November 18, 2025 • 52 mins
In this powerful conversation, Will and long-time friend Dr. Dimitrios Kostopoulos dive deep into the most critical challenges facing physical therapy private practice owners today: low reimbursement rates and the crippling staffing and recruitment crisis.
Dr. Kostopoulos shares the origin story of HODS, revealing the "ultimatum letter" in 2002 that forced him to pivot from being an "effect" to a "cause" in his own business. The discussion highlights the unsustainable disparity in reimbursement between private practices and large hospital organizations, and how this directly fuels the current struggle for talent and profitability.
What You'll Learn:
- The two major themes causing PT burnout and the industry's "massive exodus."
- Dr. Kostopoulos' powerful advocacy plan for the APTA to lobby for an exemption of the $\$100,000$ H-1B visa fee for physical therapists to solve the immediate staffing shortage.
- The three ways any private practice can grow their bottom line, and why cutting expenses is the lowest-yield activity.
- Will's proven, high-yield solution to the staffing and time crisis: Virtual Assistants (VAs).
- Why Dr. Kostopoulos and his partner sold the physical therapy component of their organization to focus on diagnostic testing and industry education through HADS.
- A combined final takeaway: The importance of hope, action, and refusing to live in the "zone of maybe."
This is an essential listen for any private practice owner looking for actionable strategies to improve profit, gain time, and secure the future of their practice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_03 (00:00):
We received a letter from an insurance carrier that
they were cutting reimbursementsfor physical therapy from
hundred and forty dollars downto sixty.
So um and that was the letterthat changed everything.
They gave us at that time anultimatum stating that hey, if
(00:22):
you do not if you are not gonnaaccept this um by January 1st,
that the rate change, then youdrop we drop you from the
network.
Yeah, it was an ultimatum.
So see, many times we talk aboutcause versus being effect, and
(00:43):
at that time I felt that I wasthe effect, not not cause.
But we had to do something tochange it.
SPEAKER_00 (00:54):
Well, Demi, I'm so excited to be with you today.
It's been a few months or yearssince I've seen you.
It's been very you're someoneI've known for a very long time.
And man, I sure appreciate youspending some time with me
today.
SPEAKER_03 (01:05):
Uh, likewise, it's it's it's been a long time, and
um you have um uh a tremendousevolution um since the time that
I have met you, and and you haveuh, besides all the other
business endeavors, you have youhave an amazing podcast right
now.
And uh um I'm I'm very excitedto kind of uh share this uh
(01:31):
podcast with you now, from mypodcast to your podcast, from
your podcast to my podcast, andand uh it will be awesome.
SPEAKER_00 (01:40):
Well, and it's such a cool moment for me because um
you, as I was a physical therapypractice owner, as my audience
knows, and maybe yours doesn't,but I was a PT owner who was
really wanting to make a bigdifference in the industry, and
that's when we found you.
And we the the we found youthrough um a common connection
in Florida.
Oh, um I'm forgetting whichwhich of our which of our
(02:02):
referrals it was, but he was ata miserable solutions
conference.
SPEAKER_03 (02:05):
I think it was Dan actually.
SPEAKER_00 (02:07):
Dan, it was yeah, Dan Sage.
So, Daniel, thank you so much,buddy.
We wouldn't be here without you.
And he was talking about thisEMG thing and diagnostic
ultrasound and how not only wasit higher reimbursing, but more
importantly, it was totallychanging how patients were
getting healthcare in physicaltherapy, and it made us
diagnosticians versus being, youknow, healthcare providers that
(02:32):
get referred out to like aprescription.
And so when we met back and itwas 2014, I think it was 2014 or
15.
SPEAKER_03 (02:38):
Yeah, I think 14 or 15, yeah, you're right.
SPEAKER_00 (02:41):
Yeah, I mean, who'd have thought that we would have
evolved the way that we did?
I I know we were the sixth, Ithink, client of yours.
We were in the first 10.
I know that early the earlydays, yeah.
And how how many companies areyou partnered with now?
SPEAKER_03 (02:56):
Ish?
Gosh, um, we have right now, Ithink about 65 companies, 245
locations.
Wow.
Um, like I think 31 differentstates.
So that's yeah.
SPEAKER_00 (03:15):
Amazing.
You know, for my audience sideof things, can you share why you
decided to do hands-ondiagnostics?
Why are because you're a medicaldoctor, like I'll say in my
intro, and a physical therapist.
You have both of these likecombined talents.
What was it about the industrythat had you want to jump into
it?
SPEAKER_03 (03:34):
Yeah, look, uh uh, I mean, definitely uh, first of
all, I was involved in uh uhelectrodiagnostics from the
early days of my practice, likeuh Costas and I, my business
partner, um, we opened the firstphysical therapy office back in
(03:56):
1992.
Wow, very early.
What how old were you, Will?
I was I was um 16.
I I I had that number.
I had that number in mindexactly.
So anyway, um we opened that uhoffice and and we did very well.
We grew um rapidly and uh umright around um 1996, 95, 96, I
(04:25):
was like, okay, I want to dosomething more, I want to do
something different.
Meanwhile, I had a bunch ofFrench um physicians who were
performing electrodiagnosticstudies at that time, and I did
see um a flyer advertisementabout these guys from the US
(04:47):
Navy that they had physicaltherapies, that they had studied
electrodiagnostics and they wereteaching others.
And I joined at that time myvery good friend uh Rick Nielsen
um and uh we did some trainingwith him, and I started very,
very slowly um doingelectrodiagnostic studies.
(05:11):
But the point that uh pushed meand to develop this as a real
business is actually the samechallenges and problems that
physical therapists have rightnow.
It was about reimbursements, itwas about reimbursements that
(05:32):
yes, on the one hand, we couldsee back then some uh clinical
utility, some clinicalimportance, clinical
significance ofelectrodiagnostic testing, but
uh we could have never fathomedhow to take this and create a
business opportunity with it sountil um we started facing some
(05:56):
of the industry uh uhchallenges.
You know, when I talk to people,actually Will many times I say
um you know that we received theuh letter that changed
everything.
SPEAKER_00 (06:11):
What letter was that?
SPEAKER_03 (06:13):
What letter was that?
I'll tell you exactly that itwas um two days before
Thanksgiving of 2002.
Meanwhile, we had reallyexpanded our practices.
We had opened, I think at thattime we had 13 um uh physical
(06:36):
therapy locations, and wereceived a letter from an
insurance carrier that they werecutting reimbursements for
physical therapy from$140 downto 60.
So um, and that was the letterthat changed everything.
(06:56):
They gave us at that time anultimatum stating that hey, if
you do not if you are not gonnaaccept this um by January 1st,
that the rate change, then youdrop we drop you from the
network.
Yeah, it was an ultimatum.
So see, many times we talk aboutcause versus being effect, and
(07:21):
at that time I felt that I wasthe effect, not not cause.
So we had to do something tochange it.
SPEAKER_00 (07:29):
It's interesting that this is a story that still
exists today, that people areexperiencing this, maybe even
more so.
But that was the same thing thatyou said that started this whole
journey for you to go, wow,reimbursement for what we do is
not representative of the valuethat we bring.
And you were and you had achoice.
Could I be at the effect of thisor could I be at cause over this
(07:52):
situation?
So it sounds like Hods was yourway of being at cause.
SPEAKER_03 (07:56):
That was that was that was a way of of of being of
being.
Yeah, but let me ask you this.
Like you you speak some people,right?
You you speak to you have yourpodcast, you have your uh
consulting clients, you haveyour um uh conference and and
and and events that you putaround the country.
(08:19):
What do you see what what arethe common themes that that
physical therapy, especiallyprivate practice owners, come to
point and and and complainingabout or seeing as challenges?
What's the common theme themesthat you see?
SPEAKER_00 (08:37):
You know, there's an there's an overarching
singularity, and then there'sthe subcauses.
The subcauses look likerecruiting.
The one thing I hear in myworld, since I spend a lot of
time consulting on recruiting onhow to hire physical therapists
or how to develop people,they're the most overwhelmed
when it comes to that initially.
(08:58):
And that just might be how theyshow up to me directly, although
I know it's an industry problem.
The second thing isreimbursement.
Reimbursement between those twothings alone, they just that
becomes the singular issue ofjust not feeling in balance in
life.
And it's that's a horrible word,balance, because you know, I
don't I don't really trulybelieve in balance.
(09:20):
But what the better way ofsaying it is that they don't
feel in exchange with their ownbusiness.
They feel like their businesstakes way more out of them than
they get back in return.
So, like in terms of time andmoney that they invest in, what
they get back in terms of timeand money is so skewed that we
use industry, you know, commonwords like burnout or um, you
(09:43):
know, the fact that people areleaving the industry more than
entering it.
There's this massive exodus.
And it's so interesting, Dimi,because as you know, there is
such a demand for what we do.
Like that's right, this is thisis the opposite environment
where those events should beoccurring because there is so
much demand for it.
But it comes down to, and thosetwo issues of recruiting and
(10:05):
reimbursement are sointerlinked.
If we had more money, we couldhire more.
If we could hire more, we couldmake more money.
But it it comes back to yourcore reason as to why you
started the hands-on diagnosticseminars because at the end of
the day, what we get paid pervisit by the insurance is the
driving force.
That's the in I that has to bethe first thing that's causing
(10:26):
all this.
Because if that was triple whatit is now, people would be
staying in the industry.
We could pay people more, we'dhave more profits the whole nine
years.
SPEAKER_03 (10:33):
And and and and we see the application of this
actually right now in therelationship between private
practices and hospitalorganizations.
So you're talking about aboutrecruitment, right?
Right.
Uh, and although the numberschange from year to year a
little bit, but we are producingabout 5,000 less physical
(10:59):
therapies every year than whatthe industry really requires,
right?
So 5,000 less up to now.
Now, moving forward, this isgoing to become even more
challenging.
And I care less about the um uhpolitical persuasion of anyone
(11:21):
who is watching the podcast,your podcast, or whoever I talk
to.
But it is a real challenge.
Private practice, physicaltherapists who in larger
metropolitan areas, they wererecruiting therapists,
foreign-trained therapists fromother countries, from India,
(11:43):
from the Philippines, fromAustralia, from various places
like that.
SPEAKER_00 (11:48):
Now, a private practice has to pay$100,000
application fee to apply forsomeone to come in uh with an H1
visa, provided that they can'tkill that killed what I thought
was the only viable solution.
Because when we had, I was justin my coaching world about six
(12:10):
months ago, we were reallytrying to figure out because
there's already some challengearound that.
You've got to the person has totake the the boards in the
United States.
So you're flying people from thePhilippines, for example, to the
to Hawaii.
And so you're looking at about a$20,000 to$25,000 cost that has
some risk already tied to it,and then the government threw a
hundred thousand dollar uhpenalty or whatever it is, like
(12:32):
fee to in order to do that.
So that killed the only viablesolution, which for me I loved.
I loved bringing people in fromother countries and to solve
that problem for us because thenit would increase our
profitability.
SPEAKER_03 (12:43):
I mean, look, uh I came to the country uh initially
as a student with an A-sponsoredvisa.
I didn't know that in the past,yeah, in August of 1987.
World were you both?
Okay, so we were both younger,that's for sure.
SPEAKER_00 (13:03):
We I always think of us as the same age, and for what
it's worth, you look better atyour age than I do at mine.
Like, I'm looking the wholetime, I'm like, where are his
wrinkles?
Anyway, so yeah, I I get it.
You were here on a visa, andthat's like the whole point of
this thing is is that we're ableto take the I not just the
country of America, but theidea.
I mean, there's again, I'm not Idon't want to get into a
political thing.
People have all sorts of viewsabout the border control, but
(13:25):
getting people in legallythrough visas who want to
provide health care.
No, those are people we have towant to support.
We want those people.
SPEAKER_03 (13:33):
So so so here is what I I am going to advocate.
I got actually the agreement ofthe HADS group to advocate.
And I am asking you also if yougot it, agree on this to join me
in this advocacy, advocating tothe American Physical Therapy
(13:54):
Association to utilize theirlobbyists to advocate for an
exemption of the$100,000 H1B feefor professions where there is a
significant need in the UnitedStates, such as physical
(14:17):
therapy.
Because let's get this now.
If who is gonna afford$100,000?
Private practitioner is notgoing to, but the either larger
national organizations orhospital organizations, perhaps
(14:38):
they'll be able to afford thehundred thousand dollars with a
contract that they'll stay withthese organizations for the the
employee will stay for fiveyears or so.
So so but but that is a problemfor the uh private practice
small business owner.
So I'm advocating that the APTAutilizes their lobbying
(15:04):
resources to actually lobby thatthere is an exemption for
specific professions,specifically for the profession
of physical therapy for um forthe H1B visas.
Um, yeah.
SPEAKER_00 (15:18):
Yeah, I'm in.
I we are 100% supportive ofthat.
I think that's makes so muchsense because I don't know
anything outside of my narrowscope.
So, like if the$100,000 thingmakes sense for legal or for
other professions where thatmoney is a little bit of a
sting, but it's not a big deal,okay, great.
That brings us more money,whatever.
But for physical therapycompanies, I love the H uh B1 Vs
(15:43):
or H1V.
I'm always dyslexics, whatever.
H1B, those visas are so vitalbecause they allow us to the
high overseas, and it it's noteven a smooth process without
the$100,000 thing.
So if anything, I would love tofind ways to simplify that
while, and it's not thelong-term solution, in my
opinion.
I would love to hear yours.
Um, I don't think that's thelong-term solution because we're
(16:05):
still fighting a diminishinggame with reimbursements, but at
least it provides us with somespace to be able to get
profitable, to organize andfight, because we don't have
time as the private practicesector is what's going to save
our industry or transform ourindustry.
And right now we just don't havetime to go lobby or like if
we're too busy treating crazyhours or running around trying
(16:28):
to hire full-time.
What are your thoughts on that?
SPEAKER_03 (16:30):
All right.
So, my thoughts on that.
Um, first of all, um what willreally create a significant
difference is a positivedifference, is parity.
Parity in reimbursement betweenhospital organizations and
(16:56):
private practice privatepractices, private practice
physical therapy.
So here is what happens rightnow when it comes to commercial
insurances, uh hospitalorganizations they are able to
uh retrieve significantmultiples of reimbursement
(17:19):
compared to a private practicephysical therapy, and there are
websites where you can go,because this is now public
information, where you can goand see the reimbursement
precipity code.
But I'm gonna give you a verysimple example.
For uh let's say a visit on apatient where a private
(17:39):
practitioner receives$85, forthat same visit a hospital
organization will receive morethan$300.
This is not only limited to umcommercial carriers, it extends
also to uh um Medicaid andMedicare Advantage, not the
(18:08):
straight Medicaid, not thestraight Medicare, because there
there is um you know a littlebit of difference, but not
significant difference.
But the advantage plans theyhave also three or four times
greater reimbursement withhospitals.
So what happens now is largeorganizations um in private
(18:34):
practice who own five hundredfacilities, six hundred
facilities, a thousandfacilities in various regions
they collaborate with hospitalsso the hospital rates extend to
those private practiceorganizations.
(18:54):
And they are able to have thosesignificant rates, and then we
have competition for the smallprivate practitioners, small
business uh physical therapists.
We have competition not only bythe hospital itself, but also by
those larger organizations thatnow their reimbursement
(19:18):
increases significantly, andthey have to and they can
compete for um the same physicaltherapy talent, but paying them
a lot more because they canafford to do that.
SPEAKER_00 (19:32):
It's interesting to me that these groups are
actually getting increasedreimbursement because that shows
that there's there's a battlethat's being won, of course, by
the bigger companies, but theyare winning.
Like if they're increasing, itreally kills that that
individual who's just dreams ofhanging their shingle one day
and having their own practice.
(19:52):
But it the only positive Ireally hear from that is well,
at least some groups are able toget with insurance companies and
fight.
It just puts us in a position oflike, well, how do we do that?
How do we do you have thoughtson how we as a group so look?
SPEAKER_03 (20:05):
Here is King, right?
There are three things thatsomebody can do to um increase
um their bottom line.
They cut our expenses, and theycan increase our revenue from
their existing business, andthey can add additional revenue
(20:31):
from related businesses that canbe incorporated within their
organizations.
Now, the very first thingcutting expenses is probably the
easiest thing that somebody cando with only short-term result
and low yield.
(20:52):
Because what are you going tocut?
Can you cut your rent ormortgage?
No, because that is what youpay.
You probably have a lease, youprobably have a mortgage.
It is what it is, right?
At the end of the day, you haveto have the space to see your
patients.
(21:12):
Are you gonna cut salaries?
How are you gonna compete in themarketplace if you cut salaries?
You're not gonna be able to.
And your uh uh the towels thatyou use in your office?
(21:36):
Fantastic.
You did it, you saved$55 amonth.
Great win.
Let's go have a beer.
SPEAKER_00 (21:43):
Uh beer, by the way, costs$55.
Yeah, the round of beers cost$55, but yes.
SPEAKER_03 (21:50):
So it's it's it it's it's a low-yield um uh type of
activity to decrease expense.
Now let's look at increasingincome.
Increasing income from yourspecific service line of
physical therapy can be done byum negotiating rates with
insurance carriers.
(22:12):
Okay, you may be able to joinsome IEPA and join forces with
other physical therapists, andthen you can go and try to
negotiate those those rates to arelative success on your region.
Um, you try to go cash also insome cases where pay uh um you
(22:37):
can uh manage to get some betterreimbursements uh directly from
patients, or then you addservices that uh where you are
able to uh receive much higherreimbursements, and those
services can be quite a variety.
(22:57):
You can have some cash-basedservices where they are unique
in nature, uh, where no othertherapists offer those services
around you, where you have anincredible marketing plan um and
approach where you are able torecruit patients who are willing
to pay$150 to$200 for that.
Or you add um reimbursableservices by insurance company
(23:23):
that have a multiple of what youpay for PT, such as diagnostic
testing, EMG, ultra pay three toten times more than what PTV is.
And and this pretty much at themath unfortunately will by 2028
(23:43):
it is anticipated that 50% ofthe existing physical therapy
private practices will beacquired by larger corporations.
SPEAKER_00 (23:57):
How what percentage was that again?
SPEAKER_03 (23:58):
50%.
SPEAKER_00 (24:00):
50% of all physical therapy, outpatient, private
practice will be acquired bylarger practices.
SPEAKER_03 (24:04):
Correct.
That's that's what the number isright now by the year 2028, the
estimate.
Um if we if we ate the entireoutput of physical therapy, the
entire physical therapy,inpatient, outpatient, private
practice, large entities, 34% ofthe entire PT is being delivered
(24:31):
uh by private practices.
Okay.
So imagine that um when largercompanies take over half of that
34%, so you're gonna have only17%, the entire PT industry
being served by privatepractices, small private and
(24:52):
medium.
SPEAKER_00 (24:52):
But that scares me for so many reasons, and I think
you know this as well as I do isthat what makes any uh unique
physical therapy practicesuccessful is the passion and
the creativity of theindividuals who are giving care.
And you can't find a morepassionate or creative group
than a private practice becausethey are they are the ones who
(25:14):
hung their shingle, they're theones who put the risk up.
They care arguably more aboutthe patient experience in
general.
Now, you'll get somestandardized care with larger
groups for sure, but I worryabout that devaluing what we do
to be more of this service thatgets referred out to, and we
only focus on routine care itemsversus becoming doctors in our
(25:37):
community and having those deepemotional relationships, which
is what drives you and I.
What we care about is the bodyand soul of each patient.
And and people go into physicaltherapy for that, don't they,
Deanny?
Where absolutely yeah, I mean,look, the people who get into
physical therapy school, theyare the ones who are in a very
interesting niche.
(25:57):
They're they're definitelyintelligent enough to go to a MD
type program, but they choose togo this route usually, not all,
but usually they they are, andthey choose to go this route
because what they really careabout is the connection with the
individual, combined with thefact that they love anatomy in a
way they get to work with itmore over time.
(26:18):
But in exchange of that, theygive up their profit.
I told my wife this, Dimi.
I remember when I became aphysical therapist, the day I
got my license.
This was in the early 2000s.
My wife and I didn't have anykids.
I was in my 20s.
And I remember turning to herand saying, Man, honey, um, we
we're not gonna be wealthy onany level.
(26:38):
I just want to prepare you forthat.
We're never gonna be wealthy,but I am gonna be happy because
I'll be serving people.
And that is, I think, a greatyou know, example of what most
people feel when they become aphysical therapist.
They're looking, they, they,they're driven by those same
things.
And I was I was wrong on bothcounts, by the way, but it's one
(26:58):
of those things where I'm justkidding.
But it's one of those thingswhere it's it's really it's
unfortunate that we would getour basically our our our whole
industry, the vast majority savethat 17% by 2028 is gonna be
standardized in these largegroups.
And again, I'm not gonnabadmouth the large groups
completely, but there is thissomething about the heart and
(27:20):
soul of our industry with theprivate practices that drives so
much of what attracted me to theindustry in the first place.
SPEAKER_03 (27:26):
Look, uh, there are large groups that are very
ethical and they are that uh thepatients uh uh and the
therapists value their therapiesabsolutely uh the same people.
Um, they all have umshareholders or um uh board of
directors, and and they theyhave sometimes people who are a
(27:49):
bit uh further away from thedelivery place, uh, and they
cannot see what the frontlinePTs can see when they uh deliver
the service and they are uminteracting with their patients.
And uh look, I I don't know ifyou are aware of that, but um
I've I've talked about this bothrecently at the HUD Symposium
(28:13):
and and also in uh uh mypodcast.
As you know, uh hands-onorganization that Kostas and I
developed, um it has a physicaltherapy component, the
diagnostic testing component, uhas well as the uh consulting and
education component, right?
The HUD component.
(28:34):
So, you know, looking atconditions, um in especially in
the state of New York where thehands-on organization is, uh
Costas and I made a decision toactually sell our physical
therapy component of ourorganization, and we did as of
uh as a few months ago.
Uh oh my goodness, I didn'tknow.
(28:56):
Yeah, yeah.
We well, yeah, that's correct.
So I'm breaking the news.
Breaking the newcongratulations!
SPEAKER_00 (29:02):
Thank you, thank you, thank you.
That's wonderful because you'vehad that for decades and you've
grown a beautiful businessthere, but you've recognized the
opportunity to help.
You're you're it sounds likeyou're going all in on helping
the industry, is what I hear.
SPEAKER_03 (29:14):
Yes, uh, plus we we sold our physical therapy
operation, but we did not sellour diagnostic testing
operation.
So we have currently in New York35 locations where we perform
electrodiagnostic testing andmusculoskeletal ultrasound.
So that part we kept because webelieve that that is where um
(29:36):
the future lies, and uh, and ofcourse, HUDs where we can create
an impact in the industry andand in practices around the
country, and uh uh puttingputting more of attention on
those two areas, I believe itwill uh yield better, uh, not
only for us, but also for uh allthe people that we care around
(29:58):
uh our the PTs.
And the patients in need, youknow.
SPEAKER_00 (30:03):
So that's so beautiful that you guys are
doing that.
And again, you know, obviouslyyour podcast people already know
this, but for me, for my end ofit, you know, the
electrodiagnostic journey haswas a beautiful part of our
growth.
When we joined Hods and webrought it into our four
locations in Arizona, thatincreased our reimbursement, but
it also spawned uh a newbusiness in Alaska that Nathan
(30:25):
Shields took off and started andgrew.
And then we ended up selling uhto a physical therapist who had
become a key hand.
So it was it's a very it's apowerful, there are things out
there.
And you know, there's like yousaid, it kind of boils down to
cutting expenses, which reallythere are I until some I'd love
to see the business that showsup and says, We're here to help
(30:46):
you make money by cuttingexpenses.
Um, well, I guess except formine, which I'll talk about
later, but but in terms of likeyour regular expenses, like your
lease and that stuff, but thenincreasing reimbursement is one.
And I'm really hoping Nathanwill take that on.
He's got a program I know he'sbeen working on for a while to
help people get morereimbursement just through like
(31:07):
you know, tactical supportthrough negotiating and that
kind of stuff.
But then there's your companythat helps you get more
reimbursement in a way thatcreates additional value that
actually supports the industryin terms of autonomy and just
straight up marketing.
Like when patients and other MDsstart seeing physical therapists
as the musculoskeletal expertsbecause we're doing diagnostic
(31:29):
works, is the day that ourindustry as a whole benefits
because we're no longer somemedication that gets referred
out to.
We become equals in the referralprocess.
SPEAKER_03 (31:39):
And I'll give you actually um, if you want to put
uh in your in your in yourpodcast podcast website, yes,
please have you a copy of awhite paper that I wrote
recently that compares actuallyphysician electronistic
residencies with what physicaltherapists have in place right
(32:01):
now, and yes, it's like aside-by-side comparison.
So um our listeners can can takea look at that.
But tell me something from fromyour viewpoint and the things
that you are doing, what aresome meaningful ways that you
have put together that physicaltherapists can save money right
(32:23):
now in their practices?
SPEAKER_00 (32:25):
Yes, so my audience can tune out because they
understand this point, but it'sum my journey, as you know, I
had a medical billing company tohelp fight that piece of it.
And then I started coachingacross the board.
I started hiring virtualassistants for my core business
back in 20 in 2001.
And I had clients Demi that wereworking with me on multiple
(32:46):
levels.
They were coaching forrecruiting, they were getting
their billing done, all thesethings.
And I had a handful of reallyclose friends say, Hey, can we
try that VA thing?
And I said, No, leave me alone.
I've got four other companies.
I'm I'm dying.
And so they they just asked,they said, please can you help
me?
And so I ended up hiring virtualassistants for them.
And recruiting is my favoritething.
(33:07):
So we started hiring virtualassistants, and they came back
two months later, this was yearsago, and they said, This is the
best thing you've ever done forme.
And so very quietly, we addedthat business line into what I
do.
And now it's 99% of what I donow, and it's been that gap for
a few years.
We we have 150 clients acrossthe country, um, somewhere
(33:29):
around four to five hundredlocations.
We have hundreds of VAs that wework with.
It's really scaled.
And the reason I bring it upisn't to promote, but because
whether you use me or somebodyelse, um, one thing that people
can do immediately is look atsupporting their non-clinical
team with virtual assistance.
It's the second fastest growingtrend next to AI.
Yeah.
SPEAKER_03 (33:49):
And I I totally agree with that.
Uh and and yes, you shouldpromote it.
And and and and yes, uh, youknow, especially from someone
who comes from the physicaltherapy industry, you can trust
that will recruit individualswho really can pay more
(34:11):
attention to the proper to aphysical therapy practice.
So absolutely, please promotethat's that's oh, I appreciate
that.
SPEAKER_00 (34:20):
I I think you know, and I appreciate that because
um, of course, I'm going a bri abusiness, but you and I are both
are are pushing a movement.
What we're really are at the endof the day, what you and I are
aligned in and always have beenis our passion.
And and I and for my audiencesakes, and I I don't say this
often on my podcast ever, ifever, but Demi is in the top one
(34:41):
percent of the best human beingsI've ever had the privilege of
working with.
He can be trusted in every wayif you're looking at
diagnostics.
So for me, what we're doingtogether is the same thing, it's
just in a different way.
You're trying to get reincreased reimbursement and more
awareness from the industry ofour professionalism and our
expertise.
(35:01):
I am trying, I've been trying tohelp the industry in some way.
When this came around, it waslike, oh, not only am I using a
talent that I have that I love,but we're doing it in an
immediately impactful way thatincreases profit and time.
We have less than a 2% churn,meaning 98% of the people who
hire us never leave us.
And it's because when we canhave good people supporting us,
(35:23):
then we can make decisions likehow do I hire professional help
or how do I do this?
And and so they all these piecesneed to come together for the
ultimate battle, which isfighting the insurance companies
for reimbursement, or as BrandonSiegel says, if you know who
that is, that he's a good guy.
He was telling me he's he'slike, you know, I believe that
(35:45):
he's not a clinician like us.
So he has a differentperspective.
He's like, he goes, I think it'scrazy that PT OT and SLPs keep
doing the same business modeldespite these horrible
conditions versus changing thebusiness model.
And that's where Hodz comes in.
That's where some really coolcash pay services come in that
are going to be really powerful.
Um, he's like, you guys shouldhave created stretch labs.
(36:07):
You guys should have, you shouldhave owned that space and you
still can.
And so if we came, if we had alittle bit more profit and time
and if we organize better, whichis where Hodds does it better
than any organization, in myopinion, is that we get people
together to talk about how wecan change the industry, then we
can move the needle globally forall of us, like a rising tide,
so that we all have becausehere's the funniest thing is
(36:29):
Dimi, you and I both know if allthe people you and I work with
tripled their profits, theywould use those profits to like
better the patient experienceand maybe take a vacation for
once in their lives.
Like they like the selfishreturn on that would be so
unselfish from the outsidelooking in.
And everything else would gointo the industry, and then we
(36:51):
would start preventing surgeriesmore.
We'd stop opioid addictions,like the the cascading effect
across the human experience interms of health would be
significant.
And so it's it's interestingbecause we all know that within
the industry that if we just hadmore profits and time, we could
shift healthcare globally reallydramatically.
But my word, we stink atmarketing because we just don't
(37:13):
have time, we don't have thebusiness training.
So yeah, I think guys like youand I just feel very called and
very fortunate to be in aposition where we might be able
to help organize and educate alittle bit.
SPEAKER_03 (37:23):
Absolutely.
Uh uh and and definitely the thethe solution you have provided
um of a lower cost of veryhighly capable individuals uh as
virtual assistants that can thatcan help in many functions in in
(37:44):
an organization is is absolutelyextremely valuable.
I mean, we are using uh both inHADS and in my uh the hands-on
emg testing, our localdiagnostic company, we do use
virtual assistants for certainthings, and the best uh
experience I personally have ismy personal executive assistant.
(38:09):
She is a virtual assistant, andshe is oh my god, absolutely
incredible.
I don't know what I could dowithout her.
Um, she is very valuable to me.
What country is she from?
SPEAKER_00 (38:24):
Kenya, Kenya.
Do you know I I leave for Kenyain two days, Dimi?
You you you're I'm going toKenya in two days.
Nairobi.
Nairobi specifically, yeah.
Oh wow.
SPEAKER_03 (38:38):
I'll I'll I'll give you the information so you can
maybe uh meet up for some Kenyancoffee.
SPEAKER_00 (38:45):
Yeah, send me her, send me her, do an introduction
in WhatsApp, and then I'll reachout to her.
I'm in Kenya.
And um, I'm so excited becauselike I love that you've had that
experience.
Everyone needs to have thatvirtual assistant experience.
And I always tell people don'tgo through an agency if you'd
like to try doing it yourself.
You can go if you're gonna hireone or two, go to through, like,
you know, there's in in thePhilippines, there's online
(39:07):
jobs.ph.
Africa has its own uh boards aswell.
And it just depends what you'relooking for.
Some people are now going moretowards like Central America and
South America because they're onsimilar time zones and they like
the Spanish speaking.
It just depends what you'relooking for.
But yeah, like for everyonewho's listening, like don't you
don't have to go through anagency.
You can go try to do this onyour own.
(39:28):
I uh services like mine are forpeople who are looking to scale
or just want to help people whodon't want to do it.
But Dini, like, you know, it'sfunny because the Africa, one of
the reasons I'm going is becausewe're expanding into that
country.
And we we love uh I was inMozambique a year ago with my
family, and this is a cute storyI just want to share because
it's kind of related to thehumanity.
(39:48):
I took my four boys there, andyou know, an American father.
I don't think I really did agood job of like pushing them to
challenge them and and make themwork hard because you know, I'm
I I don't know, I just didn't doa good job.
So we took him down toMozambique, which is one of the
poorest countries in the world,hands down.
It's usually tied in the top,the bottom five of the poorest.
And it was rough.
(40:09):
Like we're we're digginglatrines for villages that had
earned it through thisorganization, Care for Life,
this non-for-profit.
And my youngest son, Van, was12, and he's big-hearted, and
and and not I've never reallyworked him hard.
And he was starting, he juststarted sobbing.
And I said, Oh, buddy, are youjust exhausted from the work?
(40:30):
And he said, No, I'm happierthan I've ever been in my life,
and I never want to leave.
I think that what we forget inour physical therapy worlds is
that we have the power to helppeople with technology globally.
We can serve you, we can servepeople in so many ways across
the the borders of our country,you know, whether it's an HB1
(40:51):
visa or whether it's a virtualassistant or whether it's just
being really passionate abouthelping.
I mean, it's really amazing.
We feel such a scarcitysometimes in the industry, but
we are in a position where we wewe are blessed.
At the end of the day, we reallyare abundantly blessed.
Yeah, and if we just had alittle bit more time, we could
see it.
SPEAKER_03 (41:08):
Awesome.
Yeah, oh my goodness.
Um, let's see.
Um, what is uh let's both of usanswer this question.
Uh take home message, take homemessage for for everybody.
Yes, please watching orlistening.
SPEAKER_00 (41:24):
Yeah, let's do that.
Um, you you know what?
If it's okay too, I also do arapid fire at the end of my
podcast for people.
I asked I ask some questions.
Would that work for you as well?
Good.
Do that, do that.
Okay, let's do some rapid fire.
SPEAKER_03 (41:37):
Let's do that first, and then we'll do the the the
take-home.
SPEAKER_00 (41:39):
I like that because yours could be like um, you
know, our parting thoughts as weget into that that space of it.
So let me just pull up thesequestions uh really fast.
Oh, there we go.
All right, okay.
So these questions they're meantto go fast.
So don't worry about gettingthem right.
Just go as best as you can.
(42:00):
Oh my god.
Now I'm like, oh okay.
Okay, so um, what's theinsertion of the quadrice?
I'm just kidding.
Rapid fire, number one.
What's the top book that you'veread recently in the last couple
of years that's blown your mind?
SPEAKER_03 (42:16):
Uh this is supposed to be a rapid fire.
Oh, it's okay, don't worry aboutit.
Um so um I'm gonna take in thiscase um you know, my spiritual
journey is a little bit um umvery specific, and um um I would
(42:40):
say uh something like the 15thAmerican ACC.
SPEAKER_00 (42:48):
Okay, um it's very ritual and uh so the title is
15th American ACC?
Oh, okay.
SPEAKER_03 (42:59):
Awesome, love that.
Very good.
Standing for um Americanclinical course.
SPEAKER_00 (43:06):
Okay, mind blow.
Love that.
Okay, next question.
What's your top time saver hack?
My virtual thing, I hope shelistens to this.
Me sure love you.
SPEAKER_03 (43:22):
She'll listen to it.
SPEAKER_00 (43:23):
She'll listen to it.
Oh, I love it.
Okay, number three.
What's the one thing you wishyou'd stop doing way sooner in
your business?
SPEAKER_03 (43:31):
Um not taking advice that donated wrong statistics,
but instead putting a lot moreattention on how I felt about
(43:54):
something, not about what thenumbers showed.
SPEAKER_00 (43:58):
That's powerful.
Because it's kind of an arc,right?
Like we come in because of thepassion, and then we don't know
how to track the numbers, andthen we start tracking the
numbers because we have to, andthen we start making it about
the numbers.
So it's a full cycle.
Okay.
What is the most time-consumingtask that you secretly enjoy?
(44:20):
Um secretly enjoy.
It's kind of like a maybe likeone of those um, what do they
call those?
It's uh one of those things thatyou do that like you know you
probably shouldn't do, but youkind of love doing it, so you
keep doing it.
SPEAKER_03 (44:35):
Um, you you you know what what um uh I enjoy um
definitely having uh long uh umuh conversations with friends
while wine tasting.
SPEAKER_00 (44:54):
That's a good one.
SPEAKER_03 (44:55):
Especially when it's more than a couple of glasses.
SPEAKER_00 (44:59):
More than a couple of friends and more than a
couple of glasses come together.
Okay, and then um what is if youhad unlimited time, what would
you focus on in your life?
SPEAKER_03 (45:17):
Um training somehow more than I do right now to
create a larger influence insociety in general.
(45:38):
Yeah.
SPEAKER_00 (45:39):
Because your your passion's huge for that larger
dynamic.
SPEAKER_03 (45:43):
Yeah.
I mean I I if you see if you candefinitely you can deliver stuff
to a single individual andanother individual, another
individual, uh but if somehowyou can deliver in someone who
they themselves have caninfluence a bunch of other
(46:03):
people, then your effect will bemuch larger, right?
SPEAKER_00 (46:08):
Yeah, absolutely.
Like uh Okay, well good job.
You answered those rapid firesvery well.
SPEAKER_03 (46:17):
Okay, I I I I think this I'm gonna have to go uh
triple, you know?
And that will make my six shotsfor the day.
So uh uh look, what time are werecording this?
It's like uh almost one o'clock.
I had three.
Wow.
Uh so uh the the three ones arenow we've gotta go for the three
(46:41):
afternoon ones.
So wait, um, how about uh uhwe'll do um take-home message,
last words, or something likethat?
SPEAKER_00 (46:53):
I like that.
I like that.
Um, do you want me to go andthen you'll you'll you can
finish?
Yeah, that's fine.
Yeah, my take-home message foreveryone listening is the
importance of recognizing thatthere's hope, that this is the
best time in the history of ourprofession to be a leader or
owner in the physical therapyspace because we are at this
(47:15):
kind of like I had to compare itto being like in the real estate
industry in market around 2008.
The best time in the history ofreal estate to get into real
estate was 2008.
You know, and so a lot of peoplewho'd been through 2006 and
seven wouldn't agree in 2008 ifthey weren't able to see the
future.
But when you look backwards,like, oh no, the beginning of
(47:36):
great things was about to occur.
We have so many things pivoting.
So I just want to encourageeveryone who's listening to
never give up.
Focus on on increasingreimbursement, be bold enough to
join uh an event.
The hands-on diagnosticsymposium is one that I highly,
highly, highly recommend.
It has that symposium has a lotto do with why I have my own
(47:59):
events.
So if you have to choose betweenthe two, go to that one because
I wouldn't have mine withoutthat one.
It's a it's a networkingopportunity on steroids.
So just be brave enough to buildthat network, and that would be
my parting thought.
What about you, Dimi?
SPEAKER_03 (48:13):
Yeah, well, first of all, we have to make sure that
our symposiums don't conflict interms of dates.
SPEAKER_00 (48:19):
I scheduled mine intentionally not to conflict
with yours.
I scheduled mine in March, so Iwould never step over your your
November, your November, Octoberevent.
SPEAKER_03 (48:29):
Awesome.
Uh, is is yours coming up thismonth?
SPEAKER_00 (48:33):
It is.
We have we we made the mistakeof only giving a hundred seats
out, and so we're almost alreadysold out for March.
SPEAKER_03 (48:41):
Awesome, awesome.
What's where are you where areyou hosting it?
SPEAKER_00 (48:44):
Phoenix.
We have this really cool spot inPhoenix where we have a state,
you know me.
I need to be the center ofattention.
So we we have like a live band,and then me and my comedic
partner get up on stage and wedo comedy songs about physical
therapy, but the whole event isabout learning how to recruit,
train, and retain talent.
It's all about the people sideof the business.
(49:04):
And we have come most peoplecome from out of state,
ironically.
Um, so we have people fromacross the country, and then we
do something really fun.
We invite all the localuniversity students to attend
one day to get interviewed, andit turns into an actual hiring
event.
And so um half of the Arizonastudents leave the state and
want to go out of cut out ofstate, so it's perfect.
(49:24):
People usually will hire, soit's fun, it's a lot of fun.
SPEAKER_03 (49:28):
Fantastic.
And and and you you will give usalso the link, so we're gonna
post it also in our um uhpodcast uh resources.
And vice versa, please.
All the links.
Awesome.
Okay, final thoughts, Debbie.
Uh final thoughts.
I mean, um, I totally agree withwith uh what you talked about,
uh uh and hope and and and Iwant to add to that action,
(49:50):
yeah.
Right?
Yes, there is hope to dosomething, but we have to do it,
we have to take action on it.
And uh if nobody is gonna justgive you the world, nobody's
gonna just come and tell you allof a sudden we're gonna double
your reimbursement just becauseyou are cute.
No, you gotta do something aboutit, you have to take some
(50:13):
action.
And many people they're like uhmany times in a zone of
indecision.
They're like, okay, should I dothis or I shouldn't do this?
Should I do HUDs or I shouldn'tdo HUDs?
Should I get a virtual assistantfrom Will or I should not get a
well, you know what?
The worst place you can be isthe zone of maybe because
(50:37):
indecision is actually adecision.
So just indecision is adecision, right?
Absolutely.
Indecision is a decision.
It's a decision of not doing it,actually.
Yes, uh good.
You're embracing the change, youare embracing the new, you are
(51:01):
embracing the new opportunity.
If your decision is no, uh atleast you are freeing up your
mind from being stuck somewherein the middle, not knowing what
to do.
And and eventually you'll beable to put those attention
units to something else that youwant.
Never be in the middle, never bein a state of maybe or
indecision.
(51:22):
Just make up your mind and dosomething.
SPEAKER_00 (51:26):
Okay, uh, Dami, it has been too long.
I am so grateful that we got tobe together.
I sure appreciate you being onthe show.
I am honored every time I'm withyou.
Awesome.
SPEAKER_03 (51:37):
Likewise, and you know what I guess we should get
our friend Nathan and Rio.
SPEAKER_00 (51:45):
That let's do it.
I would do that'd be so fun thethree of us to talk and share
memories from the battlefieldsof me calling doctors and
hanging up after introducingmyself and as an electrician,
like all the things, like wecould do all the things.
SPEAKER_03 (51:58):
Exactly, be awesome.
Thank you, Will.
Uh thank you, Did you uheverything to do and appreciate
uh giving the opportunity alsofor your audience to for me to
share with your audience uh someof my thoughts.
Thank you.
Thank you.
All right, so I guess we sayokay.
SPEAKER_00 (52:18):
Well, Dimi, thank you so much.
Let's stay in touch and please,I mean that.
Let's stay in touch.
I'll I'll send out all theassets and stuff, and then yeah,
man, great to be with you today.
I sure appreciate your time.
Sounds good, likewise.
We received a letter from an insurance carrier that
they were cutting reimbursementsfor physical therapy from
hundred and forty dollars downto sixty.
So um and that was the letterthat changed everything.
They gave us at that time anultimatum stating that hey, if
(00:22):
you do not if you are not gonnaaccept this um by January 1st,
that the rate change, then youdrop we drop you from the
network.
Yeah, it was an ultimatum.
So see, many times we talk aboutcause versus being effect, and
(00:43):
at that time I felt that I wasthe effect, not not cause.
But we had to do something tochange it.
SPEAKER_00 (00:54):
Well, Demi, I'm so excited to be with you today.
It's been a few months or yearssince I've seen you.
It's been very you're someoneI've known for a very long time.
And man, I sure appreciate youspending some time with me
today.
SPEAKER_03 (01:05):
Uh, likewise, it's it's it's been a long time, and
um you have um uh a tremendousevolution um since the time that
I have met you, and and you haveuh, besides all the other
business endeavors, you have youhave an amazing podcast right
now.
And uh um I'm I'm very excitedto kind of uh share this uh
(01:31):
podcast with you now, from mypodcast to your podcast, from
your podcast to my podcast, andand uh it will be awesome.
SPEAKER_00 (01:40):
Well, and it's such a cool moment for me because um
you, as I was a physical therapypractice owner, as my audience
knows, and maybe yours doesn't,but I was a PT owner who was
really wanting to make a bigdifference in the industry, and
that's when we found you.
And we the the we found youthrough um a common connection
in Florida.
Oh, um I'm forgetting whichwhich of our which of our
(02:02):
referrals it was, but he was ata miserable solutions
conference.
SPEAKER_03 (02:05):
I think it was Dan actually.
SPEAKER_00 (02:07):
Dan, it was yeah, Dan Sage.
So, Daniel, thank you so much,buddy.
We wouldn't be here without you.
And he was talking about thisEMG thing and diagnostic
ultrasound and how not only wasit higher reimbursing, but more
importantly, it was totallychanging how patients were
getting healthcare in physicaltherapy, and it made us
diagnosticians versus being, youknow, healthcare providers that
(02:32):
get referred out to like aprescription.
And so when we met back and itwas 2014, I think it was 2014 or
15.
SPEAKER_03 (02:38):
Yeah, I think 14 or 15, yeah, you're right.
SPEAKER_00 (02:41):
Yeah, I mean, who'd have thought that we would have
evolved the way that we did?
I I know we were the sixth, Ithink, client of yours.
We were in the first 10.
I know that early the earlydays, yeah.
And how how many companies areyou partnered with now?
SPEAKER_03 (02:56):
Ish?
Gosh, um, we have right now, Ithink about 65 companies, 245
locations.
Wow.
Um, like I think 31 differentstates.
So that's yeah.
SPEAKER_00 (03:15):
Amazing.
You know, for my audience sideof things, can you share why you
decided to do hands-ondiagnostics?
Why are because you're a medicaldoctor, like I'll say in my
intro, and a physical therapist.
You have both of these likecombined talents.
What was it about the industrythat had you want to jump into
it?
SPEAKER_03 (03:34):
Yeah, look, uh uh, I mean, definitely uh, first of
all, I was involved in uh uhelectrodiagnostics from the
early days of my practice, likeuh Costas and I, my business
partner, um, we opened the firstphysical therapy office back in
(03:56):
1992.
Wow, very early.
What how old were you, Will?
I was I was um 16.
I I I had that number.
I had that number in mindexactly.
So anyway, um we opened that uhoffice and and we did very well.
We grew um rapidly and uh umright around um 1996, 95, 96, I
(04:25):
was like, okay, I want to dosomething more, I want to do
something different.
Meanwhile, I had a bunch ofFrench um physicians who were
performing electrodiagnosticstudies at that time, and I did
see um a flyer advertisementabout these guys from the US
(04:47):
Navy that they had physicaltherapies, that they had studied
electrodiagnostics and they wereteaching others.
And I joined at that time myvery good friend uh Rick Nielsen
um and uh we did some trainingwith him, and I started very,
very slowly um doingelectrodiagnostic studies.
(05:11):
But the point that uh pushed meand to develop this as a real
business is actually the samechallenges and problems that
physical therapists have rightnow.
It was about reimbursements, itwas about reimbursements that
(05:32):
yes, on the one hand, we couldsee back then some uh clinical
utility, some clinicalimportance, clinical
significance ofelectrodiagnostic testing, but
uh we could have never fathomedhow to take this and create a
business opportunity with it sountil um we started facing some
(05:56):
of the industry uh uhchallenges.
You know, when I talk to people,actually Will many times I say
um you know that we received theuh letter that changed
everything.
SPEAKER_00 (06:11):
What letter was that?
SPEAKER_03 (06:13):
What letter was that?
I'll tell you exactly that itwas um two days before
Thanksgiving of 2002.
Meanwhile, we had reallyexpanded our practices.
We had opened, I think at thattime we had 13 um uh physical
(06:36):
therapy locations, and wereceived a letter from an
insurance carrier that they werecutting reimbursements for
physical therapy from$140 downto 60.
So um, and that was the letterthat changed everything.
(06:56):
They gave us at that time anultimatum stating that hey, if
you do not if you are not gonnaaccept this um by January 1st,
that the rate change, then youdrop we drop you from the
network.
Yeah, it was an ultimatum.
So see, many times we talk aboutcause versus being effect, and
(07:21):
at that time I felt that I wasthe effect, not not cause.
So we had to do something tochange it.
SPEAKER_00 (07:29):
It's interesting that this is a story that still
exists today, that people areexperiencing this, maybe even
more so.
But that was the same thing thatyou said that started this whole
journey for you to go, wow,reimbursement for what we do is
not representative of the valuethat we bring.
And you were and you had achoice.
Could I be at the effect of thisor could I be at cause over this
(07:52):
situation?
So it sounds like Hods was yourway of being at cause.
SPEAKER_03 (07:56):
That was that was that was a way of of of being of
being.
Yeah, but let me ask you this.
Like you you speak some people,right?
You you speak to you have yourpodcast, you have your uh
consulting clients, you haveyour um uh conference and and
and and events that you putaround the country.
(08:19):
What do you see what what arethe common themes that that
physical therapy, especiallyprivate practice owners, come to
point and and and complainingabout or seeing as challenges?
What's the common theme themesthat you see?
SPEAKER_00 (08:37):
You know, there's an there's an overarching
singularity, and then there'sthe subcauses.
The subcauses look likerecruiting.
The one thing I hear in myworld, since I spend a lot of
time consulting on recruiting onhow to hire physical therapists
or how to develop people,they're the most overwhelmed
when it comes to that initially.
(08:58):
And that just might be how theyshow up to me directly, although
I know it's an industry problem.
The second thing isreimbursement.
Reimbursement between those twothings alone, they just that
becomes the singular issue ofjust not feeling in balance in
life.
And it's that's a horrible word,balance, because you know, I
don't I don't really trulybelieve in balance.
(09:20):
But what the better way ofsaying it is that they don't
feel in exchange with their ownbusiness.
They feel like their businesstakes way more out of them than
they get back in return.
So, like in terms of time andmoney that they invest in, what
they get back in terms of timeand money is so skewed that we
use industry, you know, commonwords like burnout or um, you
(09:43):
know, the fact that people areleaving the industry more than
entering it.
There's this massive exodus.
And it's so interesting, Dimi,because as you know, there is
such a demand for what we do.
Like that's right, this is thisis the opposite environment
where those events should beoccurring because there is so
much demand for it.
But it comes down to, and thosetwo issues of recruiting and
(10:05):
reimbursement are sointerlinked.
If we had more money, we couldhire more.
If we could hire more, we couldmake more money.
But it it comes back to yourcore reason as to why you
started the hands-on diagnosticseminars because at the end of
the day, what we get paid pervisit by the insurance is the
driving force.
That's the in I that has to bethe first thing that's causing
(10:26):
all this.
Because if that was triple whatit is now, people would be
staying in the industry.
We could pay people more, we'dhave more profits the whole nine
years.
SPEAKER_03 (10:33):
And and and and we see the application of this
actually right now in therelationship between private
practices and hospitalorganizations.
So you're talking about aboutrecruitment, right?
Right.
Uh, and although the numberschange from year to year a
little bit, but we are producingabout 5,000 less physical
(10:59):
therapies every year than whatthe industry really requires,
right?
So 5,000 less up to now.
Now, moving forward, this isgoing to become even more
challenging.
And I care less about the um uhpolitical persuasion of anyone
(11:21):
who is watching the podcast,your podcast, or whoever I talk
to.
But it is a real challenge.
Private practice, physicaltherapists who in larger
metropolitan areas, they wererecruiting therapists,
foreign-trained therapists fromother countries, from India,
(11:43):
from the Philippines, fromAustralia, from various places
like that.
SPEAKER_00 (11:48):
Now, a private practice has to pay$100,000
application fee to apply forsomeone to come in uh with an H1
visa, provided that they can'tkill that killed what I thought
was the only viable solution.
Because when we had, I was justin my coaching world about six
(12:10):
months ago, we were reallytrying to figure out because
there's already some challengearound that.
You've got to the person has totake the the boards in the
United States.
So you're flying people from thePhilippines, for example, to the
to Hawaii.
And so you're looking at about a$20,000 to$25,000 cost that has
some risk already tied to it,and then the government threw a
hundred thousand dollar uhpenalty or whatever it is, like
(12:32):
fee to in order to do that.
So that killed the only viablesolution, which for me I loved.
I loved bringing people in fromother countries and to solve
that problem for us because thenit would increase our
profitability.
SPEAKER_03 (12:43):
I mean, look, uh I came to the country uh initially
as a student with an A-sponsoredvisa.
I didn't know that in the past,yeah, in August of 1987.
World were you both?
Okay, so we were both younger,that's for sure.
SPEAKER_00 (13:03):
We I always think of us as the same age, and for what
it's worth, you look better atyour age than I do at mine.
Like, I'm looking the wholetime, I'm like, where are his
wrinkles?
Anyway, so yeah, I I get it.
You were here on a visa, andthat's like the whole point of
this thing is is that we're ableto take the I not just the
country of America, but theidea.
I mean, there's again, I'm not Idon't want to get into a
political thing.
People have all sorts of viewsabout the border control, but
(13:25):
getting people in legallythrough visas who want to
provide health care.
No, those are people we have towant to support.
We want those people.
SPEAKER_03 (13:33):
So so so here is what I I am going to advocate.
I got actually the agreement ofthe HADS group to advocate.
And I am asking you also if yougot it, agree on this to join me
in this advocacy, advocating tothe American Physical Therapy
(13:54):
Association to utilize theirlobbyists to advocate for an
exemption of the$100,000 H1B feefor professions where there is a
significant need in the UnitedStates, such as physical
(14:17):
therapy.
Because let's get this now.
If who is gonna afford$100,000?
Private practitioner is notgoing to, but the either larger
national organizations orhospital organizations, perhaps
(14:38):
they'll be able to afford thehundred thousand dollars with a
contract that they'll stay withthese organizations for the the
employee will stay for fiveyears or so.
So so but but that is a problemfor the uh private practice
small business owner.
So I'm advocating that the APTAutilizes their lobbying
(15:04):
resources to actually lobby thatthere is an exemption for
specific professions,specifically for the profession
of physical therapy for um forthe H1B visas.
Um, yeah.
SPEAKER_00 (15:18):
Yeah, I'm in.
I we are 100% supportive ofthat.
I think that's makes so muchsense because I don't know
anything outside of my narrowscope.
So, like if the$100,000 thingmakes sense for legal or for
other professions where thatmoney is a little bit of a
sting, but it's not a big deal,okay, great.
That brings us more money,whatever.
But for physical therapycompanies, I love the H uh B1 Vs
(15:43):
or H1V.
I'm always dyslexics, whatever.
H1B, those visas are so vitalbecause they allow us to the
high overseas, and it it's noteven a smooth process without
the$100,000 thing.
So if anything, I would love tofind ways to simplify that
while, and it's not thelong-term solution, in my
opinion.
I would love to hear yours.
Um, I don't think that's thelong-term solution because we're
(16:05):
still fighting a diminishinggame with reimbursements, but at
least it provides us with somespace to be able to get
profitable, to organize andfight, because we don't have
time as the private practicesector is what's going to save
our industry or transform ourindustry.
And right now we just don't havetime to go lobby or like if
we're too busy treating crazyhours or running around trying
(16:28):
to hire full-time.
What are your thoughts on that?
SPEAKER_03 (16:30):
All right.
So, my thoughts on that.
Um, first of all, um what willreally create a significant
difference is a positivedifference, is parity.
Parity in reimbursement betweenhospital organizations and
(16:56):
private practice privatepractices, private practice
physical therapy.
So here is what happens rightnow when it comes to commercial
insurances, uh hospitalorganizations they are able to
uh retrieve significantmultiples of reimbursement
(17:19):
compared to a private practicephysical therapy, and there are
websites where you can go,because this is now public
information, where you can goand see the reimbursement
precipity code.
But I'm gonna give you a verysimple example.
For uh let's say a visit on apatient where a private
(17:39):
practitioner receives$85, forthat same visit a hospital
organization will receive morethan$300.
This is not only limited to umcommercial carriers, it extends
also to uh um Medicaid andMedicare Advantage, not the
(18:08):
straight Medicaid, not thestraight Medicare, because there
there is um you know a littlebit of difference, but not
significant difference.
But the advantage plans theyhave also three or four times
greater reimbursement withhospitals.
So what happens now is largeorganizations um in private
(18:34):
practice who own five hundredfacilities, six hundred
facilities, a thousandfacilities in various regions
they collaborate with hospitalsso the hospital rates extend to
those private practiceorganizations.
(18:54):
And they are able to have thosesignificant rates, and then we
have competition for the smallprivate practitioners, small
business uh physical therapists.
We have competition not only bythe hospital itself, but also by
those larger organizations thatnow their reimbursement
(19:18):
increases significantly, andthey have to and they can
compete for um the same physicaltherapy talent, but paying them
a lot more because they canafford to do that.
SPEAKER_00 (19:32):
It's interesting to me that these groups are
actually getting increasedreimbursement because that shows
that there's there's a battlethat's being won, of course, by
the bigger companies, but theyare winning.
Like if they're increasing, itreally kills that that
individual who's just dreams ofhanging their shingle one day
and having their own practice.
(19:52):
But it the only positive Ireally hear from that is well,
at least some groups are able toget with insurance companies and
fight.
It just puts us in a position oflike, well, how do we do that?
How do we do you have thoughtson how we as a group so look?
SPEAKER_03 (20:05):
Here is King, right?
There are three things thatsomebody can do to um increase
um their bottom line.
They cut our expenses, and theycan increase our revenue from
their existing business, andthey can add additional revenue
(20:31):
from related businesses that canbe incorporated within their
organizations.
Now, the very first thingcutting expenses is probably the
easiest thing that somebody cando with only short-term result
and low yield.
(20:52):
Because what are you going tocut?
Can you cut your rent ormortgage?
No, because that is what youpay.
You probably have a lease, youprobably have a mortgage.
It is what it is, right?
At the end of the day, you haveto have the space to see your
patients.
(21:12):
Are you gonna cut salaries?
How are you gonna compete in themarketplace if you cut salaries?
You're not gonna be able to.
And your uh uh the towels thatyou use in your office?
(21:36):
Fantastic.
You did it, you saved$55 amonth.
Great win.
Let's go have a beer.
SPEAKER_00 (21:43):
Uh beer, by the way, costs$55.
Yeah, the round of beers cost$55, but yes.
SPEAKER_03 (21:50):
So it's it's it it's it's a low-yield um uh type of
activity to decrease expense.
Now let's look at increasingincome.
Increasing income from yourspecific service line of
physical therapy can be done byum negotiating rates with
insurance carriers.
(22:12):
Okay, you may be able to joinsome IEPA and join forces with
other physical therapists, andthen you can go and try to
negotiate those those rates to arelative success on your region.
Um, you try to go cash also insome cases where pay uh um you
(22:37):
can uh manage to get some betterreimbursements uh directly from
patients, or then you addservices that uh where you are
able to uh receive much higherreimbursements, and those
services can be quite a variety.
(22:57):
You can have some cash-basedservices where they are unique
in nature, uh, where no othertherapists offer those services
around you, where you have anincredible marketing plan um and
approach where you are able torecruit patients who are willing
to pay$150 to$200 for that.
Or you add um reimbursableservices by insurance company
(23:23):
that have a multiple of what youpay for PT, such as diagnostic
testing, EMG, ultra pay three toten times more than what PTV is.
And and this pretty much at themath unfortunately will by 2028
(23:43):
it is anticipated that 50% ofthe existing physical therapy
private practices will beacquired by larger corporations.
SPEAKER_00 (23:57):
How what percentage was that again?
SPEAKER_03 (23:58):
50%.
SPEAKER_00 (24:00):
50% of all physical therapy, outpatient, private
practice will be acquired bylarger practices.
SPEAKER_03 (24:04):
Correct.
That's that's what the number isright now by the year 2028, the
estimate.
Um if we if we ate the entireoutput of physical therapy, the
entire physical therapy,inpatient, outpatient, private
practice, large entities, 34% ofthe entire PT is being delivered
(24:31):
uh by private practices.
Okay.
So imagine that um when largercompanies take over half of that
34%, so you're gonna have only17%, the entire PT industry
being served by privatepractices, small private and
(24:52):
medium.
SPEAKER_00 (24:52):
But that scares me for so many reasons, and I think
you know this as well as I do isthat what makes any uh unique
physical therapy practicesuccessful is the passion and
the creativity of theindividuals who are giving care.
And you can't find a morepassionate or creative group
than a private practice becausethey are they are the ones who
(25:14):
hung their shingle, they're theones who put the risk up.
They care arguably more aboutthe patient experience in
general.
Now, you'll get somestandardized care with larger
groups for sure, but I worryabout that devaluing what we do
to be more of this service thatgets referred out to, and we
only focus on routine care itemsversus becoming doctors in our
(25:37):
community and having those deepemotional relationships, which
is what drives you and I.
What we care about is the bodyand soul of each patient.
And and people go into physicaltherapy for that, don't they,
Deanny?
Where absolutely yeah, I mean,look, the people who get into
physical therapy school, theyare the ones who are in a very
interesting niche.
(25:57):
They're they're definitelyintelligent enough to go to a MD
type program, but they choose togo this route usually, not all,
but usually they they are, andthey choose to go this route
because what they really careabout is the connection with the
individual, combined with thefact that they love anatomy in a
way they get to work with itmore over time.
(26:18):
But in exchange of that, theygive up their profit.
I told my wife this, Dimi.
I remember when I became aphysical therapist, the day I
got my license.
This was in the early 2000s.
My wife and I didn't have anykids.
I was in my 20s.
And I remember turning to herand saying, Man, honey, um, we
we're not gonna be wealthy onany level.
(26:38):
I just want to prepare you forthat.
We're never gonna be wealthy,but I am gonna be happy because
I'll be serving people.
And that is, I think, a greatyou know, example of what most
people feel when they become aphysical therapist.
They're looking, they, they,they're driven by those same
things.
And I was I was wrong on bothcounts, by the way, but it's one
(26:58):
of those things where I'm justkidding.
But it's one of those thingswhere it's it's really it's
unfortunate that we would getour basically our our our whole
industry, the vast majority savethat 17% by 2028 is gonna be
standardized in these largegroups.
And again, I'm not gonnabadmouth the large groups
completely, but there is thissomething about the heart and
(27:20):
soul of our industry with theprivate practices that drives so
much of what attracted me to theindustry in the first place.
SPEAKER_03 (27:26):
Look, uh, there are large groups that are very
ethical and they are that uh thepatients uh uh and the
therapists value their therapiesabsolutely uh the same people.
Um, they all have umshareholders or um uh board of
directors, and and they theyhave sometimes people who are a
(27:49):
bit uh further away from thedelivery place, uh, and they
cannot see what the frontlinePTs can see when they uh deliver
the service and they are uminteracting with their patients.
And uh look, I I don't know ifyou are aware of that, but um
I've I've talked about this bothrecently at the HUD Symposium
(28:13):
and and also in uh uh mypodcast.
As you know, uh hands-onorganization that Kostas and I
developed, um it has a physicaltherapy component, the
diagnostic testing component, uhas well as the uh consulting and
education component, right?
The HUD component.
(28:34):
So, you know, looking atconditions, um in especially in
the state of New York where thehands-on organization is, uh
Costas and I made a decision toactually sell our physical
therapy component of ourorganization, and we did as of
uh as a few months ago.
Uh oh my goodness, I didn'tknow.
(28:56):
Yeah, yeah.
We well, yeah, that's correct.
So I'm breaking the news.
Breaking the newcongratulations!
SPEAKER_00 (29:02):
Thank you, thank you, thank you.
That's wonderful because you'vehad that for decades and you've
grown a beautiful businessthere, but you've recognized the
opportunity to help.
You're you're it sounds likeyou're going all in on helping
the industry, is what I hear.
SPEAKER_03 (29:14):
Yes, uh, plus we we sold our physical therapy
operation, but we did not sellour diagnostic testing
operation.
So we have currently in New York35 locations where we perform
electrodiagnostic testing andmusculoskeletal ultrasound.
So that part we kept because webelieve that that is where um
(29:36):
the future lies, and uh, and ofcourse, HUDs where we can create
an impact in the industry andand in practices around the
country, and uh uh puttingputting more of attention on
those two areas, I believe itwill uh yield better, uh, not
only for us, but also for uh allthe people that we care around
(29:58):
uh our the PTs.
And the patients in need, youknow.
SPEAKER_00 (30:03):
So that's so beautiful that you guys are
doing that.
And again, you know, obviouslyyour podcast people already know
this, but for me, for my end ofit, you know, the
electrodiagnostic journey haswas a beautiful part of our
growth.
When we joined Hods and webrought it into our four
locations in Arizona, thatincreased our reimbursement, but
it also spawned uh a newbusiness in Alaska that Nathan
(30:25):
Shields took off and started andgrew.
And then we ended up selling uhto a physical therapist who had
become a key hand.
So it was it's a very it's apowerful, there are things out
there.
And you know, there's like yousaid, it kind of boils down to
cutting expenses, which reallythere are I until some I'd love
to see the business that showsup and says, We're here to help
(30:46):
you make money by cuttingexpenses.
Um, well, I guess except formine, which I'll talk about
later, but but in terms of likeyour regular expenses, like your
lease and that stuff, but thenincreasing reimbursement is one.
And I'm really hoping Nathanwill take that on.
He's got a program I know he'sbeen working on for a while to
help people get morereimbursement just through like
(31:07):
you know, tactical supportthrough negotiating and that
kind of stuff.
But then there's your companythat helps you get more
reimbursement in a way thatcreates additional value that
actually supports the industryin terms of autonomy and just
straight up marketing.
Like when patients and other MDsstart seeing physical therapists
as the musculoskeletal expertsbecause we're doing diagnostic
(31:29):
works, is the day that ourindustry as a whole benefits
because we're no longer somemedication that gets referred
out to.
We become equals in the referralprocess.
SPEAKER_03 (31:39):
And I'll give you actually um, if you want to put
uh in your in your in yourpodcast podcast website, yes,
please have you a copy of awhite paper that I wrote
recently that compares actuallyphysician electronistic
residencies with what physicaltherapists have in place right
(32:01):
now, and yes, it's like aside-by-side comparison.
So um our listeners can can takea look at that.
But tell me something from fromyour viewpoint and the things
that you are doing, what aresome meaningful ways that you
have put together that physicaltherapists can save money right
(32:23):
now in their practices?
SPEAKER_00 (32:25):
Yes, so my audience can tune out because they
understand this point, but it'sum my journey, as you know, I
had a medical billing company tohelp fight that piece of it.
And then I started coachingacross the board.
I started hiring virtualassistants for my core business
back in 20 in 2001.
And I had clients Demi that wereworking with me on multiple
(32:46):
levels.
They were coaching forrecruiting, they were getting
their billing done, all thesethings.
And I had a handful of reallyclose friends say, Hey, can we
try that VA thing?
And I said, No, leave me alone.
I've got four other companies.
I'm I'm dying.
And so they they just asked,they said, please can you help
me?
And so I ended up hiring virtualassistants for them.
And recruiting is my favoritething.
(33:07):
So we started hiring virtualassistants, and they came back
two months later, this was yearsago, and they said, This is the
best thing you've ever done forme.
And so very quietly, we addedthat business line into what I
do.
And now it's 99% of what I donow, and it's been that gap for
a few years.
We we have 150 clients acrossthe country, um, somewhere
(33:29):
around four to five hundredlocations.
We have hundreds of VAs that wework with.
It's really scaled.
And the reason I bring it upisn't to promote, but because
whether you use me or somebodyelse, um, one thing that people
can do immediately is look atsupporting their non-clinical
team with virtual assistance.
It's the second fastest growingtrend next to AI.
Yeah.
SPEAKER_03 (33:49):
And I I totally agree with that.
Uh and and yes, you shouldpromote it.
And and and and yes, uh, youknow, especially from someone
who comes from the physicaltherapy industry, you can trust
that will recruit individualswho really can pay more
(34:11):
attention to the proper to aphysical therapy practice.
So absolutely, please promotethat's that's oh, I appreciate
that.
SPEAKER_00 (34:20):
I I think you know, and I appreciate that because
um, of course, I'm going a bri abusiness, but you and I are both
are are pushing a movement.
What we're really are at the endof the day, what you and I are
aligned in and always have beenis our passion.
And and I and for my audiencesakes, and I I don't say this
often on my podcast ever, ifever, but Demi is in the top one
(34:41):
percent of the best human beingsI've ever had the privilege of
working with.
He can be trusted in every wayif you're looking at
diagnostics.
So for me, what we're doingtogether is the same thing, it's
just in a different way.
You're trying to get reincreased reimbursement and more
awareness from the industry ofour professionalism and our
expertise.
(35:01):
I am trying, I've been trying tohelp the industry in some way.
When this came around, it waslike, oh, not only am I using a
talent that I have that I love,but we're doing it in an
immediately impactful way thatincreases profit and time.
We have less than a 2% churn,meaning 98% of the people who
hire us never leave us.
And it's because when we canhave good people supporting us,
(35:23):
then we can make decisions likehow do I hire professional help
or how do I do this?
And and so they all these piecesneed to come together for the
ultimate battle, which isfighting the insurance companies
for reimbursement, or as BrandonSiegel says, if you know who
that is, that he's a good guy.
He was telling me he's he'slike, you know, I believe that
(35:45):
he's not a clinician like us.
So he has a differentperspective.
He's like, he goes, I think it'scrazy that PT OT and SLPs keep
doing the same business modeldespite these horrible
conditions versus changing thebusiness model.
And that's where Hodz comes in.
That's where some really coolcash pay services come in that
are going to be really powerful.
Um, he's like, you guys shouldhave created stretch labs.
(36:07):
You guys should have, you shouldhave owned that space and you
still can.
And so if we came, if we had alittle bit more profit and time
and if we organize better, whichis where Hodds does it better
than any organization, in myopinion, is that we get people
together to talk about how wecan change the industry, then we
can move the needle globally forall of us, like a rising tide,
so that we all have becausehere's the funniest thing is
(36:29):
Dimi, you and I both know if allthe people you and I work with
tripled their profits, theywould use those profits to like
better the patient experienceand maybe take a vacation for
once in their lives.
Like they like the selfishreturn on that would be so
unselfish from the outsidelooking in.
And everything else would gointo the industry, and then we
(36:51):
would start preventing surgeriesmore.
We'd stop opioid addictions,like the the cascading effect
across the human experience interms of health would be
significant.
And so it's it's interestingbecause we all know that within
the industry that if we just hadmore profits and time, we could
shift healthcare globally reallydramatically.
But my word, we stink atmarketing because we just don't
(37:13):
have time, we don't have thebusiness training.
So yeah, I think guys like youand I just feel very called and
very fortunate to be in aposition where we might be able
to help organize and educate alittle bit.
SPEAKER_03 (37:23):
Absolutely.
Uh uh and and definitely the thethe solution you have provided
um of a lower cost of veryhighly capable individuals uh as
virtual assistants that can thatcan help in many functions in in
(37:44):
an organization is is absolutelyextremely valuable.
I mean, we are using uh both inHADS and in my uh the hands-on
emg testing, our localdiagnostic company, we do use
virtual assistants for certainthings, and the best uh
experience I personally have ismy personal executive assistant.
(38:09):
She is a virtual assistant, andshe is oh my god, absolutely
incredible.
I don't know what I could dowithout her.
Um, she is very valuable to me.
What country is she from?
SPEAKER_00 (38:24):
Kenya, Kenya.
Do you know I I leave for Kenyain two days, Dimi?
You you you're I'm going toKenya in two days.
Nairobi.
Nairobi specifically, yeah.
Oh wow.
SPEAKER_03 (38:38):
I'll I'll I'll give you the information so you can
maybe uh meet up for some Kenyancoffee.
SPEAKER_00 (38:45):
Yeah, send me her, send me her, do an introduction
in WhatsApp, and then I'll reachout to her.
I'm in Kenya.
And um, I'm so excited becauselike I love that you've had that
experience.
Everyone needs to have thatvirtual assistant experience.
And I always tell people don'tgo through an agency if you'd
like to try doing it yourself.
You can go if you're gonna hireone or two, go to through, like,
you know, there's in in thePhilippines, there's online
(39:07):
jobs.ph.
Africa has its own uh boards aswell.
And it just depends what you'relooking for.
Some people are now going moretowards like Central America and
South America because they're onsimilar time zones and they like
the Spanish speaking.
It just depends what you'relooking for.
But yeah, like for everyonewho's listening, like don't you
don't have to go through anagency.
You can go try to do this onyour own.
(39:28):
I uh services like mine are forpeople who are looking to scale
or just want to help people whodon't want to do it.
But Dini, like, you know, it'sfunny because the Africa, one of
the reasons I'm going is becausewe're expanding into that
country.
And we we love uh I was inMozambique a year ago with my
family, and this is a cute storyI just want to share because
it's kind of related to thehumanity.
(39:48):
I took my four boys there, andyou know, an American father.
I don't think I really did agood job of like pushing them to
challenge them and and make themwork hard because you know, I'm
I I don't know, I just didn't doa good job.
So we took him down toMozambique, which is one of the
poorest countries in the world,hands down.
It's usually tied in the top,the bottom five of the poorest.
And it was rough.
(40:09):
Like we're we're digginglatrines for villages that had
earned it through thisorganization, Care for Life,
this non-for-profit.
And my youngest son, Van, was12, and he's big-hearted, and
and and not I've never reallyworked him hard.
And he was starting, he juststarted sobbing.
And I said, Oh, buddy, are youjust exhausted from the work?
(40:30):
And he said, No, I'm happierthan I've ever been in my life,
and I never want to leave.
I think that what we forget inour physical therapy worlds is
that we have the power to helppeople with technology globally.
We can serve you, we can servepeople in so many ways across
the the borders of our country,you know, whether it's an HB1
(40:51):
visa or whether it's a virtualassistant or whether it's just
being really passionate abouthelping.
I mean, it's really amazing.
We feel such a scarcitysometimes in the industry, but
we are in a position where we wewe are blessed.
At the end of the day, we reallyare abundantly blessed.
Yeah, and if we just had alittle bit more time, we could
see it.
SPEAKER_03 (41:08):
Awesome.
Yeah, oh my goodness.
Um, let's see.
Um, what is uh let's both of usanswer this question.
Uh take home message, take homemessage for for everybody.
Yes, please watching orlistening.
SPEAKER_00 (41:24):
Yeah, let's do that.
Um, you you know what?
If it's okay too, I also do arapid fire at the end of my
podcast for people.
I asked I ask some questions.
Would that work for you as well?
Good.
Do that, do that.
Okay, let's do some rapid fire.
SPEAKER_03 (41:37):
Let's do that first, and then we'll do the the the
take-home.
SPEAKER_00 (41:39):
I like that because yours could be like um, you
know, our parting thoughts as weget into that that space of it.
So let me just pull up thesequestions uh really fast.
Oh, there we go.
All right, okay.
So these questions they're meantto go fast.
So don't worry about gettingthem right.
Just go as best as you can.
(42:00):
Oh my god.
Now I'm like, oh okay.
Okay, so um, what's theinsertion of the quadrice?
I'm just kidding.
Rapid fire, number one.
What's the top book that you'veread recently in the last couple
of years that's blown your mind?
SPEAKER_03 (42:16):
Uh this is supposed to be a rapid fire.
Oh, it's okay, don't worry aboutit.
Um so um I'm gonna take in thiscase um you know, my spiritual
journey is a little bit um umvery specific, and um um I would
(42:40):
say uh something like the 15thAmerican ACC.
SPEAKER_00 (42:48):
Okay, um it's very ritual and uh so the title is
15th American ACC?
Oh, okay.
SPEAKER_03 (42:59):
Awesome, love that.
Very good.
Standing for um Americanclinical course.
SPEAKER_00 (43:06):
Okay, mind blow.
Love that.
Okay, next question.
What's your top time saver hack?
My virtual thing, I hope shelistens to this.
Me sure love you.
SPEAKER_03 (43:22):
She'll listen to it.
SPEAKER_00 (43:23):
She'll listen to it.
Oh, I love it.
Okay, number three.
What's the one thing you wishyou'd stop doing way sooner in
your business?
SPEAKER_03 (43:31):
Um not taking advice that donated wrong statistics,
but instead putting a lot moreattention on how I felt about
(43:54):
something, not about what thenumbers showed.
SPEAKER_00 (43:58):
That's powerful.
Because it's kind of an arc,right?
Like we come in because of thepassion, and then we don't know
how to track the numbers, andthen we start tracking the
numbers because we have to, andthen we start making it about
the numbers.
So it's a full cycle.
Okay.
What is the most time-consumingtask that you secretly enjoy?
(44:20):
Um secretly enjoy.
It's kind of like a maybe likeone of those um, what do they
call those?
It's uh one of those things thatyou do that like you know you
probably shouldn't do, but youkind of love doing it, so you
keep doing it.
SPEAKER_03 (44:35):
Um, you you you know what what um uh I enjoy um
definitely having uh long uh umuh conversations with friends
while wine tasting.
SPEAKER_00 (44:54):
That's a good one.
SPEAKER_03 (44:55):
Especially when it's more than a couple of glasses.
SPEAKER_00 (44:59):
More than a couple of friends and more than a
couple of glasses come together.
Okay, and then um what is if youhad unlimited time, what would
you focus on in your life?
SPEAKER_03 (45:17):
Um training somehow more than I do right now to
create a larger influence insociety in general.
(45:38):
Yeah.
SPEAKER_00 (45:39):
Because your your passion's huge for that larger
dynamic.
SPEAKER_03 (45:43):
Yeah.
I mean I I if you see if you candefinitely you can deliver stuff
to a single individual andanother individual, another
individual, uh but if somehowyou can deliver in someone who
they themselves have caninfluence a bunch of other
(46:03):
people, then your effect will bemuch larger, right?
SPEAKER_00 (46:08):
Yeah, absolutely.
Like uh Okay, well good job.
You answered those rapid firesvery well.
SPEAKER_03 (46:17):
Okay, I I I I think this I'm gonna have to go uh
triple, you know?
And that will make my six shotsfor the day.
So uh uh look, what time are werecording this?
It's like uh almost one o'clock.
I had three.
Wow.
Uh so uh the the three ones arenow we've gotta go for the three
(46:41):
afternoon ones.
So wait, um, how about uh uhwe'll do um take-home message,
last words, or something likethat?
SPEAKER_00 (46:53):
I like that.
I like that.
Um, do you want me to go andthen you'll you'll you can
finish?
Yeah, that's fine.
Yeah, my take-home message foreveryone listening is the
importance of recognizing thatthere's hope, that this is the
best time in the history of ourprofession to be a leader or
owner in the physical therapyspace because we are at this
(47:15):
kind of like I had to compare itto being like in the real estate
industry in market around 2008.
The best time in the history ofreal estate to get into real
estate was 2008.
You know, and so a lot of peoplewho'd been through 2006 and
seven wouldn't agree in 2008 ifthey weren't able to see the
future.
But when you look backwards,like, oh no, the beginning of
(47:36):
great things was about to occur.
We have so many things pivoting.
So I just want to encourageeveryone who's listening to
never give up.
Focus on on increasingreimbursement, be bold enough to
join uh an event.
The hands-on diagnosticsymposium is one that I highly,
highly, highly recommend.
It has that symposium has a lotto do with why I have my own
(47:59):
events.
So if you have to choose betweenthe two, go to that one because
I wouldn't have mine withoutthat one.
It's a it's a networkingopportunity on steroids.
So just be brave enough to buildthat network, and that would be
my parting thought.
What about you, Dimi?
SPEAKER_03 (48:13):
Yeah, well, first of all, we have to make sure that
our symposiums don't conflict interms of dates.
SPEAKER_00 (48:19):
I scheduled mine intentionally not to conflict
with yours.
I scheduled mine in March, so Iwould never step over your your
November, your November, Octoberevent.
SPEAKER_03 (48:29):
Awesome.
Uh, is is yours coming up thismonth?
SPEAKER_00 (48:33):
It is.
We have we we made the mistakeof only giving a hundred seats
out, and so we're almost alreadysold out for March.
SPEAKER_03 (48:41):
Awesome, awesome.
What's where are you where areyou hosting it?
SPEAKER_00 (48:44):
Phoenix.
We have this really cool spot inPhoenix where we have a state,
you know me.
I need to be the center ofattention.
So we we have like a live band,and then me and my comedic
partner get up on stage and wedo comedy songs about physical
therapy, but the whole event isabout learning how to recruit,
train, and retain talent.
It's all about the people sideof the business.
(49:04):
And we have come most peoplecome from out of state,
ironically.
Um, so we have people fromacross the country, and then we
do something really fun.
We invite all the localuniversity students to attend
one day to get interviewed, andit turns into an actual hiring
event.
And so um half of the Arizonastudents leave the state and
want to go out of cut out ofstate, so it's perfect.
(49:24):
People usually will hire, soit's fun, it's a lot of fun.
SPEAKER_03 (49:28):
Fantastic.
And and and you you will give usalso the link, so we're gonna
post it also in our um uhpodcast uh resources.
And vice versa, please.
All the links.
Awesome.
Okay, final thoughts, Debbie.
Uh final thoughts.
I mean, um, I totally agree withwith uh what you talked about,
uh uh and hope and and and Iwant to add to that action,
(49:50):
yeah.
Right?
Yes, there is hope to dosomething, but we have to do it,
we have to take action on it.
And uh if nobody is gonna justgive you the world, nobody's
gonna just come and tell you allof a sudden we're gonna double
your reimbursement just becauseyou are cute.
No, you gotta do something aboutit, you have to take some
(50:13):
action.
And many people they're like uhmany times in a zone of
indecision.
They're like, okay, should I dothis or I shouldn't do this?
Should I do HUDs or I shouldn'tdo HUDs?
Should I get a virtual assistantfrom Will or I should not get a
well, you know what?
The worst place you can be isthe zone of maybe because
(50:37):
indecision is actually adecision.
So just indecision is adecision, right?
Absolutely.
Indecision is a decision.
It's a decision of not doing it,actually.
Yes, uh good.
You're embracing the change, youare embracing the new, you are
(51:01):
embracing the new opportunity.
If your decision is no, uh atleast you are freeing up your
mind from being stuck somewherein the middle, not knowing what
to do.
And and eventually you'll beable to put those attention
units to something else that youwant.
Never be in the middle, never bein a state of maybe or
indecision.
(51:22):
Just make up your mind and dosomething.
SPEAKER_00 (51:26):
Okay, uh, Dami, it has been too long.
I am so grateful that we got tobe together.
I sure appreciate you being onthe show.
I am honored every time I'm withyou.
Awesome.
SPEAKER_03 (51:37):
Likewise, and you know what I guess we should get
our friend Nathan and Rio.
SPEAKER_00 (51:45):
That let's do it.
I would do that'd be so fun thethree of us to talk and share
memories from the battlefieldsof me calling doctors and
hanging up after introducingmyself and as an electrician,
like all the things, like wecould do all the things.
SPEAKER_03 (51:58):
Exactly, be awesome.
Thank you, Will.
Uh thank you, Did you uheverything to do and appreciate
uh giving the opportunity alsofor your audience to for me to
share with your audience uh someof my thoughts.
Thank you.
Thank you.
All right, so I guess we sayokay.
SPEAKER_00 (52:18):
Well, Dimi, thank you so much.
Let's stay in touch and please,I mean that.
Let's stay in touch.
I'll I'll send out all theassets and stuff, and then yeah,
man, great to be with you today.
I sure appreciate your time.
Sounds good, likewise.
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