E652 | How The Industry Has Evolved and Where It's Going

In this episode, join Jerred Moon, Yves Gege, and Doc Danny as they delve into the ever-changing world of physical therapy and performance-based clinics. With over 10-20 years of experience, they reflect on the significant shifts they have witnessed and provide compelling predictions for the next decade of this industry.

First, they delve into the issue of reimbursement rates dropping for physical therapists due to over-coding by certain clinics. This unfortunate trend has forced clinics to see more patients per hour in order to maintain financial stability. However, they also shed light on the emergence of a new path for physical therapists, where they venture into the health and fitness realm. Through direct-to-consumer cash-based models, therapists can now enjoy more freedom and potentially earn higher incomes.

Additionally, our hosts highlight the positive change in the perception of physical activity and strength training within the general population. Over the last 10 years, people have become more aware of and accepting the importance of incorporating physical exercise into their lives. As a result, clinics have evolved to meet this demand, incorporating gym spaces alongside treatment areas. This innovative approach enables the provision of pre-hab, re-hab, and small group training to bridge the gap between injury and returning to the gym.

Looking into the future, our hosts envision an even greater integration of the gym/fitness space with the healthcare industry. They predict the rise of standalone clinics with 3-4 practitioners who offer both treatment and training. These establishments have the potential to become 7-figure businesses, revolutionizing the way healthcare and fitness merge.

While discussing challenges in reaching underserved populations through the traditional medical system, they also recognize the opportunity to empower other clinicians to provide proactive health education. By leveraging their expertise and offering valuable resources, these clinicians can make a difference and improve overall healthcare outcomes.

Join us as we explore the past, present, and future of physical therapy and performance-based clinics. Gain insights into the evolving landscape of this industry and discover what the next 10 years may have in store.

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Podcast Transcript

Danny: [00:00:00] Hey, real quick, if you were serious about starting or growing your cash based practice, I want to formally invite you to go to Facebook and join our PT entrepreneurs Facebook group. This is a group of over 6, 000 providers all over the country. And it's a pretty amazing place to start to get involved in the conversation.

Hope to see you there soon. Hey, are you a physical therapist looking to leverage your skillset in a way that helps you create time and financial freedom for yourself and your family? If so, you're in the right spot. My name is Danny Matei, and over the last 15 years, I've done pretty much everything you can in the profession.

I've been a staff PT. I've been an active duty military officer, physical therapist. I've started my own cash practice. I've sold that cash practice, and to date, my company, Physical Therapy Biz, has helped over a thousand clinicians start, grow, and scale their own cash practices. If this sounds like something you want to do, let me know.

Listen up because I'm here to help you.

Hey, Danny here. And I'm excited for you to listen to this podcast all about how the industry has evolved for physical therapy and how we really feel like it is going to evolve going forward. Again, this is a cool [00:01:00] opportunity for me to get together with my business partners and talk in person. And we have a video of this one as well on the YouTube channel, but if you want to listen, this is where it's at.

We want to share. Kind of what we've seen, the trends that we've seen. And more importantly, it's definitely stick around for the end of this podcast, because we go over where we see it going and we're calling our shots of where we see is going to happen over the next 10 years, in particular, in this sort of cash based or performance world that we live in.

Every single day. And the clinics that we help grow every single day, they live in that as well. So this is what we think this is us calling our shots. We'll see if we're right, because we can always go back. It's like a time capsule. See what it looks like 10 years from now, if we were right or if we were wrong, but hope you enjoy this one where we've been, where we think we're going to go.

And where you should really think about moving towards with a, what Wayne Gretzky always said, skate to where the puck is not where, or where the puck is going, not where the puck is. So you want to know where we're going, where you need to be to really put yourself in the best position to be successful going forward.

Damon Tate here with Physical Therapy Biz with Jared Moon and Eve Gigi, and we are on a a trip. See some clients here [00:02:00] in Boston. Check out their practices, highlight what they have going on. We have some really, cool spaces that we're going to be able to share with you guys in other videos.

But one of the things that, one of the things that we wanted to get into is we're just having this conversation, especially looking back at our own practices and things that we've seen as in the performance based clinical world, and I lump that into really don't really care what your degree is in, right?

If you're a clinician and you're helping people, move better, you're loading them up, you're teaching them how to, whatever your subspecialty is run better. And you want to actually help people not just, get out of pain and then discharge them. And you want to actually help them achieve some sort of.

Health and wellness goal that's who I'm talking to. And that's what we did. That was like, that's our bread and butter. That was our niche. But over the last 10 years, there's been a massive change in terms of what these clinics look like the viability of these clinics as well as the knowledge to the general population, that's a huge 10 years, we're going to chat a little bit about what we've seen.

But then also what I'd like to do is maybe be able to call our shot for the next 10 years. And say here's what I think we're going to see. Yeah. So if [00:03:00] I'm like, pointing out to left center, I'm telling you, I'm going to hit it there. I want to see, we'll see if we're right. So we'll document that and and really see what we think is going to happen over the next 10 years.

I'll, we'll start with this. Eve, for you, you've been actually a physical therapist even longer than I have. You're far older and clear, yeah, or older and you're, you, but you have a lot more experience that. So I'd love to get your opinion on like for the last 10 years, what have you seen?

As the biggest difference, maybe even 20, right? Because if we look at these couple decades prior, we definitely seen some evolution in terms of the clinical space, healthcare, and like how bad it is in comparison and stuff like that. So what have you seen in terms of like big evolution and changes in that space for the last couple

Yves: of years?

For sure. This is something I think about a lot because you have almost two trajectories. You have a trajectory of the medical world. And what it's doing, and then you have a trajectory of health and fitness in general and how that's become a little bit more part of today's world. So you look at PT, which is a fairly new profession, and performance space [00:04:00] even being even more new.

And when I was researching to become a physical therapist, basically I remember somebody coming into my high school and saying, you can make six figures a year, it's super easy, all you do is put hot packs on people, like it's a great job, you can move around, you can do all these things, it's gonna be awesome.

And by the time I made it, To PT school, right? It had already totally changed. Reimbursement had dropped. You were seeing, four or five people sometimes in an hour. It just completely shifted.

Danny: The thing about reimbursement dropped because of primarily physical therapy clinics that were Incorrectly coding on purpose to be able to get more money like they shot themselves in the foot.

Listen that's why, when you start looking these audits by companies and they're like, Oh, I'll get 80 bucks to put a hot pack on somebody. Everybody gets a hot pack. And they were making more money in, the 80s, 90s, early 2000s. Then they are now because reimbursement got cut by so much because of greed, frankly, from practice owners.

Yeah,

Yves: and so you had that model and then we had to change the model, right? So [00:05:00] people had to see more patients. They had to try to find a way to create more value. And the only way to create more value in the clinical space was to try to increase their degrees. So going from master's to doctorate, right?

Try to create a way to, physical therapists being more like direct like direct to consumer, come to them first before doctors. But I don't think that was the model that was going to work, right? We can't just, we couldn't carve out more in the medical world. So what happened is people started peeling off into the health and fitness realm, right?

And people started saying I can provide value here. I can. Go directly to the customer. They can come see me directly. I don't need to worry about insurance and people are going to pay me a premium rate. That's what I saw because I was buried in the insurance realm. I was buried and did pediatrics. I did that for 10 years before I went into the cash based realm.

I didn't know anything about strength conditioning. CrossFit was my like in my 30s. I finally learned like how to squat and do these things. And so it was just, I think my journey was [00:06:00] absolutely crazy. So what we saw is more people doing this. More people getting excited about teaching them how to live a healthier lifestyle, teaching them how to reach their fitness goals.

And as soon as that became a thing, now we're seeing it exploding. And now you're seeing it exploding in the medical realm in general. Yeah. You're seeing MDs go that route. You're seeing chiropractors go that route. You're just seeing

Danny: more Lifestyle medicine. Yeah. As I think it's a

Yves: term, yeah. Like, all these things.

Just having health and fitness and just living better, just becoming more of a thing, which is so cool for our profession, because we timed it because now that is just expanding. And PTs, in my opinion, are, and clinicians in general, are a great, entry point for a lot of people because we know the medical realm you can know the strength conditioning realm and I think we'll I think it'll become A huge part of the medical

Danny: world.

I think the other thing you're seeing too, this isn't clinically necessarily with us, but if you look at traditional medicine, so here's a good example. My sister in [00:07:00] law, she's a nurse practitioner, high level nurse practitioner. Working at one of the, probably top five hospitals in this whole country is starting her own functional medicine practice and leaving this hospital because of, I'll tell you what it really is.

It's difficulty with not feeling like she's able to make a change with people. It's frustrating, right? It's oh, you, what am I going to do with this person that's literally so sick and I can get 10 minutes with them? My neighbor is an internist in a big hospital in Atlanta. And he's doing the exact same thing and moving towards this lifestyle medicine.

And I had a conversation with him at it was like a neighbor's house party that they had a couple of weeks ago. And he said the same thing. He's man, I get, these people are so sick by the time they come in. I can't do anything for them. I want to talk to them about eating better and drinking more water and like sleeping, and I think we're all going the same direction in all these different medical fields and straining conditioning.

Is has been there much longer. People are a lot of people are scared to go to a gym. They're scared to go to a [00:08:00] trainer. They're scared to work with the coach of some sort. But their doctor doesn't scare them off, a physical therapist doesn't scare them off, so it's a really good gateway to get them there.

So I'm seeing that a lot in a lot of other professions, but Jared, from the strength and conditioning side, you've seen this on the other side, right? To where it's starting to become more acceptable for people to be physically active more than the general population. We're outliers. I don't...

View it that way until I get around my kids friends, and I ask them to come over and drag sleds and then get in the sauna and cold plunge, and they look at me like I'm crazy. Yeah what? Can I tell you how many people ghost me when I say that? They're like, bro, let's hang out. Come over.

We'll drag sleds. We'll get in the sauna and the cold plunge. And they're like, oh, sorry, I'm sick. Or, oh something popped up last minute. It's they're not doing it, right? Still too extreme for most people. So what are you seeing with the general population moving towards acceptance of I need to be physically active?

Yeah, I think. I think that you were in one of two camps. It's like you were either one type of athlete, or you were like super, just worried about how much weight you could lose or whatever, like that was what fitness was, especially when I [00:09:00] got started.

And it was just like people looking to lose weight and people looking to perform. But on the performance side, there's a ton of injury, right? Because people are just trying to max perform their body. So what I'm seeing Is this way more of a longevity push just across every capacity? I think people were actually starting to see the ultra runner or the CrossFitter kind of peeking out of there because those things are new, right?

And now we're seeing people like, Oh, wow, you like tore your body apart. You can barely move. You can't do anything. And so they know that these professions are more important, right? So I think that they're getting more involved there, but people were also like. What's the, what is the actual best thing I can do?

What is the actual answer here for me to be the healthiest human that can keep moving for the longest period of time? And that's typically going to be some form of strength and conditioning, not being a runner or being a lifter or whatever. And it's certainly not max performing your body for decades, if you're gonna, you're gonna pay the price for that.

Yves: I was jealous of strength conditioning coaches and gym owners because I felt like when I saw patients. I could not [00:10:00] create transformations. I didn't have the equipment in my facility. I honestly didn't have the knowledge in my facility. And that's really what spurred on the cash based thing. It's just I don't know how to have these conversations about lifestyle.

I know how to get somebody out of pain. I do know, like, how to heal tissue and get more range of motion. But I knew nothing beyond that. And I was like, why can't I do more? And as soon as you go down that route it gets really fun. Because you can make... Some absolute amazing transformation. It's harder to go that route.

Like I still think what we're doing is form based clinicians is definitely harder. We talk about this in the made to move all the time. Like I always tell people, it's you need to go there. You need to go and like, why do you want to be healthy? Like it's not only, just the physical part, but it's probably a lot emotional too.

Like we're all talking, but we're still probably the least fit. We've ever been as a country, probably ever, but it's becoming more of the forefront. So I see the things changing. And again, that's why I think the opportunity is so big because they're going to want to go to somebody right. And the clinician, the strength conditioning coach, like these are the people that I think are going to be.

Healthcare of the future, right? You're going to go somewhere and you're sick, but if you [00:11:00] want to just live longer, like that's who you're probably going to go to, they're going to have way more knowledge than than it indeed is there in way more knowledge than anybody else. Hey,

Danny: sorry to interrupt the podcast, but I have a huge favor to ask of you.

If you are a long time listener or a new listener and you're finding value in this podcast, please head over to iTunes or Spotify or wherever you listen to the podcast and please leave a rating and review this actually. It's very helpful for us to get this podcast in front of more clinicians and really help them develop time and financial freedom.

So if you would do that, I would greatly appreciate it. Now back to the podcast.

And I think the coaches, I look at it like the coach is the tip of the spear. And this is what, when I was teaching with Kelly Kelly's group, we were trying to empower coaches to understand more. Deep understanding of movement, biomechanics of even baseline injuries, not to be physical therapists, not to be chiropractors, not to be athletic trainers, to know when someone needs to go see somebody and to be able to talk to them and have that [00:12:00] conversation.

And then also is for them to like, who should you look for to have this symbiotic relationship with? Because. It's not really up to us to just do teach somebody how to squat under load versus a coach do these things. It's far more, cost effective. It's a better environment for them to get them to.

But in a lot of cases, people need a lot more time to get to a gym, to get to a coach than they even think because they're in such a bad spot. Physically, as a country, we're in a terrible position. It's if, and it's not trending the right direction, really. It hasn't been for a long time.

So if you're in that realm, I think that you've got great job security. Cause I just don't see the population as a whole getting healthier on their own anytime soon, but there's definitely interest there more so now. And what's been interesting is even to see post COVID people that are like, Oh crap, I need to get myself, I need to get myself together. I have a family that's been like this, that literally had no interest in any sort of physical training, and all of a sudden they felt vulnerable, very vulnerable. [00:13:00] And they started to make these health changes because of that. So I think on the back of that, this is probably like a really good silver lining that hopefully people take that as maybe I do need to be healthier, I need to work on myself.

But it's just like fish in a barrel. If you really think about it, like there's such low hanging fruit with most of the people that we work with, and this is in the health and wellness space, but also in the, the clinical space. And if you can understand that and you can start to get people in that are making those positive changes, it's so big and you're right.

It's it's not as simple as, I just want to look a little bit better. It's like deeper than that. And people have to, they have to independently come to that conclusion. Like I remember I was at a networking event and this guy. was telling me, he's like this big real estate guy, all these like multifamily properties.

They had almost a billion dollars of assets under management, right? And I'm like, Whoa, cool. That's awesome. Like it's a lot of, it's a lot of apartments. That's, so I was like asking him about his stuff and I'm just interested in learning about what he's doing. And he asked me what I do. And I go, I'm a physical therapist.

So that's, I still identify as a physical [00:14:00] therapist. I don't know. It's it's not really treat anybody at this point, but that's still like my background. And he goes, Oh, that's awesome. I need a lot of help there. And I, within a few minutes, he's crying. And I'm like, this is crazy. This guy, and this is exactly what I did.

This is what I said to him. He's he goes, that's my biggest area. I need to improve. And I go, do you, and he told me he listens to all these podcasts. And I go, do you mind if you show me your phone and what podcasts are you listening to? Every single podcast, finance, real estate, like all these personal development ones that are all just related to money.

And I go, you could tell me that's your biggest problem, but your attention is not on that. And he literally started crying, at this table. And I'm looking around oh shit. Like I'm new to this group and this guy's been around forever and he's bawling at the table. And I didn't know what to do.

And he just started basically he's you're right, you're like, I know I'm like, he's basically committing gradual suicide. That's what's happening. I didn't say it in those terms. But it's, he wasn't a healthy guy and his, what he tells me is important is not what is showing to [00:15:00] be important and what he information he's taken in.

I go, dude, if you just took half of the amount of time that you're listening to podcasts about real estate and you did that and you listened to health and wellness things and I gave him a whole bunch of different things to listen to. That's the start that you need to start to change this right away because you can dig yourself out of this hole if you want to.

So I think that the average person is like this guy, they don't even know what they don't know. And as soon as you have a conversation with them, it's all of a sudden it's oh crap. I can't make a difference and it is important.

Yves: We're seeing that we're so when we started thinking about a cash based businesses, the conversation was around, is it a scalable, can you hire more?

Yes. Think about it. That was like a long time where everybody in the profession was like, there's no way you'll ever scale past yourself. You'll never get a standalone space. Now it's common. Now it's common to have multiple practitioners. It's common to have a gym in your space and almost be all inclusive, which I think is absolutely cool.

So this has just happened in the past four or five years. So what does a decade from now look like? You know what I mean? Like it's not going to stop. It's not going to get, it's not going to stop growing, we're just [00:16:00] going to continue to get more, let's call it market share of this stuff. We're only going to get better at doing this.

We're going to have more clinicians figuring it out. As we see the group of 200 people and all these best practices coming just keeps getting bigger and better all the time. So I'm just, I'm excited to see what the next 10 years. I'll

Danny: tell you, I think what, if I was to start a practice again, right?

Because we sold our practice, but yeah, I had these. delusions of grandeur where I'm like, okay, round two, right? What would I do? Not I really don't think it's whatever happened, but this is what I think people will evolve to if they have the capital for this, right? Say you could find an investor and you wouldn't have to start in a subleased office like we did.

There was, 200 a month. If I had money to do this, I would. I would build a space out that's probably like 3, 000 square feet, I would have probably four or five treatment offices and I'd have a gym space that was maybe, 1, 500 to 2, 000 square feet of that space.

Because what I see more than anything is this, there's this in [00:17:00] between area for people that we're really good at that people need help with and that's, they go from injury to then gyms over here. But in the middle is like getting your tissue integrity even ready to load you in a group style setting, getting your conditioning up, getting your mobility, potential, like your control through range and to do so in a group setting that is smaller with someone that knows how to modify based on your injury history.

And like that right there, if there's somebody that's hurt, that's gotten hurt in a gym. I could sell that person into that at whatever amount that I wanted them to pay me. Because all I'm competing with at this point is a personal trainer. And a personal trainer one on one with somebody that is, that might be what they want or what they need, but it's far less engaging and the level at which somebody that has now worked with you to get you out of back pain or whatever it is, that doesn't have to then have the telephone game with somebody trying to tell them what they need to avoid and the things that you've found and that person can then...

Train multiple people at once. This is very similar. We did the military by default. [00:18:00] We had to, because we didn't have enough clinicians. So it's okay, ACL, we have ACL groups that we would meet with. You're at this stage, we go through this. And I always found it so much more beneficial for those people because misery loves company.

You're doing it with other people. They get to know each other. They develop friendships. It's a huge part of like accountability, why people show up, right? So that for me, I see that 10 years from now, I don't know who's going to do that. Probably a lot of people, probably a lot of people that we work with as they grow and they build like that model right there, just on the business side, even you're talking, probably if you, if done correctly, this multiple seven figure revenue facility that you actually get to fucking help people like.

That's amazing that you can mesh the two together, and I think that's where it's going to go. Yeah, I think,

Yves: Having, if we're talking about 10 years, what our prediction is, I think it's merging the gym fitness space with the healthcare space, and we'll be the ones to probably successfully do that.

You'll see a physical therapy clinic looking like a gym, and a gym looking [00:19:00] like our version of a physical therapy clinic. They'll be merged. People will be doing small group training and treating people out of these stand alone facilities. Having three to four practitioners, seven figure businesses, and that's just going to become, I think very common, and hopefully some, somebody figures out a model, and I think you'd franchise the heck out of something like that. You could. I think it could absolutely kill her because you're just going to find the right people. It's very profitable, you keep them all in house. It's also very enjoyable for the clinician.

We need to talk about how. The state of the medical profession, how many people are burning out, like they're not going to want to work at a hospital. You're going to say you want to work at a hospital, you want to work at this place, see four to five people, do a little bit of training on the side, they're going to pick that all day.

So we're going to get the top people, all the time into this region. And yeah, I think it's going to explode.

Danny: And I think the cash pay world in general is just. Also exploding. Because insurance sucks. They're terrible. Even if you have your insurance plan and your deductible might be so high that it doesn't really make sense to get worse care or pay the same.

You know what I'm saying? That's what can happen with a really high [00:20:00] deductible. Because I did it when I first started in PT Biz. Yeah, some of our clients, that was a big thing, was like, how do I talk to people

Yves: about cash? That was, that's

Danny: not really as much of a conversation anymore. Some people might have that in their community, but the general public is so much more aware of that.

I have a medical doctor, I have a physical therapist, I have a chiropractor, all three of those are cash backed right now. And that's not even on purpose at all, because I'm a part of PT Biz. It's just I need to do a biodegradable healthcare plan. And I'm like, Why would I get paid to see a 15 minute physical therapist or, 15 minute medical doctor when I get a full hour of their time to be focused on me?

And so I think that's gonna become just way more complex. It already is. The fact that I can't even find a medical doctor, physical therapist, and contractor at all, at a basic point, when it's focusing on me accepting cash,

Yves: I'm like, the insurance space world now, which is crazy. Yeah,

Danny: why would anybody go back, right?

I had to go to the dermatologist. And I sat there for 45 minutes in the waiting room, like I'm there early.[00:21:00] I'm filling out paperwork, whatever, but like 45 minutes after I'm supposed to be seen, this person comes in, not only, are they only in there for about 5 minutes, but they Google.

They like, look up what the, what this thing was. Like, I'm not Googling an ankle diagnosing your ankle sprain or something like that. I'm like, are you seriously gonna sit there? And Google what this is called? You're just searching this? Am I even in the right place? I like, okay it was like, not a big deal, like super insignificant, and I go out and it's 300 bucks.

I'm like, you should give me 300 dollars. You wasted my entire hour. And I could have looked this up myself. And it makes me so irritated because I know what great care should look like. And anybody that's had an experience like that, which is most damn people. In a medical setting and all of a sudden they come and they see one of our folks and that person's paying attention to them.

They're having a conversation with them. They're learning about what they actually want or, they're listening to them. They spend time with them. They create something that's specific to them. And they're also subject matter experts in that thing. You'll never go somewhere else. [00:22:00] They'll never go somewhere else because it's such a better health care environment, and it's too bad that we can't figure out how to also have that to where insurance does pay for those things.

And because if they did, and we could pay our people what they deserve and get reimbursed without having to fight with them for like barely any money, I would say get in a heartbeat, and, but it's just not where we're at. And I think that's not something that's changing anytime soon, right?

So if we look 10 years from now, is insurance in a better place or a worse place? It's probably worse. Even if it gets socialized even if they say, okay, Medicare for all, look at other countries they've done that with. Canada, Australia, England. I've been to those countries and talked to those clinicians about it and it's a mess there because it's such a long wait.

Now all of a sudden, instead of wasting people's money, you're making, you're wasting their time. Okay, you can wait three months to get into, get an evaluation for X, Y, and Z or whatever, unless it's an emergency. And it's very similar to the government system, which I worked in for years. And it's, you pay with your time and people are still gonna value Get me in faster.

You pay more attention to me. Like they're skipping the line. And [00:23:00] in some cases, it's even better for a clinician that can do that because Time is a very valuable asset.

Yves: Yeah. I think what we're really good at is you have, you bring your leg and you have a traumatic event we can get that taken care of.

But if you want to live longer, you want to live a better life, you want to reach those goals, then going into the medical world is not going to be worth it. It's

Danny: sick care, not health care. Sick. You gotta be sick or dying to really be someone that is a priority in those settings. Versus, if you went to your doctor and you're like, I feel fine.

I'd like to get some blood work done so that I can see what my biomarkers on are at right now and make sure that I'm not turning the wrong direction. Maybe give me some advice based on what the panel shows, what areas maybe I'm insufficient in and take a look at my diet and maybe talk to me about, my, my exercise routine and stuff.

And they'll be like, what are you doing? Come here when your liver is failing and we got you until then go away, and it's too bad because that's the conversations we should be having. And that was all a lot of our [00:24:00] actual healthcare problems. Instead of people waiting to get sick, we can actually work on those things on the front end, which is obviously probably the biggest problem we have as a country.

A lot of people say there's a lot of shit that, is wrong. And then, and you could point a lot of things, but if you look at the biggest drain on our government, monetarily, the biggest ones is healthcare. It's us having to pay for people making. Bad health decisions and being in such a bad spot that, it's expensive and we are really great at the proactive side.

And we're really good at the reactive side. One of the, best countries in the world. If you're dying, people come here. They're like, I'm dying. I'm going to the U. S. so they can solve this, and we have great doctors. And it's too bad we can't turn that attention to be more proactive because I think we could solve so many long term problems.

Yves: Yeah, I think the general public is now finally seeing that quality. Matters. I think before it was like, you went to the doctor, you felt like you got a really good experience no matter what, they were knowledgeable, and now they're having experiences like you have, and they're like, I actually need to find somebody good.

What is, how do I do that, right? And that's carving off, [00:25:00] like Jared said these people are typically cash paid, like we see it all the time. My dad's a doctor. My father in law's doctor, all MDVIP, all going in some form of a cash, we'll call a hybrid model. I think you're going to see it more.

You're going to see the top, and they're going to be some form of cash performance based. And then, unfortunately, you're going to see the bottom, which is typically going to be hospital based care. And there's not going to be much room in the middle. I think

Danny: that's a, I think that's a bigger problem in its own right, too.

I do, I feel like the it's challenging sometimes that I think that the clinics that we set up. The average person, a lot of people cannot actually afford to even work with us in those settings, right? So when you look at somebody like Kelly and Juliette Sturette with the book they just wrote with Built to Move, and how can you take basic information, simple information in a book that costs ten bucks, and be able to start to have this change that people can make, you gotta be pretty self motivated to want to do that from reading a book.

But how can you take that information and you can empower that into clinicians that are at like rural hospitals that are at, places where [00:26:00] they've got, Medicaid and high Medicare population or people that are like uninsured that are at free clinics. How can you start to actually change some of those things?

That's just a. Such a challenging not to unwind, right? And I think for us, we take for granted just how lucky we are to have people that have the resources to work with us, as well as the drive to want to get better. And it's fun to work with them, but, on the same side the problem that really, exists, and I think we're going to learn a lot from what we're doing here, can be applied in that setting, is if we can solve that, and if people can solve that, good lord, what an amazing thing to be able to improve.

Does that make, that's, that changes. So much for so many people that don't even know the right thing to do that's where a lot of people actually are. I think

Yves: yeah, I think what was interesting and this I've got a unique experience in the insurance based practice. We didn't do anything really for the community.

Like I really didn't feel like I was making a difference. I saw a lot of patients, but I didn't have those transformations. Now in a in the performance space realm the amount of workshops, healthcare, and that's [00:27:00] all free. We're not even understanding the impact that's making for all the free stuff that we're doing.

You know what I mean? Create actionable things for people in gyms to keep them healthy, right? Arguably, ways, because we hear this all the time Oh, is it affordable for everybody? Are you making a difference? You're being, like, too picky or whatever. I was like, man, I'm doing more free healthcare now than I ever did in insurance based, right?

Because it wasn't worth it for us. There's no reason for us to go out and market it. It was just like, people came in for a co pay. They clocked in, they clocked out. That was basically it. So I think we're making more of a difference. Think about how many workshops people put up, between all of our 200 plus practices, how much free healthcare information is happening on a monthly basis between all those massive, right?

Massive. They're not all coming in, but they're all getting information of how to keep themselves healthy. So there's just a lot of cool stuff. Yeah.

Danny: And free content. Like I think that's key, but but it's I'm excited to see what the next 10 years look like. And it's really just a blip on the radar.

If you think about it, like 10 years, it's just Flies by unless you're 10, right? And then it's, it's not like my kids are just like, Oh my [00:28:00] God, it's like school's so long and I like, man, it's Christmas before I know it, and the older you get, it's just like such a smaller part of your actual life.

It's interesting to see 10 years for us. It doesn't really seem like a lot of time. But we'll see if we're right, it's cool to have these conversations and hopefully, share with. People that are watching this and and people that are in the space and what we see and what we're seeing.

And this is what we'd like to have conversations in person with too, is what are other people see, and what are they seeing in their city? What are they seeing in their town? Small towns are different than, Boston, major city, right? The way in which people view things can be very different if your town's 10, 000 people.

A very different messaging and all that. So that's it. So we're calling our shop. That's what we think is going to happen, what we've seen in the last 10 years and we'll see if we're right. So we got this as proof documentation. Boom. Cool.

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