Called to Care Spotlight: AI Gave Clinicians Time Back. Who Gets It?

WEBVTT

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Benz and I'm excited.

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We're here going to have a fascinating

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conversation with Alex Bandersky and we're

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really going to try to approach Called to

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Care.

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This is the Called to Care podcast to

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promote the book and all the elements of

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the revised and expanded edition.

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And we're going to get to some areas

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around AI in the areas where Alex is

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an expert in,

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but I want to kind of do it

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in a little bit of a circuitous route

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here.

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In, there's a lot of stuff we added,

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had to add to call to care since

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the, uh, around topics, AI,

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clearly virtual health was just becoming,

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this is at the initial period of COVID.

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And one of the things I talk a

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lot about in the book are some concepts

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that actually came out of the customer

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service industry, um,

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primarily through call center research,

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which is where a lot of research has

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done.

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And it's the concept of what is called

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calcification.

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which effectively says that repeated

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exposure to very routine negative clinical

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detail numbs you to the humans in front

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of your eyes.

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So in other words, what happens is

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a natural tendency is we dehumanize and

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turn a three dimensional person into a two

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dimensional.

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This is natural.

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This is normal.

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It happens to good clinicians and it

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happens slowly over time.

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Typically when you get a little more

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fatigued or you get into a routinized

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situation,

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if you had a lot of productivity for

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that day, for example,

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Decalcification is any ritual that

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restores the connection.

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And a lot of what we talk about

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in call to care is restoring connection.

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So the surprise of that chapter though,

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is that AI,

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can be a decalcification tool by allowing

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you to maintain the connection fuel loop

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with a patient.

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That's what Alex is going to get into.

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A quarter of a provider's time,

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according to surveys, and in some cases,

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if it's a Medicare patient,

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has nothing to do with the patient,

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has to do with documentation.

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So we give that time period back and

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you've created space for the thing that we

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got into this for,

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human connection and being called to care.

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But only if we use it that way.

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And I'm already seeing AI not as an

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instrument to get humanity and humanness

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back,

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but a way to get more productive and

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a way to have more time at home,

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which obviously we want people to have

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more time at home.

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So that's the backdrop.

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to this podcast today.

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We're going to eventually get there.

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And I'll start out, you know,

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really in a more, you know,

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big picture way, you know, Alex,

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what would you,

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how would you kind of characterize the

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state of AI and rehab therapy?

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What's real?

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What's not real?

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What's hype?

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You know,

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what's somebody saying they're building it

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or built it, but hasn't really been built.

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And from your perspective,

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as you've done your deep dive.

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Yeah, thank you, Larry.

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And first, truly a pleasure to be here.

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And thank you for everything you have done

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with the book and with Charity.

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Truly amazing how much you are just doing

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for our community.

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And in terms of AI,

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so we treat AI as novelty because AI

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is omnipresent,

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but it's availability heuristic.

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Artificial intelligence as a science is

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seventy years old.

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close to almost eight years.

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The construct, the design,

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the theories have been around for a while.

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The reason why we're much more sensitive

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to it now is because it's available to

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us, but I think it's also,

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it's finally maturing to the point where

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it becomes table stakes.

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Artificial intelligence at this point is

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not a novelty,

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but it's consistently something that is

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available and present in every part of our

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life.

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And so I think one of the biggest

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issues

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things for us as a community to do

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is to start to dig deeper into what

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do we mean by artificial intelligence and

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AI and what is behind the statement?

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And is it artificial intelligence in terms

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of better data processing efficiency?

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Is it artificial intelligence in terms of

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better rule logic?

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So we become more logical in our ability

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to conduct ourselves?

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Or is it artificial intelligence in terms

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of how this data gets

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us to learn more.

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So it's machine learning,

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but it's also human learning that's based

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on machine learning.

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But overall,

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I think artificial intelligence follows

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the same trajectory of humanity using

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tools to extend our ability.

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It uses a rock to smash a nut.

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We use cars instead of horses.

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So now we use algorithms to process large

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amounts of data to make us

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better at what we do.

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So my stance is highly optimistic.

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And in essence, don't trust the hype,

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but do allow yourself exposure to this

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technology as it emerges and as it becomes

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more present.

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No, that's interesting.

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And as you look back on your twenty

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three years,

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you've really been on a path of digital

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health for quite a while.

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You had to change your mind somewhere

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along,

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anybody who is an adopter of digital

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health has had to.

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And help us understand where your

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viewpoint is now and sort of where PT's

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real problems are.

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Yeah,

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so I think it's like any good technology,

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the operator is the culprit,

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the operator is the bottleneck.

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And so PT as a world in an

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ideal way should be the clinicians and

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administrators should be the innovators.

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They should be the ones that have a

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position at a table where decisions are

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made.

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And so from the design of this technology

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as it emerges,

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you need equilateral

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power of clinicians shaping this

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technology into the maturity that it's

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entering.

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And so when changing the mind,

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I think I have been involved in some

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form of health technology for close to a

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decade.

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And the biggest culprit was the

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technology.

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The biggest difficulty was actually making

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technology operational.

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And now we're at a point where technology

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is operational, but the human factor,

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we need the operators to gain better

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mastery of how to best use this

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technology.

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So to reference your prior point,

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um this ai can be a great liberator

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of power a great liberator of knowledge

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and intelligence only one designed to do

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so by the clinician or it could steal

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away from your energy if you are

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preoccupied with the operational side so i

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i think we need to start shaping

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clinicians to become clinician

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technologists clinician innovators

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clinician entrepreneurs essentially

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Yeah.

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And, you know,

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the work that you're doing at WebPT,

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tell me a little bit about how you

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are integrating these thoughts and where

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sort of WebPT draws it in there.

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You know,

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how do they make product decisions based

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on native AI, augmentative?

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ancillary, built into the product,

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integrated.

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How do you think about all those things?

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Yeah,

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so I think I have a true unique

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luxury of being associated with this

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wonderful organization.

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And this is the organization that brought

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technology into the physical therapy space

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in two thousand.

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So at the foundation, at the start,

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the technology was essentially

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operationalized by YPT.

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That was the first name of the brand

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that was available.

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But now we're at a point where we

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have technology at a state of maturity

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where we can build the architecture of a

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platform.

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that works on this next stage,

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next phase of tech, this agentic AI,

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this process where you have multiple

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independent entities that operate based on

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closed loop system with goals in mind.

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You can have an infinite amount of these

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agents that allow you to create this

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larger operable efficiency, which again,

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agent is one of the labels,

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but think of anything that needs to be

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redundantly outsourced to this tech.

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is outsourced and you have a thousand

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experts working on your side to help you

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deliver better quality of care which is

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what we do as clinicians so this is

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where ypt is ypt is building a product

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that is going to shape and serve rehab

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community for the next decade and beyond

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based on availability of this technology

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that wasn't available twelve months ago

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and so it's really an exciting time to

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be a clinician because this is going to

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be a game changer

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Yeah,

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do you think about the intended or

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unintended effects on things like clinical

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reasoning?

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Does an AI node or a scribe node,

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can it facilitate or kill clinical

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reasoning?

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Yeah, I think it's a wonderful question.

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And I think about it a lot because

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I think it's,

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we as clinicians have been guilty of

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templatizing our clinical reasoning for a

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while.

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So the protocolizing and templatizing,

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we create templates and create protocols

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so that we don't have to think,

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we can just follow.

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And I've always have been conflicted,

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especially on the clinical side.

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So having my students or having residents,

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if you're following a protocol,

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you're not really making it patient

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centric.

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You're making it a protocol centric care

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process.

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But at the same time,

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scribe is a scribe,

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which is a generic term for something

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that's a little bit different,

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where an ambient sound delivery and

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reception as a tool.

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is brilliant because it captures a lot

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more data than our human ability has the

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capacity to do.

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There's something that I would call data

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exhaust.

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Even in a typical exchange of information,

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you and I right now are talking and

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all we're doing is we're using words and

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language as a way of delivering content

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and information to each other.

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And your ability to receive my language or

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my ability to express this language is

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being hamstrung by our organic capacity.

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And this ambient scribe technology has

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maximizing capacity to capture this data.

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But then that's step one.

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Once you capture it,

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what do you do with this data?

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And that's the key is that a smart

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scribe solution doesn't just capture

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sound.

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It makes it operational.

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It actually makes the clinician better at

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understanding the perspective of how this

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information is being delivered from the

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patient side.

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And that's where we are.

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So it's great to capture maximized data,

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but then

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What's next?

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And how do we make this operational?

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How do we make clinician empowered to

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deliver a more comprehensive care?

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Because now I have better understanding of

00:11:00.730 --> 00:11:04.731
the client or a patient that I'm treating.

00:11:04.772 --> 00:11:10.212
Have you seen a clinic adopt AI

00:11:10.273 --> 00:11:11.452
documentation?

00:11:11.692 --> 00:11:11.852
I mean,

00:11:11.893 --> 00:11:13.613
the advantage you have is you've been

00:11:13.633 --> 00:11:14.913
around the block for, you know,

00:11:14.933 --> 00:11:16.193
twenty three plus years as a PT.

00:11:17.528 --> 00:11:20.932
and you understand the human part of the

00:11:20.971 --> 00:11:22.592
connection and the visit.

00:11:23.874 --> 00:11:25.394
Have you seen a clinic adopt this type

00:11:25.436 --> 00:11:28.258
of documentation actually get worse at the

00:11:28.298 --> 00:11:29.198
human part of the visit?

00:11:29.999 --> 00:11:32.081
So I wouldn't call it worse,

00:11:32.140 --> 00:11:33.282
but there's inefficiencies.

00:11:33.881 --> 00:11:36.004
So there's optimal and suboptimal

00:11:36.024 --> 00:11:36.443
adoption.

00:11:37.664 --> 00:11:40.187
And optimal adopters are adopters that

00:11:40.227 --> 00:11:42.288
actually have a structure and have

00:11:42.308 --> 00:11:44.230
logistics behind this adoption.

00:11:45.658 --> 00:11:49.149
So optimal adapters know exactly what to

00:11:49.168 --> 00:11:49.551
do with it.

00:11:49.591 --> 00:11:51.275
They also have champions and ambassadors

00:11:51.296 --> 00:11:52.480
that are associated with this technology.

00:11:53.089 --> 00:11:54.950
And champions are the ones that gain

00:11:54.970 --> 00:11:57.312
mastery of this technology and are able to

00:11:57.331 --> 00:11:57.892
train others.

00:11:58.332 --> 00:12:00.413
And ambassadors go beyond mastery.

00:12:00.453 --> 00:12:02.355
Ambassadors are the ones that tweak with

00:12:02.375 --> 00:12:05.376
this technology and actually shape it to

00:12:05.437 --> 00:12:09.019
better fit the workflow that is presented

00:12:09.039 --> 00:12:09.340
to them.

00:12:09.659 --> 00:12:11.902
And so that optimal adapters will have

00:12:12.121 --> 00:12:14.423
human factor that is already associated

00:12:14.443 --> 00:12:14.964
with this tech.

00:12:15.224 --> 00:12:16.605
And suboptimal adapters are the ones that

00:12:16.625 --> 00:12:18.326
are essentially just trying to jam it in,

00:12:18.385 --> 00:12:20.107
that are trying to plug and play.

00:12:20.927 --> 00:12:23.129
Plug and play, it's like, you're right,

00:12:23.169 --> 00:12:24.509
I'm old enough where we used to have

00:12:24.591 --> 00:12:27.231
a VCR that had a blinking twelve o'clock

00:12:27.312 --> 00:12:29.153
screen that it probably took us two years

00:12:29.173 --> 00:12:31.335
to figure out how to change it because

00:12:31.375 --> 00:12:32.535
we were suboptimal adapters.

00:12:32.556 --> 00:12:34.017
We just lived with this blinking twelve

00:12:34.037 --> 00:12:34.657
o'clock screen.

00:12:35.197 --> 00:12:36.839
But we don't have to be there.

00:12:38.139 --> 00:12:38.820
Interesting, you know,

00:12:39.019 --> 00:12:42.241
when I when I hear how you I

00:12:42.282 --> 00:12:45.344
like your framework of suboptimal and

00:12:45.423 --> 00:12:45.745
optimal.

00:12:46.677 --> 00:12:48.740
And it really lends into something I've

00:12:48.759 --> 00:12:50.621
been thinking about for a long time,

00:12:50.662 --> 00:12:52.884
which is, you know,

00:12:52.903 --> 00:12:55.466
I see AI enabled on virtually everything

00:12:55.525 --> 00:12:56.125
these days.

00:12:56.706 --> 00:12:57.707
And when I see that,

00:12:57.748 --> 00:12:59.109
it's a marketing gimmick, right?

00:12:59.188 --> 00:13:00.809
But when I see it in relationship to

00:13:00.870 --> 00:13:01.971
physical therapy,

00:13:04.312 --> 00:13:05.975
is it a measurable difference in a

00:13:05.995 --> 00:13:07.035
clinician's day to day?

00:13:08.211 --> 00:13:10.831
So it could be and it should be

00:13:10.851 --> 00:13:12.793
when you have clinical intelligence

00:13:12.813 --> 00:13:13.754
associated with it,

00:13:14.374 --> 00:13:16.755
which there's organic clinical

00:13:16.796 --> 00:13:18.756
intelligence, which is experiential.

00:13:18.937 --> 00:13:20.298
And then there's inorganic clinical

00:13:20.317 --> 00:13:20.778
intelligence,

00:13:20.857 --> 00:13:22.219
which is a construct of

00:13:23.504 --> 00:13:25.005
optimal clinical guardrails,

00:13:25.285 --> 00:13:27.028
like the guardrails that shape your

00:13:27.067 --> 00:13:27.828
delivery process.

00:13:28.269 --> 00:13:30.091
And those guardrails are static based on

00:13:30.152 --> 00:13:32.274
emergence of empirical evidence to support

00:13:32.573 --> 00:13:34.517
your output of clinical care.

00:13:35.538 --> 00:13:39.302
So the organic part is what it is,

00:13:39.322 --> 00:13:40.624
but the inorganic part, actually,

00:13:40.844 --> 00:13:42.785
these clinical decision support tools,

00:13:42.826 --> 00:13:44.128
clinical intelligence tools,

00:13:44.788 --> 00:13:48.970
that are built into operating software can

00:13:49.190 --> 00:13:52.831
help align us to deliver a better

00:13:52.871 --> 00:13:54.972
concordant care, a more aligned care,

00:13:55.753 --> 00:13:57.994
while still giving us enough agency to

00:13:58.293 --> 00:13:59.934
deviate if we want to.

00:14:00.955 --> 00:14:02.235
You don't have to substantiate.

00:14:02.416 --> 00:14:05.856
And that's why we deliver evidence-guided

00:14:05.897 --> 00:14:07.097
care, not evidence-based care.

00:14:07.597 --> 00:14:09.481
The guidance is from that technology that

00:14:09.522 --> 00:14:10.803
helps shape the guardrails.

00:14:11.205 --> 00:14:13.288
But then the evidence itself,

00:14:13.328 --> 00:14:15.052
it's my choice as an agent to apply

00:14:15.091 --> 00:14:17.076
this evidence or to listen to the patient

00:14:17.115 --> 00:14:18.999
and do what is necessary for the patient's

00:14:19.038 --> 00:14:19.259
needs.

00:14:21.397 --> 00:14:23.859
That's a great way to frame it up.

00:14:24.919 --> 00:14:26.380
I want you to help me understand,

00:14:26.480 --> 00:14:29.423
does AI get this kind of debate with

00:14:29.462 --> 00:14:31.303
large practices, small practices?

00:14:31.844 --> 00:14:33.144
And there are some that look at this

00:14:33.184 --> 00:14:35.027
as an equalizer to some extent.

00:14:35.767 --> 00:14:38.708
So do big documentation gains,

00:14:38.729 --> 00:14:40.490
for example, show up in large system?

00:14:40.549 --> 00:14:43.312
Or does AI kind of widen the arc

00:14:43.371 --> 00:14:45.253
or the gap for small practices?

00:14:45.273 --> 00:14:46.594
And the reason I ask that is it's

00:14:46.634 --> 00:14:48.274
always been my observation that the

00:14:48.375 --> 00:14:49.035
innovators are

00:14:50.130 --> 00:14:52.633
in technology adoption have primarily been

00:14:52.673 --> 00:14:54.875
private practice bts as opposed to large

00:14:54.934 --> 00:14:58.957
systems but ai is not a simple investment

00:14:59.018 --> 00:15:01.419
and it's not a cheap investment so what

00:15:01.440 --> 00:15:03.322
is your what is your um take on

00:15:03.341 --> 00:15:06.104
all that so there's there's the business

00:15:06.144 --> 00:15:09.386
side the revenue side uh which is pretty

00:15:09.427 --> 00:15:12.168
much a table stakes because if you don't

00:15:12.208 --> 00:15:14.610
have artificial intelligence or smart

00:15:14.650 --> 00:15:15.991
systems we'll just call them smart systems

00:15:16.491 --> 00:15:17.893
guiding your revenue cycle,

00:15:18.693 --> 00:15:24.317
then you're bringing a knife to a gunfight

00:15:25.097 --> 00:15:27.558
because the payers all have optimal

00:15:27.578 --> 00:15:30.701
systems designed to authorize or

00:15:30.880 --> 00:15:33.222
invalidate your delivery process and your

00:15:33.582 --> 00:15:34.143
revenue stream.

00:15:34.163 --> 00:15:35.344
So on the revenue side,

00:15:36.705 --> 00:15:38.086
you cannot afford not to have smart

00:15:38.105 --> 00:15:39.626
systems supporting your revenue flow,

00:15:40.346 --> 00:15:42.349
especially if you are more than just a

00:15:42.528 --> 00:15:44.330
single provider cash business where

00:15:45.791 --> 00:15:47.532
On a clinical side,

00:15:48.572 --> 00:15:50.272
there's a lot of complexity actually.

00:15:50.292 --> 00:15:52.852
There's an amazing amount of complexity

00:15:53.533 --> 00:15:55.092
within the construct of physical therapy

00:15:55.893 --> 00:15:57.254
delivery cycle,

00:15:57.354 --> 00:16:00.953
which never ceased to amaze me about just

00:16:00.974 --> 00:16:03.034
the vast amount of complexity in terms of

00:16:03.554 --> 00:16:05.095
diagnostic factors,

00:16:05.475 --> 00:16:06.635
in terms of clinical factors,

00:16:06.676 --> 00:16:08.975
in terms of recovery trajectory factors,

00:16:09.436 --> 00:16:12.037
which if I have to keep all this

00:16:12.076 --> 00:16:13.297
knowledge inside,

00:16:14.136 --> 00:16:15.817
I don't have enough energy or bandwidth to

00:16:15.876 --> 00:16:18.057
actually provide optimal clinical product.

00:16:18.097 --> 00:16:18.577
In a way,

00:16:18.677 --> 00:16:21.057
I can outsource some of the stored

00:16:21.138 --> 00:16:25.078
information into the tech sector and help

00:16:25.139 --> 00:16:26.599
the technology guide me along the way

00:16:26.658 --> 00:16:28.639
because I still have my cognitive

00:16:28.679 --> 00:16:31.799
emotional factor being part of my entity

00:16:31.840 --> 00:16:34.880
as a service delivery personnel.

00:16:35.701 --> 00:16:37.620
That's the key is that there's some parts

00:16:37.640 --> 00:16:39.120
that can be outsourced to technology

00:16:39.140 --> 00:16:41.442
because my working memory is limited by my

00:16:41.562 --> 00:16:42.241
organic computer.

00:16:42.981 --> 00:16:44.702
But the synthetic computer will do a good

00:16:44.743 --> 00:16:47.764
job cuing me into what is necessary for

00:16:47.784 --> 00:16:48.184
the patient,

00:16:48.446 --> 00:16:49.745
cuing me about what the patient's

00:16:49.785 --> 00:16:51.547
preference is, cuing me about, like,

00:16:51.768 --> 00:16:53.528
we know physical therapy is a longitudinal

00:16:53.609 --> 00:16:56.811
cycle, so it's not a single visit entity,

00:16:56.870 --> 00:16:57.010
right?

00:16:57.030 --> 00:16:58.131
There's an episode of care.

00:16:58.772 --> 00:17:01.113
But I don't have to keep it in

00:17:01.173 --> 00:17:01.854
my working memory,

00:17:01.913 --> 00:17:03.674
what happened three episodes ago or five

00:17:03.735 --> 00:17:04.955
episodes ago.

00:17:04.976 --> 00:17:06.817
Technology can help me shape a more

00:17:06.856 --> 00:17:09.818
consistent output product based on the way

00:17:09.838 --> 00:17:10.098
it's built.

00:17:12.559 --> 00:17:14.260
Yeah, it's fascinating.

00:17:14.480 --> 00:17:14.882
You know,

00:17:15.162 --> 00:17:17.202
there hasn't been a lot of data out

00:17:17.462 --> 00:17:18.284
on this yet.

00:17:18.943 --> 00:17:20.605
But the one study I'm familiar with,

00:17:20.625 --> 00:17:22.967
there was a six health system and it

00:17:22.987 --> 00:17:25.568
was like two hundred sixty plus clinicians

00:17:25.729 --> 00:17:27.930
across, you know,

00:17:27.950 --> 00:17:29.151
various types of clinicians.

00:17:29.191 --> 00:17:30.731
And they saw, you know,

00:17:30.791 --> 00:17:33.134
pretty statistical difference in burnout

00:17:33.173 --> 00:17:35.035
from the adoption of AI.

00:17:35.736 --> 00:17:37.616
Fifty one percent was fifty two percent on

00:17:37.696 --> 00:17:39.657
almost thirty nine percent or below thirty

00:17:39.698 --> 00:17:40.199
nine percent.

00:17:41.003 --> 00:17:43.136
What they found was that the time savings,

00:17:45.050 --> 00:17:45.510
you know,

00:17:45.631 --> 00:17:48.372
was at least ten percent in sort of

00:17:48.951 --> 00:17:50.252
face-to-face clinician,

00:17:50.292 --> 00:17:53.192
twenty to thirty percent in cuts to after

00:17:53.212 --> 00:17:55.413
hours, what they call, you know,

00:17:55.493 --> 00:17:57.755
pajama time in an observational study.

00:17:58.615 --> 00:18:00.195
I would think with physical therapy,

00:18:00.236 --> 00:18:01.615
because we tend to have a heavier

00:18:01.675 --> 00:18:03.656
documentation load, we just do,

00:18:03.696 --> 00:18:05.757
our profession is piled on over the years,

00:18:06.196 --> 00:18:08.137
and there might actually be bigger upside

00:18:08.198 --> 00:18:08.438
here,

00:18:09.097 --> 00:18:10.739
but my fear is that

00:18:11.743 --> 00:18:13.844
It doesn't allow the clinician back to

00:18:13.903 --> 00:18:15.825
connection time with the patient.

00:18:15.845 --> 00:18:17.184
And you have to understand,

00:18:17.204 --> 00:18:18.484
I'm from the age,

00:18:18.545 --> 00:18:19.585
I've been practicing for years.

00:18:19.605 --> 00:18:20.285
We had paper,

00:18:20.305 --> 00:18:23.026
we had a card of paper templates.

00:18:23.586 --> 00:18:24.685
Those went on forever.

00:18:24.865 --> 00:18:25.665
We hand wrote it.

00:18:26.166 --> 00:18:27.366
Then we had a PC.

00:18:28.166 --> 00:18:30.366
Then we had a little mobile device.

00:18:31.507 --> 00:18:32.448
Then you could argue, well,

00:18:32.468 --> 00:18:34.248
you don't even have a phone now.

00:18:35.008 --> 00:18:37.248
You have a scribe that listens.

00:18:38.209 --> 00:18:40.288
All of these over time have taken away

00:18:40.971 --> 00:18:43.031
have now given back time to your patient.

00:18:43.051 --> 00:18:45.512
But my fear is that we're not doing

00:18:45.532 --> 00:18:45.673
that.

00:18:45.692 --> 00:18:46.993
We're doing it to promote more

00:18:47.054 --> 00:18:49.634
productivity and to promote more billable

00:18:49.755 --> 00:18:50.115
units.

00:18:50.775 --> 00:18:52.036
And the very thing we're trying to

00:18:52.096 --> 00:18:55.636
correct, we're actually, to some extent,

00:18:55.656 --> 00:18:56.397
if we're not careful,

00:18:56.518 --> 00:18:57.637
the unintended consequences,

00:18:57.657 --> 00:18:58.498
it could get worse.

00:18:59.118 --> 00:19:00.679
How are you thinking about that with the

00:19:00.699 --> 00:19:02.660
advice to clinicians that are adopting

00:19:02.680 --> 00:19:02.920
this?

00:19:02.960 --> 00:19:05.881
And how is WebPT as a company approaching

00:19:05.942 --> 00:19:06.642
it holistically?

00:19:07.261 --> 00:19:09.564
So it's so interesting that you and I

00:19:09.604 --> 00:19:10.743
have the same frame of reference.

00:19:10.903 --> 00:19:11.845
When I started practicing,

00:19:11.865 --> 00:19:13.205
I had a three-pager like that.

00:19:13.625 --> 00:19:15.247
You write yourself, right?

00:19:15.267 --> 00:19:17.248
The top page goes to the chart,

00:19:17.327 --> 00:19:18.489
the middle page goes to the biller,

00:19:18.509 --> 00:19:19.190
and the bottom page,

00:19:19.450 --> 00:19:20.951
you say for the record your thoughts.

00:19:21.830 --> 00:19:23.632
And then we had those gigantic shredders

00:19:23.672 --> 00:19:25.393
that would shred all this information at

00:19:25.413 --> 00:19:26.074
the end of the month,

00:19:26.213 --> 00:19:27.454
like the ones that wasn't necessary.

00:19:28.675 --> 00:19:30.377
It's interesting design.

00:19:31.258 --> 00:19:34.622
The handwriting is actually a better way

00:19:34.682 --> 00:19:36.123
of conceptualizing information.

00:19:36.544 --> 00:19:38.705
There's not evidence that shows when you

00:19:38.726 --> 00:19:40.106
are using your pen and paper,

00:19:40.647 --> 00:19:41.929
you're working through a problem

00:19:41.969 --> 00:19:43.049
differently than when you're using a

00:19:43.131 --> 00:19:46.314
computer because it outsources your mental

00:19:46.614 --> 00:19:48.076
ability or cognitive ability.

00:19:49.810 --> 00:19:50.751
On the other note,

00:19:51.092 --> 00:19:53.513
I think that natural evolution of

00:19:53.574 --> 00:19:54.694
technology that you've described,

00:19:55.134 --> 00:19:59.278
from paper to computer to wearable to now

00:19:59.699 --> 00:20:00.740
ambient sound reception,

00:20:03.201 --> 00:20:06.203
the method of data capture is important.

00:20:06.564 --> 00:20:08.185
What you do with this data is so

00:20:08.226 --> 00:20:08.925
much more important.

00:20:09.066 --> 00:20:11.008
This is where the design and architecture

00:20:11.028 --> 00:20:12.808
of these systems comes into play.

00:20:13.349 --> 00:20:14.349
With WebPT,

00:20:14.790 --> 00:20:16.652
I think that there's been so much energy

00:20:16.672 --> 00:20:17.272
and so much effort

00:20:18.992 --> 00:20:21.634
given to designing and creating the

00:20:21.814 --> 00:20:24.815
optimal architecture for this or for the

00:20:24.855 --> 00:20:27.455
platform so that the architecture reflects

00:20:27.796 --> 00:20:29.817
what a clinical workflow should look like,

00:20:29.957 --> 00:20:30.916
what does look like,

00:20:31.636 --> 00:20:33.097
and the end user in mind,

00:20:33.137 --> 00:20:34.417
essentially the clinician,

00:20:34.898 --> 00:20:36.898
is the primary recipient,

00:20:36.939 --> 00:20:38.519
the primary person that the system is

00:20:38.539 --> 00:20:39.099
designed for.

00:20:39.599 --> 00:20:41.019
And so the question is,

00:20:41.079 --> 00:20:42.201
would the clinician want to use it?

00:20:42.840 --> 00:20:44.560
And so this is my position right now

00:20:44.580 --> 00:20:46.301
as the head of clinical innovation at YPT.

00:20:46.682 --> 00:20:47.201
But beyond,

00:20:47.221 --> 00:20:49.803
it's my position as a clinician who loves

00:20:49.923 --> 00:20:51.522
technology and sees it as the only way

00:20:51.542 --> 00:20:55.463
for us to improve our efficacy and not

00:20:55.483 --> 00:20:56.585
supplement for what we do.

00:20:57.244 --> 00:20:59.786
Because given the right design and the

00:20:59.806 --> 00:21:00.885
right system,

00:21:01.526 --> 00:21:03.606
it democratizes your time and your ability

00:21:04.126 --> 00:21:05.906
to actually spend time with the patient.

00:21:06.227 --> 00:21:08.087
And it democratizes your time and your

00:21:08.127 --> 00:21:08.508
ability

00:21:09.067 --> 00:21:10.808
to think through problems.

00:21:10.929 --> 00:21:13.329
When you're referencing in a typical

00:21:13.369 --> 00:21:13.630
clinic,

00:21:13.670 --> 00:21:14.990
if you have a higher patient roster,

00:21:15.010 --> 00:21:15.851
a higher patient load,

00:21:17.051 --> 00:21:21.253
you have very little time to devote to

00:21:21.314 --> 00:21:22.815
critical thinking because you are just

00:21:23.115 --> 00:21:25.135
thinking through process of patient

00:21:26.036 --> 00:21:27.916
development, next patient, next visit,

00:21:28.037 --> 00:21:28.156
next.

00:21:29.817 --> 00:21:31.898
If we can democratize even five minutes of

00:21:31.959 --> 00:21:34.079
time to critical thinking because you no

00:21:34.099 --> 00:21:35.160
longer have to document,

00:21:35.641 --> 00:21:37.000
you no longer have to sit in front

00:21:37.020 --> 00:21:38.241
of your laptop and stare at your laptop.

00:21:39.271 --> 00:21:39.952
I think that's wonderful.

00:21:39.992 --> 00:21:41.493
That's five minutes of time that the

00:21:41.554 --> 00:21:43.056
patient will benefit from because now I

00:21:43.076 --> 00:21:45.077
get to use my twenty three years of

00:21:45.137 --> 00:21:47.339
clinical experience to better understand

00:21:47.599 --> 00:21:49.521
how to reduce the barriers to recovery

00:21:49.541 --> 00:21:51.785
that you are facing and how to apply

00:21:51.865 --> 00:21:53.465
some of the skill set and knowledge base

00:21:53.886 --> 00:21:55.407
to help you achieve your goals.

00:21:55.729 --> 00:21:58.832
So I think we are absolutely thinking

00:21:58.872 --> 00:21:59.172
about that.

00:21:59.934 --> 00:22:01.996
No, that's great, because I think, again,

00:22:03.876 --> 00:22:04.997
all these things have trade-offs,

00:22:05.017 --> 00:22:06.038
and you've got to be careful.

00:22:06.157 --> 00:22:10.200
I mean, you know, everybody, every day,

00:22:10.240 --> 00:22:11.621
everybody's asking about the existential

00:22:11.641 --> 00:22:12.300
crisis of AI,

00:22:12.441 --> 00:22:14.102
and you're going to be eliminated.

00:22:14.122 --> 00:22:15.301
And I'm old enough to remember when they

00:22:15.321 --> 00:22:17.083
said the same thing about a fax machine,

00:22:17.103 --> 00:22:18.304
and then they said the same thing about

00:22:18.344 --> 00:22:18.943
the Internet,

00:22:18.963 --> 00:22:20.345
and then they said the same thing about...

00:22:21.345 --> 00:22:23.445
early days of LLM models and now it's

00:22:23.465 --> 00:22:25.366
agentic AI.

00:22:25.406 --> 00:22:26.847
I think you have to have a rational

00:22:26.887 --> 00:22:27.448
strategy.

00:22:27.468 --> 00:22:27.828
As you said,

00:22:27.848 --> 00:22:30.190
there's business purposes and then there's

00:22:30.390 --> 00:22:31.730
all the things around the clinical

00:22:31.750 --> 00:22:32.250
encounter.

00:22:34.112 --> 00:22:35.211
Now we're going to flip it around here

00:22:35.231 --> 00:22:35.893
a little bit, Alex,

00:22:35.913 --> 00:22:37.133
and allow you to ask a couple,

00:22:37.153 --> 00:22:38.253
I always ask my guests,

00:22:38.574 --> 00:22:39.595
they want to ask me a couple of

00:22:39.615 --> 00:22:42.935
questions to finish things off.

00:22:43.016 --> 00:22:43.936
Fire away at me.

00:22:44.627 --> 00:22:46.249
Well, I think it's wonderful.

00:22:46.269 --> 00:22:46.868
So first,

00:22:46.888 --> 00:22:48.650
and this is a little bit off the

00:22:48.670 --> 00:22:48.950
script,

00:22:49.049 --> 00:22:51.790
but what is your view and what is

00:22:51.810 --> 00:22:55.633
your reflection of how, in a neutral,

00:22:55.692 --> 00:22:56.952
non-positive, non-negative way,

00:22:57.053 --> 00:22:59.815
how this technology can actually shape the

00:22:59.974 --> 00:23:03.056
output of our clinical deliverables,

00:23:03.096 --> 00:23:04.596
our clinical process, our clinical flow?

00:23:04.616 --> 00:23:07.198
You know,

00:23:07.798 --> 00:23:11.539
my honest answer is that I fall back

00:23:11.559 --> 00:23:11.640
to

00:23:13.277 --> 00:23:15.688
leadership, that it's a decision

00:23:17.009 --> 00:23:18.809
And AI and all the other things are

00:23:18.849 --> 00:23:20.690
not necessarily a software feature.

00:23:21.171 --> 00:23:23.731
If AI hands a clinic clinician,

00:23:23.771 --> 00:23:24.791
I should say, you know,

00:23:24.811 --> 00:23:27.373
fifteen minutes back on a visit and the

00:23:27.472 --> 00:23:29.953
owner just stuffs another patient into it

00:23:29.973 --> 00:23:30.413
or say, oh,

00:23:30.433 --> 00:23:31.894
go take a walk in or somebody who

00:23:31.934 --> 00:23:32.454
showed up.

00:23:33.115 --> 00:23:35.756
All we've done is we've sort of automated

00:23:36.195 --> 00:23:37.155
the calcification.

00:23:37.195 --> 00:23:37.457
Right.

00:23:38.557 --> 00:23:39.497
And that's a choice.

00:23:39.557 --> 00:23:39.717
You know,

00:23:39.737 --> 00:23:41.978
I've run thousands of clinicians across

00:23:42.238 --> 00:23:43.298
now two industries.

00:23:44.159 --> 00:23:46.626
And the operators who win long term treat

00:23:46.647 --> 00:23:49.576
that recovered time as clinical capacity.

00:23:50.441 --> 00:23:52.342
clinical reasoning, as you mentioned,

00:23:52.642 --> 00:23:55.202
connection, you know, tracking things,

00:23:55.242 --> 00:23:59.244
becoming engaged and retention actually in

00:23:59.345 --> 00:24:00.846
outcomes actually gets better.

00:24:01.365 --> 00:24:03.988
And here's the strange KPIs that matter.

00:24:04.728 --> 00:24:06.269
Those who connect the best get better

00:24:06.308 --> 00:24:07.048
clinical outcomes.

00:24:07.068 --> 00:24:07.929
That's been demonstrated.

00:24:07.969 --> 00:24:09.690
We know that because the soft skills are

00:24:09.730 --> 00:24:11.171
hard skills and that all works.

00:24:11.790 --> 00:24:14.432
But the other factor that shows up is

00:24:14.492 --> 00:24:16.413
that the patients refer more friends,

00:24:16.432 --> 00:24:16.834
family,

00:24:17.693 --> 00:24:18.714
and former patients,

00:24:18.755 --> 00:24:21.137
which lowers your lead generation costs

00:24:21.157 --> 00:24:22.839
and your customer acquisition costs.

00:24:23.319 --> 00:24:26.284
Your therapists tend to stay longer,

00:24:26.584 --> 00:24:27.825
so that retention number.

00:24:28.625 --> 00:24:29.247
In dentistry,

00:24:29.267 --> 00:24:31.568
your clinical case acceptance goes sky

00:24:31.628 --> 00:24:33.131
high because you're connecting better.

00:24:33.711 --> 00:24:34.792
And in physical therapy,

00:24:34.813 --> 00:24:36.535
the patients come in for more of their

00:24:36.654 --> 00:24:37.134
visits.

00:24:37.938 --> 00:24:40.640
And so these aren't just nice things to

00:24:40.700 --> 00:24:41.201
do.

00:24:41.661 --> 00:24:43.942
The soft sciences, positive psychology,

00:24:44.022 --> 00:24:45.163
social neuroscience,

00:24:45.304 --> 00:24:48.165
all of those things have very good

00:24:48.226 --> 00:24:51.548
business purposes outside of the fact that

00:24:51.567 --> 00:24:52.709
they're a very good thing.

00:24:53.309 --> 00:24:55.211
And that's to a large extent why I'm

00:24:55.270 --> 00:24:57.573
focusing a lot of my time in the

00:24:57.633 --> 00:25:00.095
shift between skills and operations.

00:25:01.057 --> 00:25:02.959
because everybody wants an ROI.

00:25:02.979 --> 00:25:04.578
Everybody wants to understand the

00:25:04.618 --> 00:25:06.480
implementations on the business stand of

00:25:06.500 --> 00:25:06.539
it.

00:25:06.940 --> 00:25:09.060
And the reality is we don't have enough

00:25:09.161 --> 00:25:12.643
emphasis on operations only on third-party

00:25:12.682 --> 00:25:14.702
things like productivity and metrics and

00:25:14.762 --> 00:25:16.644
net promoter score and schedule

00:25:16.683 --> 00:25:18.285
optimization and efficiency.

00:25:19.065 --> 00:25:20.486
And what I think we have to do

00:25:20.546 --> 00:25:21.965
is we have to flip that a bit

00:25:22.066 --> 00:25:23.707
because the dollars when you have

00:25:23.747 --> 00:25:26.488
shortages of PTs and when you have

00:25:27.048 --> 00:25:28.969
patients that don't fulfill all their

00:25:29.009 --> 00:25:31.109
treatment planning and you have marketing

00:25:31.150 --> 00:25:32.790
dollars spending on new patients in an

00:25:32.851 --> 00:25:34.330
environment where margins are getting

00:25:34.371 --> 00:25:34.852
smaller,

00:25:35.432 --> 00:25:36.751
I think you've got to double down on

00:25:36.791 --> 00:25:38.553
humanity and the humanness factor and the

00:25:38.573 --> 00:25:40.253
connection factor and the soft skills.

00:25:41.337 --> 00:25:44.119
Because we know that in the absence of

00:25:44.160 --> 00:25:47.182
those, the cost of turnover,

00:25:47.501 --> 00:25:49.623
the cost of patients not fulfilling their

00:25:49.663 --> 00:25:50.104
visits,

00:25:50.784 --> 00:25:52.785
it's a lot easier to get your existing

00:25:52.805 --> 00:25:54.346
patients to finish a visit than it is

00:25:54.365 --> 00:25:55.307
to get a new patient.

00:25:55.666 --> 00:25:57.048
And then you got the leaky bucket of

00:25:57.087 --> 00:25:58.328
marketing and lead generation.

00:25:58.949 --> 00:26:02.049
So I view all these as elements of

00:26:02.069 --> 00:26:05.751
a well-performing operational approach to

00:26:05.811 --> 00:26:06.192
the business.

00:26:06.271 --> 00:26:08.492
Operational excellence is what I typically

00:26:08.512 --> 00:26:09.073
refer to as.

00:26:09.133 --> 00:26:10.913
Yeah, absolutely.

00:26:10.973 --> 00:26:12.673
I think that there's interesting research

00:26:12.713 --> 00:26:13.334
about that.

00:26:13.875 --> 00:26:15.694
We see economics as only financial

00:26:15.714 --> 00:26:16.115
economics,

00:26:16.135 --> 00:26:18.796
but then there's time economics, right?

00:26:18.916 --> 00:26:22.278
And time as an economic factor, we can...

00:26:23.558 --> 00:26:27.823
spend time wisely or we could spend time

00:26:27.903 --> 00:26:28.343
losing it.

00:26:28.363 --> 00:26:28.763
Exactly.

00:26:28.784 --> 00:26:32.146
So ROI should go beyond how many KPIs

00:26:32.166 --> 00:26:34.588
you can hit and how many SFQs you

00:26:34.628 --> 00:26:35.910
can actualize.

00:26:36.210 --> 00:26:37.672
That's right.

00:26:37.692 --> 00:26:38.192
In PT,

00:26:39.505 --> 00:26:41.125
we have a real clinician shortage,

00:26:41.226 --> 00:26:44.567
not just not enough clinicians per se,

00:26:44.707 --> 00:26:47.307
but only about twenty percent on an empty

00:26:47.347 --> 00:26:49.909
basis of licensed PTs are actually seeing

00:26:49.949 --> 00:26:50.469
patients.

00:26:51.249 --> 00:26:52.910
And I'm from a generation, granted,

00:26:52.950 --> 00:26:53.869
I'm a baby boomer.

00:26:53.890 --> 00:26:55.471
You tended to be with the same employer

00:26:55.490 --> 00:26:56.070
your whole life.

00:26:56.090 --> 00:26:57.432
And I'm not saying that's realistic,

00:26:58.011 --> 00:26:59.452
but I'm seeing just the opposite.

00:26:59.653 --> 00:27:02.653
I'm seeing migration and flight risk

00:27:03.314 --> 00:27:04.295
daily, weekly.

00:27:04.375 --> 00:27:06.676
I see PTs lasting at certain jobs three

00:27:06.717 --> 00:27:08.999
and six months and moving on to the

00:27:09.019 --> 00:27:09.319
next.

00:27:09.359 --> 00:27:12.122
And I see employers adopting new comp

00:27:12.182 --> 00:27:14.223
plans and then sign-on bonuses and all

00:27:14.243 --> 00:27:15.705
these other externalities.

00:27:16.306 --> 00:27:17.948
Whereas if I really think they invested in

00:27:17.968 --> 00:27:19.669
the human capital side of this,

00:27:19.689 --> 00:27:22.251
the talent management connection,

00:27:22.311 --> 00:27:23.472
getting patient,

00:27:23.553 --> 00:27:26.596
getting PTs more money based on what

00:27:26.635 --> 00:27:27.536
they're actually

00:27:28.176 --> 00:27:28.737
you know,

00:27:28.797 --> 00:27:30.958
producing and revenue for a company rather

00:27:30.978 --> 00:27:32.738
than being overmanaged by middle

00:27:32.778 --> 00:27:33.419
management.

00:27:33.959 --> 00:27:35.239
And I would have never said that six

00:27:35.298 --> 00:27:36.819
and seven and ten years ago because the

00:27:36.859 --> 00:27:38.519
margins were enough to get by on.

00:27:38.660 --> 00:27:39.539
Well, they're not anymore.

00:27:39.599 --> 00:27:41.300
They're not all of a sudden you're not

00:27:41.340 --> 00:27:42.580
going to wake up and Medicare is going

00:27:42.601 --> 00:27:44.481
to increase your fee schedule ten percent

00:27:44.602 --> 00:27:45.801
or anybody else for that matter.

00:27:45.821 --> 00:27:46.742
Well, sure.

00:27:46.762 --> 00:27:47.883
And then the ten percent of zero is

00:27:47.903 --> 00:27:48.403
still zero.

00:27:48.462 --> 00:27:48.702
Right.

00:27:48.722 --> 00:27:49.823
So exactly.

00:27:51.723 --> 00:27:53.945
But it is interesting.

00:27:53.965 --> 00:27:55.086
And I think what you just referenced,

00:27:55.125 --> 00:27:56.948
I think that's actually a perfect point

00:27:56.988 --> 00:28:00.250
where we as an industry need more Larry

00:28:00.269 --> 00:28:04.212
Banzas leading our way because you were

00:28:04.272 --> 00:28:07.355
able to change your construct and your

00:28:07.654 --> 00:28:09.875
mental model from ten years ago based on

00:28:09.915 --> 00:28:11.037
emergence of new evidence.

00:28:12.137 --> 00:28:14.819
Why do you think we have fewer clinicians,

00:28:14.839 --> 00:28:16.161
fewer clinical leaders?

00:28:16.901 --> 00:28:18.803
changing this mental model as the new

00:28:18.864 --> 00:28:19.584
evidence emerges?

00:28:19.924 --> 00:28:21.406
How do we shape the industry to get

00:28:21.487 --> 00:28:23.249
better?

00:28:24.170 --> 00:28:26.352
Our industry just hasn't changed enough.

00:28:27.614 --> 00:28:28.734
If you view the world,

00:28:28.994 --> 00:28:30.176
and I like to view the world this

00:28:30.217 --> 00:28:34.000
way a little bit, into pre-COVID,

00:28:34.141 --> 00:28:34.842
post-COVID,

00:28:36.057 --> 00:28:37.837
And you view your management and your

00:28:37.877 --> 00:28:40.718
leadership pre-COVID, post-COVID.

00:28:40.978 --> 00:28:42.659
And you view the business model of

00:28:42.699 --> 00:28:45.460
physical therapy pre-COVID, post-COVID.

00:28:45.500 --> 00:28:46.380
And you say to yourself,

00:28:46.460 --> 00:28:48.099
nothing's changed during those times.

00:28:48.740 --> 00:28:51.621
What kind of leader, manager, clinician,

00:28:51.740 --> 00:28:53.281
business owner are you?

00:28:54.342 --> 00:28:56.623
and business models have to evolve to the

00:28:56.682 --> 00:28:59.803
times we live in declining reimbursement

00:28:59.843 --> 00:29:01.963
for the last several years higher

00:29:02.023 --> 00:29:04.663
regulatory influence a shortage of

00:29:04.723 --> 00:29:07.305
clinicians yet the demand for pt is

00:29:07.345 --> 00:29:09.585
ridiculously high you know we still have a

00:29:09.825 --> 00:29:11.986
significant amount of the population that

00:29:12.026 --> 00:29:14.526
does not access pt for low back pain

00:29:14.905 --> 00:29:16.707
only about twelve to fourteen percent and

00:29:16.727 --> 00:29:17.826
probably growing a little bit

00:29:18.166 --> 00:29:19.748
Now I'm in the dental world where forty

00:29:19.788 --> 00:29:21.567
percent of the population never go to the

00:29:21.607 --> 00:29:22.288
dentist, period.

00:29:22.308 --> 00:29:23.148
They don't have a dentist.

00:29:23.588 --> 00:29:25.490
And the sixty percent of the population,

00:29:26.250 --> 00:29:27.891
one in eight avoid it because of dental

00:29:27.951 --> 00:29:28.550
anxiety.

00:29:28.971 --> 00:29:31.071
One in six have enough anxiety to go

00:29:31.112 --> 00:29:32.373
there and they leave right away or they

00:29:32.413 --> 00:29:32.853
cancel.

00:29:33.313 --> 00:29:35.473
And that leaves one in five that actually

00:29:35.493 --> 00:29:37.974
attend up or some bizarre statistic at

00:29:37.994 --> 00:29:38.295
that.

00:29:38.875 --> 00:29:40.336
And the way to handle it is not

00:29:40.375 --> 00:29:41.896
better schedule optimization,

00:29:41.957 --> 00:29:44.958
not more efficiency, not more technology.

00:29:45.597 --> 00:29:48.420
The way to get it is to restore

00:29:48.500 --> 00:29:50.101
what brought patients to you in the first

00:29:50.141 --> 00:29:52.061
place, a relationship with somebody,

00:29:52.382 --> 00:29:54.262
confidence they have in their clinician,

00:29:54.923 --> 00:29:55.964
self-efficacy.

00:29:56.045 --> 00:29:58.066
I believe that I can get better in

00:29:58.125 --> 00:29:59.946
working with my clinician.

00:30:00.287 --> 00:30:01.867
I have a lot of proxy efficacy.

00:30:01.907 --> 00:30:03.388
What do I think of the clinician?

00:30:03.689 --> 00:30:05.730
Do I think they're the best one for

00:30:05.770 --> 00:30:05.911
me?

00:30:06.778 --> 00:30:09.719
and the more we migrate away from that

00:30:09.759 --> 00:30:11.640
you know this is not anything new alex

00:30:11.660 --> 00:30:13.060
if you think about high touch high

00:30:13.101 --> 00:30:15.981
technology you know nisbit they saw they

00:30:16.041 --> 00:30:19.163
recognized that years ago that any time

00:30:19.183 --> 00:30:20.845
you bet that you get into high tech

00:30:20.865 --> 00:30:23.286
you better double down on high touch i

00:30:23.306 --> 00:30:24.846
just think we're seeing another generation

00:30:24.906 --> 00:30:26.928
of it but with the model of physical

00:30:26.968 --> 00:30:29.469
therapy the those who are practicing by

00:30:29.509 --> 00:30:31.470
the old model are driving clinicians out

00:30:31.490 --> 00:30:34.111
of being clinicians they just are

00:30:34.780 --> 00:30:35.521
And that's a shame.

00:30:36.102 --> 00:30:38.104
And so we have to regain that.

00:30:38.183 --> 00:30:39.546
Everyone's talking about alternative

00:30:39.566 --> 00:30:41.548
payment models and risk models and this

00:30:41.587 --> 00:30:41.948
and that.

00:30:42.449 --> 00:30:43.589
It ain't going to matter if we don't

00:30:43.609 --> 00:30:45.951
have clinicians that are engaged in really

00:30:45.971 --> 00:30:48.013
looking at retention of their profession

00:30:48.034 --> 00:30:48.595
for the long haul.

00:30:48.615 --> 00:30:50.737
Yeah, absolutely.

00:30:51.357 --> 00:30:51.798
Absolutely.

00:30:51.817 --> 00:30:54.299
I think it's like if we can solve

00:30:54.340 --> 00:30:54.881
this puzzle,

00:30:54.921 --> 00:30:56.863
then we definitely have a much brighter

00:30:56.923 --> 00:30:57.584
future ahead of us.

00:30:58.406 --> 00:30:59.548
Well, that's a great way.

00:30:59.827 --> 00:31:01.450
That's a great quote to end it on.

00:31:01.910 --> 00:31:03.211
Alex, I really enjoyed having you.

00:31:03.251 --> 00:31:04.172
If we can solve that,

00:31:04.192 --> 00:31:05.313
you are absolutely right.

00:31:05.353 --> 00:31:06.815
If we can solve this puzzle,

00:31:06.835 --> 00:31:08.476
we have a great future ahead of us.

00:31:09.037 --> 00:31:10.538
And it's a complicated puzzle.

00:31:11.179 --> 00:31:13.280
And, um, I just want to continue to,

00:31:13.441 --> 00:31:15.603
to listen and hear people, uh,

00:31:16.243 --> 00:31:18.867
Or to have people get on their bully

00:31:18.907 --> 00:31:21.832
pulpit and talk about fundamental changes

00:31:21.852 --> 00:31:23.714
that have to happen at the clinician level

00:31:24.256 --> 00:31:25.877
and really become back to a therapist

00:31:25.959 --> 00:31:27.340
centric organization,

00:31:28.241 --> 00:31:30.586
because it's not only good for business,

00:31:30.625 --> 00:31:31.207
it's good for.

00:31:32.228 --> 00:31:33.769
the profession, and more importantly,

00:31:33.788 --> 00:31:34.650
it's good for patients.

00:31:35.230 --> 00:31:35.770
Absolutely.

00:31:35.830 --> 00:31:36.912
And you're absolutely right.

00:31:37.251 --> 00:31:38.272
There's so much demand.

00:31:38.413 --> 00:31:40.115
I think we're sitting at such an

00:31:40.134 --> 00:31:41.816
opportunity to take a leadership role in

00:31:41.836 --> 00:31:42.236
the U.S.

00:31:42.276 --> 00:31:42.977
healthcare system.

00:31:43.497 --> 00:31:44.959
If only under the right design,

00:31:45.659 --> 00:31:47.039
we can be the leaders.

00:31:47.099 --> 00:31:48.781
We can be the primary musculoskeletal

00:31:48.801 --> 00:31:49.843
providers in the country.

00:31:50.623 --> 00:31:51.183
No question.

00:31:51.203 --> 00:31:52.184
Yep.

00:31:52.345 --> 00:31:52.904
That's okay.

00:31:52.924 --> 00:31:54.365
So we are the force multipliers.

00:31:54.385 --> 00:31:55.626
Well, thank you again.

00:31:55.646 --> 00:31:56.248
Thank you, Larry.

00:31:56.766 --> 00:31:57.468
I appreciate it.

00:31:57.488 --> 00:31:57.827
I appreciate you.

00:31:57.847 --> 00:31:59.090
Keep on doing all the great work that

00:31:59.111 --> 00:32:01.256
you're doing at WebPT and love your

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LinkedIn posts as well.

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They're high value posts.

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So keep on doing it.

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Appreciate it.