
audience.
just saying make it easy and make it
get a lot of it a lot of
attention isn't good if it's bad attention
and yeah there is bad attention good
morning stephen down um so that's what i
was thinking what would you taking that
what would you say what would you say
to the ai to make that look more
appealing more you know like how would you
change that
Uh, first I would have,
and this sounds like it's going to take
you minutes,
but you're going to do it once,
once a year is you're going to design
your own brand standards.
Here's what we look like.
Here's what we sound like.
We use words like this.
We do not use words like this.
We sort of, you can say,
I say this all the time.
We sort of feel like a mix of
Apple design this without the PR without
being pretentious.
You can do that until you find a
brand standard and then you create,
then you lock that into a design,
a document.
And then what's it called when you upload
that to ChatGPT?
It's got a name and it's like,
it sort of saves it in the GPT
and you can refer to it.
There's like a document.
I forget what Paul,
but like when you're designing a GPT
you're going to use over and over again,
you can upload a hard document and then
I use it with prompt.
If I design something, I say,
refer to the prompt brand and voice
guidelines in this.
I'm essentially getting it to the three
yard line.
And then I'm like, yeah, but I don't,
this, this is for internal.
I still want to make it look great.
I don't,
I'm not going to call in a designer
from the design team for two hours.
It doesn't, it doesn't,
it's not elevated to that,
but make it look and make sure it's
on brand.
Design your brand standards first.
I mean,
do you think that that place is even
that, those are the business colors?
I mean, those colors, right?
It's like hot turquoise.
I don't even know what you would call
that.
It's like electric.
It's electric.
I don't know.
It's electric swimming pool.
I don't know what you would call that.
Yeah.
So let's do a quick comparison.
I got one more coming.
Just look at what that does.
So this one,
I basically took the original image,
which was this, and I just said,
can you recreate this as a more
professional image infographic to attract
professional OTs?
And it kind of muted it down.
Yeah.
You know, I wonder too, though,
like I get a lot of people want
to join my Facebook groups from India and
other countries.
And then I go into their profiles and
I look at their stuff.
And look, my mom was from South America.
She was born and raised in South America,
immigrated to the U.S.
Like there are cultural differences.
You're not wrong.
yeah what she was looking for and wanted
to see was very different than what we
were uh comfortable with here so i just
wonder because this was posted by fatty
muhammad um and i did look at his
profile and you know it's clearly an
overseas marketer i just wonder if this is
because this is what he's used to
culturally this is what he's been brought
up with
I went and looked up the company.
This is now telling.
Everything on here is a stock image.
Stock image, stock image, stock image,
stock image.
They're a staffing company.
That's what they are.
Your gateway to top tier.
They might be trying to attract people who
are used to this.
That might be their strategy and they
might be right on.
I don't know.
I don't know how this still works in
today's world.
If you're trying to recruit people who
have come from overseas,
that's the only thing I can see.
What you just said,
if that were their target,
that makes sense.
If it's not,
you're off because your image took eleven
seconds longer and, in my opinion,
looked more on point for paying someone
fifty dollars an hour.
now i said add in a nike or
apple aesthetic there you go so if this
was something that they were sharing what
would it look like yep and now it
took us here yeah it's clean man i
mean i don't know why the guy dunking
the ball is there but yeah obviously some
nike blood but it even still looks better
right right
But this is the thing.
So back to now,
we didn't even put any time into,
like you said,
I didn't give any information or context
to who's the target demographic.
Who am I trying to relay the message
to?
What are the emotions around?
Like,
who is the OT if this is targeting
OT?
Who is the OT looking for a new
job?
Why are they looking for a new job?
What is it that,
what is the need that they're trying to
fulfill?
Like there are so many deeper layers to
this that we could get into writing sales,
copy, copying old ads that came out.
I was,
I was looking at old Tic Tac,
the candy Tic Tac breath freshener ads.
Like we could pull so much of that
context into this kind of marketing.
Yes.
There's a great ad that my former boss
had.
He would have one of those desk calendars
tacked to his wall.
And underneath that was a newspaper ad.
And I asked him, I'm like,
why is it hidden under there?
He goes, well, once a year,
I have to take this thing down and
put up a new calendar.
And he goes,
I love to be reminded of it.
And I want to find the ad because
it was great.
It was done by Holiday Inn.
And it was a full page ad and
it had a towel,
like a pile of towels there,
like hotel towels.
And they invented a holiday and they
called it towel amnesty day.
And they said, listen,
we know what happens every once in a
while.
You accidentally bring one of our towels
home.
If you bring it,
if you bring the towel back on towel
amnesty day, no harm, no foul.
This was holiday and being very,
very self-aware before social media,
in my opinion,
because it got good attention.
It was worth a laugh, right?
So the other one reminded me of VW
Bug was coming out in the seventies and
the car of the seventies was the Mustang,
baby.
It was all was muscle cars.
And if you were the marketer for VW,
what are you supposed to do?
So it's a full page ad,
ton of white space, top left corner.
three hundred feet away was a tiny little
bug.
And they said, think small, think small.
Right.
I'm not going to out Amazon, Amazon.
You're not going to out market, you know,
Google.
You're not going to do it.
So don't do not do it.
You will do a piss poor job.
You'll say marketing doesn't work.
Go where your strengths are.
So let's use this.
Oh, what do we got here?
All right.
So great ad looks like Rolls Royce and
the copy reads what?
At sixty miles an hour,
the loudest noise in the new Rolls Royce
comes from the electronic clock.
You know,
this is a classic example that every
marketer understands and knows.
This is talking to a very sophisticated,
specific audience.
You understand that that individual is
buying luxury.
Yeah, they're buying precision.
They're willing to spend the money.
They have the money.
They have unreasonable amounts of money
and they value this kind of thing.
So, like,
this would be something where I would
reference because that is so well known
and well studied when I'm using whatever
the platform I would reference that
specific ad.
I would reference that genre.
Sometimes I reference direct response.
Sometimes I reference something else, but.
gary halpert alex hermosi like i put in
the names of the people that i want
to embrace and and this is where it
goes back to the difference between i can
watch a youtube video to learn how to
stretch my hamstring or i could go to
a licensed physical therapist to learn pnf
patterns right i can be a marketing
professional who understands all of this
history and context or i could see
something online and be like uh i'm gonna
do that
Yeah.
And you can.
You can.
I tell people, if you have no budget,
do it.
Good artists borrow, great artists steal.
Right?
That was Picasso.
So we've got ten minutes left.
Let's continue this conversation.
But I want – this is personal now.
So now part of my job is –
I run this career connection program.
And essentially, this is Prompt,
who's an EMR company,
who should not be anywhere near the hiring
game, right?
But we just discussed earlier,
what are the two biggest problems for
clinics?
Reimbursement,
this doesn't really help that.
finding great clinicians.
So Prompt has essentially hired Jimmy
McKay and said, how do we,
an EMR company of all places,
we're not in the top hundred of thoughts
to get clinicians to come to our website
to look for a job.
But we're essentially going to be a free
matching service.
I'm Chuck Woolery.
I'm the dating game.
My goal isn't to just place people.
It's to place the right people.
If I do five a month,
I'm a hero.
I'm a hero because right now we're doing
nothing.
We're not charging the clinics that are
prompt customers.
We're not charging the clinicians.
It's not an AI automated thing.
It's not a job board.
So where would you go into getting people,
and I don't want to use marketing terms,
but getting people to at least know, like,
and trust us?
I've got a few ideas of what I'm
doing,
but I want to see what Tony's brain
would do.
Because the pitch is,
instead of leaving the profession,
what if it's this job, not the job?
That's the problem.
What if it's not physical therapy?
That's a problem.
What if it's just a place you're going
to,
and there's a better place three and a
half miles that way that you just don't
know about?
What if I could help you find it?
Are you talking about,
and it's a marketplace really,
bringing employer-employee together?
Kind of.
So what happens is Tony goes,
I'm just frustrated here.
I got two options.
Find a new place,
but I don't know where to look.
I've been to Indeed.
I see ads online that look a lot
like this.
This is what the world is.
Everything's trash.
Everything sucks.
Or do I give this one last shot
and I go,
you tell me everything you want to know
about you.
I then manually go and look and see
who's in your area.
What's their NPS score?
What kind of quality?
Who are they seeing?
What kind of technology do they use?
If you say,
I hate documenting until nine o'clock at
night, I go,
we got an organization using this, that,
and everything.
And our average closed note time is this.
You're telling me you hate this.
I'm telling you this place doesn't do
that.
It's a manual search.
It's jimmying.
i i think first you embrace the fact
that the emr is probably one of the
biggest impact on a therapist job
performance right like there there are
countless facebook posts everybody
complaining about documentation and emr
It makes or breaks the job and the
profession completely.
So you have your hands on what could
be the most impactful aspect,
even knowing people will take less money
to do the job if they have a
better experience with the EMR.
Correct, correct.
so so this is where you look at
what are those pain points how do i
start these conversations how do i bring
uh this either onto linkedin or wherever
therapists are and you're not even trying
to recruit and hire therapists for
employers you're just fostering this
conversation around the frustrations the
pain points hey we there are solutions for
this and then
As you identify the candidates,
that's when it turns into also, hey,
we've got this employer.
They're using this system.
This could be the solution to your
problem.
Let me make a connection.
Do what you want to do.
Let me just make you connect you with
John at so-and-so physical therapy.
The process is you tell me about you.
I then go hunt and search for three
good options.
I run those options by you before I
make the connection.
Like, hey man, swipe right or swipe left?
Which one do you want to do?
Tony doesn't even know which way to swipe.
He's like, which one is the connect?
Because you were never on Tinder.
Tony's like, I don't know what that is.
Before my time.
You give me three thumbs up.
I then send three emails.
I'm introducing you to A, to B,
to C. And I go,
this is on you.
Good luck to both of you.
I check back in in two weeks and
go with each of you.
What happened?
How was the experience?
Good experience?
Bad experience?
What was wrong about that?
Help me understand where we missed and
maybe I can go look again.
So it's sort of the rotary phone to
the AI chat bot in twenty twenty six,
where it's manual,
it's meet to meet its people.
And that's sort of why I like it,
which is
I'm not going to out AI or out
volume indeed.
I'm just not.
I'm not going to be able to outreach
LinkedIn jobs.
But I can have conversations where people
are having conversations.
And those conversations all touch on why
are you leaving?
What would keep you?
Why do you love your job and you
hate yours?
What's missing?
Because it's different for everybody.
Yeah.
Right.
I mean,
this ad is great because it just screams
luxury.
It doesn't it's not about the clock.
Right.
The Rolls Royce at sixty miles an hour,
the loudest noise in the new Rolls Royce
comes from the electric clock.
Ironically,
it's about everything except the clock.
It's about this.
This entire piece of machinery is put
together so well you don't hear a squeak.
I mean,
think about the mustard company that did
that did Rolls Royce level advertising in
the nineties, eighties and nineties.
Great coupon, baby.
I mean, imagine the marketer.
We got like,
we got a zhuzh up mustard.
Well, let's talk about where we,
where we recruit the,
where do we get our bean,
our mustard beans from?
And,
and we're being organically sourced and
where it's our, our,
our mustard is the cheapest.
It's like, no,
we're the most expensive mustard and we
are for these people.
And fancy people buy the mustard,
but also people who want to be fancy
in a little way buy the mustard.
That's a smart play.
All right.
So while we were talking,
I put the voice ad into chat on
the same thread.
And I said, now, you know, take this,
put it into the ad that we're looking
at.
That's a good one.
The best occupational therapy jobs still
let you be an occupational therapist.
But see, you touched,
you just hit on something that I don't
even know that you knew that you were
going to do when you got there.
What?
Look at the difference between this ad and
this ad.
We are more sophisticated in terms of
technology.
You can have a hundred dollar a year
Canva account and design million-dollar ad
campaigns, visuals.
It still takes skill to do that, though.
That's the problem.
So we've got all the technology in the
world at our fingertips with an AI
anything.
You don't have to type.
You can just do it by voice.
And we generate this
Or you think about it and you go,
what is the opposite of that?
This.
Or this.
This would be the best.
I might steal this for the campaign I'm
working on.
Why?
Because there's no color.
It's quite literally the opposite of this,
and it will stand out because, I mean,
the twenty-eight immutable laws of
marketing or whatever, make the big small,
make the small big,
make the visible invisible.
Make the colorful monochrome would be one
of those laws.
Make the loud quiet.
I don't know.
Maybe I steal that.
I know we have about two minutes left.
My question to you,
what do you think about the fact that
it stayed black and white?
It stayed like dated, you know,
I'm assuming the occupational therapist is
the woman, of course,
occupational therapy has a huge percentage
of women over men.
What do you think of the aesthetic of
actually even considering just sticking
with this picture?
Like what, like how do,
why do I think the AI got there
or do I like using it?
Do you like using it?
Would this be something you would use in
two thousand twenty six?
I might judge it up a little bit,
but I like the fact that it's dated
because it's so anti that.
Or do you do?
There was a Tobey Maguire movie years ago
where they got teleported back to the
fifties and their life was in black and
white.
There was a way to make that look
a little modern.
Like.
I don't know.
I think, is that what you're asking?
Like,
would I use that straight or would I
use the picture a little bit to make
it look modern, but black and white?
I like it the way it is.
I'm just saying, like, we are looking...
Effectively,
we are looking for a call back to
tradition.
A slower time.
Pleasantville.
Exactly.
Yeah, yeah, like...
I think it stops the scroll.
I think it catches attention.
I'm sure there are going to be people
offended by it,
but that's not a bad thing either.
It's not.
You know, so...
Yeah, this is really interesting.
And this was the fourth iteration.
We went from the first to the second
to the third, and now we got this.
I think that's the problem with people
using some of these tools is they do
quite literally one input and they go,
well, I guess that's it.
I guess because I don't know what I'm
doing.
Listen,
if you asked me to design something like
from scratch,
it's going to be a B minus, right?
But I can look at work and go,
man,
I love looking at great graphic design
because a good graphic designer,
in my opinion...
it's not the this it's the this and
being able to turn this into an image
it's their thought all right let's wrap it
up so parting shots i thought that's it
oh i didn't say orgasms i thought i
said orgasms organisms orgasms oh is that
what led to the return of color in
pleasantville orga i didn't i i might have
been too young to understand that
I'm sure Bo knows.
Wasn't there an official diagnosis of
hysteria?
Hysteria, yeah.
Women were being sent to doctors to be...
Unhysterical.
All right.
So I think we had a great real
time illustration.
How to use AI, how to, you know,
get extract a little more value out of
the tool.
It can't just be a one shot.
This is what I want.
That's what you get.
this ain't it but this could be this
is better this could be better it depends
but i think we agree this blends this
blends into the background this image that
i'm showing if you're watching the live
stream screams like a monster truck
commercial for gravedigger and this says
we're looking for great occupational
therapists it still has the same
information it just does it a different
way right right what's your parting shot
i'm done
I would say understand what game you're
playing and either hire someone to do it
or learn how to do it really well.
Because as a great professor told me once,
you're either doing public relations or
communications well or you're doing it
poorly.
There is no in the middle.
Just saying we don't have to do marketing.
When people say we rely on word of
mouth and I say what words and whose
mouth?
You're doing this well or poorly.
You get to decide what it is.
All right.
See you on Thursday.
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 PG Podcasts on
YouTube, the socials,
and wherever you binge podcasts you
pretend are for CEU.
And hey, just a reminder,
none of this was for advice.
This was for entertainment only.
Our lawyers say that counts.
Thanks, Keith.