“I performed 15,000 surgeries… and too many of them were unnecessary.”

Amber and Josh Schachter, welcome to Rebels with a Root Cause. Thank you so much.

Thank you, Tim. We're so excited to be here.

Thank you for having us.

You're so welcome. So introduce yourself to the audience. They'd love to know who you are, where you're from, and, and what it is that you do.

Well, I'm Dr. Joshua Schachter. I'm a board-certified orthopedic surgeon. I had been employed for about 15 years in a small town in Texas, Wichita Falls, Texas. Then even though I was the head of the department and, and doing a lot of, I did about 15,000 surgeries in my, in my career. I started to get really, really burned out. And so we were really looking for a solution and our solution was to go into integrative orthopedics. So we left a traditional practice. We opened an integrative orthopedic practice in Wichita Falls, Texas. And it's been quite a journey for us. Yeah.

Yeah. And Wichita Falls. Wichita Falls, Texas is about 2 hours from Dallas, correct?

Yeah. So we're in the north central part of Texas. Yeah. So, um, I, my background before I rescued Josh from the abuse of the traditional medical system was I spent the last 15 years in hospitality and I've done everything from a big convention center, fashion show design workflow of people and, and how to move them in those big areas down to high-end white tablecloth fine dining. And so I really had spent a lot of time creating experiences for people to feel seen and held and enjoy, uh, their experience with me and in my environments. And so that's where my background comes in. Uh, Josh and I have been married, uh, since I was 18 and he was 20. So we have got lots of time and road, you know, under our belts between us. But we came to Integrative Orthopedics and started the Pinnacle Method 3 years ago. Yes. So I know that Josh had talked about, you know, working 15 years as an employed doctor. I mean, how did you feel about this? Like, why did I create this business for you?

Yeah. I mean, that's, that's the, that's, that's the real question is, you know, I'm sure things were good, right? In the system, right? You were—

Well, you made lots of money.

Sure. Like, hey, listen, I was caught as well, right? The golden handcuffs. Like they, You know, you get to rise inside the organization, right? You're, you know, become, become respected in the community, like all those things, right? And then, but something went wrong. What was that? What's that rebel story?

Well, I, you know, as I did more and more surgeries through my career, I started to really question, one, do we need to be doing all these procedures? There's, there are measures that I was starting to become aware of, regenerative therapy and other measures that maybe could prevent us from needing to do fair number of this.

So where were you learning all this from, right? Because you're a small town, right? Where were you learning regenerative medicine?

Well, it's, it's something that I started to get interested in, in— is sort of an augment to my sports medicine surgeries. I did a, a massive number of like ACL reconstructions and shoulder scopes for rotator cuff repair, and, and I started to get exposed to the use of PRP and stem cells to sort of help accelerate healing in those cases. And as I was, as I was sort of diving into that, I got more and more interested in how can we use these to maybe prevent doing some surgeries. Yeah, this is not a popular sentiment, by the way, in hospital employee practice because it's a moneymaker, right?

Well, let's just talk about the thing most people don't understand is that you as a surgeon, you're incentivized to do more surgery or not more necessary surgery, not give people the longest, healthiest life possible. Just to do the surgeries. And so when you are going to hospital administration and you are being told you, you need to do 10% more surgeries than last year, you need to see patients in a quicker amount of time. When Josh was getting so much pushback because he's saying, hey, I would like to not operate on people with A1C so high, so I'm not going to operate on them. So then the hospital gets mad because that's cutting into the increase in surgery, right?

They got that new building they're building there, right? Exactly.

We have a whole new I need everybody to have 5 MRIs this year. Right?

Yeah.

Yeah.

And so he would— for me as the business person and entrepreneur, I saw my healer. So also something that you didn't mention, Josh is an osteopath, so he's a DO. So when— and there's a bit of a fundamental difference between an MD and a DO in that you are— you go to school and train about the whole body. You're to look at the human. As a whole integrated system. And so your basic training is more than that.

Yeah. So the difference between a DO and an MD is we do a lot more manipulative medicine, and then we also look more holistically at a patient from the training perspective, right? From medical school, wasn't really able to use that in my traditional orthopedic practice. And as we were doing initiatives in the hospital, you know, hey, when, especially when we look at joint replacements, how, how do we prevent some of the complications that are so disastrous in joint replacement, right? Infection and chronic pain and stiffness. Well, we know that these things are very closely tied to nutrition and, and overall metabolic status of a patient. So we started to really dig in and, and start some initiatives in our hospital system. I was the director of their Joint Center of Excellence for a decade. And so that, that our specialty was hip and knee replacement at that time.

Which, um, a little brag, the smallest hospital in Texas to have that. So Josh was at elite level.

Oh, sure.

So he was an orthopedic surgeon doing more surgeries than he can handle. At a hospital that had an excellent status and still having these kind of pushback.

Yeah. And, and so when we wanted to do something like, oh, we weren't gonna take care, we weren't going to operate on somebody if they were smoking. This was a huge move, Ellen, you would imagine.

Yeah.

Yeah. So my initiative was, well, okay, so we know that nicotine products and, and smoking in particular causes an increased risk to patients who have joint replacements. So we're not gonna—

even, even, even nicotine, not, we're not talking about— yeah.

It causes infection.

It causes contraction of the small blood vessels. So it can cause us problems. When I brought that to the hospital administration as an initiative, they were like, wait, what? We're gonna stop doing surgery on people who are smoking? That, there was a lot of pushback there. And so there, there were a lot of, there were a lot of instances where I was trying to improve the health of our patients overall to improve my outcomes. And, and the, the system, not just my hospital system, but the system as a whole was resistant. So there's a debate in orthopedic surgery. Do we need to do surgery on people who smoke or not? I'm like, come on. Is this a debate, really?

Yeah.

And those sorts of tensions are what really drove me into burnout so deeply. I was doing almost 1,000 cases a year. I did 15,000+ surgeries in my career.

And I want you to think about how much that is.

15,000 surgeries in your career. And how long was your career for in the system?

It was, well, in the system I worked for about, in, in the traditional system, I worked as an attending orthopedic surgeon for 15 years.

All right. So you're basically doing 1,000 a year.

Super busy. 30+ cases a week.

Break that down.

Way above the national average. Yeah.

And then think of call and think of how much— how now you're having to see the patients after the surgery.

Well, and with reimbursement cuts every year, our hospital administration would come to us and raise the bar. So when you are an employed doctor and don't think that— I think that your audience should really understand the vast majority of surgeons and proceduralists now are employed. And this is a— this is not a results driven market anymore. It is a, it is a production-driven.

Sure.

Yeah, you're paid based on the amount of procedures you do as a proceduralist, as an orthopedic surgeon, and it's, it gains the hospital system quite a lot of money. And so we were always incentivized to do more procedures, um, and they were always sort of moving the target. Well, this year you need to do 10% more, this year you need to do 10%.

It almost sounds like a sales role. It's exactly right.

It is.

I got a new quota this year, I got 10% more. I got it for them in the same amount of time, right?

Yeah.

I remember my, my administrator once told me, my CEO of my hospital, I was the chairman of our physician group at the time, and we were talking about salary and she's like, we're gonna move the, we're gonna move your goal up 10%. I said, so you're gonna pay us less? She goes, no, no, no, no, no. What it means is you're just gonna have to work harder for what you make. Yeah. Totally bizarre. Totally bizarre. But the problem is this really incentivizes your proceduralists to do procedures, right? Your orthopedic surgeon, when you come and see them, is not looking at you as a whole organism, right? They're not looking to give you more longevity and more and help you heal your joint without that procedure. They're only looking to do that procedure.

Yeah.

And that's a real shame.

Yeah, it's tied to the whole insurance game as well. Yeah. Well, that's, that's, that's, you know, let's look at it because it's You know, they're driven to do more, right? Because they got that beautiful building. And by the way, I understand your hospital is probably the most spectacular looking hospital. That's a beautiful hospital. Beautiful.

We live in a town, Wichita Falls, Texas. It has 102,000 people in North Texas. And I, I love our town. It's a nice town.

Mm-hmm.

But we can't get a pothole in the street fixed. And our hospital, which is a public hospital system, which receives federal and state monies to take care of the indigent. Has $1 billion in reserves.

Billion.

Billion. Yeah, with a B.

A billion.

Wow.

So we can't fund our schools.

Well, we also—

Our public hospital is taking a billion dollars out of the local—

Yeah. Economy.

Economy.

Yeah.

It's, it's, and I, I think that, that Wichita Falls is not the only community that suffers from this.

No.

We happen to be unlucky in that, in that the organization there is one of the most expensive in the country. Yeah. And if you look at how expensive traditional medical care is, and you're looking at public health, Wichita Falls' public health is some of the worst in Texas. And that's some of the worst in the nation. So we were— there's a real disconnect between the cost of care, the quality of care, and what it's doing for the community.

Was there a competing hospital in town?

No, there was a competing small surgical hospital that was a full-service hospital that had been— that was a physician-owned hospital.

Yeah.

And that hospital sort of struggled along in competition for 25 years. And then this year, United Regional bought them.

Yeah.

So drove them into the ground.

Yeah. Well, drove— competed them out, competed them for sure.

Well, they have $1 billion in reserves. How is a small, locally owned hospital that's putting patients first going to keep up with that monster who has federal subsidies, state subsidies, doesn't pay any taxes?

Yeah.

So, and it's not— they're not playing in the same game.

No, no. And it's rigged. We all, we all know it's rigged.

Yeah.

And the most concerning thing is, is that, you know, these doctors, you know, were driven to say, you got to produce more, you know, with the same amount of time or less time, meaning you got to work more efficient, harder, right? Be able to do more with less. And the challenge is, is that that's not doing justice to the patient. Right, to the individual and where your whole journey has taken you to is like, is that joint replacement really needed?

Right?

Because that's what's fueling the industry. Like, you look at this cabal of the insurance and the hospitals all working together to spin this thing up, of course, with the, with the companies as well that are producing these joint replacements. And it is, it's, it's a, it's a, it's a heavy thing, right? You know it. You've seen it. Like, there are quotas. Inside the system. And, and that was— I can imagine the frustration that you were feeling in that system. Now, what were some of the things that you were saying and doing that started to tip the, tip the scale, so to speak, right, with the system?

So things that I was saying and doing as far as tip the—

this isn't right, this isn't right.

Like, like, just, just having any sort of resistance to, to really optimizing a patient's health around a procedure. In traditional medicine, there's an understanding that whole health is important, but you can only spend— if a primary care doctor can only spend 5 to 10 minutes with the patient, how much, how deeply into their health are they digging? So that was, I think, a big driver for me is I'm seeing 50 patients a day. My PA's seeing 30 patients a day. We're doing 30 surgeries a week. How am I present and focused with each person that I want to heal? And that lack of connection really drove me to disenchantment with, with my own specialty, which I, which I love. And then understanding that the traditional system puts us in this box and there are so many treatments that our system here in the United States either doesn't believe in or, or doesn't ascribe to, or it's, it's experimental that can help our patients.

It's only good for animals. Yeah. Yeah.

That we're completely not using in a, in a, in a traditional orthopedic or any type of practice. Dr. Joshua John-Ram Schacter.

You think that this is about, like you were saying, this is an insurance issue.

Yeah.

Insurance dictates care.

Yeah.

If insurance doesn't pay for it, most physicians, hospitals, and practices aren't going to offer it.

Mm-hmm.

Because we've been trained as Americans that if insurance doesn't pay for it, it must not be legitimate medicine.

Right.

And now I see this sea change coming, and this is part of the beautiful work that you do, Tim. Mm-hmm. Is giving a platform for the few doctors and the few people who have been able to break through that major wall of insurance to offer medical care outside of the box, uh, to give the patient what they deserve. They get to choose what's right for them instead of somebody who's counting beans in an office somewhere to tell you what medicines are appropriate for you. It's ridiculous.

It turns out we can't do this based on a 5-minute office visit. Yeah, we can't do this on a superficial look at someone's health, and we can't do this based on the approval of somebody who's probably not qualified to give you approval. Right. So the insurance company has these, you know, these employees who are not at your educational level, don't have your exposure, don't know that person, and they're dictating whether or not they can receive a treatment. If it's even approved at all.

Yeah.

Well, yeah.

And that system is, is really constraining. Look, we all went into medicine to be healers, right? We felt a close connection with other human beings and we want to help them feel better. This system puts us in such a box that we are, we, we're in a constant state of frustration and a constant state of, of, you know, no, no doctor in the traditional system that I've ever spoken to. Loves working with an insurance company.

Have you met one, Tim?

No, I have not met one yet. It's not— I'm still looking for one. So yeah, and the only ones that really love is the ones that are completely gaming the system. Yeah, those are the ones that love them.

The ones that are— yeah, right, right. They're not patient forward.

You— I guess you could love it if you're, you know, if you're a fraudster. But when you want to, when you want to really give good care and spend time with people, you have to exit. You have to, you have to give patients an alternative to what they, what they're able to get in their traditional system.

Yeah.

From their traditional.

So, so let's talk about that because this is, this is such, and I listen, I 100% totally agree with you that there are doctors that have became doctors to become healers, right? And what they didn't realize is that they got caught in, in basically the vertical system, right? It's like there's one thing we know, big pharma controls a lot of things inside medical schools, like medical schools. Are basically teaching you one thing, right? So they're programming you to do one thing, right? Depending upon your specialty, this is what you're going to do, how you're going to do it, right? And then the hospital basically backs that up and says, this is what you need to do, how you need to do it. You have 10% more you got to do. Like, we got this new imaging center, right? We got— we have things we have to build this, you know, this fund, right? We have to have these things in reserve. And the challenge is, is that they're so programmed, it's— they think this is such a huge divide How do I cross this river, right? From, from being in the system to doing exactly what you did and how you set this up, understanding that there is a passion inside of you. It's like, this isn't right. I gotta get out. And there's a lot of doctors in the system who are feeling that right now. So what is the advice? Like, give us your journey as how you set this up, Amber and Josh, to get this thing put together.

So on my end, I had a partner who was a wonderful doctor who had turned into a carpenter.

Mm-hmm.

That's all he did was surgeries. He wasn't helping people. He didn't have control of who was coming to him, what really he was doing. He became a factory worker replacing joints who worked in a hospital. Burnt out, angry, and frustrated.

Am I right on this? That's accurate.

Yeah.

Yes. I've never heard the term carpenter, but that's a, well, that's how, that's a great analogy.

Like, he used to say that when he would come home. Yeah.

Because you're basically sawing, you're sawing bones and you're—

You make widgets.

Yeah.

All day long.

That's what you do.

You put people back together.

Yeah.

But he felt trapped in this.

Yeah.

He knew this was not his path. He was miserable, completely burned out, frankly, very depressed. His anxiety was through the roof, although he was functioning at an elite level. At home, there was nothing left of the person who I'd married.

How many, how many doctors did you know in the system that were facing this same issue, this burnout?

And just, I don't honestly know any doctors in the system who aren't facing it.

Wow.

Because if it's, it's, there's two types of doctors in my opinion, in that system, in that sort of you know, hamster wheel, hamster wheel scenario where I truly believe there are doctors who are burned out and there are doctors who are going to be burned out. And, and it's just a matter of time and frustration. And if you're the type of person who wants to be an employee and wants to just go and make widgets, then maybe the traditional system is good for you. It's not good for anybody else, but maybe just for that type of doctor. Yep. That's not the type of doctor that I wanted to be.

Mm-hmm.

And so it was absolutely essential.

But we meet doctors all the time because they feel like you're saying the golden handcuffs. So you've gotta understand, in order to be an orthopedic surgeon, it is a very hard residency and fellowship track to get to. So you have been fighting, yeah, for 20 years to get to this position. And so now you're a decade into something that's put you $500,000 in debt. You didn't have your first real job until you were 30, and now you're a decade in and you're miserable. So you feel like it's your fault.

Yeah.

You feel broken, not the system. And you're told that you, you are broken.

Yeah.

And so what happens is they feel trapped. They feel hopeless because where are you going to get another job? What am I going to do? They're not trained in business.

Yeah.

Actually, I think intentionally, and this is, I don't know, maybe between you and I, They're in medical school. They're told not to think about money or business.

Why? Because they want you to go in the system, right? You don't have to worry about it. You can take it.

And it's just crazy for a physician. This is your livelihood. And what other place do you spend all of this money for training, become an elite expert, top of your field, and then told that you're not supposed to make money? Like, is it supposed to be a hobby? How is that possible? And so I would say a lot of doctors, like you're saying, Tim, feel so trapped that they can't even vocalize it because there's a lot of shame involved.

Yeah.

You've been sold one thing, wanted to be a physician, wanted to help people and be well respected. And now you're treated like a factory worker by a medical administrator who's dictating how you're going to treat your patients and what you're going to do. So for me and us and, and what I saw in my partner, we were lucky enough that in my medical history, I had seen, I'd been doctor to doctor, and I knew that the medical system was broken. So I had my own personal view on it. And then watching my husband get broken by the system, I said this, uh, for me, I was like, screw the golden handcuffs. I don't need a golden parachute. You have got to quit this or there's not gonna be anything left of you.

Mm-hmm.

And so We decided, I said, let's talk about what would you love?

What would you love? In the, in the, in the Mary Morrissey way. Yes.

What would you love? How would you treat patients if you could really treat somebody? And he said, I wanna spend an hour with patients.

Yeah.

Do you remember this?

Mm-hmm. I do.

You wanna talk to them about their health. You wanna talk to them about what they want because nobody wants a knee replacement surgery. They wanna get down. And pick up their grandkids.

Yeah.

So for us, the, the journey was really one from, you know, what am I going to do next, right? Like, I don't— and, and so many doctors feel like I'm a one-trick pony. Yes. I only have this to offer, especially if you spent a lot of time in your specialty and if you're highly trained in it like a fellow. And so when we— when there was a lot of resistance to me internally making these changes, luckily, you know, I have a partner and a mission that helped me make these changes in myself internally. But for us, what we did was we started a private practice and we quickly learned that the traditional insurance game was not going to work.

And, and you did this while you were still working at the hospital?

Yeah. So we started in 2022, we started planning our practice and we opened January of 2023. Okay.

Well, and you left the hospital on that day?

Yeah, I left the hospital. I left the hospital at the end of January 2022.

Because remember, the hospital is not going to allow an employee physician to open up their own thing, right?

It was the whole thing. They tried to enforce a no-compete clause. And at that time, no-compete clauses still were not enforced. So they— there's a whole lot of friction that your employed practice will create. So there's that friction that the system puts on you. There's the friction that you put on yourself. And those things combined to make it feel insurmountable, but it's really quite simple. I mean, you just do it. You just You know your why, not necessarily your what, but like not necessarily your how. You know what you want to do, you know why you want to do it, and you don't need to know how you, how you're actually going to do it. There's lots of resources. You and JJ and Health Business Growth Collective, there's, there are so many wonderful masterminds that can give you absolutely a step-by-step roadmap of how to make this happen. That is something that we discovered after some trial and error. So I would urge docs who are thinking about doing this, to one, go and get it done, you know, make it happen. And two, seek some resources. And this is a great place to start.

Yeah. Yeah.

Yeah.

I mean, I know that if you're putting the patient first and real science first and not just our Western idea, but Ayurvedic, Chinese medicine, movement, somatic, understanding how much our mind has a role in how our body heals. If you make that the center, the business part will follow. Yeah.

Yeah.

The basic business principles are the same everywhere, really. Right? Mm-hmm. I mean, I knew from going to restaurants into our practice, that part was for me easy. I know it was a lot, big learning curve for you, but you stayed in your genius in medicine.

Yes.

And created a system that really changed, changed the way that you perceive. So how many surgeries do you do now versus the 1,000 a year that you used to do?

I don't do— I haven't done surgery in a year. My focus is really— Yeah, exactly.

So I stopped.

For the big surgeons out there, you don't have to stop making money.

How are you two making money? How is the law?

So we stopped. We stopped doing surgery. My goal was to exit a system that I saw was broken. And in my particular market, it's really difficult to do any surgery at any center there without taking traditional insurance. So that did sort of drive us to, to not want to do surgery. And I also saw such a great benefit to doing regenerative orthopedics.

Yeah.

Right. So we focus on holistic health and integrative orthopedics is a wonderful combination of integrative medicine and musculoskeletal care. So we use, we use hormones and gut health in diagnostics, lab testing, and lifestyle change, movement strengthening combined with regenerative medicine like stem cell and PRP to heal people's joint pain. And our goal is really to prevent surgeries, particularly joint replacement surgeries, because these can be so damaging. So that's, that's how we make money.

Yeah. So, so, so how are you doing this in a community that it, it's not, it's not a wealthy community, right? It's. Like, let's be honest, right?

It's a, it's a community that is a very blue-collar, smaller town, North Texas, very conservative. It's not like we're in California and there's a bunch of people interested in, in alternative medicine, right?

Right. Yeah.

But what I can tell you is that being an excellent, trusted surgeon, his patients know that in spending that time with them that he cares. And also, we have, we have treated I guess we're on like 500 patients now in what we call the Pinnacle Method. So we have proven that we can heal your joint pain without steroids, without narcotics, and without surgery. And so we have patients who are years after the treatment doing better than they've ever done because the system, like you were saying, Josh, is it, it really looks at if we can get Why, why do you have that inflammation in your knee? Where is that pain coming from? If it's not an injury from a tear, if this is just, if this is arthritis or inflammation that's causing the pain, which is very painful and real and is gonna continue to get worse, what do we do about it? And of course we, he treats the joint itself, but he creates an environment in the joint that becomes healthier and turns your body's own natural ability to heal itself back on. And so that method, that proprietary method that Josh has developed over the last 3 years, that's— he doesn't have to do surgery because guess what? His patients get better without it.

There's always going to be a percent of people who are going to benefit from an orthopedic surgery. There are, there are. But, but if you look at the surgeries that we do now, for a lot of different reasons, a good percent of them, maybe even 30% and 40% are not necessary, either not necessary at all or not necessary now. As of 2018, about 33% to 36% of knee replacements in particular were done unnecessarily, which means the joint wasn't ready for surgery. And this leads to younger and younger people getting surgery, which leads to more and more downstream problems with health, need for additional surgeries or revisions. Risks of complications are actually higher in young patients, especially with joint replacement. So that's a really concerning, that's a really concerning trend in the United States that we, you know, you, your orthopedic surgeon has a hammer and everything looks like a nail, right? That's not the way we do. I watched, I saw a sign on the way here that's, it was for a healthcare system and it said, your treatment is our priority. And I thought to myself, well, shouldn't that be your health is our priority, your wellness is our priority? But I think it speaks to the, the entire idea of the traditional system is, guess what, your procedure really is their priority.

Yeah, it's with— yeah, your treatment is great for our bottom line.

Yeah.

So, and so for us, yeah, your treatment is not our priority, right?

Your health and wellness, your overall well-being, your ability to, to Yeah. To play with your grandkids and to, and to lose that weight and to, and to not suffer from type 2 diabetes.

Right.

That's our priority.

Right. And also you keep them out of the airport scanners as well, right? They can walk through this.

And we don't have to do the frackin' metal detectors.

None of that stuff.

Well, I mean, yeah.

None of that stuff.

It's pretty incredible. It's incredible to see the change, not only in you, Josh, but in our patients.

Yeah. Yeah.

How just people who couldn't walk without walkers now are running into them at the grocery store because we are in a small town. They're showing me how they can squat.

Oh, wow.

Picking up their legs. And I was like, oh, Betty, honey, we're at the grocery store. Wow.

That must be like, boom. Like that heart just like—

it's beautiful.

Feels so good, I imagine.

And being a doctor in a small town, I think, is a classic way to do it.

Yeah.

There's nowhere to hide. You get to see patients right there.

The good and the bad, right? Like, that thing didn't work. That you put in me, right?

And luckily, luckily I haven't had very— you know, I had a very low complication rate. It's not like I stopped doing surgery because I wasn't good at it. I was tremendous.

You're very good at it. Yeah, yeah.

But, but this is a better way to do it, and this is a better way to do medicine.

Yeah, yeah. So how is the— how's the system reacting to what you're doing? I imagine there's not a whole lot of you in the community that's doing what you're doing that's kind broken free. I don't know if there's other— if there's functional medicine docs in your community and they're starting to see your model and starting to duplicate it. Like, what has this created in your, in your community?

Well, first, there's a lot of resistance both in ourselves for leaving the traditional system. We also have this idea that our colleagues are going to, you know, are going to see that— think that we're crazy or quacks, or we're doing stuff that's, you know, not approved. And, and to some extent that's true. I, I did suffer that from, from my colleagues, you know, referring doctors who'd send people to be, you it sent people to me for years or telling their patients, don't go see him, he doesn't take insurance. Like, it's not a—

it's not, don't go see him, he's a quack, or a windowist doctor, he's going to take your money.

Don't go see him, he doesn't take insurance. That's so ridiculous.

That's like, let's just analyze that statement here again. Like, because he doesn't take insurance, like, like that dictates— like, the brain is like, I can't— like you said, Amber, earlier, it's like if it doesn't take insurance, it's not real medicine, right?

That's right. So we've fooled ourselves and our patients into thinking that their health and their well-being and their wellness is worth a $20 copay.

Yeah.

And when you ask people like, what's the value of your health? It's infinite, right? Like, it's at least more than a Cybertruck, which is a $100,000 truck that's not actually bulletproof, right? But But what I mean is, is like, people are willing and in most cases able to invest in their health, especially if it's something reasonable that creates real transformation in them. And so the whole, he doesn't take insurance thing was really, you know, that, that's just super, super ridiculous. There is a reaction from the traditional system when you leave it. And it is, but it is not one, it's totally one that can be overcome with a mission. Our patients come to us outside of referrals. They come to us of their own volition.

Right.

And so when we have interactions with— we consistently hear every day how much we change people's lives and how they've never experienced a doctor's office like ours and how they're so grateful that somebody does this for them. So to the last part of your question, are other providers in Wichita Falls starting to offer? Since we started our practice, We've had people start to, you know, a lot of my colleagues are now offering very basic regenerative medicine, like PRP.

Yeah. Yeah. It seems to be one trick pony in the systems, right?

It's like PRP.

Like it's like, it's like the hammer and the nail, right? It's like PRP, PRP, PRP.

Like it's, and people wonder why it doesn't work.

Yeah.

You, you use PRP, but don't you, you don't optimize the body to use its ability to heal to the maximum effect and it, and nothing works. So they're, they're doing it. They're coming along. We are seeing more kind of sort of functional providers out there, which I think is encouraging. It's— I don't see it as a source of competition. I see it as a wonderful resource for the community.

Yeah, it's a plus one to everything that's going on. It's starting to— it's starting to enlighten the community that there is a different way.

Yeah.

Of, of improving your health, right? And it starts with lifestyle, right? That's the most important part.

The most important, and something that doctors aren't even educated about in medical school.

Yeah.

When I went to medical school, I had a cardiologist tell me that statins should be in the water in a lecture.

Oh, what? There's enough stuff in the water that you shouldn't have to be drinking. There's enough stuff in the water. We don't need the statin in the water.

And then the second thing that I had was a lecture from some consultant that doctors had an obligation to take care of patients and not worry about business, right? Like, we, you know, we shouldn't worry about how much it costs. We should just be able to to give this service and it's our calling. It turns out that guy worked for an insurance company.

So it's like, well, I think that's something that we as people who care about our health and not just providers of medical care, it's important for us to— I have this conversation quite often with some of our colleagues to look at the true cost. So we think with insurance that my insurance is going to cover it, that But in the true, if you were to look at dollars and cents on what you're going to spend on copay, on downtime, on whatever your max amount, you know, that's covered and all of the loopholes and then these bills that you're going to get, surprise bills at the end of every procedure.

Every, every, every, every doctor.

From every different one. And what's going to be denied and how much time and energy are you going to have to— and our time does cost something.

Sure.

If we look at that versus you've come into our office, we're going to give you the actual price, which is reasonable. You are going to buy, you are gonna know exactly what you're getting. You are going to have an outcome that you're choosing on the care that you have chosen. And yes, it costs money, but in the long run, in dollars and cents, we actually are much less expensive than going to get the knee replacement. Yeah. Than missing how much work, than losing the strength in your calf. Then— and we're not even talking about downstream problems from that. And so when, for me being a business person, the dollars and cents of it, we are really being sold a bunch of nonsense when we think that it's cheaper to use your insurance. It isn't. It isn't cheaper.

But the cost of carrying insurance is wickedly expensive.

Exactly right.

It keeps going up, like getting more and getting more, 20, 30%, like every year 20% higher, 20% higher.

And at some point we're getting diminishing returns.

Yeah, the cost is going up, the reimbursements are going down, right? The spread is killing a lot of families. Like, and I'm not meaning killing them, it is financially devastating, right? It's a, you know, they're caught in a vacuum basically. They don't know how to get out.

And the great way is that the more and more doctors that can exit the system gives these people an opportunity for them to exit insurance as well, right? You don't have to— we could get a catastrophic care policy if you're really interested in that, and then go find a primary care provider that you can be fee-for-service or join their practice or like us, join our practice and come and we can give you that musculoskeletal care at a reasonable rate and you're going to get the outcome that you deserve.

Yeah. At the end of the day, I mean, it's, you know, insurance has taken away competition. Let's just be honest, right? And having, having doctors like yourself and businesses like yours that are, that are coming to communities and providing excellent care and they are truly taking care of the patient, right? It should make these other doctors in the system say, you know what, I can do that too. And let me learn from them and let me, you know, let's not call it competition, but let's, let's figure out how we can start to uplift these communities. Exactly right. Because that's the most important thing. It's, We have to remember that we're taking care of individuals. We're taking care of mothers and fathers and grandparents and children. And the only thing we should be doing is really focusing on them.

Yes.

Right. And making sure they're getting the best care and that they're being seen like they're truly being seen and not the 5 to 7 minutes that they're being seen. Right. Then they're just being that here's your, here's your medication, here's your, you know, here's your joint replacement. You know, it's, it's becoming a point where these things are not actually getting to the root cause. They're just kicking the can down the road. They're making them more sick.

Exactly right.

And they're making them have more problems. Like you made mention, Josh, that, you know, when these kids are doing these things earlier, it's causing— oh yeah, problems way down the line. And that is not good.

Over 20% of our children now have chronic disease diagnoses. That's a staggering amount of children, and it's probably actually higher than that. And I think it's, I think it's really important here for physicians and, and practices who are interested in going and taking this path to understand that your impact is so much greater than just the patient in front of you. You know, I have a, I have a wonderful patient, Steve's buddy, and he came to us with knee arthritis. And this, this was in '23 when we just sort of started our program. So the wonderful thing is we've been able to watch this whole course. It's really exciting. So we treated his knees, but he also joined our metabolic program. So we did our whole Pinnacle Method on him. We helped him lose 100 pounds and like almost, we did it gradually. So it's about 18 months. He, every time he comes in, he's so grateful. He comes in, he's feeling better. He's fishing. He's riding his horse. He's spending more time with his wife. He's able to. To climb the bleachers and watch his grandkids play soccer. And at his last visit, we're sitting down and I'm talking to him and he's like, I just got to tell you, I'm so grateful. And he broke down, he's crying. And he's like, when, when I was first talking to you about this program, I felt like it was so expensive. And I went home and I talked to, to my daughters and, and they said, Daddy, this is an investment in you. But not just you. We want you here to watch these children of ours grow, to be able to be engaged and intent and not distracted by your pain or your illness. And that money is well spent, right? We are impacting so much more than just the person who sits in front of us. We're impacting their whole family and by extension their entire community. And so when we do these practices, it's tremendously important. You, you might think that you're only affecting that one person you get to spend an extra hour with, but really you're affecting your entire community. You're raising the bar for health overall, and it's going to bleed over into the traditional system of it.

Right. That's what's most important about that. It's such a great story. Thank you so much. How can the audience learn more about who you are, what you do, where you are, like, learn more about your method?

So if you look at pinnacleintegrativeorthopedics.com, you'll find us. You'll also find Pinnacle on Instagram and Facebook, but Pinnacle Integrative Orthopedics is what you wanna search for, or search for Dr. Schachter, Joshua Schachter.

Dr. Joshua Schachter, Instagram and Facebook. Wonderful. Also TikTok.

We've got some great videos. If you wanna learn more about integrative orthopedics and maybe how it can help you or somebody that you really care about, go to YouTube. Dr. Schachter has some great lectures there, some wonderful opportunities to educate yourself. But, but really, you know, we're out there everywhere. Come, come check us out. Stalk us.

Wonderful. Thank you so much for your time, Dr. Josh. Amber, thank you.

Thanks, Tim.

Yeah.