February 26, 2025 • 50 mins
David Bruton Jr is no stranger to adversity. After eight seasons in the NFL and a long list of football-related injuries, he’s using the skills he learned playing professional sports to forge a new kind of physical therapy practice: one with the good vibes of an NFL locker room.
The physical space is just one way David is doing things differently. In this episode, he tells Denzil about some unexpected choices he’s made, the failures he’s faced, and how his experimentation resulted in something incredible.
To check out more stories like David's, head to frontdesk.jane.app.
As a former NFL veteran, David spent eight years on the gridiron, with seven of those years dedicated to the Denver Broncos, culminating in a thrilling Super Bowl 50 Championship victory. His journey began at the University of Notre Dame, where he honed his skills both on the field and in the classroom, laying the foundation for his future endeavours.
After David’s NFL career, he pursued higher education with the same determination, earning a Doctorate in Physical Therapy from the University of Colorado in 2021. But his commitment to making a difference didn't end there. He founded Bruton's Books in 2015, a literacy foundation aimed at supporting young readers in the Denver Public Schools system, channelling his passion for education into meaningful community impact.
Off the field, David finds joy in cycling, relishing the freedom of the open road. And when he’s not on two wheels, you can often find him lost in the pages of a good book, fuelling his curiosity and expanding his horizons. But above all, his greatest joy comes from spending time with his family, cherishing every moment they share together.
- Between the Lines Physical Therapy
- Bruton’s Books
- David Bruton Jr on Instagram
- David Bruton Jr on X (formerly Twitter)
This podcast is for informational purposes only and should not be considered as professional medical, legal, or financial advice. The views and opinions expressed in this podcast are those of the guests and do not necessarily reflect the official policy or position of Jane or Front Desk magazine. Listener discretion is advised. This episode contains mature content and language that may not be suitable for all audiences.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
And I have my special teams coach, comes and sits
next to me and he's like hey,brute, I want you to know we're
probably going to go with theother safety, we're going to cut
you.
And he's like, unless you dosomething special, you aren't
going to be on the team.
So, with that being said,something about that about that
kind of motivated me and pushedme with my back against the wall
(00:22):
and I would go out there andblock two punts and it kind of
catapulted me to stay on theteam as well as be seen as a
special teams ace throughout theNFL.
Speaker 2 (00:33):
All right, david Bruton.
This guy is no stranger toadversity.
After eight seasons in the NFLand a long list of football
related injuries, he's using theskills he learned playing
professional sports to forge anew kind of physical therapy
practice, one with good vibes ofhis experience as an athlete.
For David, the worst part ofhis injury was being sidelined
(00:53):
from his teammates.
That's why his clinic Betweenthe Lines brings patients back
into a space that feels justlike the sport, full of energy
and camaraderie.
Stepping inside, you'll hearconversation flowing and the
music pumping.
The physical space is just oneway David is doing things
differently.
He's tried a lot of things,faced some failures, but the
result of his experimentation isa flourishing practice in the
(01:16):
suburbs of Denver.
We chat about all of this intoday's episode and I'm excited
for you to hear it.
Welcome to Radio Front Desk, ashow that surfaces what real
people in real clinics are doingto open, run and grow
successful health and wellnessbusinesses.
I'm your host, denzel Ford,editor-in-chief of Front Desk
Magazine by JNAP.
Here we have powerfulconversations with health and
(01:37):
wellness professionals on thebusiness side of clinic life.
We hear their stories anddiscover what works and how to
do it, and we also talk aboutwhat doesn't work.
If you want to check out morestories like this, head to
frontdeskjaneapp.
Well, let's start off by I justlike to hear your story and
(01:57):
like get to know you a littlebit.
So I wonder if you'd tell me alittle bit about yourself, your
early life, your early careerand how you came here to have
this conversation with me today.
Speaker 1 (02:05):
Kind of started playing football when I was in
seventh grade.
Football was never truly myfirst passion.
I loved the track so I alwaysdreamt of running the Olympics.
Obviously that never came tofruition.
But with that being said, I wasfirst exposed to physical
therapy during my seventh gradefootball season.
(02:25):
So I you know that was my firsttaste of it and pretty much
fell in love with the professionever since.
So, where I had multiple PTsthat I still have relationships
with even today, I'm throwing mytime in middle school, high
school, college and,professionally, freshman year.
I'm on the team and I don'tplay a single snap.
(02:45):
I'm on the bench, I don't playa single snap.
So I get talked into playingfootball my sophomore year, like
I don't want to play.
I'm so dejected, I don't haveany desire to go out there and
play and not, you know, see anytime on the field.
I'm dealing with that adversityas a young man.
And then, come sophomore year,I play A freshman, dealing with
that adversity as a young man.
And then, come sophomore year,I play A freshman's brought up
(03:08):
ahead of me to play.
And in junior year everythingstarts clicking and it's
something about the years.
The third year that's somethingspecial for me, like something
about the third year throughoutmy career playing football.
That's just, I don't know.
I'm able to triumph andovercome any adversity.
So fast forward.
(03:28):
I go to the University of NotreDame, I have my oldest kid
during my freshman season atNotre Dame, so I'm a pre-med
major with a full-time footballjob, and then my oldest son is
born.
So let's talk, talk about.
There's a lot thrown at me,right?
Speaker 2 (03:47):
so yeah, that's a lot .
Speaker 1 (03:49):
So I'm over here saying, yeah, seeing counselors
talking to teammates, talking tocoaches.
What's the best decision?
I'm not entirely sure what'sthe best decision.
Do I drop out, go back to ohioor do I stay at school?
And ultimately, obviously Istayed in school and it worked
out for the best, honestly.
But again, I wasn't.
I didn't have footballprofessionally in my mind, I was
(04:11):
just there to play.
I was fortunate enough to get ascholarship, because if I
didn't, would I have gone toNotre Dame?
No, no, I don't even know if Iwould have gone to college.
We weren't financially stablein that sense when I was growing
up.
So fast forward to that thirdyear, third year, it's just like
things start clicking and nowI'm getting NFL attraction.
This is a possibility for me,which was never even possibly a
(04:36):
dream.
It's now more so a reality forme that I could play at the next
level.
So we have our junior year,senior year.
I graduated from Notre Damewith two degrees political
science and sociology and aminor in Africana studies and
I'm drafted by the DenverBroncos in the fourth round in
(04:56):
2009.
Very fortunate, very blessed.
Love this organization.
It was very, very much so ablessing and um, that never was
really a true dream of mine andnever was on the on the radar
for me.
Um, and then let's fast forwardto that third year as far as
far as adversity.
Um, so we have pre-game meals,right, so you're eating your
(05:19):
food.
Um, before the game, I'mwatching phineas and Ferb and
eating my food Again.
I had my son at the time.
He's six, seven at the time.
That's what we did.
We watched cartoons all thetime.
My special teams coach comesand sits next to me and he's
like hey, Bru, I want you toknow, we're probably going to go
(05:42):
with the other safety.
We're going to cut you, he'slike, unless you do something
special you aren't going to beon the team and this is what
four hours before the game wow,third preseason game of yeah
talking about, yeah, talkingabout some adversity and like,
okay, well, how the heck am Isupposed to shake that off?
(06:03):
Pretty much got told that I'mgoing to get fired before I have
to go out there and play um.
So, with that being said,something about that about that
kind of motivated me and pushedme with my back against the wall
and I'll go out there and blocktwo punts.
And it kind of catapulted me tostay on the team as well as um
be seen as a special teams acethroughout the NFL One that guys
(06:27):
have the game plan against,coaches have the game plan
against and kind of helped mehave an eight-year career and
throughout all that time I sawcountless PTs and kind of
reinvented or reestablished mylove for the profession of
reinvented or re-established mylove for the profession.
(06:49):
Um, they are what kept orathletic trainers, pts and some
doctors are what kept me on thefield.
You know I have a binder aboutthis big of like all my injuries
from college and the pros umthat I had to overcome, had to
deal with and uh, and it wasthrough.
My experience on the table iswhat kind of drove me to after I
retired.
Let's go back into school,let's do our prereqs, that we
(07:10):
didn't finish at Notre Damelet's do our, then let's do the
two and a half years of thedoctoral program.
So kind of that's how, in aroundabout way.
That's kind of how I got hereoutside the traditional student
way.
Speaker 2 (07:23):
Yeah, I love it.
What I love about your story ishow you say that like it wasn't
like a hard intention that youwere pushing for.
For instance, since adolescence, my kids play hockey and
there's definitely anenvironment of like these kids
at seven, eight years old arelike trying to push them, or
their parents are trying to pushthem so hard that they have a
(07:43):
chance at the NHL, right, and soI love your story because it's
just like the road's almostrolling out behind you or
something like that.
Speaker 1 (07:51):
And.
Speaker 2 (07:53):
I find that inspirational because there's so
much of life where you're goingto hit a fork and you got to
choose a different path, and soI think there's so much of that
in your story absolutely, and Imean I think that fork comes at
any point in time.
Speaker 1 (08:09):
Right, like you could be done playing sports at high
school, you can be done collegeyou can be done one year in the
league, three years, eight years, 15 years, like at some point
in time, sports comes to an endyeah, totally that's if that's
your, if that's your, yourreason.
At some point in time you haveto choose.
Either the game's going toforce you or you're going to
choose to get out of there.
Speaker 2 (08:29):
Yeah, yeah, yeah.
I have a little anecdote totell you that I just realized
yesterday.
So we've been prepping for thisinterview for a while, but I
was telling somebody that I'minterviewing you and it just hit
me in the middle of theconversation.
I was like wait, the DenverBroncos are the team that my
family was like obsessed withwhen I was a kid.
They were just like so intofootball, and it was the Broncos
(08:50):
.
And I was like, wait, what?
Yeah, that's just so funny.
It was a long time ago, though,but still like, I thought, wow,
I can't believe I didn'trealize that until yesterday.
So I like to get into see if wecan talk a little bit about the
mentality that you're, that youhave brought to this next phase
(09:10):
of your life of like.
You've mentioned a few things,like one performing in the in
the face of great adversity, andalso just like the I'm
imagining cause I don't reallyknow, I've never been a
professional athlete, but I met.
I imagine the mental part ofthat is really intense, and I'm
I'm less asking you to talkabout it as an athlete, but just
(09:31):
like what?
What is that mental space whereyou're really performing at as
hard as you can, and how doesthat apply to your life today,
if it does at all?
Speaker 1 (09:42):
um, yeah, I think.
I think mentally.
Um, it's what's yourself-motivation?
Um, because you're constantlyunder the pressure of being
tired.
You're never 100 healthy whenyou're playing, like never.
And and some they're alwayslooking to replace you, like the
nfl stands for, not for longyeah, right so.
(10:05):
And every year there's 200 plusplayers who are drafted to come
in and essentially take your job.
So there's all this pressure.
So how do you manage that?
How do you manage that stress?
How do you separate work fromhome and home from work Like you
can't bring home into work andthat's going to affect your play
and vice versa, it's going toaffect how you, you know,
interact with your family orheck, just how you interact in
(10:28):
society in general.
So that mentality just comesfrom, I think, a lot of growth
as far as experience wise, alongwith having you know great
mentors.
We talk about mentors in thephysical therapy space or the
medical space, but you also havementors in the athletic space
as well, and I was veryfortunate enough to have these
(10:49):
vets when I was drafted, and twoof them, two of which are hall
of famers and Brian Dawkins andchamp champ Bailey, who taught
me how to be a pro, taught mehow to manage this, taught me
how to study film, taught meessentially how to become more,
more irreplaceable.
Taught me essentially how tobecome more irreplaceable
because I'm able to do multiplejobs, so I brought more value
versus just I'm essentially juststealing money from the
(11:12):
organization, so to speak.
And then also to that pointwhere I mentioned like you're
never healthy.
So, taking that mentality tothe physical therapy practice,
do I have a freshman sophomorein high school or junior senior
in high school and that's goingto change my treatment path?
(11:33):
It's going to change like, okay, freshman sophomore, I have a
lot more time.
I have more time to get themhealthy, versus a junior senior
who's trying to get ascholarship and to play college
ball or swim or what.
What have you so understanding?
Like?
Sometimes the protocol or theclinical practice guideline has
to be thrown out the window, andthat's what I experienced as a
(11:54):
professional athlete, as acollegiate athlete, to be able
to still play.
Is 80 still good enough?
Is 70 still good enough?
Is 70% still good enough?
Right, as long as there'snothing being detrimental to the
body, to the injury, anything'snot getting worse, then let's
get you back onto the field,because I know this is your
livelihood.
Speaker 2 (12:16):
Yeah, yeah, I love that.
So let's get into theenvironment in which you're
doing that now, in your clinic.
Between the lines, if you couldjust intro to me, introduce me
to your clinic, what it's aboutand like what's kind of the vibe
when you step into there.
Speaker 1 (12:35):
Oh, so the vibe is like to work.
You know, honestly, that's theculture we try to set forth,
like if you, if you are, youlike to work, you like to get
better of set forth, like if you, if you are, you like to work,
you like to get better.
Yeah, you know, you like tohave fun.
That's that's kind of theculture that we have here.
I make it so.
It's kind of mimics a NFLlocker room which what I've had,
like the music's playing, it'snot just you know, taylor Swift
(12:58):
radio, good lord, I mean she'sgreat, but I am not a Taylor
Swift fan, so I'm playing likeI'm playing 90s and 2000s hip
hop.
Speaker 2 (13:07):
Oh, right on.
Speaker 1 (13:07):
Yeah, you know you're playing, playing Lil Jon Radio
or Lil Wayne, like the vibe isis a little different than the
typical office space.
So we have an office spacewhere we can treat concussions
and things that nature, but wehave a gym.
That is where we do most of ourtreatment.
Um, or there there's racks andweights and BFR and four stacks
(13:31):
and med balls, literally tryingto tap into that mental space.
Cause, when you're hurt andthis is what's for me, it's like
when I was put on IR you'reessentially separated from the
team.
You're not in meetings.
Your treatment times aredifferent.
You are removed from the teamto a certain extent.
(13:52):
Yes, you still are a rosterspot or whatever, but IR is like
well, it's the next man up.
Speaker 2 (13:58):
in that sense, and what does that stand for?
Ir?
What is that acronym?
Speaker 1 (14:04):
Injured Reserve.
Speaker 2 (14:05):
Oh, okay, yeah, sorry Thanks.
Speaker 1 (14:07):
No, no problem.
So tapping into that space,like because a lot of people
they go once they get hurt highschoolers or whatnot they're in
a training room where you're notseeing the gym, or you're going
to a PT space that doesn'tnecessarily have weights and
racks and things.
So if you're in an environmentthat embraces, you know,
strength training and powertraining, things that you are
(14:29):
used to, like, we're positivelytapping into that mental space
like okay, even though you'rehurt, you're still an athlete,
we're still going to get youthere.
We're still going to tap intothat.
That uh uh, that psychologicalaspect of rehab.
Speaker 2 (14:43):
Oh, I love that.
My follow-up question to thatis where did you, where did you
get the confidence that thatwould work Like in a, in a in a
business perspective, because Ithink that you have a very
personal understanding of whythat environment would feel good
.
But where did you get theconfidence that that would work
for a clinic?
To set up your clinic like that, to play that kind of music and
(15:05):
to really set that environment?
Speaker 1 (15:09):
I think I had a multitude of different
influences, right?
So like what does my18-year-old son like to listen
to, like?
Speaker 2 (15:18):
what did he?
Speaker 1 (15:19):
listen to during his time in high school, kind of,
what are the kids listening tonow?
And then, you know, I had my,one of my clinical experiences.
It was a baseball focusedclinic and they worked out of a
gym sometimes too.
So just seeing that it couldwork in an actual gym setting,
even though they weren't thereall the time, the three or four
(15:41):
hours that they were there theywere seeing people on the high
schoolers on the table and theywere enjoying it and buying.
So just the different exposuresto it, um, and then you know,
ultimately I think it's justwhat would I have liked to be
treated in you know.
You know, if I didn't playfootball, what would I like to
be treated in?
But I want to be in a room, youknow where.
(16:02):
You know you're hearingelevator music or today's
hip-hop and R&B or somethingthat more so pertains to me,
pertains to my energy or what Iused to experience in the locker
room.
So, yeah, there comes a fearevery now and then.
Some people are like can youchange the music?
I'm not comfortable hearing theN-word in certain songs, yada,
(16:23):
yada.
So yeah, I'll appease them andI'll change the music Again.
Am I going to go Taylor Swiftradio?
No, we'll go clean hip hop andR&B.
We will make a shift.
I love it.
We just try to have a good timeand have energy, and I'm always
dancing, even while I'm treating, and singing and rapping,
(16:45):
whatever the case may be, andthat's just the culture that I
love to work in and I embrace.
Speaker 2 (16:52):
Yeah, I love that.
I'm just thinking of my own PTenvironment.
It's a little more clinicalthan that and I'm like, oh, this
would be so fun, because someof the treatments don't
necessarily feel perfectlycomfortable, right?
Speaker 1 (17:05):
And so I'm like if someone was like dancing.
Speaker 2 (17:07):
I'd take my mind off of it a little bit.
Speaker 1 (17:09):
Yeah.
Speaker 2 (17:10):
Yeah, would you talk to me about your brand and how
you came up with the name?
Between the Lines, I havesomething in my head that I
think it might refer to.
But and just talk about how youcreated that.
How did you create the brandoverall, the name, the logo, the
choices that you've made indesign in your clinic and setup
(17:32):
and all of that?
Speaker 1 (17:37):
Yeah, final clinical rotation.
While prepping for boards and,you know, putting the finishing
touches on the program, I juststarted throwing out a list of
names, that kind of you know howI would want to name the clinic
.
So I've always wanted to own aclinic Since I got into PT
school.
This is something that Ithought I could do, that I think
I was going to do it right outthe gate.
(17:58):
No, I thought I was going to golet's get some clinical
experience route, let's have amentor at another clinic.
I thought I was going topossibly jump on my last
clinical instructor, butultimately kind of settled on
the name between the linesbecause it's just an adage
that's always used, that I'vealways heard throughout my time
(18:19):
playing.
You know there's always betweenthe whistle, make sure the
plays are done between thewhistle, nothing after the
whistle.
The game is played between thelines, right?
And you think about every sport.
What sport doesn't require yourequire lines, right.
There's a start line, finishline in trail running and
cycling.
There's lines on track, there'slines at the bottom of the pool
(18:40):
, there's lines in football,like, every sport has some type
of line somewhere.
So what we're trying to do ismake you better between those
lines, you know, and the workyou do outside of those lines is
going to translate to betweenthose lines and how your
performance is, into that sportmentality where it's not just
(19:05):
isolated to rehabilitation.
We're rehabbing to sportsperformance.
So we're always trying to pushyou to jump higher, run faster,
feel more powerful, feel moreconfident by the time you leave
rehab.
I don't want you to just ACLsurgery.
Okay, you can walk and now youcan do all your strength
training yourself.
Well, why the heck did you doteri ACL in the first place?
What were these factors?
Okay, let's strengthen the core, let's strengthen your glutes,
(19:26):
let's bring in the cognitiveaspect, let's have you walk and
run through a play mentallywhile you're still doing these
exercises, just tapping intothose different aspects.
I feel that's kind of hard todo it without the gym.
So, like I said my lastclinical instructor, they worked
out of a gym, sometimes as well.
(19:46):
So I said, okay, I want to havea gym, I want to have a gym
lines as far as.
Does it have a gym?
Does it have an office space?
Is it big enough to kind offacilitate what we want to do in
(20:07):
the clinic?
And we landed on this space inCentennial.
And you know, you go throughyour whole business acumen.
What's the SWOT analysis?
So what's my strengths, myweaknesses, my opponents, my
threats?
You know what's the demographiclike.
Are we in an affluent area?
What are my goals once thisclinic's thriving day in and day
out, on repeat?
(20:27):
Okay, well, in order to provideno charge service once or twice
a month in an underprivilegedarea in Denver, we have to be in
an affluent area.
Okay, how many high schools arearound me?
I think there's 10 high schoolswithin 20 minutes of where my
clinic is.
So just there's a.
There was a lot of a lot ofmoving pieces as far as why we
(20:47):
landed in this place, why thename and kind of why.
Why that set up with the gym?
Speaker 2 (21:02):
here because there's so much of like knowing your
audience in these choices thatyou're making, in the thought
process behind the decisionsthat you're making.
So I think that, um, I thinkthat will help a lot of people
to hear how you achieved all ofthis.
Um, my next question is do youdo any marketing and how do you?
How do you manage kind oftapping into those 10 high
schools and getting people inthe door?
Speaker 1 (21:24):
So we I have done radio marketing one time and
that was a crash and burn.
You know it was 15, 20 grand.
That did absolutely nothing.
Not one referral from it.
So there's been a bigger push tobe a little more present on
social media.
I hate social media.
It's tough, it's the bane of myexistence.
To stay on top of it, to changemy algorithm, I'm gonna have to
(21:45):
hire somebody.
But but most of our, most ofour marketing is coming from
word of mouth.
Like we will go and do talks atlike a track team I even had, I
had my cousin who's Tyson Gay,who's the fastest American in
the 100.
Speak to the track team, youknow to tap into the athletic
components, like, okay, this iswhat it's like to get to the
(22:05):
next level he's talking about.
He did PT, he was alwayspracticing, even outside of
practice.
He did strength training andthen doing movement assessments
at these high school footballteams.
Trying to tap into thatfootball aspect and football is
very tough because you're tryingto break that old adage throw
some dirt on it.
Uh, you know, you know, pain isweakness.
(22:28):
Uh, leaving the body, yada,yada, yada.
Right, there's all these oldsayings with football and I feel
like football, is the one sportthat doesn't do a lot of
preventative care um outside of,like your strength training.
There's no, there's not a lotof mobility, extra mobility work
.
There's not a lot of okay, I'mgonna do this before the season
(22:48):
starts.
I'm only going to do it when Iwhen I get hurt versus like
baseball.
I think baseball is probablythe most preventative sport that
I've seen, especially pitchers,right, they're always doing arm
care, they're always doing hipmobility stuff.
They're always working onrotation, excuse me.
So that's so trying to breakinto that, break that old, those
(23:11):
old sayings, those old adages,those that old school mentality.
Um has been been tough, but ourbiggest bang for buck is just
word of mouth.
Our work speaks for itself.
You know, we I've been pushinggoogle reviews.
People are loving like avoidingsurgery and getting stronger,
or yeah or pr or they'resomebody's got.
Some of these individuals aregetting scholarships and I'm
(23:31):
like and I'm not taking anythingfrom because they're the ones
doing the work from the field um, but to get them back onto the
field to perform, to keep thatscholarship things of nature, is
something that we're very proudof here yeah, that's awesome.
Speaker 2 (23:44):
Uh, what, what is your?
You're kind of talking about itright now, but I wonder if
there's any anything more inthere, and how you approach
patients and how you, um, howyou think of that is like your
approach, and then not justyours as a practitioner, but
everyone in your clinic.
How is there like a unifiedapproach that you're going for
(24:05):
with how you interact withpatients in your clinic?
Speaker 1 (24:10):
No, I think kind of what I set forth is like treat
your own way, you know.
Right, we'll have huddles, youknow.
But how I treat might notnecessarily be how Linda treats
or how Mac treats.
But how I treat might notnecessarily be how Linda treats
or how Mac treats.
We all have differentbackgrounds and different
upbringings and have haddifferent experiences.
I like to dance and I like tosing and I like to shoot the
(24:33):
crap with patients and theirparents or whomever, just having
an actual conversation.
Linda's a little moreprofessional as far as how she
carries herself in, her acumenand how she talks and explains
to patients.
Mac has a military background.
So there's just these differentflavors here in the clinic.
But ultimately what ourconsensus is and what our goal
(24:54):
is is not to just rehab, it's tomake sure they are performing
better.
So now, like we've had thesehuddles, we've had these
discussions, we've had thesetalks, let's utilize the blaze
pods, let's utilize the soccernets that we have, let's utilize
all this extra equipment hereto help them be the best version
of themselves, whether that'sdance or whether that's soccer,
whether that's football,basketball, track, whatever that
(25:15):
case may be.
For me personally, my flavor islike kind of how I'm talking to
you now.
Right, it's like I'm very chill, very laid back.
Well, you know, I'm one ofthose PTs where I don't avoid
cussing, like if I want to cuss,like it's okay, I'm not cussing
at you, like, let's say, it'ssentence enhancers.
(25:37):
So sometimes I enhance mysentence a little bit like that.
But people relate to it.
I think there's even been astudy like PTs who are
practitioners who cuss aroundtheir patients, there's a more,
a greater relatability in that.
In that sense, yeah, I love thatyou know, yeah, so it's like
I've been able to buildrelationships with these
patients, these individuals.
Where, you know, I have acouple that I go golfing with,
(26:01):
there's a couple that I've gonecycling with, we've gone to
baseball, track meets, swimmeets all this in the community.
So I don't try to handcuff howthey treat Like everybody has
their different experience andone size doesn't necessarily fit
all right.
So we work as a team and ifsomething that I do is not
(26:23):
working, I have no problempassing the Mac or passing the
Linda and so on and so forth.
But we try to keep thatcontinuity of care as close to
consistent as possible.
Speaker 2 (26:33):
Yeah, I love that.
I love that you kind of alsojust letting people excel at
their own way of being as apractitioner.
I think that's awesome Onething.
Just to jump back to thebusiness side, one thing we know
that our community isstruggling with is just how to
(26:54):
actually do the nuts and boltsof their business and also kind
of getting ahead of the unknownif they were going to open their
own clinic.
And so I wonder if there'sanything that you could identify
that surprised you when youopened your clinic or the
process of running it or growingit.
And there's a lot of littlenitty gritty details like when
(27:14):
do you hire somebody, or what'sit like to negotiate a lease, or
do you sell inventory?
Like, is there anything likethat that popped in your mind
that you were surprised by, orthat didn't work and crashed and
burned like radio advertisingor anything like that?
Speaker 1 (27:30):
Yeah, yeah, no, negotiating the lease was
probably the tough part, right,because a lot of.
So I ran into a couple ofissues.
One where they would upchargebecause they found out what I
used to do.
There was a space that wassimilar size to here and they
(27:50):
were trying to charge an extra$1,500.
After he quoted me a certainamount Once, I told him okay,
sent all my financials, yada,yada, yada to prove that I can
afford the lease or whatnot.
Oh, actually the price is there.
So I've ran into that a coupleof times.
And then then there was a whole.
I haven't had a job in fiveyears, so I did two and a half
years of prereqs, two and a halfyears of the doctoral program.
Well, I still, I still have thefinancials for it.
(28:13):
But since I didn't have a jobfor five years, it was frowned
upon.
So a lot of there was a lot ofa lot of fear as far as taking
that chance, even though, hadyou know, you had your
collateral, you had things thatcould, essentially, if the
business failed, like it wascovered.
So that that was always thetough part.
And then trying to what the bigthing is that?
(28:35):
One of the nitty gritties andnuts and bolts that, you realize
, is like how much it costs tolike make it look your way right
so like contracting outanything.
So I remember getting quotes forhow to make this office space
and the walls and everythinglike that.
It was about 25 30 grand justin the actual office space.
(28:57):
Um.
So, fortunately for me, I had abuddy who he did pretty much
does all his house stuff.
I had another buddy who's donefloor stuff.
So we kind of did it allourselves in the front office
and it was just the supplies andit costs us.
You know, cost me $2,500 beerand pizza.
(29:17):
Pretty much that's all it costs, right?
So just finding ways to saveespecially as when you're new,
right, you're trying to savemoney because it takes a while
for you to make money there'salways some type of new overhead
that you're not worried about.
There's always hidden costs.
(29:37):
Like, if the toilet goes down,is that in your lease?
If the HVAC goes down, is thatin your lease or is that
something you got to take careof yourself?
So there's all these thingsthat you kind of have to worry
about.
Make sure you're looking atthat.
So a big bit of advice is justmake sure you have a lawyer,
make sure you have a businesslawyer to look over the contract
, make sure you're not gettingscrewed over To make sure, like
(29:59):
things are copacetic and this isnormal, because every now and
then they might try to sneaksomething in Can your cam stay
the same year in and year out?
Or are you getting a kickback?
There's all types of things, asfar as a business owner that
you're constantly worrying about.
I still worry about thingstoday, and I'm going on three
(30:20):
years.
And then to your question as faras when to hire somebody.
It's, it's, it's difficult withuh, with a cash-based clinic,
right, cause you're not always,it's not always you know 18, 20
referrals a day from insurance,right?
So referrals are coming fromthat word, that word of mouth.
So when?
When was I confident enough tohire somebody?
(30:42):
I hired Linda almost a year ago, a little more than a year ago
last year, and she was ready fora change.
She was at a cash-based clinicbefore, but the rates were low,
she wasn't getting paid as much,so on and so forth.
So what ultimately came down,what made my decision, is, as a
(31:06):
business owner, I need to hiresomebody, because everything
that I'm bringing in it's goingback to the clinic, yeah, yeah.
So that's not ideally what youwant to do.
You kind of want, you want, youknow some to go to the clinic,
but you want to also be able topay yourself.
So essentially I wasn't payingmyself, I was just paying the
(31:29):
clinic to keep lights on doors,open equipment, yada, yada, yada
.
So that was kind of where thatlooked like.
But also a big thing is like howto talk to your employees when
you're a cash-based clinic,because you have to build trust.
You have to build trust in thatcommunity.
Everybody trusts insurance,Everybody trusts wherever
(31:50):
they're referred to.
How do you build trust and howdo you build your caseload?
So it takes a few months tobuild your caseload in a
cash-based clinic, especially anew one.
Right, it's not like I hadpatients on deck for you, but my
thing is like I try to push youknow patients to them as much
(32:11):
as myself when they call or ifwe go to meeting or go to
pop-ups or things of that nature.
Okay, mac, linda, y'all got it.
Everybody who signs up, makesure you put them on your
schedule, you know, and I'lltake a seat back, cause I would
love to have time to just doadmin stuff or you know what
else do I need to do?
Okay, we're short on this, shorton this.
(32:33):
Okay, yada, yada, so on and soforth.
Um, or do the social media part?
So?
Um, there's just, there's justa lot of hidden things in
business and you'll get yourbumps and bruises along the way,
right?
That's kind of the flow ofbeing a business owner, like you
got to roll with those punchessometimes.
Speaker 2 (32:54):
Yeah, you've mentioned Cashbase Clinic a few
times.
Could you just talk a littlebit?
So our listeners are going tobe somewhat based in Canada,
somewhat based in the UnitedStates, but I wonder if you
could just talk about yourdecision to be a cash-based PT
clinic and just what you knowabout the insurance side of it
(33:17):
all, how you made that decision.
I think that's really what I'mcurious about is how you made
that decision.
Speaker 1 (33:25):
Well, I made that decision because I have kids and
seeing 18 to 20 people a dayand then having to do those
notes at home kind of, wouldjust negate my time as a father
right.
Like, my kids are in gymnastics, swimming, soccer, want to play
golf.
You know football.
My oldest is in Ohio so I gotto fly out there, right.
(33:47):
So there's a lot.
There's a lot of moving piecesthere.
So what would give me the bestopportunity to remain a dad
Right and not just be drowningin all this excessive paperwork
and insurance and having tofight for all these visits?
Secondly is what would I preferas a patient?
Would I prefer 20 minutes onthe table and then I do a couple
(34:07):
of exercises here and I'm out?
Or would I want the 30 minutes,40 minutes on the table?
Then we use the last 20, 30 todo exercises strengthening,
reinforce, kind of what we did.
And then, thirdly,reimbursement rates.
Reimbursement rates areterrible, especially out here in
Colorado.
I know Virginia is a lot betterthan here, but in Colorado
(34:33):
reimbursement I think on averageis between 40, 50 bucks for a
30-minute session, right, andthen premiums have gone up.
Reimbursement continues to godown.
So now I would have to see morepatients.
So doing my analysis and myspreadsheet as far as what it
(34:55):
would look like to break even ina clinic that's cash-based,
with an average of $45 roughlyversus an average of $172 per
patient, I'd have to see 13, 14patients a day in a 19-day
working month to break evenversus to break even.
To pay myself everythingoverhead, I have to average four
a day at the $172.
Speaker 2 (35:17):
Right, that's a big difference.
Speaker 1 (35:19):
That is a huge difference, right.
That's four hours of treatment,or seven hours, roughly every
30 minutes.
Speaker 2 (35:27):
Yeah.
Speaker 1 (35:28):
At 14 people.
Yeah, it's a huge difference totry to find that work-life
balance and not be bombarded bynotes and, yeah, ultimately,
that's's why those are the threereasons why I decided to go go
to cash base route, and it'sscary for a lot of people that
(35:48):
they think that right, but goout there and not have these
constant referrals comingthrough.
Yeah, but there's so much valueand when people when people
understand and see andexperience the value of going to
a cash-based model, not just asa business owner but as a
patient, that's okay, cool, thisis great.
(36:11):
I'm actually getting better,faster and paying less than what
I would if I did thetraditional route.
Speaker 2 (36:17):
Right.
Speaker 1 (36:19):
Right, and there's so much education We're're
constantly doing education withpatients like super bills.
How does that work?
All we are seen as an out ofnetwork provider.
What does it look like?
They should be able toreimburse you not reimburse, but
maybe put it towards yourdeductible or out of pocket max
or something along those lines.
(36:39):
Like there is a way for you toget get your money back, or
something along those lines.
Like there is a way for you toget your money back.
But who wants to read those 20,30 pages of insurance jargon
that you get when you sign upfor?
your insurance right.
There's so many little nuancesthat unless you're there going
through it or you're ahealthcare professional, you're
not going to understand.
Speaker 2 (36:59):
Yeah, long ago I worked in a couple of clinics
and one of them my job wasactually to handle this process
of billing insurance when theydon't pay.
That clinic hired a person fulltime to just like go in, and
this was before it was allonline, so it was on the phone
basically all day talking to theinsurance companies like so
what do you think about this?
And a lot of times it wouldjust be like the code was wrong
(37:23):
or something, and so it was justlike such an administrative
hassle but a whole human fulltime just to get that percentage
paid.
Yeah, yep, yeah.
So tell me more about whatyou're doing to educate patients
on the insurance.
Is this just a conversationthat happens at the front desk,
or how do you actually pass thatinformation to them in an
(37:45):
effective way?
Speaker 1 (37:47):
So I'm hoping to do a little, hoping to do a forum at
some point in time to anypatients to jump on Zoom, kind
of educate them about Jane andinsurance and how to navigate
that space, understanding whatto look at, why they should
reimburse you, all thesedifferent things.
(38:09):
But there's a lot of educationthat happens on the phone.
There's a lot of education thathappens when I'm selling
packages, right?
So the big thing for a lot ofpeople is like okay, well, that
is a lot right.
Speaker 2 (38:21):
Yeah.
Speaker 1 (38:21):
Say, our 10-pack, that's 10-pack and an eval is
almost two grand.
Right, but the education pieceof it it kind of circulates
around.
Okay, we can provide you superbills, so you should get 70, 80%
of that back towards yourdeductible or out-of-pocket max
or, if you met it post-surgery,all of it back to your pocket.
(38:42):
But also the fact that we'renot trying to burn through your
visits, so like we kind of setup a plan where, okay, you get a
10-pack, I'll see you twicethis week, twice next week.
Oh, you're doing better, yourpain's at a two, three versus
that six, seven.
Okay, let's go once a week.
For the next two, okay, it'sstill sticking, all right, let's
face the other one two weeks.
All right, let's face the lastone a month.
(39:03):
So now a 10 pack is roughly fourmonths, the startup, the
beginning of the fourth month.
So kind of try not to burnthrough those visits unless they
absolutely need it.
I'm not, I'm not here, justlike, let's just burn, burn,
burn, burn, burn, burn, causethen it just seems like we're
just taking away the reason whywe're doing it.
(39:23):
We're doing it to get thembetter, we're not doing it just
to bring in as much money aspossible.
If that was the case, then we'dgo to that insurance-based
model.
Speaker 2 (39:33):
Yeah, yeah, interesting, so fascinating.
Is there anything that youwould advice that you'd give to
a clinic owner who's trying tomake this decision for
themselves?
Speaker 1 (39:50):
I mean my, my advice, especially a clinic owner who's
trying to make like, educateyour patients, that you're you
might be making that shift Right.
Educate your patients if you'redropping their insurance, maybe
you're not dropping all of it,maybe you're dropping some but
also making sure, like you cando the insurance in the
(40:13):
cash-based model and just makingsure it's like, hey, do you
want to fight at the end of your20 visits for an ACL and
possibly get denied for thoseextra visits?
Or you can go the cash-basedroute and I can give you a
discounted rate per visit and wecan possibly even do longer
visits now that we're notdealing with insurance.
So, just being confident andcomfortable with that
educational piece with thesepatients, because it is scary.
(40:37):
It's scary.
It's like, oh, wow, I'm payingtwo grand here, but in that same
breath breath especiallydepending on what area you are
like is it very sports driven?
Because you know some of theseleagues they're paying five
thousand dollars for the leagueyou know, just for the spring
ball or whatever, uh, springbaseball or all these camps that
they're going to or to be onthis national club team.
(40:58):
Like there's so much moneygoing into that it's like some
of them probably won't have aproblem paying it for health
care, as long as you justify why, why they need it.
It's always one in that.
Why?
What can you do as a pt thatmay be different than what the
coach is doing, or the strengthconditioning performance coach
(41:21):
like, what can you do?
That's that sets yourself apartI love that.
Speaker 2 (41:26):
You just said that it really aligns with another.
Um, we wrote this article for aprint magazine how to raise
your fees, and it's it's allabout like feeling confident in
in that act of charging peoplemoney for health care and that
people actually want to give itto you because they want the
healing, or I don't know if I'msaying this correctly, but
(41:46):
there's a mentality there oflike of feeling confident in
that, and I think that it's itcan apply to different segments
of this conversation, likeraising your fees or even just
like, how do you set up your,your revenue model for your
clinic?
So, yeah, that's super helpfulyeah, absolutely.
Speaker 1 (42:06):
I think, just doing some research too about what's
going on around there, likeeverybody's talking about, like
my price.
Some people say, oh, yourprices are high, lend this
clinic.
Compared to mine, yeah, myprices are almost two times as
much as what they were chargingthere, but there's a clinic down
the maybe 10-15 minutes away.
That's actually.
They were charging there, butthere's a clinic down the maybe
10, 15 minutes away.
That's actually.
They're charging essentially$50 more than every follow-up
(42:30):
visit.
That I am right.
It just all depends on kind ofthe area you're in and kind of
what are your goals and whatallows you to feel comfortable
to treat for 45 minutes or anhour, like what's?
How allows you to feelcomfortable to, you know, treat
for 45 minutes or an hour, likewhat's?
How do you value yourself?
Like we all have school debt.
(42:50):
You know.
Like everybody in the healthcare space has school debt.
What's going to help you paythat you know.
And what's going to put food onyour table and take your kids
to all these activities, and Ifeel like that's kind of the
norm.
We undervalue ourselves and Idon't know why, as PTs, we
(43:12):
undervalue ourselves so much.
Is it because we're still seenas a service here in the States
and not seen as a doctor in theinsurance world.
That's why they keep cuttingand cutting, cutting prices,
even though we have to get adoctorate now, yeah.
Or is it because we're sodriven to, you know, be kind and
(43:35):
friendly and provide the bestcare possible, and like we want
to help our people, but we, wesacrifice ourselves for it,
whether that's time or money.
I feel like it's just a normthat we constantly deal with or
that I constantly hear fromother PTs.
Speaker 2 (43:54):
Yeah, yeah, that's so interesting.
I think that applies across allof the disciplines that we come
across at Jane as well, so Iappreciate you saying that so
much.
I also want to talk about somethings that you do outside of
your clinic.
So would you mind going throughyour charity a little bit and
(44:16):
telling everyone what you dothere, and one what it is, how
you came to have that and thenhow it relates to your
underlying ethos as a personwho's interested in health care?
Speaker 1 (44:29):
Yeah, absolutely so.
My foundation is calledBruton's Books and it's geared
towards childhood literacy, k-3,third grade here in the Denver
public school system.
We've been founded since 2015.
So we were very active in2015-16, kind of got a little
slow during my time in schooland kind of slowed with COVID,
(44:52):
but revamped back up.
We came up with the nameBruton's Books because of
alliteration and obviously it'sliteracy, so we thought that was
pretty clever.
But ultimately what our missionis is to address accessibility
in the DPS area.
So I'm in a very affluent area.
It's Cherry Creek SchoolDistrict.
(45:12):
Every kid's one-to-one as faras iPads, google Chromes and the
libraries are ginormous.
They have all these books, yada, yada, yada.
But in DPS, in the Denver PublicSchool System, there's been a
big shift as far as culturalinfluences, demographics, people
moving in and now staying.
(45:32):
So what we are trying to do isaddress that accessibility as
far as culturally enriched books, like that relatability piece
to what you're reading, becausethat's going to be a motivating
factor.
Right, and I seen it when Iwould go talk to the schools.
Or sometimes when I go talk tothese underserved and
underprivileged schools, like,oh, it's a black man who played
(45:55):
football but also went back intoeducation and he's a doctor,
and he's a doctor, right.
So like that is a motivatingpiece, instead of having
somebody who doesn't look likeyou come up there and talk, say,
hey, you can do it, you can dothis, you can do that.
You know, there's a look andI'm not saying there's nothing
wrong with it.
I think if you can get up infront of somebody and try to
motivate them by all means, butthere's something to say with
(46:19):
that relatability piece, thatgoes a long way and it's the
same.
It's the same with the book.
You know, if you're reading uh,junie B Jones, right, and it's,
it's a young white girl in abook and you're a young black
girl.
Like, are you going to berelating to that?
Right, you got to findsomething else that that may
most more so pertains to you andyour culture and things of that
(46:42):
nature.
So, ultimately, what we doevery year is we the last three
years is we do a golf outingwhere we raise funds to purchase
iPads, to purchase books andpurchase two years of
supplemental programming onthese iPads so kids can learn as
(47:04):
well as parents can have accessto it via their computer or
something along those lines,whatever they have at home to
keep track of what their kidsare doing.
So, dps, I don't know howfamiliar you are with our prison
sizes and things like that, butbased on our third grade
reading levels, is what ourprison sizes and things that,
things like that, but based onour third grade reading levels,
(47:25):
is what bit is what our prisonsizes are based off of really?
So, whatever you're reading atthere, yes, so we did.
There was a research done bymaha united way that prison
rates, prison sizes, are basedon third grade reading levels
whoa Whoa.
Speaker 2 (47:42):
No, I did not know that.
Speaker 1 (47:44):
Yeah, so that's kind of why we focused on K through
third grade.
So kindergarten through second,we're learning to read.
Third grade is huge.
Now we're getting to the pointwhere we read to learn.
So there's definitely a shiftas far as what the purpose of
our education is.
Speaker 2 (48:00):
This one was David Bruton, and I love talking to
him so much because, I mean,obviously it's fun to talk to
somebody who has had aprofessional sports career.
What I loved about it, though,was that we didn't really dwell
on that too much.
We're able to really get intohow he's building his business
and maybe how that previous lifeand experience informs how he
approaches his clinic.
That was really fun, and one ofthe things that I caught was
(48:24):
how the clinic culture is reallyimportant to him, and, in
particular, he's trying tocreate this vibe of the
positivity that he experiencedin a professional sports locker
room, and he's trying to providethat for his patients and
clients now, who are athleteswho are working really hard to
be great at what they do, sothat was really fun to hear.
(48:44):
Another aspect of that wasalmost veering into his approach
to the treatment outcomes, butit was really a comment on how
he puts his patients first, andI think what he was trying to
say is that, if you go by thebook, you kind of were trying to
get patients to like 100%, butin practice, especially with
(49:04):
athletes who are pushing reallyhard, that the goal is really to
get them good enough so theycan get back out there, and I
thought that was just a reallyfascinating part of his business
model.
The other piece that was, Ithink, really helpful to a lot
of listeners out there was hischoice around having a
cash-based model, and for him itallows him to have a much
(49:26):
shorter workday, sometimes likea four-hour workday, I think he
said, which gives him so muchmore time, one to focus on the
business as an owner and thenalso, of course, more time with
his kids.
So that was really cool.
And then I really pushed to askhim about how he educates his
patients on the benefits of howthat cash-based model works,
because sometimes they need togo and then send the insurance
(49:48):
documents to the insurancethemselves.
So that was a reallyinteresting part too, that the
education of his patients abouthis business model is so
important.
And then I really loved hearingabout his charity Bruton's
Books.
Loved hearing about his um, hischarity Bruton's Books, and if
you if that's not going to makeit into the final cut, you can
(50:09):
go look that up called Bruton'sBooks and it's how he's focusing
on improving third gradereading averages in the Denver
region and such a great littleum thing that he's doing there
and trying to make a realdifference in people's lives and
how they can grow up and make adifference themselves.
So hopefully this was a goodepisode.
Chat soon.
And I have my special teams coach, comes and sits
next to me and he's like hey,brute, I want you to know we're
probably going to go with theother safety, we're going to cut
you.
And he's like, unless you dosomething special, you aren't
going to be on the team.
So, with that being said,something about that about that
kind of motivated me and pushedme with my back against the wall
(00:22):
and I would go out there andblock two punts and it kind of
catapulted me to stay on theteam as well as be seen as a
special teams ace throughout theNFL.
Speaker 2 (00:33):
All right, david Bruton.
This guy is no stranger toadversity.
After eight seasons in the NFLand a long list of football
related injuries, he's using theskills he learned playing
professional sports to forge anew kind of physical therapy
practice, one with good vibes ofhis experience as an athlete.
For David, the worst part ofhis injury was being sidelined
(00:53):
from his teammates.
That's why his clinic Betweenthe Lines brings patients back
into a space that feels justlike the sport, full of energy
and camaraderie.
Stepping inside, you'll hearconversation flowing and the
music pumping.
The physical space is just oneway David is doing things
differently.
He's tried a lot of things,faced some failures, but the
result of his experimentation isa flourishing practice in the
(01:16):
suburbs of Denver.
We chat about all of this intoday's episode and I'm excited
for you to hear it.
Welcome to Radio Front Desk, ashow that surfaces what real
people in real clinics are doingto open, run and grow
successful health and wellnessbusinesses.
I'm your host, denzel Ford,editor-in-chief of Front Desk
Magazine by JNAP.
Here we have powerfulconversations with health and
(01:37):
wellness professionals on thebusiness side of clinic life.
We hear their stories anddiscover what works and how to
do it, and we also talk aboutwhat doesn't work.
If you want to check out morestories like this, head to
frontdeskjaneapp.
Well, let's start off by I justlike to hear your story and
(01:57):
like get to know you a littlebit.
So I wonder if you'd tell me alittle bit about yourself, your
early life, your early careerand how you came here to have
this conversation with me today.
Speaker 1 (02:05):
Kind of started playing football when I was in
seventh grade.
Football was never truly myfirst passion.
I loved the track so I alwaysdreamt of running the Olympics.
Obviously that never came tofruition.
But with that being said, I wasfirst exposed to physical
therapy during my seventh gradefootball season.
(02:25):
So I you know that was my firsttaste of it and pretty much
fell in love with the professionever since.
So, where I had multiple PTsthat I still have relationships
with even today, I'm throwing mytime in middle school, high
school, college and,professionally, freshman year.
I'm on the team and I don'tplay a single snap.
(02:45):
I'm on the bench, I don't playa single snap.
So I get talked into playingfootball my sophomore year, like
I don't want to play.
I'm so dejected, I don't haveany desire to go out there and
play and not, you know, see anytime on the field.
I'm dealing with that adversityas a young man.
And then, come sophomore year,I play A freshman, dealing with
that adversity as a young man.
And then, come sophomore year,I play A freshman's brought up
(03:08):
ahead of me to play.
And in junior year everythingstarts clicking and it's
something about the years.
The third year that's somethingspecial for me, like something
about the third year throughoutmy career playing football.
That's just, I don't know.
I'm able to triumph andovercome any adversity.
So fast forward.
(03:28):
I go to the University of NotreDame, I have my oldest kid
during my freshman season atNotre Dame, so I'm a pre-med
major with a full-time footballjob, and then my oldest son is
born.
So let's talk, talk about.
There's a lot thrown at me,right?
Speaker 2 (03:47):
so yeah, that's a lot .
Speaker 1 (03:49):
So I'm over here saying, yeah, seeing counselors
talking to teammates, talking tocoaches.
What's the best decision?
I'm not entirely sure what'sthe best decision.
Do I drop out, go back to ohioor do I stay at school?
And ultimately, obviously Istayed in school and it worked
out for the best, honestly.
But again, I wasn't.
I didn't have footballprofessionally in my mind, I was
(04:11):
just there to play.
I was fortunate enough to get ascholarship, because if I
didn't, would I have gone toNotre Dame?
No, no, I don't even know if Iwould have gone to college.
We weren't financially stablein that sense when I was growing
up.
So fast forward to that thirdyear, third year, it's just like
things start clicking and nowI'm getting NFL attraction.
This is a possibility for me,which was never even possibly a
(04:36):
dream.
It's now more so a reality forme that I could play at the next
level.
So we have our junior year,senior year.
I graduated from Notre Damewith two degrees political
science and sociology and aminor in Africana studies and
I'm drafted by the DenverBroncos in the fourth round in
(04:56):
2009.
Very fortunate, very blessed.
Love this organization.
It was very, very much so ablessing and um, that never was
really a true dream of mine andnever was on the on the radar
for me.
Um, and then let's fast forwardto that third year as far as
far as adversity.
Um, so we have pre-game meals,right, so you're eating your
(05:19):
food.
Um, before the game, I'mwatching phineas and Ferb and
eating my food Again.
I had my son at the time.
He's six, seven at the time.
That's what we did.
We watched cartoons all thetime.
My special teams coach comesand sits next to me and he's
like hey, Bru, I want you toknow, we're probably going to go
(05:42):
with the other safety.
We're going to cut you, he'slike, unless you do something
special you aren't going to beon the team and this is what
four hours before the game wow,third preseason game of yeah
talking about, yeah, talkingabout some adversity and like,
okay, well, how the heck am Isupposed to shake that off?
(06:03):
Pretty much got told that I'mgoing to get fired before I have
to go out there and play um.
So, with that being said,something about that about that
kind of motivated me and pushedme with my back against the wall
and I'll go out there and blocktwo punts.
And it kind of catapulted me tostay on the team as well as um
be seen as a special teams acethroughout the NFL One that guys
(06:27):
have the game plan against,coaches have the game plan
against and kind of helped mehave an eight-year career and
throughout all that time I sawcountless PTs and kind of
reinvented or reestablished mylove for the profession of
reinvented or re-established mylove for the profession.
(06:49):
Um, they are what kept orathletic trainers, pts and some
doctors are what kept me on thefield.
You know I have a binder aboutthis big of like all my injuries
from college and the pros umthat I had to overcome, had to
deal with and uh, and it wasthrough.
My experience on the table iswhat kind of drove me to after I
retired.
Let's go back into school,let's do our prereqs, that we
(07:10):
didn't finish at Notre Damelet's do our, then let's do the
two and a half years of thedoctoral program.
So kind of that's how, in aroundabout way.
That's kind of how I got hereoutside the traditional student
way.
Speaker 2 (07:23):
Yeah, I love it.
What I love about your story ishow you say that like it wasn't
like a hard intention that youwere pushing for.
For instance, since adolescence, my kids play hockey and
there's definitely anenvironment of like these kids
at seven, eight years old arelike trying to push them, or
their parents are trying to pushthem so hard that they have a
(07:43):
chance at the NHL, right, and soI love your story because it's
just like the road's almostrolling out behind you or
something like that.
Speaker 1 (07:51):
And.
Speaker 2 (07:53):
I find that inspirational because there's so
much of life where you're goingto hit a fork and you got to
choose a different path, and soI think there's so much of that
in your story absolutely, and Imean I think that fork comes at
any point in time.
Speaker 1 (08:09):
Right, like you could be done playing sports at high
school, you can be done collegeyou can be done one year in the
league, three years, eight years, 15 years, like at some point
in time, sports comes to an endyeah, totally that's if that's
your, if that's your, yourreason.
At some point in time you haveto choose.
Either the game's going toforce you or you're going to
choose to get out of there.
Speaker 2 (08:29):
Yeah, yeah, yeah.
I have a little anecdote totell you that I just realized
yesterday.
So we've been prepping for thisinterview for a while, but I
was telling somebody that I'minterviewing you and it just hit
me in the middle of theconversation.
I was like wait, the DenverBroncos are the team that my
family was like obsessed withwhen I was a kid.
They were just like so intofootball, and it was the Broncos
(08:50):
.
And I was like, wait, what?
Yeah, that's just so funny.
It was a long time ago, though,but still like, I thought, wow,
I can't believe I didn'trealize that until yesterday.
So I like to get into see if wecan talk a little bit about the
mentality that you're, that youhave brought to this next phase
(09:10):
of your life of like.
You've mentioned a few things,like one performing in the in
the face of great adversity, andalso just like the I'm
imagining cause I don't reallyknow, I've never been a
professional athlete, but I met.
I imagine the mental part ofthat is really intense, and I'm
I'm less asking you to talkabout it as an athlete, but just
(09:31):
like what?
What is that mental space whereyou're really performing at as
hard as you can, and how doesthat apply to your life today,
if it does at all?
Speaker 1 (09:42):
um, yeah, I think.
I think mentally.
Um, it's what's yourself-motivation?
Um, because you're constantlyunder the pressure of being
tired.
You're never 100 healthy whenyou're playing, like never.
And and some they're alwayslooking to replace you, like the
nfl stands for, not for longyeah, right so.
(10:05):
And every year there's 200 plusplayers who are drafted to come
in and essentially take your job.
So there's all this pressure.
So how do you manage that?
How do you manage that stress?
How do you separate work fromhome and home from work Like you
can't bring home into work andthat's going to affect your play
and vice versa, it's going toaffect how you, you know,
interact with your family orheck, just how you interact in
(10:28):
society in general.
So that mentality just comesfrom, I think, a lot of growth
as far as experience wise, alongwith having you know great
mentors.
We talk about mentors in thephysical therapy space or the
medical space, but you also havementors in the athletic space
as well, and I was veryfortunate enough to have these
(10:49):
vets when I was drafted, and twoof them, two of which are hall
of famers and Brian Dawkins andchamp champ Bailey, who taught
me how to be a pro, taught mehow to manage this, taught me
how to study film, taught meessentially how to become more,
more irreplaceable.
Taught me essentially how tobecome more irreplaceable
because I'm able to do multiplejobs, so I brought more value
versus just I'm essentially juststealing money from the
(11:12):
organization, so to speak.
And then also to that pointwhere I mentioned like you're
never healthy.
So, taking that mentality tothe physical therapy practice,
do I have a freshman sophomorein high school or junior senior
in high school and that's goingto change my treatment path?
(11:33):
It's going to change like, okay, freshman sophomore, I have a
lot more time.
I have more time to get themhealthy, versus a junior senior
who's trying to get ascholarship and to play college
ball or swim or what.
What have you so understanding?
Like?
Sometimes the protocol or theclinical practice guideline has
to be thrown out the window, andthat's what I experienced as a
(11:54):
professional athlete, as acollegiate athlete, to be able
to still play.
Is 80 still good enough?
Is 70 still good enough?
Is 70% still good enough?
Right, as long as there'snothing being detrimental to the
body, to the injury, anything'snot getting worse, then let's
get you back onto the field,because I know this is your
livelihood.
Speaker 2 (12:16):
Yeah, yeah, I love that.
So let's get into theenvironment in which you're
doing that now, in your clinic.
Between the lines, if you couldjust intro to me, introduce me
to your clinic, what it's aboutand like what's kind of the vibe
when you step into there.
Speaker 1 (12:35):
Oh, so the vibe is like to work.
You know, honestly, that's theculture we try to set forth,
like if you, if you are, youlike to work, you like to get
better of set forth, like if you, if you are, you like to work,
you like to get better.
Yeah, you know, you like tohave fun.
That's that's kind of theculture that we have here.
I make it so.
It's kind of mimics a NFLlocker room which what I've had,
like the music's playing, it'snot just you know, taylor Swift
(12:58):
radio, good lord, I mean she'sgreat, but I am not a Taylor
Swift fan, so I'm playing likeI'm playing 90s and 2000s hip
hop.
Speaker 2 (13:07):
Oh, right on.
Speaker 1 (13:07):
Yeah, you know you're playing, playing Lil Jon Radio
or Lil Wayne, like the vibe isis a little different than the
typical office space.
So we have an office spacewhere we can treat concussions
and things that nature, but wehave a gym.
That is where we do most of ourtreatment.
Um, or there there's racks andweights and BFR and four stacks
(13:31):
and med balls, literally tryingto tap into that mental space.
Cause, when you're hurt andthis is what's for me, it's like
when I was put on IR you'reessentially separated from the
team.
You're not in meetings.
Your treatment times aredifferent.
You are removed from the teamto a certain extent.
(13:52):
Yes, you still are a rosterspot or whatever, but IR is like
well, it's the next man up.
Speaker 2 (13:58):
in that sense, and what does that stand for?
Ir?
What is that acronym?
Speaker 1 (14:04):
Injured Reserve.
Speaker 2 (14:05):
Oh, okay, yeah, sorry Thanks.
Speaker 1 (14:07):
No, no problem.
So tapping into that space,like because a lot of people
they go once they get hurt highschoolers or whatnot they're in
a training room where you're notseeing the gym, or you're going
to a PT space that doesn'tnecessarily have weights and
racks and things.
So if you're in an environmentthat embraces, you know,
strength training and powertraining, things that you are
(14:29):
used to, like, we're positivelytapping into that mental space
like okay, even though you'rehurt, you're still an athlete,
we're still going to get youthere.
We're still going to tap intothat.
That uh uh, that psychologicalaspect of rehab.
Speaker 2 (14:43):
Oh, I love that.
My follow-up question to thatis where did you, where did you
get the confidence that thatwould work Like in a, in a in a
business perspective, because Ithink that you have a very
personal understanding of whythat environment would feel good
.
But where did you get theconfidence that that would work
for a clinic?
To set up your clinic like that, to play that kind of music and
(15:05):
to really set that environment?
Speaker 1 (15:09):
I think I had a multitude of different
influences, right?
So like what does my18-year-old son like to listen
to, like?
Speaker 2 (15:18):
what did he?
Speaker 1 (15:19):
listen to during his time in high school, kind of,
what are the kids listening tonow?
And then, you know, I had my,one of my clinical experiences.
It was a baseball focusedclinic and they worked out of a
gym sometimes too.
So just seeing that it couldwork in an actual gym setting,
even though they weren't thereall the time, the three or four
(15:41):
hours that they were there theywere seeing people on the high
schoolers on the table and theywere enjoying it and buying.
So just the different exposuresto it, um, and then you know,
ultimately I think it's justwhat would I have liked to be
treated in you know.
You know, if I didn't playfootball, what would I like to
be treated in?
But I want to be in a room, youknow where.
(16:02):
You know you're hearingelevator music or today's
hip-hop and R&B or somethingthat more so pertains to me,
pertains to my energy or what Iused to experience in the locker
room.
So, yeah, there comes a fearevery now and then.
Some people are like can youchange the music?
I'm not comfortable hearing theN-word in certain songs, yada,
(16:23):
yada.
So yeah, I'll appease them andI'll change the music Again.
Am I going to go Taylor Swiftradio?
No, we'll go clean hip hop andR&B.
We will make a shift.
I love it.
We just try to have a good timeand have energy, and I'm always
dancing, even while I'm treating, and singing and rapping,
(16:45):
whatever the case may be, andthat's just the culture that I
love to work in and I embrace.
Speaker 2 (16:52):
Yeah, I love that.
I'm just thinking of my own PTenvironment.
It's a little more clinicalthan that and I'm like, oh, this
would be so fun, because someof the treatments don't
necessarily feel perfectlycomfortable, right?
Speaker 1 (17:05):
And so I'm like if someone was like dancing.
Speaker 2 (17:07):
I'd take my mind off of it a little bit.
Speaker 1 (17:09):
Yeah.
Speaker 2 (17:10):
Yeah, would you talk to me about your brand and how
you came up with the name?
Between the Lines, I havesomething in my head that I
think it might refer to.
But and just talk about how youcreated that.
How did you create the brandoverall, the name, the logo, the
choices that you've made indesign in your clinic and setup
(17:32):
and all of that?
Speaker 1 (17:37):
Yeah, final clinical rotation.
While prepping for boards and,you know, putting the finishing
touches on the program, I juststarted throwing out a list of
names, that kind of you know howI would want to name the clinic
.
So I've always wanted to own aclinic Since I got into PT
school.
This is something that Ithought I could do, that I think
I was going to do it right outthe gate.
(17:58):
No, I thought I was going to golet's get some clinical
experience route, let's have amentor at another clinic.
I thought I was going topossibly jump on my last
clinical instructor, butultimately kind of settled on
the name between the linesbecause it's just an adage
that's always used, that I'vealways heard throughout my time
(18:19):
playing.
You know there's always betweenthe whistle, make sure the
plays are done between thewhistle, nothing after the
whistle.
The game is played between thelines, right?
And you think about every sport.
What sport doesn't require yourequire lines, right.
There's a start line, finishline in trail running and
cycling.
There's lines on track, there'slines at the bottom of the pool
(18:40):
, there's lines in football,like, every sport has some type
of line somewhere.
So what we're trying to do ismake you better between those
lines, you know, and the workyou do outside of those lines is
going to translate to betweenthose lines and how your
performance is, into that sportmentality where it's not just
(19:05):
isolated to rehabilitation.
We're rehabbing to sportsperformance.
So we're always trying to pushyou to jump higher, run faster,
feel more powerful, feel moreconfident by the time you leave
rehab.
I don't want you to just ACLsurgery.
Okay, you can walk and now youcan do all your strength
training yourself.
Well, why the heck did you doteri ACL in the first place?
What were these factors?
Okay, let's strengthen the core, let's strengthen your glutes,
(19:26):
let's bring in the cognitiveaspect, let's have you walk and
run through a play mentallywhile you're still doing these
exercises, just tapping intothose different aspects.
I feel that's kind of hard todo it without the gym.
So, like I said my lastclinical instructor, they worked
out of a gym, sometimes as well.
(19:46):
So I said, okay, I want to havea gym, I want to have a gym
lines as far as.
Does it have a gym?
Does it have an office space?
Is it big enough to kind offacilitate what we want to do in
(20:07):
the clinic?
And we landed on this space inCentennial.
And you know, you go throughyour whole business acumen.
What's the SWOT analysis?
So what's my strengths, myweaknesses, my opponents, my
threats?
You know what's the demographiclike.
Are we in an affluent area?
What are my goals once thisclinic's thriving day in and day
out, on repeat?
(20:27):
Okay, well, in order to provideno charge service once or twice
a month in an underprivilegedarea in Denver, we have to be in
an affluent area.
Okay, how many high schools arearound me?
I think there's 10 high schoolswithin 20 minutes of where my
clinic is.
So just there's a.
There was a lot of a lot ofmoving pieces as far as why we
(20:47):
landed in this place, why thename and kind of why.
Why that set up with the gym?
Speaker 2 (21:02):
here because there's so much of like knowing your
audience in these choices thatyou're making, in the thought
process behind the decisionsthat you're making.
So I think that, um, I thinkthat will help a lot of people
to hear how you achieved all ofthis.
Um, my next question is do youdo any marketing and how do you?
How do you manage kind oftapping into those 10 high
schools and getting people inthe door?
Speaker 1 (21:24):
So we I have done radio marketing one time and
that was a crash and burn.
You know it was 15, 20 grand.
That did absolutely nothing.
Not one referral from it.
So there's been a bigger push tobe a little more present on
social media.
I hate social media.
It's tough, it's the bane of myexistence.
To stay on top of it, to changemy algorithm, I'm gonna have to
(21:45):
hire somebody.
But but most of our, most ofour marketing is coming from
word of mouth.
Like we will go and do talks atlike a track team I even had, I
had my cousin who's Tyson Gay,who's the fastest American in
the 100.
Speak to the track team, youknow to tap into the athletic
components, like, okay, this iswhat it's like to get to the
(22:05):
next level he's talking about.
He did PT, he was alwayspracticing, even outside of
practice.
He did strength training andthen doing movement assessments
at these high school footballteams.
Trying to tap into thatfootball aspect and football is
very tough because you're tryingto break that old adage throw
some dirt on it.
Uh, you know, you know, pain isweakness.
(22:28):
Uh, leaving the body, yada,yada, yada.
Right, there's all these oldsayings with football and I feel
like football, is the one sportthat doesn't do a lot of
preventative care um outside of,like your strength training.
There's no, there's not a lotof mobility, extra mobility work
.
There's not a lot of okay, I'mgonna do this before the season
(22:48):
starts.
I'm only going to do it when Iwhen I get hurt versus like
baseball.
I think baseball is probablythe most preventative sport that
I've seen, especially pitchers,right, they're always doing arm
care, they're always doing hipmobility stuff.
They're always working onrotation, excuse me.
So that's so trying to breakinto that, break that old, those
(23:11):
old sayings, those old adages,those that old school mentality.
Um has been been tough, but ourbiggest bang for buck is just
word of mouth.
Our work speaks for itself.
You know, we I've been pushinggoogle reviews.
People are loving like avoidingsurgery and getting stronger,
or yeah or pr or they'resomebody's got.
Some of these individuals aregetting scholarships and I'm
(23:31):
like and I'm not taking anythingfrom because they're the ones
doing the work from the field um, but to get them back onto the
field to perform, to keep thatscholarship things of nature, is
something that we're very proudof here yeah, that's awesome.
Speaker 2 (23:44):
Uh, what, what is your?
You're kind of talking about itright now, but I wonder if
there's any anything more inthere, and how you approach
patients and how you, um, howyou think of that is like your
approach, and then not justyours as a practitioner, but
everyone in your clinic.
How is there like a unifiedapproach that you're going for
(24:05):
with how you interact withpatients in your clinic?
Speaker 1 (24:10):
No, I think kind of what I set forth is like treat
your own way, you know.
Right, we'll have huddles, youknow.
But how I treat might notnecessarily be how Linda treats
or how Mac treats.
But how I treat might notnecessarily be how Linda treats
or how Mac treats.
We all have differentbackgrounds and different
upbringings and have haddifferent experiences.
I like to dance and I like tosing and I like to shoot the
(24:33):
crap with patients and theirparents or whomever, just having
an actual conversation.
Linda's a little moreprofessional as far as how she
carries herself in, her acumenand how she talks and explains
to patients.
Mac has a military background.
So there's just these differentflavors here in the clinic.
But ultimately what ourconsensus is and what our goal
(24:54):
is is not to just rehab, it's tomake sure they are performing
better.
So now, like we've had thesehuddles, we've had these
discussions, we've had thesetalks, let's utilize the blaze
pods, let's utilize the soccernets that we have, let's utilize
all this extra equipment hereto help them be the best version
of themselves, whether that'sdance or whether that's soccer,
whether that's football,basketball, track, whatever that
(25:15):
case may be.
For me personally, my flavor islike kind of how I'm talking to
you now.
Right, it's like I'm very chill, very laid back.
Well, you know, I'm one ofthose PTs where I don't avoid
cussing, like if I want to cuss,like it's okay, I'm not cussing
at you, like, let's say, it'ssentence enhancers.
(25:37):
So sometimes I enhance mysentence a little bit like that.
But people relate to it.
I think there's even been astudy like PTs who are
practitioners who cuss aroundtheir patients, there's a more,
a greater relatability in that.
In that sense, yeah, I love thatyou know, yeah, so it's like
I've been able to buildrelationships with these
patients, these individuals.
Where, you know, I have acouple that I go golfing with,
(26:01):
there's a couple that I've gonecycling with, we've gone to
baseball, track meets, swimmeets all this in the community.
So I don't try to handcuff howthey treat Like everybody has
their different experience andone size doesn't necessarily fit
all right.
So we work as a team and ifsomething that I do is not
(26:23):
working, I have no problempassing the Mac or passing the
Linda and so on and so forth.
But we try to keep thatcontinuity of care as close to
consistent as possible.
Speaker 2 (26:33):
Yeah, I love that.
I love that you kind of alsojust letting people excel at
their own way of being as apractitioner.
I think that's awesome Onething.
Just to jump back to thebusiness side, one thing we know
that our community isstruggling with is just how to
(26:54):
actually do the nuts and boltsof their business and also kind
of getting ahead of the unknownif they were going to open their
own clinic.
And so I wonder if there'sanything that you could identify
that surprised you when youopened your clinic or the
process of running it or growingit.
And there's a lot of littlenitty gritty details like when
(27:14):
do you hire somebody, or what'sit like to negotiate a lease, or
do you sell inventory?
Like, is there anything likethat that popped in your mind
that you were surprised by, orthat didn't work and crashed and
burned like radio advertisingor anything like that?
Speaker 1 (27:30):
Yeah, yeah, no, negotiating the lease was
probably the tough part, right,because a lot of.
So I ran into a couple ofissues.
One where they would upchargebecause they found out what I
used to do.
There was a space that wassimilar size to here and they
(27:50):
were trying to charge an extra$1,500.
After he quoted me a certainamount Once, I told him okay,
sent all my financials, yada,yada, yada to prove that I can
afford the lease or whatnot.
Oh, actually the price is there.
So I've ran into that a coupleof times.
And then then there was a whole.
I haven't had a job in fiveyears, so I did two and a half
years of prereqs, two and a halfyears of the doctoral program.
Well, I still, I still have thefinancials for it.
(28:13):
But since I didn't have a jobfor five years, it was frowned
upon.
So a lot of there was a lot ofa lot of fear as far as taking
that chance, even though, hadyou know, you had your
collateral, you had things thatcould, essentially, if the
business failed, like it wascovered.
So that that was always thetough part.
And then trying to what the bigthing is that?
(28:35):
One of the nitty gritties andnuts and bolts that, you realize
, is like how much it costs tolike make it look your way right
so like contracting outanything.
So I remember getting quotes forhow to make this office space
and the walls and everythinglike that.
It was about 25 30 grand justin the actual office space.
(28:57):
Um.
So, fortunately for me, I had abuddy who he did pretty much
does all his house stuff.
I had another buddy who's donefloor stuff.
So we kind of did it allourselves in the front office
and it was just the supplies andit costs us.
You know, cost me $2,500 beerand pizza.
(29:17):
Pretty much that's all it costs, right?
So just finding ways to saveespecially as when you're new,
right, you're trying to savemoney because it takes a while
for you to make money there'salways some type of new overhead
that you're not worried about.
There's always hidden costs.
(29:37):
Like, if the toilet goes down,is that in your lease?
If the HVAC goes down, is thatin your lease or is that
something you got to take careof yourself?
So there's all these thingsthat you kind of have to worry
about.
Make sure you're looking atthat.
So a big bit of advice is justmake sure you have a lawyer,
make sure you have a businesslawyer to look over the contract
, make sure you're not gettingscrewed over To make sure, like
(29:59):
things are copacetic and this isnormal, because every now and
then they might try to sneaksomething in Can your cam stay
the same year in and year out?
Or are you getting a kickback?
There's all types of things, asfar as a business owner that
you're constantly worrying about.
I still worry about thingstoday, and I'm going on three
(30:20):
years.
And then to your question as faras when to hire somebody.
It's, it's, it's difficult withuh, with a cash-based clinic,
right, cause you're not always,it's not always you know 18, 20
referrals a day from insurance,right?
So referrals are coming fromthat word, that word of mouth.
So when?
When was I confident enough tohire somebody?
(30:42):
I hired Linda almost a year ago, a little more than a year ago
last year, and she was ready fora change.
She was at a cash-based clinicbefore, but the rates were low,
she wasn't getting paid as much,so on and so forth.
So what ultimately came down,what made my decision, is, as a
(31:06):
business owner, I need to hiresomebody, because everything
that I'm bringing in it's goingback to the clinic, yeah, yeah.
So that's not ideally what youwant to do.
You kind of want, you want, youknow some to go to the clinic,
but you want to also be able topay yourself.
So essentially I wasn't payingmyself, I was just paying the
(31:29):
clinic to keep lights on doors,open equipment, yada, yada, yada
.
So that was kind of where thatlooked like.
But also a big thing is like howto talk to your employees when
you're a cash-based clinic,because you have to build trust.
You have to build trust in thatcommunity.
Everybody trusts insurance,Everybody trusts wherever
(31:50):
they're referred to.
How do you build trust and howdo you build your caseload?
So it takes a few months tobuild your caseload in a
cash-based clinic, especially anew one.
Right, it's not like I hadpatients on deck for you, but my
thing is like I try to push youknow patients to them as much
(32:11):
as myself when they call or ifwe go to meeting or go to
pop-ups or things of that nature.
Okay, mac, linda, y'all got it.
Everybody who signs up, makesure you put them on your
schedule, you know, and I'lltake a seat back, cause I would
love to have time to just doadmin stuff or you know what
else do I need to do?
Okay, we're short on this, shorton this.
(32:33):
Okay, yada, yada, so on and soforth.
Um, or do the social media part?
So?
Um, there's just, there's justa lot of hidden things in
business and you'll get yourbumps and bruises along the way,
right?
That's kind of the flow ofbeing a business owner, like you
got to roll with those punchessometimes.
Speaker 2 (32:54):
Yeah, you've mentioned Cashbase Clinic a few
times.
Could you just talk a littlebit?
So our listeners are going tobe somewhat based in Canada,
somewhat based in the UnitedStates, but I wonder if you
could just talk about yourdecision to be a cash-based PT
clinic and just what you knowabout the insurance side of it
(33:17):
all, how you made that decision.
I think that's really what I'mcurious about is how you made
that decision.
Speaker 1 (33:25):
Well, I made that decision because I have kids and
seeing 18 to 20 people a dayand then having to do those
notes at home kind of, wouldjust negate my time as a father
right.
Like, my kids are in gymnastics, swimming, soccer, want to play
golf.
You know football.
My oldest is in Ohio so I gotto fly out there, right.
(33:47):
So there's a lot.
There's a lot of moving piecesthere.
So what would give me the bestopportunity to remain a dad
Right and not just be drowningin all this excessive paperwork
and insurance and having tofight for all these visits?
Secondly is what would I preferas a patient?
Would I prefer 20 minutes onthe table and then I do a couple
(34:07):
of exercises here and I'm out?
Or would I want the 30 minutes,40 minutes on the table?
Then we use the last 20, 30 todo exercises strengthening,
reinforce, kind of what we did.
And then, thirdly,reimbursement rates.
Reimbursement rates areterrible, especially out here in
Colorado.
I know Virginia is a lot betterthan here, but in Colorado
(34:33):
reimbursement I think on averageis between 40, 50 bucks for a
30-minute session, right, andthen premiums have gone up.
Reimbursement continues to godown.
So now I would have to see morepatients.
So doing my analysis and myspreadsheet as far as what it
(34:55):
would look like to break even ina clinic that's cash-based,
with an average of $45 roughlyversus an average of $172 per
patient, I'd have to see 13, 14patients a day in a 19-day
working month to break evenversus to break even.
To pay myself everythingoverhead, I have to average four
a day at the $172.
Speaker 2 (35:17):
Right, that's a big difference.
Speaker 1 (35:19):
That is a huge difference, right.
That's four hours of treatment,or seven hours, roughly every
30 minutes.
Speaker 2 (35:27):
Yeah.
Speaker 1 (35:28):
At 14 people.
Yeah, it's a huge difference totry to find that work-life
balance and not be bombarded bynotes and, yeah, ultimately,
that's's why those are the threereasons why I decided to go go
to cash base route, and it'sscary for a lot of people that
(35:48):
they think that right, but goout there and not have these
constant referrals comingthrough.
Yeah, but there's so much valueand when people when people
understand and see andexperience the value of going to
a cash-based model, not just asa business owner but as a
patient, that's okay, cool, thisis great.
(36:11):
I'm actually getting better,faster and paying less than what
I would if I did thetraditional route.
Speaker 2 (36:17):
Right.
Speaker 1 (36:19):
Right, and there's so much education We're're
constantly doing education withpatients like super bills.
How does that work?
All we are seen as an out ofnetwork provider.
What does it look like?
They should be able toreimburse you not reimburse, but
maybe put it towards yourdeductible or out of pocket max
or something along those lines.
(36:39):
Like there is a way for you toget get your money back, or
something along those lines.
Like there is a way for you toget your money back.
But who wants to read those 20,30 pages of insurance jargon
that you get when you sign upfor?
your insurance right.
There's so many little nuancesthat unless you're there going
through it or you're ahealthcare professional, you're
not going to understand.
Speaker 2 (36:59):
Yeah, long ago I worked in a couple of clinics
and one of them my job wasactually to handle this process
of billing insurance when theydon't pay.
That clinic hired a person fulltime to just like go in, and
this was before it was allonline, so it was on the phone
basically all day talking to theinsurance companies like so
what do you think about this?
And a lot of times it wouldjust be like the code was wrong
(37:23):
or something, and so it was justlike such an administrative
hassle but a whole human fulltime just to get that percentage
paid.
Yeah, yep, yeah.
So tell me more about whatyou're doing to educate patients
on the insurance.
Is this just a conversationthat happens at the front desk,
or how do you actually pass thatinformation to them in an
(37:45):
effective way?
Speaker 1 (37:47):
So I'm hoping to do a little, hoping to do a forum at
some point in time to anypatients to jump on Zoom, kind
of educate them about Jane andinsurance and how to navigate
that space, understanding whatto look at, why they should
reimburse you, all thesedifferent things.
(38:09):
But there's a lot of educationthat happens on the phone.
There's a lot of education thathappens when I'm selling
packages, right?
So the big thing for a lot ofpeople is like okay, well, that
is a lot right.
Speaker 2 (38:21):
Yeah.
Speaker 1 (38:21):
Say, our 10-pack, that's 10-pack and an eval is
almost two grand.
Right, but the education pieceof it it kind of circulates
around.
Okay, we can provide you superbills, so you should get 70, 80%
of that back towards yourdeductible or out-of-pocket max
or, if you met it post-surgery,all of it back to your pocket.
(38:42):
But also the fact that we'renot trying to burn through your
visits, so like we kind of setup a plan where, okay, you get a
10-pack, I'll see you twicethis week, twice next week.
Oh, you're doing better, yourpain's at a two, three versus
that six, seven.
Okay, let's go once a week.
For the next two, okay, it'sstill sticking, all right, let's
face the other one two weeks.
All right, let's face the lastone a month.
(39:03):
So now a 10 pack is roughly fourmonths, the startup, the
beginning of the fourth month.
So kind of try not to burnthrough those visits unless they
absolutely need it.
I'm not, I'm not here, justlike, let's just burn, burn,
burn, burn, burn, burn, causethen it just seems like we're
just taking away the reason whywe're doing it.
(39:23):
We're doing it to get thembetter, we're not doing it just
to bring in as much money aspossible.
If that was the case, then we'dgo to that insurance-based
model.
Speaker 2 (39:33):
Yeah, yeah, interesting, so fascinating.
Is there anything that youwould advice that you'd give to
a clinic owner who's trying tomake this decision for
themselves?
Speaker 1 (39:50):
I mean my, my advice, especially a clinic owner who's
trying to make like, educateyour patients, that you're you
might be making that shift Right.
Educate your patients if you'redropping their insurance, maybe
you're not dropping all of it,maybe you're dropping some but
also making sure, like you cando the insurance in the
(40:13):
cash-based model and just makingsure it's like, hey, do you
want to fight at the end of your20 visits for an ACL and
possibly get denied for thoseextra visits?
Or you can go the cash-basedroute and I can give you a
discounted rate per visit and wecan possibly even do longer
visits now that we're notdealing with insurance.
So, just being confident andcomfortable with that
educational piece with thesepatients, because it is scary.
(40:37):
It's scary.
It's like, oh, wow, I'm payingtwo grand here, but in that same
breath breath especiallydepending on what area you are
like is it very sports driven?
Because you know some of theseleagues they're paying five
thousand dollars for the leagueyou know, just for the spring
ball or whatever, uh, springbaseball or all these camps that
they're going to or to be onthis national club team.
(40:58):
Like there's so much moneygoing into that it's like some
of them probably won't have aproblem paying it for health
care, as long as you justify why, why they need it.
It's always one in that.
Why?
What can you do as a pt thatmay be different than what the
coach is doing, or the strengthconditioning performance coach
(41:21):
like, what can you do?
That's that sets yourself apartI love that.
Speaker 2 (41:26):
You just said that it really aligns with another.
Um, we wrote this article for aprint magazine how to raise
your fees, and it's it's allabout like feeling confident in
in that act of charging peoplemoney for health care and that
people actually want to give itto you because they want the
healing, or I don't know if I'msaying this correctly, but
(41:46):
there's a mentality there oflike of feeling confident in
that, and I think that it's itcan apply to different segments
of this conversation, likeraising your fees or even just
like, how do you set up your,your revenue model for your
clinic?
So, yeah, that's super helpfulyeah, absolutely.
Speaker 1 (42:06):
I think, just doing some research too about what's
going on around there, likeeverybody's talking about, like
my price.
Some people say, oh, yourprices are high, lend this
clinic.
Compared to mine, yeah, myprices are almost two times as
much as what they were chargingthere, but there's a clinic down
the maybe 10-15 minutes away.
That's actually.
They were charging there, butthere's a clinic down the maybe
10, 15 minutes away.
That's actually.
They're charging essentially$50 more than every follow-up
(42:30):
visit.
That I am right.
It just all depends on kind ofthe area you're in and kind of
what are your goals and whatallows you to feel comfortable
to treat for 45 minutes or anhour, like what's?
How allows you to feelcomfortable to, you know, treat
for 45 minutes or an hour, likewhat's?
How do you value yourself?
Like we all have school debt.
(42:50):
You know.
Like everybody in the healthcare space has school debt.
What's going to help you paythat you know.
And what's going to put food onyour table and take your kids
to all these activities, and Ifeel like that's kind of the
norm.
We undervalue ourselves and Idon't know why, as PTs, we
(43:12):
undervalue ourselves so much.
Is it because we're still seenas a service here in the States
and not seen as a doctor in theinsurance world.
That's why they keep cuttingand cutting, cutting prices,
even though we have to get adoctorate now, yeah.
Or is it because we're sodriven to, you know, be kind and
(43:35):
friendly and provide the bestcare possible, and like we want
to help our people, but we, wesacrifice ourselves for it,
whether that's time or money.
I feel like it's just a normthat we constantly deal with or
that I constantly hear fromother PTs.
Speaker 2 (43:54):
Yeah, yeah, that's so interesting.
I think that applies across allof the disciplines that we come
across at Jane as well, so Iappreciate you saying that so
much.
I also want to talk about somethings that you do outside of
your clinic.
So would you mind going throughyour charity a little bit and
(44:16):
telling everyone what you dothere, and one what it is, how
you came to have that and thenhow it relates to your
underlying ethos as a personwho's interested in health care?
Speaker 1 (44:29):
Yeah, absolutely so.
My foundation is calledBruton's Books and it's geared
towards childhood literacy, k-3,third grade here in the Denver
public school system.
We've been founded since 2015.
So we were very active in2015-16, kind of got a little
slow during my time in schooland kind of slowed with COVID,
(44:52):
but revamped back up.
We came up with the nameBruton's Books because of
alliteration and obviously it'sliteracy, so we thought that was
pretty clever.
But ultimately what our missionis is to address accessibility
in the DPS area.
So I'm in a very affluent area.
It's Cherry Creek SchoolDistrict.
(45:12):
Every kid's one-to-one as faras iPads, google Chromes and the
libraries are ginormous.
They have all these books, yada, yada, yada.
But in DPS, in the Denver PublicSchool System, there's been a
big shift as far as culturalinfluences, demographics, people
moving in and now staying.
(45:32):
So what we are trying to do isaddress that accessibility as
far as culturally enriched books, like that relatability piece
to what you're reading, becausethat's going to be a motivating
factor.
Right, and I seen it when Iwould go talk to the schools.
Or sometimes when I go talk tothese underserved and
underprivileged schools, like,oh, it's a black man who played
(45:55):
football but also went back intoeducation and he's a doctor,
and he's a doctor, right.
So like that is a motivatingpiece, instead of having
somebody who doesn't look likeyou come up there and talk, say,
hey, you can do it, you can dothis, you can do that.
You know, there's a look andI'm not saying there's nothing
wrong with it.
I think if you can get up infront of somebody and try to
motivate them by all means, butthere's something to say with
(46:19):
that relatability piece, thatgoes a long way and it's the
same.
It's the same with the book.
You know, if you're reading uh,junie B Jones, right, and it's,
it's a young white girl in abook and you're a young black
girl.
Like, are you going to berelating to that?
Right, you got to findsomething else that that may
most more so pertains to you andyour culture and things of that
(46:42):
nature.
So, ultimately, what we doevery year is we the last three
years is we do a golf outingwhere we raise funds to purchase
iPads, to purchase books andpurchase two years of
supplemental programming onthese iPads so kids can learn as
(47:04):
well as parents can have accessto it via their computer or
something along those lines,whatever they have at home to
keep track of what their kidsare doing.
So, dps, I don't know howfamiliar you are with our prison
sizes and things like that, butbased on our third grade
reading levels, is what ourprison sizes and things that,
things like that, but based onour third grade reading levels,
(47:25):
is what bit is what our prisonsizes are based off of really?
So, whatever you're reading atthere, yes, so we did.
There was a research done bymaha united way that prison
rates, prison sizes, are basedon third grade reading levels
whoa Whoa.
Speaker 2 (47:42):
No, I did not know that.
Speaker 1 (47:44):
Yeah, so that's kind of why we focused on K through
third grade.
So kindergarten through second,we're learning to read.
Third grade is huge.
Now we're getting to the pointwhere we read to learn.
So there's definitely a shiftas far as what the purpose of
our education is.
Speaker 2 (48:00):
This one was David Bruton, and I love talking to
him so much because, I mean,obviously it's fun to talk to
somebody who has had aprofessional sports career.
What I loved about it, though,was that we didn't really dwell
on that too much.
We're able to really get intohow he's building his business
and maybe how that previous lifeand experience informs how he
approaches his clinic.
That was really fun, and one ofthe things that I caught was
(48:24):
how the clinic culture is reallyimportant to him, and, in
particular, he's trying tocreate this vibe of the
positivity that he experiencedin a professional sports locker
room, and he's trying to providethat for his patients and
clients now, who are athleteswho are working really hard to
be great at what they do, sothat was really fun to hear.
(48:44):
Another aspect of that wasalmost veering into his approach
to the treatment outcomes, butit was really a comment on how
he puts his patients first, andI think what he was trying to
say is that, if you go by thebook, you kind of were trying to
get patients to like 100%, butin practice, especially with
(49:04):
athletes who are pushing reallyhard, that the goal is really to
get them good enough so theycan get back out there, and I
thought that was just a reallyfascinating part of his business
model.
The other piece that was, Ithink, really helpful to a lot
of listeners out there was hischoice around having a
cash-based model, and for him itallows him to have a much
(49:26):
shorter workday, sometimes likea four-hour workday, I think he
said, which gives him so muchmore time, one to focus on the
business as an owner and thenalso, of course, more time with
his kids.
So that was really cool.
And then I really pushed to askhim about how he educates his
patients on the benefits of howthat cash-based model works,
because sometimes they need togo and then send the insurance
(49:48):
documents to the insurancethemselves.
So that was a reallyinteresting part too, that the
education of his patients abouthis business model is so
important.
And then I really loved hearingabout his charity Bruton's
Books.
Loved hearing about his um, hischarity Bruton's Books, and if
you if that's not going to makeit into the final cut, you can
(50:09):
go look that up called Bruton'sBooks and it's how he's focusing
on improving third gradereading averages in the Denver
region and such a great littleum thing that he's doing there
and trying to make a realdifference in people's lives and
how they can grow up and make adifference themselves.
So hopefully this was a goodepisode.
Chat soon.
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