Broadcasting way too early from three
separate Wi-Fi connections.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
Happy Thursday morning.
Dave, can you see me?
I don't know if he can hear you.
Wait, is this Gene Wilder?
You can't hear me.
You can't see me.
This is Gene Wilder and Richard Pryor.
This is Hear No Evil, See No Evil.
Dave, can you hear me?
No.
So that means he's... Okay, we got Dave.
You were Gene Wilder for a minute.
But Jimmy, you're still blank.
You're still invisible.
Can you see me?
Do I exist visually?
You're in the Batcave right now.
There you are.
You can see me.
Now you're here.
Oh, there we go.
All right.
How are you guys?
What's Pie Foot?
Pie Foot?
Three, one, four, F-T on your shirt.
That's right field.
Is it right field or left?
No, right field in Yankee Stadium.
Old Yankee Stadium.
Right field down the line.
Come on now.
It's right field down the line.
It's what's written on the right field
wall in Yankee Stadium.
Got it.
It's like inside, it's like, yeah,
but pie foot would be pretty good if
I put a period right here.
So just so you know,
you're delayed and pixely.
So I don't think you have a good
connection, Jimmy, but no worries.
Now you're just frozen.
And while Jimmy figures that out,
I am standing today.
I had a marathon game of poker last
night with a bunch of New Yorkers.
It was rowdy.
It was so much fun.
My buddy, Dr. Christian Marcial,
who owns Tribeca Physical Therapy,
invited me to poker.
It was twelve.
You know how like Texas Hold'em usually is
like eight, maybe ten.
Yeah, yeah.
Yeah.
All guys at the table.
You got to do two tables or just
stick everybody at one large table.
One large table in this beautiful office.
This this guy,
this cabinet distributor office in
Manhattan.
And it was awesome.
I didn't get home because I didn't get
home until late.
But you guys play Texas Hold'em.
Yep.
Awesome.
How'd you do?
How'd you walk away?
was only up ten bucks i bought in
for a hundred lost it bought it for
another hundred so then i was you know
down two hundred um made it back probably
closer to three hundred had a couple wild
bets at the end right before the end
and uh yeah ended up ten up ten
dollars up so yeah i just jumped back
in where were where were you will be
playing
Texas Hold'em, just like a guy's night,
poker in the city.
My buddy, Dr. Christian,
who owns Tribeca PT,
he invited me and he's created this game.
Sometimes it's like only five or seven
guys or whatever, but for whatever reason,
it was twelve last night and it was
so much fun.
I used to play a ton of poker
back in like two thousand four, five, six,
like when it was on ESPN,
it was really popular with Chris
Moneymaker and all that.
Yeah.
And
sitting down also,
I was thinking of like the movie rounders
with Matt Damon and Edward Norton.
And like, again, like I'm thinking like,
it's probably like just like a fun game,
but it also might be some serious guys.
So in rounders,
the quote is if you sit down on
a poker table and you can't identify who's
the sucker, then you're the sucker.
Right.
And let's just say in the first,
it was very quick.
It was very quick in the first,
fifteen to thirty minutes I was like oh
okay I can see these guys are just
like for fun and like no one's making
no one's making like their income off this
right so we're just we're just having fun
but I was like I'm super competitive right
so I was like I was playing kind
of tight and like there were some guys
playing like loose and aggressive and just
a little wild and a couple couple like
sales guys they're you know they're just
like a different breed of like
of behavior.
Sometimes there were some like finance
guys that were like super stoic,
like wouldn't laugh at any jokes.
They like, weren't getting up.
They were just sitting the whole time.
Um, for me,
that's also why I'm standing right now.
Cause like, I'm like,
I get up and I'm like, Oh,
I'm kind of like stiff today.
And I gotta, I gotta move more.
I can't be sitting that long.
I'm not used to sitting for, you know,
three, four hours.
You know, you, you highlight something,
which is man,
poker was everywhere for about,
I don't know, five years longer.
And I think it started,
it started well before COVID, right?
Like it definitely did.
Yeah.
It was before COVID.
Um,
maybe COVID ruined it because you couldn't
be in person.
The government ruined it.
Like poker got huge when people were
gambling online.
government was not regulating.
Even though it was illegal,
they were kind of turning a blind eye
to it.
It got huge.
This is exactly what happened.
Then all the computers came in,
all the bots came in.
There were programs that you could get
that would track every player.
if you if you guys were sitting at
a table with me i'd have an app
running on my computer it would tell me
okay dave does this this and this and
this situation it would track all of these
dave's history um i could play you know
five six tables at a time which for
me like that was a much more appealing
game than what dave was doing sitting at
one table with a group of guys because
that's just so slow
You're betting one in five hands.
It just takes forever to go around.
But then the government came in and just
shut everything down.
Then a couple of main casinos got approved
to do it,
but it changed the whole game.
That's what killed everything.
I know the big jump off seemed to
be in Tony because you jumped out and
then you jump back into the call.
But do you remember the Chris Moneymaker
and that whole thing was on ESPN?
That was like two thousand four,
two thousand five ish.
Greg Raymond.
There were like a bunch of like,
you know, live poker, Phil Ivey,
a bunch of there's the other.
What's the other guy?
Phil something that's like he won like a
couple.
He was the Simon Cowell of poker.
Yes, yes, yes.
There has to be a jack.
There has to be like a heel.
But anyway, you were bringing up poker.
Maybe think of like, yeah,
poker was everywhere.
It's not completely gone now.
It's probably different.
And I was seeing some videos and comments
about pickleball and how it's the fastest
growing this and the fastest growing that.
And if we want to look at things
from patterns, it will grow.
It will keep growing.
And then something will happen, right?
Like it will shrink or it will change,
right?
There's, you know, it reminds me,
and maybe Dave has seen this.
I think I mentioned this on Tuesday.
I asked Tony if he had seen Air.
Dave, you must have seen Air,
the Michael Jordan movie.
Yeah, that one scene where he was like,
where Matt Damon was essentially looking
at Michael Jordan.
He was like,
they're going to build you up.
You're going to become this thing.
They're going to invent you.
And then you're going to fall.
Then they're going to tear you down.
So it's like,
how do we pay attention to these things?
And how do we take advantage of that?
Because everything that I'm seeing is,
oh man, the profession's over.
It's doom and gloom.
Everything's done.
But we know that it's just...
I don't know.
I wrote a LinkedIn article this morning
where essentially I said,
I looked at Sword and Hinge.
I think there was something about one of
them, right?
One of them bought a gastrointestinal
cylinder.
Is it Hinge?
I have no idea.
They bought a GI something.
And I'm like,
this is good because it shows that there's
problems that we haven't solved.
Like we're in the middle and these people
are paying tons of money to try to
solve the problem that we as a profession
have been trying to solve for a long
time.
It ain't going to be solved with an
app tomorrow.
It's not going to be solved with an
algorithm next month.
this is good that enough people with money
who are supposedly smart i'm going to
assume that they're kind of smart they
notice that this is a big hairy scary
expensive problem i don't know i look at
it as good when they show up like
when other podcasts shows up it means
there are people who want to listen
Right.
So this goes back to the big idea.
I mean, CrossFit went through this,
you know, and we've talked about, like,
ice harvesting was huge before
refrigeration.
Polaroid, or was it Kodak?
Kodak had the digital camera.
They had it first.
So physical therapy was reconstruction
aids.
Then we became physical therapists.
Why do we think that we have to
stay in the cocoon that we're in?
We don't.
Why are we still battling for declining
reimbursement?
Why are we still battling for the stuff
that therapists have historically done?
My question on this topic to you guys,
because I was researching this on the way
in.
I heard that they want to move to
a pass-fail grading system for physical
therapy school and get away from A, B,
C, D, F.
What do you guys think about this?
Like that would be something changing
pretty significant.
For every like test or like...
Every class you take in PT school would
be pass-fail.
I mean, it is sort of right,
because like if you don't pass,
it sort of is right.
If you don't move on,
like you might get an eighty three.
And if an eighty two isn't good enough,
like I mean,
I had my advisor talk me off a
ledge a few times when like I'd study
for a million hours and get an eighty
eight or I'd study for six hours and
get an eighty eight.
And I was like she was like,
what's the lesson there?
There's a law of diminishing returns.
Jimmy, what are you doing?
But wait, before we move on.
I think you hit upon something.
Why are we afraid to break out of
the cocoon when we understand that things
hit a ceiling, then change?
I think the answer is people feel like
they've earned a degree,
which means they've earned a spot.
I look at it as like the people
movers at the airport.
Like, do all this work,
and eventually I get to stand on this
people mover,
and then there's a space for me.
There's always going to be jobs.
Doing the thing like Tony or Dave does
is scary and harder,
and I might not want to do that,
so I'm going to be mad that –
The thing that I was sold and I
bought ten years ago isn't the same today.
Everybody wants change.
Nobody wants to change.
Right?
They want to have gone to the gym.
You don't want to go to the gym.
I mean,
some of us like to go to the
gym.
Dave,
were you going to say something about
anything?
We can keep riffing on this.
I was going to say basically like,
the going to this poker, right?
Like I, I, we, I and my wife,
we love putting our, you know,
two-year-old down to bed every night.
And I, it's like a night where,
so like even tonight I have a men's
league baseball game.
So I'm going to miss putting him down
to sleep again.
Um, and I love to do that.
Right.
And I'm lucky to be able to do
that.
And, um,
So it's like going to do this poker
night has to be worth my time,
either one or multiple ways.
Right.
So one is I don't know what to
expect,
but I was great in terms of just
like getting out, meeting new people,
having a bunch of laughs, you know,
having some drinks, wine, you know, food,
whatever with the guys.
But also.
Something that I kind of have gotten away
from,
which I just don't put a lot of
time into,
which is like relationship building and
like word of mouth type stuff.
And of course,
I wore my I didn't wear this hat.
I wore my concierge pain relief shirt,
though.
Right.
And so, you know,
half the guys over the course of the
night were asking me about, oh,
what's that?
Is that your company or what's concierge?
And what do you guys do?
Oh, it's physical therapy,
but it's concierge.
Like so it's like.
I didn't have to pitch anything.
I get to then just kind of briefly
say in between hands like what we do
and all that.
And I sat next to my buddy who's
a physical therapist and they're out of
network and cash and all that.
Of course, strategically,
the poker night happened to be about ten
blocks away from our brick and mortar
clinic.
Right.
So if it was if it was like
closer to like my buddy's office downtown,
like I don't know,
maybe I wouldn't have gone.
But the point of me bringing this up
is it has to be worth my time
in terms of like just the socialization
part.
If I want that,
if I wanted to do that,
which I'm always open to do that as
like an extrovert.
But then also it's like I haven't done
a lot of this.
uh, you know,
like group or like socialization,
like networking type stuff.
And I don't want to even,
it's not even really like networking,
but everyone that I sat around the table
with, like,
they're all like fairly successful.
Right.
And that's like the, that's the point,
at least for me is like, um,
I wouldn't want to go to a poker
game if it was like a bunch of
like new grads that were, um,
in i don't know other industries maybe but
it's like when i heard about who was
there or like the type of people and
i got the google invite and i could
kind of see some of their their email
addresses and all that that i'm like oh
like that's kind of like that's now it
now it does make a good use of
my time and so
I'm just trying to think moving forward of
like,
I'm not going into it of like what
is in it for me,
but it's also like,
I want there to be something that could
come from it in the medium to long
term.
And the short term is more of just
like meeting new folks,
maybe referring business to them if,
you know,
we know someone that specializes or needs
the specialization of what they offer.
One guy was, like I said, cabinet, uh,
cabinet, uh, distributor.
So he sells to like residential,
like real estate investors and owners and
all that.
So it's just like super fascinating and
interesting of like how other people have
a very specific focus,
like with their work and all that.
So anyway, just,
just like just throwing it out there in
terms of like the opposite of like paid
ads and Google ads and,
um, you know, the, the,
the dialing of paid marketing.
And then it's like, oh yeah,
like I should maybe mix in some more
of this exact stuff.
And it's fun in real time.
And it's also potentially beneficial.
I hear you saying two things.
I hear all the money you lost was
tax deductible because this was clearly a
business expense.
I didn't lose.
I left up ten dollars.
So
The government can't tax my ten dollar
cash because they don't know about it.
I hear Jimmy needs to start a PT
breakfast club poker night for recruiting.
Like there's nothing better.
Talk about putting a potential candidate.
If I wanted to hire a therapist,
put him in the hot seat of a
poker table.
Let's go.
I didn't even think,
I didn't even think we were going this
way, but I love it.
Yeah.
You talk, you get to know them.
You see how they make decisions under
pressure.
Can you tell when they're lying?
Can you tell?
I love this.
Sponsored by where Jimmy works.
If we were to spin this,
that's a good idea.
How do you organize it?
That's tough logistically.
In-person is tough.
But Tony already said he likes playing
five hands and not one.
So online actually plays well there.
But then you lose some of the
conversation.
Or is it...
If you're trying to hire PT students as
they graduate,
do you give them something that they think
they need because they don't,
but they think they need to study for
the NPTE?
You actually don't need to study.
You know enough.
I mean, you need to review,
but you need to study.
Do I do a trivia show?
Do I lean into my own skill and
go,
we're going to do an online trivia show,
and then you're going to bring people on?
I don't know.
I'm trying to figure out what's the thing
that...
Clinicians is too wide because they have
vast...
you know, likes and dislikes and hobbies.
Students are consistent because they're
like,
I'm in study mode for three point five
years.
That is a good point.
Like because you wanted that's why happy
hours and PT pub nights were so big
for a while is because it was like,
no,
you mean no one thought to like
get people together to talk.
Like the magic of the pub night was
there was no, there wasn't a cell.
It was just get together.
And then the, the hanging out is the,
is the magic.
As soon as this, this would be that,
but since PT pub night is inaccessible.
It's, you know,
you create the new PT pub night plus
from my understanding, younger people,
younger people are drinking less,
you know, you,
you could even make a situation where
everybody gets gifted,
six thousand chips and it's kind of
tournament style, you know,
and then maybe there's a prize at the
end,
but it's a combination of potential
candidates plus individuals hiring.
Oh yeah, yeah, yeah.
The magic.
And you need,
you need a reason to go.
You need a hook, right?
So are you saying like actual in-person
things or a digital thing or try both?
Probably hybrid, but actual in-person.
It's got to be in-person.
It's super hard.
I'd love to do it,
but it's super hard and not cheap.
Or, so really if we think about this,
what if Jimmy goes to colleges, right?
At the college,
you've got the entire department there.
So it's like, all right,
what if we did something where you did
the DPT department poker tournament,
whoever wants to participate,
it's streamed live,
even if the employer couldn't make it.
I mean,
the schools here by me have job fairs
we used to go to all the job
fairs try to talk to the the pt
students like you could bring in local
employers but if you streamed it live
you'd get all the benefits to potential
employers who wanted to watch and interact
online
what about like i'm surprised neither of
you mentioned this what about you do a
poker night at like the pps or csm
or whatever so instead of like usually
it's like you go to a party the
poker night now is you know the night
before or after or it's competing with the
main party or the secondary party
Oh, Jimmy's gone.
Has there never been a party with a
purpose?
Yeah,
so I'm saying now the breakfast
club-sponsored poker night would be
competing with that party,
which would be tough.
It was going to be tough,
but there's going to be certain people
that are like,
I absolutely would want to go to poker
rather than a party.
Totally agree.
This is why, oh,
Paul's saying during the pandemic,
they had a group that played online,
but on Zoom together.
Yeah.
So you had the online,
but you had the,
this is why there's an app called Discord.
You guys familiar with Discord?
Yeah.
I didn't understand what it was.
And then it completely, it clicked.
It was like, oh, got it.
You, that chat feature.
It's the social component to everything
else.
Don't disagree.
This is why, so I'm,
I won't say the school because we haven't
locked it in,
but coming up actually somewhere in Dave's
neck of the woods,
I go to PT schools and instead of
giving a talk,
I turn it into the Johnny Carson show
where I'm like,
give me fun guests who are wildly
different and have nothing to do with a
lecture.
And then I say, don't worry about it.
I pre-interview all of them.
And instead of a
They've already told me most of their
gems,
and then my job is to pull it
out.
And then I bring in the sound effects
and the music, and I zhuzh it up,
and I go,
it's got to be an hour,
no longer than an hour.
By the way, when we're done,
we're going to go down the street to
whatever bar.
We're going to mix it up,
and you're going to talk to the speakers,
and the students are going to talk to
each other.
To me, the recruiters,
their eyes get real big.
They're like,
you're going to hype all the students up
and then put them in a room?
And I'm like, yeah,
and you've got to buy them food.
And they're like...
Great.
And I'm like,
if you can't recruit from that room,
hang it up, my friend.
You're done.
That's the magic.
It's only missing the game,
the playing part of that component.
What's the reason for going?
Right.
That would be the thing.
Peeling this back to the original topic of
how things change and innovate.
We talked about how these different sports
kind of grew and changed.
I was just watching these guys do speed
golf.
And I could get into speed golf.
Two, three clubs.
You putt with a driver.
You run through.
It's a combination of how fast you can
play and what your score is.
You change and innovate how PT clinics are
recruiting therapists.
You change and innovate how PT clinics are
delivering physical therapy services.
You change and innovate how they're
getting paid.
Every single element,
including the entirety,
should change and innovate.
It should grow.
Dave is not the same physical therapist he
was when he was a new grad.
He is a very different human.
His experience,
everything has changed in the way he
delivers,
yet we still continue to hang on to
the words physical therapy.
Agreed.
Yeah.
But the actual thing that I want to
do for the patient, I believe,
is the same.
The core has stayed the same.
How,
the what and the why I believe is
the same.
The how, the where, the when,
those things should constantly be
changing.
Listen, Easter egg hunts are great,
but there was a company who revolutionized
like the concept and they made it
augmented reality and it was Pokemon Go.
It's just an old idea in a new
way or a new idea in an old
way.
One of those has to be old.
So it's, well,
we're just delivering musculoskeletal care
in the old way.
No, we come to you.
That's a vastly new way.
Ironically, it's a vastly old way,
but it's been away for so long that
it's actually new again.
All of a sudden, bell bottoms are genius.
It's like, dude,
they were so cool that they became not
cool.
And that's the idea.
It's this wave of the things that go
out.
I don't think you need to look too
far for your new idea.
On Tuesday, Tony brought up
some really great ads.
There's nothing new about this ad,
except you haven't seen these ads in the
style for so long.
Yeah.
Yeah,
they're so old that we stopped doing it
because human being brains create novelty.
When we see something too much,
it becomes noise.
And our job is to be signal in
the noise.
So I think it's time to bring ads
like this back simply because we haven't
done them for so long.
So let me ask you guys about this,
because this is still kind of related.
I shared this TikTok.
This is a therapist who started a practice
and she's talking about, you know,
kind of going through the continuum of
She's got an injured athlete.
She rehabs the athlete.
Now the athlete wants to work on
performance,
taking the athlete through performance,
going from two,
three times a week to maybe once a
month where the athlete's checking in with
her.
She's updating his program.
She's advancing him,
improving his performance on the field.
We've talked about this a lot.
My question is,
at what point does she or do we
eliminate the word physical therapy,
use it for wellness, performance training,
you know, whatever it's going to be.
Because she's basically saying how like,
I think a lot of the profession is
pigeonholed into once insurance stops
paying, we're done.
not really and i think a lot of
the therapists want to take the person
beyond just back to prior level of
function dave has clearly built the
business model in the niche where it's
it's a lifetime investment i will take you
all the way through the day you die
because there isn't a point in that time
where you you're gonna accept weakness and
frailty and you know any of that stuff
But it's like, OK,
do we keep calling it physical therapy
because the service is delivered by a
physical therapist?
There's problems with that.
Do we change what we are calling it?
And now it's performance training
delivered by a physical therapist.
Where are you guys on that spectrum?
I understand what you mean.
I don't see an easy or obvious path
where
the clinicians or the academics will agree
or change anything or the board or
whatever, the FSB, PT board or whatever,
and or the public.
I feel like, again,
I know I've mentioned it before,
but like with Facebook, Instagram video,
TikTok video, YouTube video,
I feel like every single day,
more and more of the public have a
better understanding of what
and a licensed physical therapist does for
their patients in the U S.
And when I say that, I mean,
most of the video is like obviously
outpatient stuff.
Right.
So in terms of like musculoskeletal stuff,
of course, neuro is having, you know,
there's more practices that just are neuro
only.
And Tony knows a lot of them where
they're posting a lot of content or it's
home visits or it's neuro home visits.
Right.
But like,
I feel like with all the online video,
more and more of the public know what,
a licensed physical therapist does in the
US, right?
And so to suggest a change in name,
I feel like would just detract from the
pace of people learning and acknowledging
and understanding what physical therapists
or even occupational therapists do for
certain issues or challenges.
Now,
if we just change it all of a
sudden, if, I don't know,
if the APTA or whatever the board all
of a sudden today change it to,
performance wellness or whatever,
performance training,
but then it kind of sounds like a
personal trainer maybe.
If you just change the name all of
a sudden to...
Performance wellness.
I'm a wellness performer.
It doesn't even make sense.
If they just literally had a decree today
and this is now physical therapists are
now performance wellness providers or
whatever,
then I feel like it would just take
more time for the public to even learn
that and then connect their aches and
pains and I'm looking for an issue.
I'm looking for a provider to solve this
issue.
I'm looking for a professional or someone
who's
competent to solve my back pain or my
neck pain or shoulder pain.
And I think it would just take too
much time, Tony.
I think it would just take too many
years or decades to change public
understanding if you change the name.
So in my opinion, I say leave it,
but I also fully agree that it's not
the best name, if that makes sense.
Before we hear from Jimmy, hang on.
Before we hear from Jimmy, Dave,
you just reminded me of Michael Scott
saying, I declare bankruptcy.
I want physical therapist to declare.
Okay, go ahead.
Yeah, I think there's several things.
Number one,
some people in the profession are like,
call us something different.
And there are also some of the same
people are mad that other people are
calling themselves dynamic personal
trainers.
They're like, we don't need this name.
It doesn't say what we do.
And then also, you can't use that name.
People are going to get confused.
My man, they're already confused.
Yeah.
Google's a verb now because they showed
what they did.
Doctors don't doctor, right?
Nurses don't nurse, right?
They practice medicine.
So the name,
as much as I say it needs a
name, it just needs a name.
It doesn't need to be the most obvious
name, right?
Plumbers don't plumb, right?
But we still know,
we understand what they do because...
They've done it.
They've showed that over and over and over
again.
That's the game.
The game is showing, not telling.
Show, not tell.
That was my favorite day in third grade,
man.
I couldn't wait to bring in the G.I.
Joe hovercraft.
I'm like, this floats in the tub.
I wasn't excited to tell them about it.
I was excited to bring in a little
tank and put it in there and be
like, the hovercraft floats.
Look at this thing.
Isn't this the greatest thing ever?
I'm going to bring this to the playground.
And we keep trying to tell something about
it.
I just commented on,
you guys know Alex Benderski, right?
I know Tony does.
yeah super smart dude my my only knock
on alex i'm like alex bring it up
bring it down by about grade levels for
the rest of us to be able to
breathe because he thinks up here and he
was talking about how we don't need uh
his his main idea was about pain education
and i was like
yes agreed we don't need education but
then his post then proceeded to educate
and i'm like you can't talk out of
both sides of your mouth ironically you
just talk out of the middle of your
mouth but the issue i then said if
that were true if we needed more logic
in the world to be blatantly obvious and
education about what pt can do well then
every nike commercial would be about the
chemical composition of the rubber of the
shoe
And every Toyota commercial would be about
fuel injection.
And every hinge commercial would be about
algorithms that match, you know,
people's compatibility.
And yet Toyota shows people kicking ass on
a road.
Nike shows dunks and hinge.
They have photos on that platform for a
reason.
And it's the show less of it.
You've got to show first.
And the last thing I'll say is Donald
Miller, if you're going to read a book,
Not about PT that will help you in
PT.
It's Donald Miller's building a story
brand I would do first.
And then if you're like,
I love this guy,
go to Marketing Made Simple from Donald
Miller again.
I don't get any nickels from him for
suggesting the books.
I wish I did.
You're not the hero.
The other person's the hero.
Build a story in which you show you
understand.
Concierge Pain Relief got people asking
you a question around a poker table.
later on if they're in pain or they're
like i think i sort of know that's
the thing they're going to think of
They don't care where Dave went to PT
school.
In fact,
they might not even care that he went
to PT because if the guy I had
on the podcast not long ago,
Sean Patush from Long Island,
he might be the best guy to help
you.
Why?
Because he's down the street and he
understands what I have and I think he
can help me get out of it.
That's the thing you're trying to sell,
but that's often not on a syllabus in
a healthcare degree.
we had a question for dave um before
i before i switch topics to that though
i was thinking more as much as i
would love to get rid of the name
physical therapy in general i was thinking
more switch the name of the service switch
the name of the product so so that
you have physical therapy delivered by a
physical therapist
then you have performance training
delivered by a physical therapist.
They are not the same service, product,
whatever you want to call it.
That could be done now.
That could be done today.
It doesn't take legislation.
It doesn't take state practice act.
It doesn't take anything.
And I think instantly the value,
especially in a cash pay world,
of what you are delivering,
the service or the outcome,
immediately goes up as soon as you take
the letters or the name physical therapy
away from what it is that you're selling.
This Tuesday,
Jimmy and I wanted to hear from Dave
what's going on with the flyers,
the mailers, the QR codes.
How is that going?
Yeah.
So Jimmy asked me like a week or
two ago, I think, Tony,
when you were not on the show.
So we're still at a loss.
We did get some leads.
We did get some people that did the
evaluations.
I coach my therapist on for the people
that come in.
So they already paid one hundred seventy
five dollars because it's on the mailer.
It's on the postcard.
It's a hundred and seventy five dollars
for it's basically like half off.
It's basically like fifty percent.
There's the value stack on the just if
anyone's watching or listening that has no
idea what we're talking about.
Send out two thousand mailers to a bunch
of two thousand different street addresses
in Manhattan.
The value stack like you get this, this,
this, you know,
balance and joint assessment and whatever.
and it's this money, it's this value,
this dollar amount, value,
this dollar amount,
two thousand two hundred dollar or
something value for one payment of one
hundred seventy five dollars.
So we would collect the one hundred
seventy five dollars at least twenty four
hours in advance before that first visit.
It was either a home visit or a
clinic visit.
And for this particular
I told my therapist that you're going to
tell these people and I know this is
recorded.
So like whatever,
it's like a marketing test.
So I'm OK with saying it.
I think you could all learn from it.
I'm not that I'm teaching it.
But for this approach,
I said at the end of the evaluation,
you talk about the prognosis and the
diagnosis and the plan of care and all
that.
And you're going to tell this person that
we don't sell visit by visit.
You're gonna say whatever their goal is,
and you should have already obtained
whatever the goal is in the beginning with
a subjective and confirmed it with,
what's the thing that they really care
about that they wanna get back to?
Whatever that thing is, you make a plan.
I don't care if it's five visits or
twenty visits or whatever.
And you're not gonna give them a cookie
cutter package that we currently have,
which is twelve visits or twenty-four.
You're going to say however many weeks or
visits it's gonna take them.
It could be an odd number,
an even number.
I don't care what the number is.
You're going to say it's that dollar
amount.
And you're going to just grab your phone
quickly without the patient looking.
And you're going to go three hundred and
fifty dollars times however many visits
you think is going to help them get
to the goal that they really care about
their main goal.
And so we're still testing that.
The patients, of course,
my therapist need more coaching and
training and mentoring around it.
Because now we're not just selling a
package,
we're selling a results-based and
time-based program to help this person
either...
Achieve their main goal that they care
about,
or if it's like multiple comorbidities and
like chronic and really challenging,
maybe it's a package to achieve the first
step of several goals because they have
like a chronic back pain that's been
around for ten or twenty years or
whatever.
Right.
So it depends on the patient.
The way I'm describing it,
I'm trying to make it sound as easy
as possible.
it is not easy to implement it's
challenging i think for any senior
therapist to even understand like okay i'm
confident my skills to get this person
better in twelve visits or
achieve this goal in twelve visits and
again, like Tony said before,
don't have the don't have the goal focused
around pain,
have the goal focused around function or
getting back to this particular museum,
have the goal getting back to walking on
the beach,
going to this particular restaurant,
walking this particular number of
objective blocks.
whatever it is.
So does that make sense?
Like we, we haven't,
we haven't had anyone convert to do like
the time-based package, but I was like,
that might be the best.
I believe that approach by the way,
is the,
I think that should be how we only
sell physical therapy, which is so,
I think it's so,
I think it's so aggressive and outside of
the box,
but to sell visit by visit is why.
Ninety percent of the country falls off
and drops off of physical therapy.
You said it's difficult.
What's the difficult part?
Well,
one is the physical therapist has to get
comfortable saying a large number because
they're going to say, it doesn't matter.
Like,
so we charge three fifty a visit and
we for the time based package,
I don't want to discount it.
This would be a way for us to
make our premium rate across a package or
a program into the future where we get
some.
Ideally, we get a paid in full.
We get the full package amount today.
Maybe there's a payment plan or whatever.
So it's the opposite of the revenue cycle
management.
We're actually getting the cash flow up
front.
and then we're fulfilling the visits into
the future.
But when someone pays like this,
shockingly,
they're way more committed and they're
more likely to achieve their goals and get
the outcome and tell their friends and
continue or re-up a package.
I mean, it's amazing what can happen,
but the challenging part is someone that's
entering with back pain or balance issues
or whatever, if they're calling around,
they will only hear that from our
practice.
No other practice is really going to pitch
it that way.
And obviously,
we're pitching the paid evaluation first.
So in this case,
it was one hundred and seventy five
dollars.
So they have to meet us,
start to know, like and trust us.
Obviously,
the therapist over the first hour,
build rapport, build value,
demonstrate value.
And so it's hard because.
There's no schooling.
There's no DPT rotation to learn this.
There's no, no one else's,
there's no friends.
Their physical therapist coworkers are not
doing this.
Like it's a little more foreign for a
physical therapist to like even implement
it.
They have to believe in their skills.
They have to believe that they're not
being salesy.
There's multiple challenges, right?
I've got a model in my head that
I think would work.
I want to hear what Jimmy's thinking.
Um, that's a lot.
So where do you, what do you like?
This is where selling plumbing gets a lot
easier.
Do you have puddle in bathroom?
Do you want to go away?
And that's why plumbing can be a commodity
because then you're going to call the
second guy,
the third guy and the fourth guy,
and you're just going to choose on the
cheapest.
And that's the point is we're trying to
sell the outcome.
And now you can hear I'm getting rowdy
about it.
I'm getting like,
this is a giant friction.
This is a hard thing that I think
some people do well.
I don't think they if they do it
well,
it's not they don't do one thing well.
it's lots of things they do well that
equal this being simple and more clear so
so you're in your comparison and i'm not
i'm not digging you but i'm just saying
like when you compare it to plumbing of
course so actually we just had we just
had plumbers today they brought the snake
and they cleared out the one of the
the bathroom sinks and it was just a
bunch of hair right uh i don't i
don't know the guy's names they didn't
introduce themselves i don't
I will call another plumber,
another company who can get here faster
next time.
I have no customer loyalty to that
plumbing company.
I don't care if those guys,
as long as they leave our place,
we're good, right?
Now, I don't care.
I have no affinity.
I'm not even going to write a Google
review for that plumbing company that just
came here this morning at eight a.m.
That's the difference, Jimmy.
The difference is we're trying.
Yes, it's yes.
There's more challenge to train a
therapist to talk about this time based
results based program.
But and it's not for everyone.
But the point of the offer of, OK,
you pay one hundred seventy five dollars
for the evaluation.
You come in.
The therapist does the normal evaluation
treatment.
HEP talks about the prognosis, diagnosis,
all that.
Obviously,
hopefully builds rapport and trust in all
of that.
Then when they present this and say
basically like, hey,
we don't offer visit by visit.
That's the difference is, yes,
it's going to be a twenty five or
thirty percent conversion rate from the
evaluation to these.
to the packages a very low conversion rate
whereas a plumber where it's like okay
it's uh you know i don't know a
hundred dollars or two hundred dollars for
me to come out and then for me
to get my snake machine and do that
it's good it's like a very like uh
commodity base like it's this dollar this
dollar and then now they leave and i
don't care yeah i have no i'm not
going to tell my neighbors about the
plumbing company i'm not going to say i'm
not going to say it on this podcast
oh the this the plumbing company was
amazing
they did the normal standard stuff because
that's the way that the whole industry
does it right so we're trying to do
it differently and we're trying to offer a
solution-based package that aligns our
incentives with the patient and clients
incentives they want to get they want to
resolve their chronic back pain or get
back to walking on the beach we can
make a program and a package specifically
around them every single thing that we do
in every encounter with that client
is focused on getting them back to walking
on the beach.
And now our offer becomes a one of
one so that they cannot compare our offer
to even a nearby Medicare Part B therapist
or a brick and mortar therapist that takes
in that work.
Yes, it's more challenging.
Yes,
the conversion rate is lower to the plan
of care.
But then the people that want to use
their insurance or Medicare,
sometimes not in Tony's office,
but many times people will do three visits
and drop off.
As per the WebPT data from the last
five or ten years,
like people drop off because there is no
skin in the game.
They're not committed.
They don't or they don't trust the
therapist or there's multiple reasons.
I think there's multiple reasons.
I think what you're doing is harder,
just to be clear.
I know.
Of course it is.
I mean, I do the plumbing comparison,
but I only use that.
It's hard.
It's harder to demonstrate value in an
industry.
It's way easier to be a commodity.
Sure.
One hundred percent.
Tony, do you agree?
Disagree?
I agree.
I like the plumbing analogy simply because
it shows us that we can't compare plumbing
to what Dave's talking about.
Plumbing is, I come in,
I fix the leak, I'm done.
Physical therapy is, it's not just me.
I can't come in,
rub your muscle and fix you when you're
done.
You have to be an active participant.
So my question to Dave is,
what is an existing business model right
now in the world that has those same
challenges?
Raising kids.
Raising children.
Kind of.
Not really.
It's an industry,
but there's a lot of effort.
I'm going to say higher education.
Right.
Like I had I had people in my
program that paid for school.
School did not guarantee the degree.
School guaranteed.
I'm going to put a teacher in a
classroom.
That teacher is going to teach you stuff.
It's up to you, the student,
to show up.
It's up to you, the student, to study.
It's up to you, the student, to learn,
take the test, get the credential.
The universities are doing this at massive
scale and incredibly successful.
and so and they even show like look
this can be a high ticket unaffordable
service that they are delivering that
their students their customers are
borrowing tons of money for that the
problems many will never pay back um and
so it's like okay well what what's this
value proposition there how do i bring
that model into what you're trying to sell
you're right you can't promise you can't
guarantee a pain-free resolution in six
weeks
what you do is you say just like
a university degree
this is what i can provide this is
what i guarantee i guarantee the therapist
is going to be there three days a
week two days a week whatever it is
i guarantee they're going to dedicate this
plan of care these are the expectations
just like a syllabus this is generally
what you're going to be doing within
general framework and this is what it's
going to cost at the end of the
twelve thousand dollar six week investment
maybe you feel better maybe you don't i
can't control that
But the things that I can control,
just like a university are,
the teacher is going to be there,
the material is going to be available.
We know that enough people who do this
finish with this outcome.
They can pass the test,
they can get the degree, whatever it is.
I would model that after how universities
are selling degrees to students.
And that's what I would use as my
sales process.
I think it'd be awesome.
And I think a therapist would kind of
understand because they've already
invested one fifty two hundred thousand in
their education with zero guarantees on
the outcome at the other end.
Well, not zero guarantees, right?
Because we've been told, listen,
go to Indeed.
Look at all these job openings.
If you do this, then you do it.
But look how subtly universities do that.
And I'm not saying that they're doing it
deceptively, but they're like,
we are the bridge between where you are
and where you want to go.
Isn't that what Dave sells?
We are the bridge between where you are
and where you want to go.
Exactly.
Tony's analogy of the higher education is
completely on point.
What a sage contribution.
And it's like the saying of when the
student is ready, the teacher will appear.
And that's exactly what Tony's talking
about.
Yeah, it's the same.
But it's not just what you sell because
Toyota and Ferrari both sell cars.
But they don't, right?
Because if you're stupid enough to think
the Ferrari and a Toyota are the same
thing,
and you buy the Ferrari, you're an idiot.
But if you understand what you're buying,
you're buying something wildly different.
So I don't think Dave, I mean,
I go back to this,
I know you guys hate and love what
I bring up.
You're not selling things low on the
pyramid here.
You're selling transformation, right?
And that's higher,
which is why it's worth more.
It's also harder to wrap up in one
sentence because that sentence,
doesn't might not fit for everyone right
like it what what like for one you're
selling like fall prevention on the upper
east side and the other it's return to
run your central park you can do both
but those two stories are wildly different
very far apart um
And also,
also it's like students that are going
into higher education and they like, I, I,
I don't even really remember my process of
like the,
of like the paperwork and the financing
and loans and all that.
Like, I, I don't even remember.
Right.
So it's almost like that's the only
difference, Tony,
is the process of like financing and
payment.
Right.
So like with higher education,
it's like it's like it's like, you know,
it's like funny money.
It's like envelopes and, you know, paper.
And it just it's versus like when we're
like, OK,
it's going to be a three thousand,
four thousand,
six thousand dollar package.
And now you have to, you know, oh,
we have your card on file.
Do you want to use that same card
or whatever?
Like it's like it's it's a little because
it's a smaller dollar amount compared to
like.
your future,
like your career and what you're going to
study.
There are some similarities.
There are some differences.
Did you play poker with chips or did
you play poker with dollars and coins?
Seriously.
Chips.
yeah so so when you when you were
going into college was your english
teacher the one who did the financing and
went through the the fafsa form and and
took your payment no so like they
understand we can't have the person
handling the money be the person who's
teaching you know algebra
You identify that's the problem.
You identify the weakness in the
clinician.
The weakness in the clinician is, yes,
I could probably force that person to
learn how to sell.
They're never gonna sell as great as a
salesperson.
They're never gonna be as comfortable
accepting that money as somebody who is
born to take money,
who wants to accept money, who sees money,
dollars in Dave's bank account as points
on the scoreboard,
That's the person that I want taking the
money and handling the deal.
So you work the business to optimize for
that outcome in that role.
Who is the person that literally feels
good accepting money, taking more money?
More money means better care.
More money means better outcomes.
More money is positive for the therapist,
for Dave and the patient.
They need to have that in their
personality.
That's the person that I want handling the
sales and all the other stuff.
Interesting question for Dave.
What is the biggest differentiator with
your employees?
What gets them to go from uncomfortable to
comfortable in explaining this?
Repetition?
You coach them more?
What do you think the biggest change?
My guess would be the more you do
it, the less it feels weird, right?
Yeah.
Reps is the only thing.
And that's another reason why we do the
all the interactions are recorded on the
app.
Right.
So otherwise it's not measuring it and
recording it when it's recorded.
It gives automate like it's insane.
The amount of data it tells,
like a percentage of how much I talked,
how much the therapist talk versus the
client talked and how many questions and
interruption rate.
And in the transcript,
You can listen to the audio.
You can also look at the transcript.
But in the transcript,
there'll be comments that the AI will flag
and give you feedback.
So it's like remote digital coaching that
does not come from me.
So it's amazing to have a third-party
coach where the comment will say, hey,
this explanation was a little long-winded.
Maybe focus on tightening up a bit.
Or this explanation was like...
a little too much medical jargon and it
was like a little more like complex,
like maybe like speak at like a lower
reading level or like a little bit more
in layman's terms.
And that's super helpful because they
could see that any time,
either from the email notifications or
inside the dashboard.
So it's like the system can give feedback
and the more that they are learning and
they're recording calls,
like at some point they're going to go
in and plus our
Calls as a new therapist,
like the interactions,
the meetings or the the weekly and monthly
coaching calls.
We're talking about that stuff, too.
Right.
So we'll do sales training together.
But yeah,
reps is definitely the biggest thing.
Yeah, I was going to say,
like the next hurdle you'll get into is
in my imagine is people who feel like
this is something that they want to be
doing,
because if I expected go to school and
be the authority and the patients show up
and I do the thing and they leave
and they always listen to me.
And now they're being told,
I have to listen to them and change.
I have to sell, which is this like,
get that off me.
I'm going to go take a hot shower
and scrub that.
Those people,
you're never going to make those people
like it.
I've got friends who are like,
I don't like running.
And I'm like,
do you know what exercise I'm not going
to suggest?
I'm not going to turn you into a
runner.
You're not going to turn that person into
a salesperson.
You're not even trying to turn them into
a salesperson.
You're trying to turn them into someone
who will show, not tell.
And science and healthcare love telling
stuff and showing a different skill set.
And by the way,
it's important because I strive to do all
this in terms of any new candidates.
We have a new candidate starting in like
two weeks.
So any new candidate,
I make sure before they ever start,
we go through like point by point of
like, here's like what we're going to do.
Here's what we're about.
But like specifically,
and I want to make sure this stuff,
we're going to do this stuff.
And if you don't like this,
it's probably not going to be the right
fit.
So one is the call record or the
interaction reporting.
Another one is social media video.
Right.
So it's like right now,
the way I am and you guys have
helped me a ton,
just like modeling what you guys do,
like any therapist that comes on,
like that will almost be a deal breaker.
Like if they don't want to be in
front of video or they're like afraid or
whatever and like, you know,
lapel mics and I'm going to record you
and I'm going to we're going to just
like talk shop.
Like it's nothing crazy.
Like Tony said,
like they're talking to me and all that.
But if they're like,
not comfortable in front of video,
like I probably won't hire them.
Right.
So it's like, you need to, like,
we're going to be doing social media
video.
Are you cool with that?
Like, are you all right with that?
Talking about conditions and you know,
you treat me and I treat you and
then recording the interactions and saying
these dollar amounts out loud.
And there's going to be some rejection.
Like I, I put everything out there.
right so they know they know exactly like
the income opportunity the income
potential and all the main roles and
responsibilities including like traveling
around and what's going to be your travel
radius for home visits or and clinic
visits and all that so they know all
that up front so that when we start
like they're like i can fully invest in
them and pour into them and coach them
but there's not going to be any like
surprises we do not want any surprises
I'll tell you where this is going.
And I'm going to use this reference.
There it is.
That is my Harley.
That is not me.
That is Ray.
I think I said his name right for
once.
So I've got that Harley sitting in,
you know,
one of my physical therapy clinics.
We're selling that building.
I need to get it out of there.
What do you think I did as a
consumer and owner of that?
The first thing I did was I go
to chat GPT.
I take a picture.
I say, hey, I've got this.
Nineteen ninety three Harley Sportster.
Eight eighty three cc's.
It's got under four thousand miles.
I don't know what to do with it.
Do I scrap it?
It hasn't run in twenty five years,
like it's just been sitting dry.
Do I scrap it?
Do I donate it?
Do I try to sell it?
Who do I sell it to?
What is the pricing?
Do research.
What's market value?
I go through this whole thing.
what's going to happen is chad gpt is
going to sell me on what i do
with that motorcycle moving forward i
guarantee now joey albritton gave me a
sneak preview of a tool they're building
which i can't discuss but it's amazing i
guarantee the future sales person is not
your therapist it's ai
Now you can approach it from two ways.
You can say, okay,
I'm going to build an AI dedicated to
the sales process.
And I'm going to have that AI with
an artificial voice,
talk to the consumer and sell the consumer
on my package.
I don't think that's the approach any of
us want to take.
I think more what's going to happen is
the consumer has their own AI.
They have their own ChachiBT or Gemini or
whatever.
They're going to be like, look,
these are my problems.
This is what the therapist is offering.
This is how much it costs.
This is what...
I would start on your side,
you pretend you're the consumer,
you look at the offer that you would,
need a picture of Tony riding the Harley.
It probably exists somewhere.
I need a video, definitely a video.
But you go through the consumer side of
that process,
talking to ChatGBT or Gemini or Claude and
see what the chat is telling you back.
And you refine the sales process from the
consumer side
And then you take it to the producer's
side and I could see a world where
you might be like, look,
here's what we're doing.
This is the package we're offering.
You give it to the person just like
I would get an estimate on something.
And then that person goes into their own
AI, which you're not telling them to.
They just do it.
It's just the natural process.
And the AI will sell them if you
have created the package correctly.
You know,
it's reverse engineering what the AI is
going to tell their own person because
you've done it yourself on your end.
I really think that's where the sale is
going to happen.
I can't wait to hear about more of
that because I'm trialing with them right
now, Tony, with Joey and Robbie.
Oh, sweet.
Good for you.
So we'll see how that goes.
I think you're right.
All right.
Parting shots as we got to dip out
of here.
What do you guys got?
Dave, go first.
I don't know.
We hit a bunch of stuff.
For me,
it's just clarity and focus on like the
main thing.
Right.
So we talked about a lot of different
topics,
but finding great therapists that can kind
of clearly articulate our value,
like our pitch, why we're charging,
what we're charging and what the client,
what the prospect actually gets for that.
Okay.
Twenty twenty twenty six.
Fourth of July.
Family poker tournament.
I hit my first ever royal flush.
I've never hit a hole in one,
but I hit a royal flush.
That's that's it.
That's my parting shot.
When I play poker with people,
people think I'm like sandbagging and I'm
trying to look bad because I'm always
like, what beats four of a kind?
And people are like, oh, this guy's blah,
you know, whatever.
I honestly cannot remember what beats what
in poker.
I would say clarity beats complexity.
Do not confuse clarity and complexity.
Clear beats clever every time.
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 PG Podcasts on
YouTube, the socials,
and wherever you binge podcasts you
pretend are for CEUs.
And hey, just a reminder,
none of this was for advice.
This was for entertainment only.
Our lawyers say that counts.
Thanks, Keith.