Good Tuesday morning. I think it's the first show this year that's been below freezing where we are broadcasting from. It was like twenty nine degrees when I woke up this morning in New York. Is it cold in the city, Dave? We got forty three right now with a high of sixty, a low forty three, a little weather report here. Here we go. Twenty seven where I am. You can see the difference. I'm an hour north of you. This is this is a little different. I do want to flash the new background. We did have a bowl of Froot Loops. I feel like we needed something festive. And here's the first topic. I'm going to pitch something to you and Tony will join in a minute. Went to PPS with Tony last week. That was last week, right? Yeah. And of course, everybody's paying attention to the vendors, the exhibitors, the speakers, the whole thing. I, of course, like I hang out in. the happy hour. I hang out in the hallways. I talk to the people who are watching the thing, right? Like I've been around enough shows that I don't even watch the bands anymore. I watch the people watching the bands. So talking to practice owners and I was like, this is kind of cool. I talked to three or four different people who had like interesting, Not like wildly unique, like you've never heard of it. There are those people out there that have these practice models that are like, that's crazy. Like someone just DM'd me the other day that there's a PT at Dancing with the Stars. Like that's her job. But of course there would be, right? That's obvious. But she was like, hey, check it, you know, Kay, thanks to Kay Mastricola for sending me that. She's like, you got to get her on the show because she's like, I want to know about what this girl's like. And I was like, got me thinking, like there's a lot of people out there with like unique practice models. I think we can learn a lot from that so like even when I would like and I just start conversations with random people I know this surprises you um and I'm just like what makes you unique what makes your practice unique and they'll just start like telling you and then you'll get three or four questions in you'll be like wait a minute that's kind of crazy but to the person it's been their normal for so long it's they're not like bragging about it they're just they're burying the lead so here's the pitch The pitch is, fifteen to twenty minute episodes. I'm still working on the right question combination, but I'm trying to get these little nuggets out to show other people who either have practices or want to start practice, like, oh, I never thought about doing that that way, or, oh, I never thought about that. So I'm calling it PT Blueprint, where essentially, I mean, it's not like Shark Tank where they're pitching this idea because they want to get funded. But I want to get to the nuggets and the interesting parts about where their practice works. And not everything's going to work. I mean, some things that Dave Kittle does in New York City aren't going to work in Iowa. And I'm sorry, Iowa. I don't know why we always mention Iowa being the middle of nowhere. But... So what do you think about this? Does this bring value if it's fifteen minute interviews to people and I'm trying to get at the what makes you unique? How do you what what problems have you faced? How do you solve those things? I'm trying to give people who are either opening have practices or open practice just little nuggets of ways to solve problems that maybe they have every day but just haven't thought of. Well, yeah, I mean, of course, it's valuable. I think it's especially valuable to other people in your audience that are therapists that maybe they're in business, maybe they're not, but they get to see like, oh, what else is out there? What are the opportunities out there? What are what have therapists gone and done? That is not like all this other craziness of like going to work for like some, you know, medical sales company or something like one of these alternative choices where you're like leaving the profession or whatever. uh, unfortunately. So I would say there's a ton of value as long as you think that there's some, you know, business case there, or, you know, it helps with like, you know, reaching your audience and whether it's, you know, you with a business case selling advertisements or whatever it is against those videos. Like if it makes sense for you, absolutely. It makes sense for, it makes sense for those therapists that want to get on your platform and kind of be in the spotlight and Who wouldn't want that? Yes. And then also your audience. So your audience gets to hear about these obscure practices like, oh, wow. Or this therapist that's like on Dancing with the Stars. And I'm sure by now that therapist who is on Dancing with the Stars, I'm sure that therapist probably only treats like pretty high level performers and dancers. And being on the show will absolutely help with more leads, more prospective patients, clients reaching out to her. or him, whoever it is, uh, to be treated by the therapist just because they were on the show. Obviously you have to have the clinical chops and all that. So of course this whole, this whole idea has value. Um, what are your, are you like uncertain or are you just pitching it? Like, like why, to me, it seems like a slam dunk. Why, um, why do you think it's even a question? I don't know. I think that last part, I still get, I'm still like, I don't, I think I'm stuck. I'm like, only PTs listen to the show. So do we actually think this would help people get patients? I think the video, if they repurposed it, might. Or maybe them being featured by anybody, not themselves, is seen as... Maybe your video is... maybe your videos might not help that therapist get new patients. I'm saying the therapist that's on dancing with the stars, people are going to Google that therapist name. And if they're in the city or the nearby location, Metro or whatever, they're absolutely going to reach out to that therapist. If they're a performer, if there's someone who has done a lot of dancing or whatever performances over the years, like they want to be treated by the best. Uh, and, and Tony has said it a ton of times, like whoever's like the most known popular therapist, uh, is going to get a lot of the recognition and a lot of the easier business, as opposed to a really great clinical therapist who doesn't do marketing, doesn't do any awareness, has no videos or anything. So I'll tell you where this is from. And then Tony, I'll catch you up to speed. I'm not sure if you were listening for my pitch. So I was on Instagram. This is a couple of years ago. And I saw this practitioner who was like, I only treat skiers and snowboarders in Vermont. And I was like, that's cool. Like, dude, that's like crazy niche. And I just DM'd him. and had never met this guy. His name is Steven Burkhart. And I was like, never met him before. Tell me about your practice. This is cool. And then I think I asked the question. I'd love to go back to the podcast episode. I was like, what gave you sort of the right, like internally? Oh, yeah, because he was like from Maryland. I'm sorry, Steven. It was like somewhere on the East Coast, but not from Vermont. I said, did you know anybody? Did you? He's like, I drove to Vermont, knocked on doors at CrossFit gyms, and was like, I want to work at your CrossFit gym. And now... he has snow beast performance and this is his whole thing. He treats snowboarders and, uh, and skiers in Vermont. And he's like, this is my dream life. I am on the slopes or treating athletes. And I was like, what gave you the right? And I, This was not prepared. He goes, I listened to your show since I was a PT student and heard so many people say, so I just did it and it worked. And I was like, oh my gosh. And we're not here selling a method or a checklist or a mastermind, but it was just stories. So I was like, shoot, that was a couple of years ago that Steven said that. And meanwhile, Steven and I, I've been trying to do, I was like, Steven, you should host a con ed course on how to treat skiers and snowboarders in Vermont. I'll come. And then half of the day is Con Ed and half the day is skiing and snowboarding. Who wouldn't want to come to that? Right. So like Steven, I'm still, you know, me, I'm the wow guy. We need a how guy. But anyway, Steven saying that live while we're recording made me go, oh my God, people listen to this podcast. That's crazy. And then I was like, what if we could do that for other people? So anyway, Tony, my pitch this morning was I'm doing this like new, like sort of segment or format, fifteen, twenty minute interviews is at most. I'm trying to work on the questions. Maybe that's why I'm pitching it to you guys. But here's the idea. Everybody's PT clinic is so they're all the same, but they're not like they're just not. There's a little twist or turn or we solve this problem or hey, where I live in the country, we can't do that. So we had to. So I'm trying to get those fifteen interviews to say, like, tell me about your practice. Let's get to the unique part because I want other people to hear them to go. Oh, I never thought about. Oh, my God. Why don't I just turn it upside down or something? And then. It doesn't have to be a ten thousand dollar solution to completely change your practice. So we're calling it PT Blueprint. And I'm looking for people who think they have a unique practice. And I'm just like, OK, great. Show me. Yeah. Yeah. Obviously you need to go through chat GPT. You need to work these questions through when I do the PT spotlight interviews and I want to find questions that the consumer wants the answer to. I don't want that to be a PT to PT conversation. I need to ask questions that the consumer is sitting there looking for the answer to. And I brainstorm with chat GPT. I'm like, do this, do that. And I go back and forth with it. Going back to your guys' conversation when I jumped in, this is still an available domain, celebritypt.com. Whether it be you make the patient the celebrity, obviously you have that opportunity. Or you look at it and you say, I want to get PTs and make them celebrities. You know, to Dave's point, if somebody is on Dancing with the Stars, even if you never heard of them before, they instantly become a celebrity. I really think there's an opportunity there. Yeah. And look at that. We'll bring that back up. One penny for the first year. It's a steal. Oh, wait. Oh, twenty two dollars for the first year. Well, twenty-two if you get all the other ones. Oh, I see. I've never got a domain name before besides mine. Somebody else bought mine. Somebody else bought mine. Yeah, I've never done anything like that. Dave, I'm sure you have a library of domain names. You're like me. I've been weaning them down. So wait a minute. I have too many. I've known people to do this, but I've known you guys. so so this is like gambling right I mean essentially it's like hey for five dollars a year I'm it's hoarding yeah the only one that I knew that was like people were paying attention to it was when the watch the team known as the form the team formerly known as the washington redskins there was a guy who was forward thinking enough in the dc area to be like what are they going to change their name to and he went and he sat on all those um uh, domain names and they started creating merch for it. Um, but yeah, I guess that's the thing. So obviously I'm going to do a chat GPT thing. I already did. I mean, spoiler alert, but what I also like to do is make this thing living and breathing. So if you're listening to this and you're like, Hey, I'd listen to PT blueprint. Um, what you don't have to tell me the question but what are what are some things or problems you might want me to sort of bring up or ask them that maybe I haven't asked yet so I sort of do want this pt blueprint at because now I think we're starting I don't know about you guys I'm getting a lot more dms and and emails from people who listen to this podcast probably in the last two months than I have in the last two years Probably because we're asking for it, or at least we're bringing up topics. So who knew when you actually ask people to do stuff, they do stuff. And when you don't ask them to do stuff, they don't do the stuff. So I would love to hear from you. Who's the target audience for one of these blueprints? Is it you want them talking to other therapists who are looking for innovative business ideas, or do you want them to promote their business to the consumer? for me really, it's a clinician. Like I talked to JJ yesterday and she runs puck and recovery where she's like, I treat hockey players. I was, she was a hockey player in Maine and now she lives in DC. And I was like, that's cool. So we talked all about that. So for me, JJ is not really on there to get patients. JJ is on there to like, Hey, I did it. Like you can too. I feel like that's a common thread with therapists who've made it. And she's like, I'm still dumbfounded every day. I get to go to work and do this. And I'm like, yes, that's, I think what JJ wants to do is she doesn't care if you're treating hockey players or, you know, polo players or volleyball players, but like she wants you to get up and just do that thing. So, and the audience for listening is like, people either have a business who are like, man I just need some new ideas like talk to me about me problems and let me just listen to this in the background kind of like tony the tony's of the world when dave's the world we're just like I'm just paying attention but I constantly take that thing and go how do I apply that to my life or people who haven't started a business and I want them to know the deep the deep end of the pool ain't that deep I'm not saying it's for everybody and I'm not saying it's easy but I'm saying I'm gonna we can continue to point at these people and say they wanted to do it just like you and they've done it But also let me show you some bumps in the road. Like one of the questions is like, what was your biggest challenge or failure and how'd you get over it or past it? Because I don't think this should be a highlight reel. I think it should be real tactical information. so really so for therapists then therapist facing correct and and for me like I I think I'm like I've been you know in your audience I've been your audience like over the years as well so like I think myself and other therapists probably tony as well like because we are we want to be inquisitive we want to kind of learn and see what else is out there I think it would be great even the interview uh speaking with what was his name steven in vermont yeah he's awesome so so like Yes, you can run the question through chat GPT, but like ultimately there's therapists out there that are like, maybe they're skeptical. This is on, this is an online thing, right? Like, so hold on, like how many patients a week or a month do you see? And like, are you insurance? Are you out of pocket? By answering some of those questions, you can kind of get a sense of like their top line revenue. And then you can kind of see like, wait, is this actually viable? Like, could I move to, I mean, I'm sure there's therapists in Val, Colorado that like, that just do this as well, that like they only treat skiers. And this is the huge thing that, I don't think you really can understand it or believe it until you're in it, which is like that you can actually niche down in something even like physical therapy. You can, if again, there has to be some critical mass of the population around with, with that condition or that presentation or whatever that you also either you like or love to treat and you have the skillset to kind of hang you like with golf, right? Like, I don't know all the, terminology with golf like I play baseball I don't play golf right so like I could learn it over time but if you stuck me in that situation right now like the golf pros and the golf trainers or whatever would like show more competence and professionalism than I would I don't know about all the backstrokes and all the terminology or whatever so you have to know the whole lingo and all that yep So it sounds like it would be therapy facing or therapist facing and other therapists out there. If I can speak for them just really quickly, it's like they would want to know, like, is this really possible? Wow. Wow. This is possible. And then what's the thing I can go do? Can I move to Ohio and treat business owners like Tony Meritato? And he'll introduce me to all the other business owners in the area. And I'm treating Ohio business owners only. Right. Yeah. So maybe what I'll do is this. I use JotForm. It's like a fancier version of Google Forms. I'll have them just, I'll say like, listen, if you want to be on the show, word vomit and explain, or I'll ask them a few prep questions. Then I'll run their answers through ChatGPT and say, find the thread, find the uniqueness, help me, right? And then that will help me guide my questions. So look, we just sort of workshop this in public. Instead of forcing them through a format, I'm going to make them talk to my pre-show producer, a form, and then chat GPT. And then the chat GPT person will be like, okay, today you're talking to Dave. Dave's unique because of this. So start with these questions and then get to the meat. Okay, I figured that out. That's cool. But it's funny that you say minimum viable audience. You guys know I quote Seth Godin all the time. He's got a new book coming out called This Is Strategy. It is on pre-order now, right? I don't get a nickel, but I would like a nickel for every Seth Godin book sold. And the first bullet, because of course, I love Seth Godin, but like any author, a lot of times they can get repetitive, right? Which, hey, good for them. But the first bullet that jumped out for me, I was like, why would I want to read another Seth Godin book? I have a lot of Seth Godin quotes. I don't know if I need any more. The first one he says is identify your smallest – The book will challenge you to identify your smallest viable audience and make remarkable work they can't ignore. That goes to what Dave was just saying is like, can you just move to Vermont and only treat skiers and snowboarders? It's like, okay, well, let's figure it out and figure it out as not invest all your money in a clinic and then see if it works. Like there's probably some steps that you should take before that. But the minimum viable audience for you is a lot smaller, I think, than you think. If you have a thousand people in the world who are willing to pay you a thousand dollars, that's, wait, I did the math wrong because I don't know how to do that. If you have a hundred people willing to give you a thousand dollars, that's a hundred thousand dollars. So do you need everyone to be your audience? I don't think you do. And I think one of the aspects in that that we don't talk enough about is as you make one variable smaller, you grow another variable. So like for me, one day I just woke up and said, hey, I'm going to be the knee replacement guy. Like I just I'm going to make that my niche. I believe I add unique value to that population. I answer their questions in a different way. They're low cost. They're easy to get. They have high urgency. They barely use any equipment. Like they check all of the perfect boxes for a business. And I genuinely enjoy working with that population. But as I shrink one variable, so outpatient orthopedic down to adult geriatric down to total knee replacement. I grow another variable, which is, well, what about outside my community? What about adding like my clarity.fm account? So I talked to a guy yesterday from the New York, New Jersey area. I got paid for that call. I can do telehealth. I can do digital courses. I can expand the potential audience and reach. because I'm going so specific on the topic that I wanna treat. I think everybody can find a topic. I always think truck drivers, like that is such an underserved population. They're spending hours in the cab of a truck They're looking for things to occupy themselves. They're dealing with orthopedic pain. Why don't we have some sort of telehealth and digital content from a therapist who's been a truck driver, who knows those frustrations and is just going to serve that population? Here's a crazy, so another format for probably a different channel or maybe not a different channel would be, we could just go around and interview, like, tell me about your job. Like, tell me what you do. Like truck drivers would be a good example. It's like, oh my God, how many truck drivers are there? Well, there's three million truck drivers in the country and they spend twelve hours a day. It's the number one volume job in the U.S. Like the most number of jobs of any job is truck drivers. More than teachers, more than nurses. Yes. Did not know that. Wow. So yeah, if you start to play the numbers, which is what Godin said, understand what your minimum viable audience, you could even mix those two things, which is occupational health. And I'm sure someone's done this. I don't think I'm inventing this, but it's like, you know, yellow freight was a big trucking company that actually just went under. was based out of like near my hometown. And it was like work for yellow freight because the math guy, the actuary or the finance guy understands what a driver going down means in terms of numbers at the end of the year. If you can show them with numbers that you can prevent that you're worth lots of those numbers. Yeah. I think Tony's on his phone. Are you checking? Are you Googling the number of jobs in the US? Go ahead. Tony's getting the domain name for trucker PT. Trucking PT. Trucking PT. Well, that was the thing. I mentioned JJ that I talked to yesterday and we were having some audio issues and I didn't ask her, but her Instagram is like puck and recovery. But when you say it passed, it's puck and recovery. Yeah. Puck and recovery. I imagine that's an intentional play on words. And I meant to ask her, but we had some audio issues, so I think I forgot about that. All right, so that's my new thing. I've recorded two of those so far. So if you have a unique business model, drop me a DM. Just explain to me, like, hey, it's unique. One sentence. This does not have to be a television show pitch. Just tell me one little twist. The entire model doesn't have to be unique, right? The name could be unique. I don't know if that's a way that people find you. Yeah. I mean, this is why they used to call it like AAA towing is like, cause you wanted to, you wanted to rank at the top of Google when Google was the yellow pages. So like, tell me how you've solved the unique aspect of this same business that we're all in. All right. What else are we talking about this morning? There's a lot of things that we talk about that I always get nervous to bring up. Like Dave and I were talking like Tony might want to talk about that thing that he's doing, but like we don't know if that's ready for primetime. So like the worst thing, if we're going to talk about unique business ideas and how we kind of work through these business ideas, let's go. I'll share mine. So every time I, and like you guys, you get a million ideas, nobody's short on ideas and they're all good ideas. It's which idea are you going to pick? How are you going to roll it out? What is the best, you know, potential reward? So I've been off the record talking to Dave, talking to Jimmy, talking to others about like, okay, we've got all this inbound information. I've got product companies that are reaching out to me. I'm like, how can I make this work for my community, my patients, my business? I am going to go. I'm going to bite the bullet. I'm going to go down this road. I haven't done anything to innovate my clinic in like twenty years. You guys know I brought an EMR in for the first time this year. I'm doing a couple other things. I am going down the shockwave therapy road. All right. Go ahead. Explain what shockwave is now. I'm learning. So, you know, it's an acoustic sound device. I mean, immediately you go to, well, is it ultrasound? It's a version of that. My struggle with everything is I always have to balance my ethics. I have to know that I am feeling comfortable and confident in this decision. I'm never going to just push something. So even yesterday, I was talking to patients in my clinic. I'm like, hey, I'm thinking about rolling this out. What do you guys think about it? And I'm like, well... You know, sometimes it's inconclusive. Is it effective? Is it not? I'm like, well, there are companies that are selling cigarettes. There are companies that are selling alcohol. There are companies that are selling things that we know are definitively harmful to human health. And they don't have one bit of remorse for that because they're bringing pleasure to their customers and they're satisfying their customer's need. So for me, I try to find that balance. I'm like, well, it's definitely not harmful. There are lots of individuals that have had some positive results from it. And as long as I'm not making claims that are over the top, that are not justified, that are just made up, I feel like this is something that I can bring into my clinic. I think I could target a population. And this goes to the business analysis where I'm like, I can target a population that has done everything else and nothing else has worked. You know, like, okay, they did conventional therapy. It didn't work. They did orthopedic. They're not a surgical candidate. They did non-steroidal anti-inflammatories. Maybe they did injections. They've done PRP. They've done all of these things. Nothing has worked. Right. Let's find one more option for them. And it's an option. It's all self-pay. They can choose not to do it. Nobody's forcing them to do it. And I'm not making any false claims. What do we got here? Fifty dollars a visit. I'm looking at one hundred dollars a treatment. I'm going top of the line. I'm going high end. And just so you guys know, kind of my thought process, I shared a video, but now publicly, I think I can bring legitimacy to some questionable practices. I can do a real physical therapy evaluation. I can do real patient education. We can talk about the benefits of therapeutic exercise. And I can have the shockwave therapy there. And if the patient says, no, I don't want to pay for that. No problem. You still have access to your insurance covered physical therapy services. So what are some of the questions you guys are thinking about? So the initial video that you sent. The video where it was like you would take a patient, you would do a pre and post test with the Biodex treadmill that you have, the stepper. And then you said maybe the run DNA, but I think it was three things. I want to just start with like two just to make it simple. So Tony, you have this Biodex rehab trainer, rehab treadmill. You do a normal physical therapy evaluation. You put them on this treadmill for gait analysis for two minutes, five minutes, ten minutes. I don't know. You can let us know. Then I think your video said that you would then treat them with the shockwave. It could be prefrontal neuropathy. It could be plantar fasciitis. It could be some maybe Achilles tendonitis, some chronic tendon issue, whatever it might be. And then you would put them back on the Biodex treadmill and and see if there's a change in their overall movement or quality of movement. And then you said maybe run DNA equipment and run analysis or gait analysis as well. But just for the audience to make it simple, you have that treadmill. It's got the digital screen. It provides data and feedback on step length, stride length, maybe asymmetries. Tony can get more into it. Then you have the shockwave treatment for five or ten minutes or whatever for that area, that anatomy. You put them back on the biodex. It's going to spit out some information. And Tony kind of said, like, let's see if that would provide some data for this patient. And now, real quick, and I'll kick it back over to you guys. I've known Tony long enough, and I know Tony does not like to be salesy. I know that you guys are not heavily into cash-based. So in my opinion, I think this is great for Tony to share. And I would assume, Tony... you are offering this idea because you don't want to be, you don't want to appear salesy to your patients, but if you put them on the trainer, the Biodex treadmill after the treatment, and then it shows that their quality of movement is better, their step length is further, they have less imbalances with gait, whatever it might be, the machine, the Biodex spits out the report and says, now, compared to thirty minutes ago, now you're moving better, walking better, whatever. Then the patient is like, oh, like that's obvious. That's not a therapist or a chiropractor or whoever saying like, oh yeah, like, you know, subjectively you're better. No, no, no. Objectively with data, you're better in thirty minutes or an hour. And I'm assuming, Tony, that is also kind of partly into why you would like this or why it would fit you and your style, because it's not you selling. It's it's the pre and post data. And it's kind of like obvious. Like now, if I got better in thirty or sixty minutes, Why wouldn't I buy a package for a thousand dollars or however many visits? How much of that am I right? Am I on? Am I off? Let me know. On a hundred percent. Like that's exactly it. I think you can measure success in two ways. You can measure the subjective experience of, do I feel better? But like, I'm a huge fan of pain science, Paul Ingram's articles. And he just posted on Facebook the other day, like talking about the theater of pain. And I think we can convince people that they feel better even when they might not feel better or they'll tell us, you know what? I just had a really interesting experience. This is the second time this has happened to me. I had a patient come into the clinic, um, went through a laundry list of past medical history stuff. I don't want massage because I bruise easily and I have this blood disorder. And so you can't touch me. Nobody's allowed to touch me. I don't want to do this because I have, you know, uh, osteopenia and I'm concerned about fractures and I've got a history multiple. I mean, literally like the, the SpongeBob GIF where he opens up the list and it just goes down across the room. Yeah. Okay, no problem. Let's do a very gentle approach. I'm going to show you three things. It's going to help your condition. You do these at home. I'm not discharging you. Also, there was a complaint about the copay. So I said, look, come once we'll do today. Then you can go home, do your stuff. And when you're ready to come back, we'll be here. You're not discharged. Not even ten minutes, this person walks out the clinic. I thought it was an amazing patient care experience. I thought we had great rapport. We talked about this person's personal profession and hobbies. We talked about all this stuff. Negative review on Google. One star review. Total therapy is a joke. Why? They gave me three exercises and sent me home with nothing else to do. So, you know, we can't rely on our perception of what we think is happening. We need some sort of objective measure. And so, yeah, Dave, to your point, I've got the reactive step trainer from Biodex Rehab. I've got a classic case where a patient has peripheral neuropathy. They have some difficulty walking. They feel like they're walking on cushions and pads when they're not walking. but their altered sensation and pain is causing this. If there is objective evidence from providing a treatment, I do a pre-test, post-test with shockwave treatment in the middle, I can't lie. I can't make it up. I can't really affect the objective outcome measure. And so I would feel better about the situation if I can show that objective data. Plus what I was talking about earlier this morning before I got on with you guys, we're all dealing with owner or hospital owned physicians, hospital owned referral sources. My referrals went way down as soon as the hospital acquired all the local orthopedics, but the hospital doesn't have shockwave. The hospital doesn't have the reactive step trainer or the run DNA motion analysis system. So now even if theoretically I never use that equipment, Just having that equipment gives the doctors a door to open and say, Hey, I can refer to Tony because we don't have this equipment in house. Yeah. So I go to, so Dave asked all the important questions. I'm going to ask a question and this is where you know I'm going to ask because it came from radio. What are you going to call this? Because once it has a name, then it's a real thing and someone can ask about it. And then you can build a landing page for it and someone can Google it and they can call it something. So what are you feeling like? We can workshop the name. You don't have to have it now. We need to workshop it because I'm specifically selecting and this goes back to the basics that everybody should be thinking about. Okay. I'm selecting the conditions that I have a unique competitive advantage toward. I have a predisposition toward. I don't want anything that I have to disrobe somebody and drape them. I know that shockwave is used for pelvic floor and for other conditions. I'm not doing any of that, even though it's potentially more profitable. That's not my interest. Pelvic shock. yeah that's not good um so I'm like look we're gonna do knees because obviously I have a you know almost sixty thousand subscribers on my total knee replacement youtube channel I can do non-surgical knees to address people who don't want to get another knee replacement on the other side I can do Achilles tendinopathies, maybe hips. It depends. I'm kind of on the fence about that. But peripheral neuropathy, I can do anything that's easy access, anything that's low maintenance, anything that's going to give me the biggest benefit, the greatest impact with the least amount of effort and work and risk. I don't want risk. I know you can treat wounds with shockwave. I am not treating wounds. I don't want infections. I don't want cleaning and all this stuff that needs to go along with that. I am picking the simplest route and I am going to monetize that. And my goal, and I have no idea, it's an arbitrary number, a hundred thousand in net profit. meaning a hundred thousand to the bottom line above what we would already be doing in the first year of rolling out shockwave. Now, you know, what do you guys think about that? Does that, does this include the cost of the shockwave or are you going to get it free just because you're a celebrity PT? No, no. What I do with every one of these devices is I look at it as... Now, granted, some of them I do get on loan. This particular Shockwave company, what they're doing publicly is two months free use of the machine. And I think it's six months of deferred payment. before you actually, and this is for anybody, it's not just for me. So anytime I bring a piece of equipment in, I am sharing the information based on what is the equipment cost? What is the leasing monthly payment? Like how does all of that factor in? Because just like with my patients, I don't want to fake somebody out as a therapist and be like, oh, I got it for free, but I made a hundred thousand. No. Like, what are the real expenses associated with this? Even, even the maintenance, like, do I need gels? Do I need creams? What do I need for staffing? Um, so yeah, I'm looking at, can I net a hundred thousand in pure profit after all expenses, um, Not counting the profit that I would have made anyway without the shockwave. Right, right, right, right. All right. So, of course, I'm not good at math. So I asked my favorite math person, ChatGPT, to do that. To make a hundred thousand dollars per year, this is without expenses because we've got to factor those in. You'd have to do a thousand treatments, right? And that's that's nineteen a week, eighty three a month or two and three quarters a day. So, of course, you're going to have busier days and not. So, I don't know. That seems like more than I thought it would be to make a hundred thousand dollars. I mean, what do you think the overhead is going to be? What do these units cost? Free for two months and then financing for six. So, you're already eight months in. I think when I look at the leasing options and you're paying a full lease rate, you're looking at about a thousand dollars a month. All right. So that's less than I thought. So that's twelve grand. So like we'll add that's like a five year lease. I think that's what it is. Twelve twelve grand over five years or twelve twelve grand a year for five years. Twelve grand a year for five years. So, yeah, you would need to market this, but you're highlighting the fact that you're going to fill a void that doesn't exist. We talked about niching down. There are these patients that don't really fit anywhere or they're not getting results somewhere. They come to this. This is also stacking. This is like your tech stack. You sound like a tech bro now. It's like, hey, what's in your tech stack? I use JotForm and StreamYard and CapCut. I like the fact that you know, you're the most, one of the most innovative people I know, but you don't just sort of throw money at things like that's not, that's not innovation, right? The definition of innovation is find a problem that no one else is solving, solve that problem. how you solve that problem is by definition innovation. So I think you're looking at this from two ways. Like you didn't go and find a revenue, like where's my next revenue source? You said, what are the problems that occur? How do I, can I easily and simply solve those problems? Are those the types of problems I like and want to solve? Now, what does it cost to solve them? Does the math math? So it's those four steps. I think, I mean, I don't know. I think this feels like something some of my friends would go to if they had those issues. So other aspects here that I think need addressed, and I just ran the quick math. It's not five years. It's probably eight to ten years at a thousand dollars a month. But that being said, still, what I'm looking at is I'm saying, okay, I've got the direct to consumer. I can generate a hundred dollars a session. That's an option. But let's not forget, I own a building. It's a medical building. I've got a group of chiropractors. I've got a couple LMTs in the building with me. They have their own caseload. They have their own patient base. I love this Hunt's Brothers Pizza model. Yeah, yeah, yeah. We talked about it. The biggest pizza franchise in the US is Hunt's Brothers Pizza. It's like a ten to twenty thousand dollar investment for a gas station to buy their equipment, buy their supplies, and they can get into the pizza business. So if I have this device, why would I ever just use it for my people? I would then do a revenue share with the chiropractors who are next door in my building. I would do a revenue share with the LMTs that are upstairs in my building. I would take the device. It's a forty pound units about a big printer. I would take it. I could go down the road. I could go far enough that I'm not in a competitive market, but still probably thirty, forty minutes away. And I could start building relationships with other chiropractors, massage therapists, physical therapists, CrossFit gyms and start doing on site shockwave treatments. Yeah. we're doing a revenue share, you know, and, and the best part about this is, and I've asked this, it's a class one device, whatever that means, it treats orthopedic pain and something else. I don't need a licensed person to deliver the treatment. So, you know, at that point I'm like, well, shoot, I'm not even limited to PTs and PTAs. I can use whoever, um, Um, so this is where, whether you want to call it a vending machine model or a, you know, Hunt's pizza, Hunt's brothers pizza model. It's like, I can start to bring this out into the community. I can put it in other places. It can start making money for me. Um, certainly there's justification for buying additional units and just expanding out like that. And to Dave's credit, I always think about what if I was not the clinician, but just the business owner, the investor? Why wouldn't I just do the funding if I had eighty thousand sitting in my bank doing nothing or collecting five percent interest? Why not just put that money to work, buy some of these devices, connect with clinicians who are passionate about being therapists and who are too scared to put the money into the hardware? I'll be the backer. I'll be the financer. I'll put it in. It's just like putting any other piece of equipment into your clinic, but now it's one that has a little more sex appeal. There's also things we're not talking about, which is this is your Costco hot dog. This is a rotisserie chicken. That's a loss leader, right? You might lose money or break even with this treatment being the reason someone shows up, and then they show up. and they actually like tony and they're not going to leave them a one-star review for really great a really great patient interaction so it's a differentiator that could actually lead to somebody who might not have walked in your door that walks in your door and five years from there they're still walking in your door or they come back and then they refer friends so there's a way there and here's the cool part in twenty twenty four there's ways to track those things there's you don't have to guess at those anymore with that emr that you finally got because before that you were just doing Tablets, right? You were doing like what Moses used, right? Like just stone tablets. And now you can track those things with a good EMR. For sure. And the reason why I went with Softwave just for reference, there's a lot of companies out there with a lot of comparable equipment. I watched some of their internal videos with there was a PT who works for the UFC. Oh, yeah. She works with some of the pro fighters. Blew my mind with the stuff that she was saying. Is it Heather Linden? Who? Was it Heather Linden? Yeah. She was like UFC. She was like trainer of the year like twice. I had Heather Linden on a million years ago. She was awesome. There were three physical therapists similar. She was one and there were two other ones completely blew my mind from the perspective of they were looking at it the way I would look at it. They weren't looking at the crazy claims. They were looking at real, you know, real experiences, real evidence. And they were people that I implicitly trusted and they were saying things that resonated with me. And I was like, that's it. This is this is what I needed to take me over the edge. And now we're going to do it. I'm going to run it. We'll build it in public. I'll share more resources. Yeah. Is shockwave relatively new? Dave cut out. I think he was saying, is it only a hundred dollars? What were you saying? Are you only a hundred times your pricing or is it going to be some package offer? Like obviously therapists would be curious about that. We have to experiment, you know, you can't just say this is what it is. My feeling is, and there are different protocols, so some might be six session protocols, some might be a one session protocol, but I think I'm probably gonna look at, get them in, do the evaluation, do a shockwave treatment, offer a six session protocol for five hundred dollars. If they want to do it, awesome. If they say, let me think about it, they leave. No problem. They come back. If they buy it at the time of the eval, I'll discount it to five hundred because there's going to be five additional shockwave treatments. If they want to leave and come back and say, yes, I'm going to do it. But originally they say, no, it's six hundred. And it's just, there, there's no, you know, it's one of those things where I think we fall into the trap, the, I don't know what Jimmy peace core gene, we're too close to things that we do personally. I'm not close to this. I have zero, like, I don't care if you don't want it, don't buy it. I don't feel bad if somebody doesn't buy a Ferrari. I don't feel bad if somebody doesn't buy a Rolex. If you don't want it, don't buy it. But I have zero compassion around, um, Oh, I feel like you need to have it and I'm going to pay for it out of my pocket and I'm going to take food out of my kid's mouth so I can afford to give you this service. Because that's what we do with therapy. I'm not doing that with this. This is strictly a commercial business decision. When you offer someone a potential solution and they... like how that sounds, who were you to say that that's not a good idea? Again, you started this, this entire conversation off with the big E word, which is ethics. What you said was, I'm not here to sell something that I don't believe in, that I haven't researched and looked into that you wouldn't, you know, use yourself or use on your own, uh, family. But, um, oh, this is a good point. I don't mean to be rude, but I'm seeing shockwave therapy machines on Amazon for twelve hundred dollars. I'm sure there's a difference before the research. Dave, go. I'll take this. First of all, uh, anything on Amazon is typically not effective in terms of treatment, uh, including even tangents and all that. Um, yeah. Shockwave the difference between the one Tony's talking about, the ortho Tony, you're talking about the ortho gold, one hundred or whatever it's called the right. Okay. So that one has got supersonic sound waves. Amazon ain't selling it. I've checked. It's not on Amazon. Amazon will sell the low-grade, low-intensity consumer products so that consumers do not get hurt at home. The Shockwave that Tony's talking about is a medical-grade device you cannot buy on Amazon or... I don't know any other, any other walmart.com, any other website, the one that Raj is talking about, it might be a shockwave version, but for twelve hundred, we're talking about two different. It's like it's like, I don't know, like a flip phone versus an iPhone. Raj is totally right. And, you know, it goes back to even for me, my initial gut response is, why don't I just get something that looks like a shockwave and I can rub it around with some ultrasound gel, right? We know ultrasound, it's the experience and all of these things that are just as impactful. But Also, to Dave's credit, and like he's saying, yeah, these are very different devices. I would honestly say going back to the theater, the theatrics, it is more impactful for me to purchase an eighty thousand dollar device. I think it puts more motivation and fear and pushes me harder to get it out there and get it sold and get it being used. Just like I would say a patient who comes in and pays three hundred dollars for a session compared to a patient who pays thirty dollars for a session. Just the price difference alone adds to the experience, adds to the impact, makes it a more valuable service or product that you're dealing with. Raj, it's hard, man. I hate buying shoes that are more than twenty bucks, like literally. But, you know, there's a time and a place to make these decisions. And for me, I just just happened at the right time. So, yeah, I mean, buy once, cry once. Right. Like, you know, you guys have heard the boots analogy. It's like poor guy. can't afford really good boots so he pays ten dollars for a pair of boots but they wear out in three months so he winds up paying forty dollars a year for boots where the rich guy can afford boots he buys a hundred dollar pairs of boots that's insane that's ten times the other pair of boots but those boots are gonna last ten years so when you do the math over a decade the person investing in something. And now keep in mind, organizations will use this theory against people and they'll charge you for the story and not the quality. And this is why you research. So Roger's actually absolutely right. Now I have a solo stove. You guys familiar with solo stove? Yeah. It's like cool backyard, you know, fire pit that you can put on a deck and it won't burn your house down. And there's this idea of a heat deflector. Now you've been to a bar, right? The outdoor bars that have those heaters and look like there's like a drum symbol on top. Well, I'm around my solar stove and I got to like lean over to get warm. I'm like, man, I wish there was a deflector. Well, on Amazon, there's a bunch and they're like eighty bucks. And I bought two and they were crap. They would fall over. They just weren't, you know, hooked up. Right. Because I kept looking at the solo stove brand one. It was like two hundred bucks and I wouldn't do it. I'm like, I'm not doing it. I'm not. That's insane. But then I thought about it. If I paid every time I use that thing for every for every ounce of warmth. It was nickels because I wanted the experience. So I was like, okay, if I really want the good experience, I'm going to pay for it. Now, they're situation dependent. So Raj isn't wrong, but buy once, cry once. Instead of buy once cheap and then cry every time you use it. So going back to the business models around this, another business model that I don't know if I told you guys about it in our thread or not, was I was like, well, what happens? There are claims that shockwave cures adhesive capsulitis in one treatment. Okay, well, what happens if it does? And what happens if I'm using my pricing model where I'm like, I'm gonna do the eval, maybe a unit of Therax, a unit of Activity, the shockwave is free and the patient's done and they never need to come back. I'm okay with that. I would still feel good with that because I got the reimbursement for the interventions that I provided. One thing that I was gonna say talking about the earlier conversation about specialization. So I'm the knee guy, but I also love rotator cuff repair. I also love adhesive capsulitis. The thing that got me in the therapy the first time when I was a kid was my mom had adhesive capsulitis. She was a type two diabetic. She was a smoker. She had all of these comorbidities that make it like the classic scenario. So I'm like, I could create a program for shoulders that have been non-responsive to conventional means that have rotator cuff or adhesive capsulitis or whatever. I get them in. I do the eval. I do a unit of exercise, a unit of therapeutic activity for education. I get them on RTM with Sarah Health right there at the evaluation and do the shockwave. But even if they don't need to come back, they still need to do their HEP. So Sarah Health and RTM helps me keep that line of communication open and And I get, you know, here in Ohio, ninety eight dollar reimbursement for Medicare eval, thirty dollar reimbursement for exercise, thirty eight dollars for therapeutic activity. Of course, you reduce MPPR. And then I've got one hundred and fifty on average for the RTM. So just in that single session, I've generated nearly three hundred dollars worth of revenue, even if they never come back. And guess what? If they never come back, they had a positive outcome. And I was going to say, if you if you accidentally cure adhesive capsulitis in one treatment, you will have a line out the door. People will be coming from miles around. I mean, that's that's that's going the opposite of that. If you niche, niche, niche down, one thing gets smaller, the other thing goes goes up. You can charge whatever the hell you want. If I'm saying, if this was the magic bullet for adhesive capsules, shoot, I've seen people with adhesive capsules. If you could do it in five visits, they'll show up. They'll show up five days in a row to get rid of that. Cause that's debilitating. Scott said one and done. Scott said one and done would be great. Right. Yeah. Yeah. Yeah. So good luck. You'll have to schedule people. That would be your problem. Dave, a hundred percent agree. A hundred percent. I agree with Jimmy and Scott. Here's the thing. If something like shockwave can resolve something in session, Scott's right. You do have a patient for life. And here's the thing that I think often gets overlooked in physical therapy. They will come back. So Scott said, there'll be a patient for life. Yes, I've seen it. Here's what, here's what I mean. And Scott maybe has a different meaning, but a patient for life, meaning Scott, when they start to like a month later, two months later, six months later, whatever, when they start to have like a little ache or pain or whatever, they come back into you, they call you, they reactivate their, yeah, you're at the top of their mind because most people will not go back to their physical therapy office or doctor or whatever until they procrastinate and they wait and then it gets worse and worse and worse and worse to the point where they can't sleep or they can't do normal functions. We've had some patients like this over the years. they get surprised with the speed of relief or the speed of recovery or treatment in the beginning, like the, like one or two visits. And they're like, wow, this is great. Whatever. Uh, I feel pain free, but also like, I just want to keep scheduling with you guys. Like I want to know, of course this is cash based, you know, out of pocket. So then it's like, they're like, Hey, I would love to just continue. Can I just continue to schedule and have you come, you know, once or twice a week. And we're like, uh, Yes, absolutely. We have your card on file. Like, let's do it. Let's schedule you. Right. So and then then some of those clients get busy. They travel. They have life events. They have children. You know, they move. We've had all this and they still reach back out to us. And it's crazy to think that if you didn't provide this immense value up front, You miss out on all these patients and clients over the years that should be contacting you like they sleep wrong. Right. How many times we've all slept wrong. We wake up and like our necks all jammed up and we can't turn in the car. We can't look in at the intersection. There's so many patients and clients right now that you guys all you guys and gals all have in your practice that are having aches and pains and they're not contacting you. That's something to think about. Maybe that's a takeaway for today. This type of thing can fast track that. It can provide some clarity for them. Like you are the solution for the next issue and the next issue and the next issue. Or when their friend or neighbor or coworker complains of some ache or pain, then they're gonna like vouch for you. They're gonna provide a, you know, work mouth. You need to go contact Tony. You need to go contact Jimmy. They have this machine. They have this device. They're gonna get you in tomorrow. They're gonna get you in this week, next week, whatever. Patients for life, extremely overlooked in physical therapy. Also, even if that person never has an issue again, you're the person that helped them. I put lights around my pool in my backyard. And when my friends come over, like, these are really cool. I'm like, yeah, yeah, yeah. My buddy down the street on his side gig is putting in sound systems and lights in pools, like around pools. The guy's like an engineer during the day, but just likes it. I've had four different people in the last two years be like, dude, this audio, those, look at those, those rocks. They look like rocks. They're speakers. I'm like, Oh yeah. And I got it on my phone. I got like the, the, the, the amp in the basement and I crank up iTunes and it sounds like we're live at a concert. And they're like, how'd you do that? I'm like, well, I didn't do it. Sean down the street, dude. Like he, he knows. So even if, even if I never buy anything from Sean again, it's, sean was smart enough didn't never gave me his car I mean I think he honestly did it because he's my neighbor and he's like I like doing this but even if that person never has an issue again you're their guy you're their girl oh people love to be helpful right I had like a sheet rock issue and someone was like oh I got a guy I got a guy don't worry he's great you know gonna get done fast like great fast and cheap I stopped saying good great fast and cheap right But what you're not, like the easy part of that is, I don't have to go through like an intake process. Nah, man, I'm going to call this guy for you. You become that person's girl. You become that person's guy. You become that person's like, they're in my Rolodex. Kids, a Rolodex was like your contacts app before there was an iPhone. So the other part of this, Dave and I have talked about like selling practices, acquiring practices, building value in a practice that you can sell. I told Dave before, you know, we sold our Florida clinic because I hadn't been in that clinic for like a decade. It was completely independent. Wild. here in ohio I'm the one like if I'm not there there's no other therapist I can't sell a practice that has no physical therapist so this is something that I can bring in I can build value, I can increase revenue, I can increase profits, but I can also have something that has resale value down the road that isn't dependent on me. I never made any profit on the actual device right now. I'm looking at it as long-term valuation for the company when I do want to be in a position to sell. Last one, recruitment. So I can post a job saying, hey, we're hiring a physical therapist for sixty five thousand dollars, whatever. Nobody's going to care about that. Nobody's going to want that. Nobody's going to even look at that other than to make fun of that ad. But. If I have the run DNA motion analysis, you know, in my clinic, I invest in purchasing one of those. And now I say, hey, I'm looking for a therapist who's passionate about running. I'm looking for a therapist who's passionate about gait analysis. And we have this equipment and we're looking to put the money and the finances behind growing this program. I could do it for that. I could do it for the shockwave. I could do it for the reactive step trainer, for a therapist who wants to get into balance and gait and fall prevention. These aren't just hardware investments. They're also investments in a recruitment and retention. And Doug from RunDNA, we talked about that. We were like, yeah, a great way to attract the best therapist, the most passionate therapist, is to have this hardware. And the best way to be able to afford to pay that therapist more than everybody else is to monetize the hardware, to monetize these programs. Sure, sure, absolutely. Want to do parting shots? Yeah, sounds good. All right, I'll be right back. Okay. Dave, parting shot. And Jimmy's up. I got a couple of things really quick. Tony, first thing, question. I want to go write a five-star Google review on your practice. Is that okay? Please do. I appreciate it. I think it's great to have peers write those reviews. I don't know why more people don't. Yeah. So, I mean, cause you, you were at one of my practice, uh, Google review like a couple of weeks ago or whatever. So I appreciate that. Uh, it really, it, I don't want to harp on it too much. We've had a great positive show, but that story about that patient that you provided that value and all that. And then they surprisingly go right at one star Google review. I mean, we're business owners. That can flip someone's day or week. And Tony, you take it very nicely. Guys and gals, please go to Total Therapy Solutions. Go write a five-star review. I'm going to do it right after this. Scott said he's going to go write one as well. And if you can't find it, message me and I'll send you the Google link, whatever. Patients like that, I mean, no... It's obvious who that type of patient is, unfortunately, but it is what it is. But parting shots. I love the I love the outside the box thinking from Tony. I love the things. Yeah, I'll drop a link. Give me a second. I love the outside the box of thinking and a couple of things that really are interesting. Tony mentioned with the labor side of delivering the shockwave treatment, it does not need to be a licensed individual. So, of course, it could be someone you train. It could be it could even be an it could be an aid. It could be a personal trainer. Right. I mean, I've heard the shockwave company that their practices they use like nurses and admin people to deliver the treatment. Do you want to be there in person for that? Probably, or you want to have some, I don't know, you want to have some something there in terms of liability and, you know, insurance and all that. Definitely check that out. But I love this outside the box thinking where you can show value objectively from data without even like literally you don't have to be salesy at all. You could just be like, hey, like when you came in, you walked this way. The machine is Biodex. By the way, this Biodex company, they're huge. They have great machines, great equipment, great data. Here's what you were here. And then we did X, Y, Z, maybe shockwave, maybe not, whatever. We did X, Y, Z. And now you walk the treadmill again. And now this is ten percent better. This is twenty five percent better. This step length is thirty percent better or whatever. And if they really care about movement and longevity, maybe that captures their attention. I love it. There's no side effects from it. So how about Jimmy or Tony takeaways? Parting shots. Go for it. I'll tell you the biggest thing is, you know, and anybody listening to this resonates with this. You can't just complain. You can't just sit there and complain about the situation that you absolutely have influence and control over. So, you know, I always say, hey. There's things, there's opportunities, cash pay, all this other stuff. I never really was in a position until recently where I was like, I can do something different. But now because of changing circumstances, my PTA going on maternity leave, my other PTA doing some stuff. I'm like, look, I got to do something different. I got to make a change. The business model that worked ten years ago doesn't work today. Yeah. This is part of that change. And I want to share that experience with you guys. Hopefully I can work through the mistakes so you guys can kind of fast track your way without those mistakes. Yeah, I would. You absolutely can complain, Tony. It doesn't get you anywhere, but we can complain all we want. Just drop in a couple of Facebook groups and we hear the complaints. Yeah, I would say the two shots can be put together. I'm going to do a double shot. What got you here won't get you there because the world keeps changing, right? So you have to be innovative or you evolve or be left behind. And I said this before and I was looked at – I don't know how it was looked at, but it was received uniquely, which was you're in show business whether you like it or not. And it doesn't mean you need to get a ring light and start filming videos. You don't have to do that. But you do get further if you show people versus tell people. Tell business isn't a business. It's not a thing. This ain't show friends. This is show business, right? So can you provide a solution to my problems? If the answer is yes... Explain to me how that's going to make me better. If you can show me how that's going to make me better, I'm listening. And then you explain to me what that process is going to feel like. I feel like PTs, we love to skip right to the process. We love to show how. How is much later, baby. How's much later? And a lot of times I don't even care how. I had a gutter problem. I Googled and found brothers that just do gutters. And I was like, great, do you do gutters? And they're like, yes, we do. It's in our name. I said, great. Hey, we're gonna, I don't care. I don't care. I do not care. I'm not doing gutters, right? So we're in show business, whether you like it or not. Yes, in healthcare, this doesn't mean you need to be a influencer, right? But you better show me. Otherwise, I'm not gonna pay attention to you. Back on Tuesday, and I'll do a little preview. I'm going to AOMT's conference. Did I mention this before? AOMT has a conference, American Academy of Orthopedic Manual Physical Therapy. I was there years ago as a student. They brought me out there to do podcasts. And this is like, I still didn't know what the hell I was doing. Not that I know what I'm doing now. But I'll give a little preview to that. And why I think conferences could be a really cool idea, not even if you have a society or a membership organization, but as a physical therapist. A conference, right? Different than a workshop. We'll see you guys on Tuesday.