How to Become a Musculoskeletal Primary Care Expert & Reclaim Your Value with Brad Powell

Did you know that in Utah, physical therapists are now primary care providers? The law changed in one of the most groundbreaking bills that have been passed that allow physical therapists to be the initial point of entry for all musculoskeletal disorders. Our guest is Brad Powell. He's not only a physical therapist and an entrepreneur, he is a change maker on the governmental level to help our profession take a stand in what we were born to be, which is doctors in the community. We were born to lead the musculoskeletal industry. And in this episode, we're breaking down how he did it, how you can do it, and how you can reclaim the life that you deserve. Not because you deserve it, but because your patients need the version of you that's profitable and able to change their lives on a greater scale. I can't say enough about the show other than one big plea. This episode, more than any episode. Please send to your friends. Please post this on social media. Please be loud after you listen to this. If you are in any way passionate about pt, OT or slp, this is the episode I want you to promote. Enjoy the show.

Brad, I'm so excited to have you on the show. Thanks for coming.

I'm excited to be here. Thanks, Will. Thanks for having me.

So set the table for us. Talk a little bit about who you are and why you love doing what you do.

My name is Brad Powell. I'm the owner of Foundation Physical Therapy. I raced motocross professionally as a young teenager. Really some pretty crazy injuries. Broke over 34 bones. Very similar to you. I didn't have a falling off cliff experience like you and shattering, you know, my pelvis or back or legs, but definitely had a lot of injuries through the years. Almost lost my leg to compartment syndrome. Had to learn how to walk again at 17 years old and then decided this sounded like a really cool career. So that's been literally the foundation for my life. That's why I called it Foundation Physical Therapy because it gave me my life back and I didn't think I'd ever walk again. I couldn't move my leg at all. And now I have no issues at all with my body, you know, with all my broken bones. I've done CrossFit competitions, rode my bike around Utah Lake, was about 100 miles and just done a lot of, you know, athletic competitions in the last few years. And I just love our profession as physical therapists because we literally can create so much value with just education and we can literally create freedom for so many people. Our purpose statement in my company is to help people live the life they always wanted. And it's just been such an incredible career to help people truly see what they're capable of and, you know, take them with pain and disability and show them they don't have to stay there and do it in natural ways. We don't even need medicine or medication or injections. We can do it in other ways. And I'm not saying to diminish those at all, because they have value and they're very important. But it's just so fun to use our knowledge to just take people to the next level with. With exercise and pain modulation techniques that we use. I run a podcast called the Healthcare Revolution.

Highly recommend it. I love it because I think you're tackling something in that show that is what everyone's craving right now, which is information on how we can make a difference.

Yeah, and the Healthcare Revolution just started from, you know, as I started to jump into practice, I realized that there was this huge gap in patients understanding how to navigate the complex medical system that we're in, and also the providers giving them the information that they need. It was like there was this bridge that wasn't gapped. Like, it was just like there's a huge separation between providers and patients. So the Healthcare Revolution is all about bringing us all together as one and working collectively as a team. The patient communicating ways in which helps the provider and the provider helping in ways which helps the patient, and then also giving them tips of how to navigate this complex system, how to work with their insurance companies to get the very best and to make sure they advocate for themselves and they don't get nailed with denials and things like that. So we spend some time talking about the insurance game and how to navigate that. And then we love bringing new providers on. We bring surgeons, doctors, NPs, PAs. We talk about these complex issues and how we can solve them and give people helpful tips of how they can create the best for their life and live the life they wanted. So love doing the podcast. Love talking about, you know, complex issues, and I love rocking the boat too. You know, like, there's so many issues in our. In our healthcare system that have been created, and I want to break through those barriers. I believe we're in a healthcare revolution right now where, you know, things are changing for the better. I just had a podcast this Morning on Medicine 3.0, and Medicine 3.0 is focusing on prevention. Like, why are we focusing on, you know, creating longevity for people if the quality of life isn't good as well. Let's focus on being quality of life and. And longevity of life. So that's what medicine 3.0 is all about, is what are we doing in people's twenties to prevent osteoporosis and spine disease and all these other things. It's just so fun to get everyone together and have these conversations.

Yeah. It's interesting to know how you go back two generations, even one generation, and they don't. Running, like, just going to a gym was like, why would you do that? Right. And now it's commonplace in our culture, and so it's shifting. I'm grateful to see that it will go towards prevention as we learn about, you know, Peter Attia, who talks about VO2 Max, how it's the greatest measure of one's.

Yeah, yeah. That's actually coined this term.

Yeah, yeah. And for. I love that you're in that space because this generation's smart. Like, they're in their 20s. They're. Oh, they're actually open to it. So they need people like you who are younger than me that they'll listen to, but old enough to where they can still, like, feel like they have some mentoring in there.

I thought you were a pretty young buck still.

Yeah. It's not the years, Brad, it's the mileage.

But truly, like, I'm so excited that that Healthcare Revolution podcast exists, and it's very popular. I mean, just as a side note, not only was it really good, but I listened and I was doing research. It's a very successful show. I think people are craving that kind of information, both in terms of how to navigate health care. So it sounds like the show is about the. Is for the audience of patients and the providers. Kind of connecting that to that link really is.

Yeah, because, you know, providers need to understand this as well. You know, the gaps in care, and patients come onto the podcast as well and tell their story.

Interesting.

Helpful for providers to see through a different lens, to see how what they're saying can have a negative impact. Because sometimes we don't think about what we're saying to a patient, and we don't realize how many issues that can create in their life. You know, just saying one thing in a. Just a nonchalant way can really negatively impact a patient for decades and even generations. So we've had a lot of really interesting podcasts on that and is how. You know, I have one example. A provider here in Utah told a young mom she didn't want to get a certain vaccination within their clinic. And the pediatrician kicked her out of the clinic and actually said, you have to go find a new provider. If you're not going to follow exactly what we're doing here in our practice, we will not see you. Oh, now this, this mom, she, she's never going to go to the doctor again. She's like, I don't trust doctors. Like I'm never going to do that. And then how does that perpetuate the next generation? Yeah, how are kids going to perceive doctors? Because this young mom was treated in that manner, you know, but scary. Yeah, it's wild for sure. And then I guess the last piece we've been working on quite a bit. I'm on the APTA Board of Directors here in Utah.

Oh yeah, let's dig in on this. This is a big deal. So let me set the stage before you continue. Sorry to interrupt. I want the audience to hear this because all the healthcare listener providers who are listening are all just, you know, feeling a little at effect from the way that things have gone. But, but you guys just did something massive. It's getting recognized at the private practice section of the APTA here in a couple weeks. Yeah. Let's talk about how you guys have led the way in Utah and you're a part of that APTA group. Yes, yes.

Yeah. So I'm over, I'm specifically over payment and practice. So I got recruited. They tugged my heartstrings at getting paid better. And you know, I've always been a huge advocate. Like we have a doctoral degree and we provide so much freaking value for what we do do to the world. Why are we getting paid 70k a year? You know, that is just, it blows me away that that's how much physical therapists make. So this has been a huge push for me. So, you know, a bunch of people on the board just kind of tugged me a little bit and said, hey, we need someone that has your passion to be in this specific spot. So yes, I'm over payment and practice. So representing private practice here in Utah and increasing our ability to get paid well. But yes, we passed this bill to become primary care providers in Utah. So we're the first in the nation to make this happen. It is groundbreaking legislative support. We had a hundred percent unanimous support from both the Senate and the House. It literally didn't rock the boat at all.

Everyone's like, this is a no brainer.

Yes. They literally said, why haven't you done this years ago?

And he's like, I don't know why.

That was so Funny, I just like the legislation. People are like, yeah, what took you guys so long?

Yeah, like, chiropractors have done this, you know, 20 years ago. Why. Why are you guys just doing this? Right. But ultimately, what it was about is getting paid better. You know, like, how do you get paid better? You could go after insurance companies and say, yes, we need to get paid better. Here's the research. And they're like, yeah, yeah, we don't really care. Right. But how do you show it? We. We wanted to show it by being. By having a title, if we are. We were already direct to access in Utah, which means people could come directly with. To us. We've been that for, you know, 20 years or so, but no one knows that in Utah. They're like, well, I need a referral to come to you. The majority of people think that, Right. This has been 20 years ago we've been able to do this. But now that we're primary care, we're pushing out marketing strategies to. Across the state of Utah to teach people, you don't need to go see a physician first. You know, you need. You can go directly to a physical therapist for anything, pain or injury, and they can take care of your needs there. And as the entry point to care, it's beautiful because around 75% of people get better with PT. So we can take care of the big majority. And then we are better stewards at referring out where we are telling the patients the next step is this. And we're going to refer you to this clinic if you're not improving in our clinic. Right. But that's how the system should work. We have it so backwards where people are just. They. They want the specialist. They're like, I want to go to the orthopedic surgeon specialist with the shoulder. When the. The surgeon, they're booked out for six.

Months.

And they're gonna operate. They have hammers. Yeah. Everything looking like a nail when they cut.

And that's so true. Right. You know, and hopefully we got good surgeons. They're like, well, you got to go to therapy first. Sure. People are waiting six months and then they end up back in our office anyways. So we got it so backwards, you know, so we're changing the game in that aspect where we're, you know, but these legislators, they are fully supportive. They're like, we love our pts personal, like, I love my pt and I want to be able to go them without any restrictions. So they just like pass this 100%. And the American Medical or the Utah Medical association the CEO, I don't even know her name, but she pushed back quite a bit. Close. She just. I think their practice is getting attacked a lot by the NPS and pas, their scope and their.

I see she's just feeling like the crowdedness of like these things kind of getting cut into pieces. And this was another piece for her.

Yeah. And yeah, it was just another piece of the pie that they felt like was taking away from them. But as we educated her and the whole Utah Medical association, they realized that this is going to lift a burden from them.

Yeah.

That around 40% of their patients are musculoskeletal in nature and they don't want to see those anyways. Yeah, they're not good at treating those. You know, there's been plenty of studies that have been published that say that the primary care providers are actually the. Not nearly as good. They're actually the lowest level tier for diagnosing and managing musculoskeletal conditions. And that's not against them. It's purely. Their skill is somewhere else.

They're not trained on treating injury and pain. They're trained on quality of life and managing other functions of your body. Right. But we should be the ones physical therapists leading from the front as the musculoskeletal experts in pain and injury from the start.

Yeah. And I think what's interesting about this is culturally we have been the ones holding ourselves back. Seth Coulter, who, who is the founding member of a group called Rehab Net in Arkansas, they. They're also starting to make some waves renegotiating contracts with insurances collectively in a non collusion based way. And he told me, he said, we sharpen the knives that cuts our own throat as a culture of physical therapy practitioners. And where this is evident for me was I did a video on my YouTube channel four years ago called should a physical therapist call themselves a doctor? That was the title of the video. In the first five seconds I said yes. And the rest of the video was explaining that those studies that are out there, I forgot where they were done. But there's one particular landmark study that compared musculoskeletal knowledge of a physical therapy type. So it wasn't just PTs, it was PT students, PTAs, PTA students, and then family physicians, orthopedic surgeons that compared everyone. I'm sure you've seen this, but it was interesting because the graph is so black and white. It's like a physical therapy student, third year, knows more about the musculoskeletal system than A family physician, internist and all the other doctors. A doctorate level PT is the second highest knowledge of the musculoskeletal system next to orthopedic surgeons. They have the greatest. Which I would more than happy concede that to them. But what the public doesn't understand is that again, even if they are great orthopedic surgeons and they're not going to push to surgery, they're also booked out six months like we are the conservative non surgical experts, bar none objectively. And so as I put that video out there, it blew up. But do you know that the vast majority of the comments were negative from physical therapists. Physical therapists saying how dare you say we should call ourselves doctor? Like it was that. And I was like, I'm sorry, can you help me understand? Because there's this really weird. I think it's the older generation, my group and above. Yeah, you guys and younger are starting to really shift that because you're the ones making $70,000. But I didn't pay $250,000 in student loan debt. Like I think that discrepancy is making it really clear and there's no cultural, you know, way to push against that. But I'm so glad you guys are seeing that because it's the truth. Objectively. What you're saying is objectively true.

I was literally looking at the research this last week on the diagnostic accuracy per profession and you're talking about the orthopedic. The orthopedists being at the highest level. They were only 7% higher. So it was 83% I believe of diagnostic accuracy based on compared to an mri. So they're testing the, they're saying based on my test, this is your, this is what we believe is wrong. And then PTS, physical therapists were 76% accurate. The main difference that we saw in this study is that the surgeons, they get to go verify it in the or.

Yeah.

And we don't have that piece. We miss that piece. But the fact that we're only 7% different and we can, you can get on our schedule today or wait six months for them and is a huge area that. And they're going to send you back to us anyways. Why not just start here?

That is so powerful. Brad. I didn't know that. It really speaks into our potential as we are starting to get more and more aware of how we could actually use electrodiagnostics to diagnose. I don't know if you know this but I got certified in EMG and diagnostic Ultrasound.

Oh, that's awesome. I was actually at an ultrasound course than they were teaching this.

No way. Can I ask who, who did it?

It was a local guy, Bart. He's with Mountain Land Physical Therapy. But he does it across three states. So I think Utah, Idaho and Montana. But he goes around and teach pts within those states for that practice.

It's really a powerful thing that we should be leaning into. The single smallest Specialty within the APTA is electrodiagnostics. When I got certified, there was only 80 of us in the country. 80. And now there's upwards of 3 to 400 out of 300,000 physical therapists. It's the most. And what's funny about that, reimbursement is so much higher for that. So what would happen is like someone would come to our clinic with the same referral, neck pain. And then if we felt that there was a, you know, our examination, tested them with our normal procedures as physical therapists, that there was something referral based, like their hand was tingling, some paresthesias or whatever, we would do an emg, right? Then we would do that. And here's what's interesting. The studies on that have shown that a neurologist, which is typically where someone goes for an EMG and just for, for patients that are listening, like an EMG is, you know, we do MRIs of like the, the spinal, the central nervous system, the brain and the spinal cord. You can't do an MRI for peripheral nerves because there's so many and they're so small. But you can test them with little needles and electronics. It's not a very pleasant test, but you can get fairly accurate. But most people go to neurologists and neurologists just pay lab techs to do it. Our accuracy. I had one orthopedic surgeon who's a good friend of mine say, yeah, the only reason I send out for EMG testing is because insurances require it before I operate because most of them are quote unquote crap is what he called it. And then I started sending him physical therapy tests and the studies show pts. Because we're musculoskeletal experts, we are the best people to do EMGs. There's no. Our accuracy above anyone else is so much higher, statistically speaking. So when a patient comes in, if we could start utilizing EMGs and diagnostic ultrasounds, we will surpass orthopedic surgeons because they aren't doing those in house. Typically they will under certain circumstances, but not EMG and ultrasound. And we have the ability, let's Go skeletal wise without those tests to be off by 7%, 8%, whatever you said. But if we started using those, first of all, I think we would occur to ourselves more as doctors. But then the, the patients themselves would be like, holy moly. This is, this is family. This is my direct care link. You know, this is my doctor in my community. This is who I want to go to for muscle and bone.

Yeah, absolutely. The thing is like if you have a diagnostic tool like that, I have my testing, I'm already 76 accurate with my testing. And then I peek under the hood.

Yeah.

Like, oh, I was right. Right.

Without surgery, by the way. Yeah, without surgery.

Matching card game with my daughter. Right. I'm like, I think it's that one. Then I flip it over. I'm like, it was that one. Right. Essentially that's what you're doing. And that's why orthopedic surgeons are that 7% better, is because they can peek under the hood and verify that they were accurate. And the more that you do that, the better you get at it. But we're already there and you give us a tool now we're going to take it to the next level. So I'd love for it to see, you know, we just had it at our APTA Utah conference, this musculoskeletal ultrasound and emg, kind of like a crash course in two days. It was super powerful to see where the profession's going because we ultimately there's so much value we can provide and we just need to, we need to own it and we need to go with it. Right. Because we PTs don't even know how much you know and how much value you're gonna create for the world. Like the world is shifting. People are wanting more natural ways of healing. They're not wanting all these other things. Our generation now is looking towards things that are not going to have long term effect on their body. So pts, if we're ready and we're ready to stand, we're going to make a big impact on the world. We're going to be the leading experts in musculoskeletal care. People want to come to us first.

Yes.

And the referrals are going to completely flip.

Like we're going to be the ones sending the referrals to all the other providers, not them sending them to us.

Because the vast majority, the vast, vast majority of what people go. Studies have shown billions upon billions of dollars for musculoskeletal pain and dysfunction. They start coming to us and we control the Tide, of course, that puts our profession at the top of the food chain, where it was meant to be. I get on stage when I speak at these different conferences, as you know, and I say from the beginning that physical therapy. Physical therapy is the profession that was born to be at the top of the food chain for musculoskeletal disorders, period, and full stop. And it's just, you see the uncomfortableness in the room sometimes, which is weird. But at the end of the day, I've never seen it like that until you said it. How if we're the ones controlling the referrals. And by the way, I see orthopedic surgeons loving this. I think they would just love nothing but higher qualified candidates for their service. If instead of like filtering out a third or whatever number it is of their, their inpatient visits to be like, well, you need to go to PT. What if 90% of them that came in or higher were ready for surgery? Done the pt, their muscles are ready to go, they're gonna respond to the surgery quicker.

Supposed to be there, not the ones that you're sending them back, right? You imagine 80% of your day is just redirecting people, operating on 20%. That's what a lot of these surgeons feel. And the PTs are so worried about rocking the boat with these MDs and surgeons, but they want this as well. They want help. They're literally booked out for six months. Like, that is a huge issue that we can help with. But I agree with you, pts are the worst. I've had more pushback from physical therapists in our state than any other profession. The most resistance that I physically get is from our own. It drives me crazy because I want support. I want people to uplift us. I'm like, let's create social media content. Let's get blasting this out to the state. Like, let's market this. And I get comments from people like, oh, you're marketing yourself or you're marketing your company. I'm like, oh, my God, here's who is being marketed here. It's our profession. Like, this is our duty to teach people. But it drags me down, right? And I'm a very energetic, very optimistic person. But the minute I get things thrown at me from my very own family, it's hard, it's really challenging. But I'm getting full support from our medical doctors or NPs or PAs. They're like, keep going. And then my own is like, stop. Like, we're not ready for this. Like, we're not ready for this. Moment to shine like you were born for this moment. Literally, we're. We are creating the future. We're in a revolution, and you're not ready to stand. You know, it's.

It's such a. I'm so inspired by what you're saying, Brad. And. And it really is this thing. I still can't wrap my brain around why physical therapists are resistant to this idea when they're the ones who are underpaid and overworked. I don't get it. I don't. Obviously they don't see the link as clearly as you and I do. I don't know how they don't, but it's one of those where it's so inspiring to think what we could become if we just unified. No one's kicking back. Like, there's a little. Like, there's that lady, for example. But. But the vast majority of people outside the patients don't even know that they want this. The doctors already know that they want this. In some cases, we just have to choose it. We just have to choose it. It's so easy for us if we just all got on the same page and said, yeah, let's become primary care physicians when it comes to musculoskeletal disorders. And then we just started showing up like doctors in the community, which, by the way, we've already paid for. We've got a student loan debt. We've got the educational background to prove that we're that great. We just need that support. And it's. I don't think I want to do an episode on, like, the history of why we think this way. All I care. When the. When you're knees deep in alligators, as my grandma used to say, you don't worry about who left the gate open. Like, we're in this state now where we. We are. We have knees. We're knees deep in alligators. But pioneers like you, Seth Coulter, and others are, are kicking the alligators out. Like, we're getting there. But don't. Don't get angry at the guy for kicking the alligator out, because guess what? He gets some attention. He's like a hero for doing that, and that promotes what he's doing. I call that great, great business. If we can do anything with our companies that increase the value of our clients, our company, our community, and the world at large, that's who we should be praising. We should be like, wow, that's great. Yeah, I do want to buy from that guy because. Because clearly they're not making money on this on its own direct way.

Yeah, yeah. We should all be linking together and say, dude, I love what you're doing. Let's, let's drive this together as a cohesive unit. But you know, in our profession, it's really interesting because it kind of divides us sometimes. And I think a lot of it goes down to this like, scarcity versus abundant mindset that we grew up in as physical therapists. You know, we were ancillary services for so long. We lived in the basement of surgeons clinics and that's our history. And then we became associates, then bachelor's, then master's, then doctorate. So a lot of it is growing into our own skin. Right. I'm coming into it as, you know, six years out of school and I'm a doctor. You know, I finished my doctoral program. You know, I am a doctor of physical therapy. So I grew up in that, not everyone else did. So I see it with a different lens and I see what we can become. I don't see as much as where we were because I don't believe we're ancillary services. No, Believe that we are the top level tier for musculoskeletal care. There's no one better at treating and managing musculoskeletal conditions than me. And I'll hold that up. I will argue it, I will show it, I will demonstrate it, you know, and we'll consistently do that, you know, so it's, it's so fun to chat about it.

And it is, it is to get.

People excited about it too, because a lot of it comes to internal belief too.

You know what's fun is I did an episode in May with Heidi Jananga, the founder and CEO of WebPT, who's a physical therapist herself. I got to meet three of her students who had received scholarships. She has a charity called the Rising Tide with a Z where she finds money and pairs it with up and coming physical therapists who come from under developed sectors of the world. So these are people who normally, financially couldn't afford to go to PT school. And what was so inspiring about it is that this new generation is coming up with a completely different mindset now. We're losing pts because some people jump in, they're like, oh, they hear the crap online about how horrible it is and they jump out. We're losing 5,000, 5,000 professionals above what we should every year to people saying, I'm not doing this anymore. And that's so sad because the demand is going up and up and up. So, you know, supply demand, Charts means we're in a position to where if we just unify, we'll not just take charge of like the position from a. From a leadership position. Well, we can demand more financially. And so these students coming in just were like, yeah, I know, I know that it's like skewed and all these things, but we love this too much to back down. And we're going to do whatever it takes and not just treat our patients and help them save money, but for us to make the money we deserve so that we can help more people. I was, I got emotional on camera and it was one of my top episodes this year because there was just this like wave of positivity. Just like you, Brad, like, I consider you a leader of that generation because, you know, it's just that idea of. I don't know why there's all these alligators, but let's. Let's solve it. Let's. It's too wonderful. It's too wonderful. I'm just like you. I'm that guy with the broken arms and legs and my Connie Clemens. And it's like my therapist who got me to stand and walk for the first time. That's what we do. We teach people how to reclaim their life in a literal way. There's all these products and services like, reclaim your life. Take this medication. It'll give you energy. It's like, no, we literally teach people to walk. There's no comparison in terms of what we get to do. So I love your passion. Thank you for doing that. Congratulations to you and everyone on the Utah leadership board who made this thing possible. How are you guys now taking this information and rolling it out to the rest of the world? I'm sure there's some plans or talks.

Yeah, there's so many people that were a part of this bill. You know, it started a year and a half ago and we ended up getting a whole. You know, our executive director, Katie Mansell, she's been the brains of it.

Wow.

I think there's about 20 of us all in a room and private practice owners across Utah. And she said, we have not done our part to support private practices for the past decade. I've been in this role for a decade and I want to make you guys the top priority because you guys are the drivers for our profession. I love academia, I love these big institutions. But if we're really creating change in Utah and nationally, it's private practice owners because this is your guys livelihood. So she got us all in a room and she asked us what's the most important thing to you. And this is what we ended up agreeing upon is this primary care bill. But to go back to your question, like, what are we doing now to share with the world? So at pps, you know, American Physical Therapy Association, Private Practice Sections meeting, the national leaders have asked a few of us from the board to attend, and they're gonna bring us up on stage and announce to the whole nation and the private practice world about this behavior bill. We're working with other states, so there's four other states in the nation working on the same bill right now. So our director is reaching out to other directors in different states because as we get critical mass. Critical mass is past the 50% mark. 50% of 51% of states across the nation get the same bill to pass. That's when Medicare will recognize us as primary care as well. You and we can have those conversations. But until we get that tipping point, it's just individual states. And the goal is to show extreme value. We don't want to just be primary care and not act as primary care.

Yeah.

Physical therapists need to understand what it truly means to be primary care, that you're the entry point. That doesn't mean you're silo care. That doesn't mean you're taking care of every single condition on the market and never utilizing your team. You have to know when and who to refer out. You have to know when to order imaging. You got to make good decisions early on. You know, you got to be catching cancer, like, all these things, Right. I can't tell you how many times, five times I've caught cancer in my early career. I'm only 16. Really? Yeah. And that's because I'm ordering imaging. I know when to order imaging. I make good decisions when I'm five, six minutes, six visits in. I don't wait 20 visits just hoping that things are gonna get better if they're not naturally progressing as a typical linear. You know, injuries do this, right? They get a little better. But overall, as you're progressing an injury in therapy, it should have a linear progression. And if it's not, we gotta make decisions quicker and, you know, make good decisions early on. But it's incredible. If we are truly primary care providers and we utilize our resources, we know our community. You got to know who the surgeon is in your town. You got to have his contact information. You got to know the pa, the np, like, who are your players? You're essentially the quarterback, right? You're the person that's just kind of early on making decisions. But that doesn't mean you're the coach.

Yeah.

You got to know who to punt to or who to pass to. Right. You got to make those early decisions for the best care of the patient, you know, so there's so many things that we're doing now and we're. We ended up getting Justin Moore. We called up Justin Moore. He's the national president and he is in full support of what we're doing. And he's working on a grant for Utah right now to support us financially, to be able to push some additional bills. And then we got Mike Horsfield over at pps. We're gonna meet up with him to get some matching grant money to potentially get some funding to support everything that we're doing. Because we want all of Utah to know. We don't want this to just be passing the bill and no one knows about it. We want to like, get this message across Utah showing the value in it, show them the research behind it and. And get people to line up and say this is the tipping point. Like as we get critical mass in Utah to truly understand our value and what we can provide them. And then the harder part is getting the pts to deliver it.

Yeah.

Because I believe it. Right. I believe I can do it. I believe I've trained my team to do it. But can every physical therapist in Utah double down on their con ed and on their continued education that they can make good decisions early on? Well. Right. Getting everyone to believe that they are primary care role and to act in that way to introduce themselves as a doctor of physical therapy rather than some ancillary basement service that's just required by a surgeon before surgery. There's so many things that we're working on. We're going into universities. So I just got done presenting at a university two weeks ago where I'm teaching people about primary care because I want to teach the babies.

Yeah, baby, we're gonna change the world.

Let's teach the rising generation. Because I had 60 DPT students, I think, second years, and they're riled up about this. They're so excited. And, you know, so we're working with universities to teach them and obviously teaching students in our clinic. But there's a lot of fun stuff that we're doing. We're kind of working at multiple angles here.

Yeah. It's funny because as you mentioned this, you know, I used to. Before my current company started growing, I used to do a lot of consulting for people to how to recruit. And one of the biggest things I would teach them and it was this like shift in mindset from being in scarcity versus abundance was serve them, serve the rising generation, be in front of them with your rally cry of whatever you're passionate about. And I would argue there's nothing more amazing or passionate than what you're saying to go in there and talk about how we're going to change the profession. And that is how you get trust. And now people hire. I used to have a bench of people when it was harder for others to recruit because I was teaching entrepreneurship and leadership. I wasn't changing the profession the way that you are. And the great thing is there is a scarcity in when you look at how many jobs there are versus how many pts coming there are. But there is so much opportunity for whoever is going to not like just resist, but like be openly accepting and even stand in front and say, let's change it together. Those pts will never have a hard time recruiting. And it's not. That's not again to the counter argument of people who are like, oh, you're doing it for that. It's like, no, that's just it. The purpose is what drives it. It's the product later that comes in tail. And so yeah, greater profits happen, greater recruiting happens, greater all the things because we're fighting for the greater good of all. People think with scarcity that there's limited resources, there's so much abundance. There's enough. There's a way for every PT practice in the world and then some to have plenty of PT students. But it comes from us shifting the mindset to where we get more people wanting to join because we're out there changing the industry. So I just want to point that out. I love how like the rising tide is leadership. You said something. I got a dig on Brad. You said, you know, we're changing the minds of the babies, the up and coming regeneration. You said before that you do it in your own practice. I almost feel like, you know that phrase of like, we have to change the world within our own homes. Like, how are you doing that at foundation physical therapy? How are you helping your team members, like, understand all of these things and get on board with them?

That is a great question. There's multiple facets, as you know, the biggest one that we focus on this year is making sure our orientation onboarding and mentorship experience is just through the roof. That they know our values like the back of their hand. They know what we're all about. They know our brand, they know our Heart, why we exist in the first place. They know our purpose, but it's deeply ingrained in their heart. So. So they make decisions with the values at the forefront of their mind. Not as, oh yeah, it's just on the wall in the waiting room. It's like, no, we teach these values because they're going to be a compass to you. They're going to help you navigate challenging situations and they're going to help you make the right decision. Because every decision you face, you can't have a written script for. But if I teach you a value, the value of always progressing. Right. How is that going to guide your decision when you're mapping out your continued education plan? So one thing that we do with our value is to always progress. And so we created, we call it an unlimited Con Ed budget.

Is it unlimited? To a certain extent. Right. But we have them map out their whole year. Show me your whole year Con Ed plan. I want to see how you structure it. I want to see the sequence. Here's my suggested sequence of how you build upon it. So we give that to them and then we have them map out the whole year and then, alright, let's budget it. So it's not like it's completely unlimited. It's not like we just have unlimited money. We're wise in how we spend that. But we're very particular on how we coach our therapists on their continued education. We want to know what Kool Aid they're drinking from and why, you know, and what. I mean, Kool Aid is like, what. Who are you learning from? Who do we suggest from as a company? Because these new grads come out and they're like, I want to get Trineal certified, I want to do the KT tape course. I want to do like all these passive things which are great, but let's have you master the foundational skills of how to load a tendon, how to, you know, progress a sequence of exercise. Let's get the foundation set before we build the home. Right. So we really. It's not what we are. It's a balance of not controlling, but teaching. Right. And coaching and showing them the way rather than saying being a dictator. So we're more of a guide through this process than a dictator. Because I'm saying this is. That could be a way, but here is a better way in my eyes. Right. And you can test it, you can try it, but it's been tried and true.

Yeah.

So that's one thing that we do. We also talk about different growth models. So we have different pathways in which people can grow. So you know, just a therapist, if they want to be a master clinician or if they want to be a world class clinician, we have certain criteria for each one of those things. Or they want to be a clinic director, an operations director. So there's different pathways in which they can go and sometimes they can do them simultaneously. They can follow two paths at the same time. You know, I got one clinician that he's a, he's a mentor for a new therapist and working towards being a clinical instructor, but he also is working towards being a clinic director. So. But we create these pathways for all, all of our positions. Because I worked in a hospital, I just felt like I hit the circle. I could never grow. I was always just a therapist.

Right.

I had no supervisor, I had no con ed plan, I had no growth models, I had no opportunities to move up in leadership. And I just thought like, where am I going with my career? And so that's why we created these, these growth plans. And I've had a lot of mentorship on how to do this from different people. But it's been the most powerful thing that I've done in my organization. When people can see that they have opportunities to become the next level, it's not like they're going up in tears, it's that they're going up in progression in their life. They're taking on different responsibility that they're most passionate and proficient in. You know, so it's so fun to go into those areas. We have profit share programs for every position. Even our aides have profit share programs. So they know how they're getting a piece of the pie too. Right? And it's, it's always a win win. It's not like they get a profit share and it takes from someone else. It's that if the therapist is getting a profit share because of their production, the front office coordinator is as well and the aid is as well. And we just, we power to power with everyone. And it's so great because they all, it's this lateral management. They manage each other, not the top.

Down approach, you know, man, that's so cool. You know, LinkedIn says 88% of people leave a company because they don't see a future in it. And what you do is create these futures for them. And that I think opens the door for them to understand when you start talking about the future of the industry, why it matters to them, it's kind of like I, I believe a big part of why we're in the position we're in is that we as leaders have been so subdued from the pressures and suppression of low reimbursement and not having enough time that we don't even know if we're coming or going. That's why we do stupid things like resist guys who are breaking free. And I'm willing to bet a lot of that's just jealousy. It's like, well, where's this guy get to get all this business? He's doing it for self serving. Because I care about my patients. No, you don't know. You just don't know. I'm not angry. I'm just saying they don't know what they don't know because I used to be that guy. So for you, you do that with your people. My question to you is what comes first? Or does it all go together? The investment in the team member and then the realization of how we need to stand as an industry? Or do they come to you because they're passionate about what you're doing for the industry and then just learn and grow from there? Or is it a combination of those things?

You know, I'd say it's a combination. Ultimately, I was telling talking to our marketing team who's assisting with recruiting. Yeah, ultimately that's marketing. Right. But yes, working on recruiting. And I told them, I said, I want to be so ridiculously attractive as a group that we don't ever have to place an ad. Like people are naturally drawn to us. And I can't tell you how many times we've hired a patient that is a front office coordinator. I have like five of my old patients that are now my team members. Right. Because they loved it so much and it changed their life so much. And you know who the best advocate for PT is? It's those people that were patients. Wow. I was treated by Brad and it changed my life. And I know when it gets hard and you don't want to do your exercises, it is the best thing that you can do. That's my front office coordinator on the phone or my office manager. Right. And my, my personnel director was a patient. Right. She just bends over backwards advocating for patients and for team members. Right. She's creating a team experience. And we had, we did our NPS for our employees. There's a night 9.2 rating out of 10. Let's go. Thrilled to work here. Right. And to work with us. It's because of the experience we're creating for them. And we put so much thought and intention into every Single piece. It just becomes so fun because you're literally just creating jobs for people that they love, you know? But yes, there are things happening simultaneously. But I wanted to be so attractive as a company that people just want. They walk to us because they're like, you are doing amazing things. I want to come work with you. What do I have to do to work with you? Right? And we create this funnel of students that are just like, I went to a career fair, just barely this last week at the University of Utah, talking to students, and it's so fun because they're so young and they're like, I'm coming to your clinic to do an internship. I'm like, that's awesome. And I've never met them before, right? Like, I saw you on Instagram, I saw your podcast. I love what you came and spoke to our class this one time. And then we get these students and we had seven full time students last year and we picked two. We took the two best, right? That aligned with our mission, our values and our purpose. And those two therapists are rock stars, right? But they, they've worked with us, they've learned our systems. They are like their hearts in it. One of them was an I student. He will bend over backwards. He'll take a bullet for the team. Like, it's just it, you know, when you do those things. You talked about serving. Yeah, Right. That's marketing. Figure out how you serve people, right? If you want to create a great recruiting funnel, how. Just go serve them.

Serve better and harder and more authentically than any anyone else. And recruiting will take care of itself. I think people forget that they think of all people as the same. We make the same mistake with hiring that the IND that the population does with physical therapy, we get commoditized, meaning, oh, I tried physical therapy. Really? Have you also tried dentistry? Have you tried orthopedic? No one does that except for physical therapy. Because of how we have commoditized ourselves. And we do it with. When we hire, it's like, oh, I just need a physical therapist. No, you don't need a body in their right. You need the right human being who also has a degree to be your therapist. And so when we stop thinking scarcity, we start thinking abundantly. It's like, well, I can't serve everyone. I can help everybody, but I can only go a mile deep or serve so many people. So who of the next generation can I help the most? And that was me in recruiting. I wanted to help entrepreneurs like me who really cared about Owning their own thing one day, which is counterintuitive. Why would you hire someone who's going to go up against you? Well, that scarcity mindset again. I hired people who wanted to learn from me because I was going to teach them everything I knew about entrepreneurship. And those are guys like your partner, Jared Egan, who wanted to own his own thing one day. And when we. Before I sold my practice, he told me, he's like, I'm never going to. I don't ever want to open my own thing. I just want to work together with you forever. Because there's nothing. Not everyone's a Jared Egan. They're very few and far between. The two that you hired are very few and far between the guys that take a bullet for the team. So as we serve harder and deeper, we attract the best of the best. And those are the game changers, the rainmakers, the ones that make everything possible for us to achieve the bigger dream. But the dream can't be ours. It's got to be ours. It can't be ours personally. It's got to be ours collectively. What can we do for the industry to make a change? And when we start with that dream and pronounce it, we attract those people. And then while everyone else is fighting over the rest of the individuals with various alignment and talent and capability, the very select few are working with the best of the best. And so when we. I love the idea of how thinking abundantly isn't just right for some of us. It's actually there's enough space for everyone in the industry to think that way because we would just grow the pie instead of fighting over the. The scraps that we perceive that is left.

Absolutely. Yeah. I totally agree. And it's, you know, it's. It's so fun. The. The book, the Go Giver, I'm sure you've read. Yeah, it's. It's all about this, right? Like, how do you solve people's problems? How do you truly, authentically serve people in the most authentic way of who you are? Right. And my authentic way is just to. To go and teach. I love teaching. I love explaining things that make sense in my head. I love advocating for our profession. I love having a voice. You know, I think you're probably cut from the same cloth as me. You've probably felt suppressed as a child, and that's why you have such a strong voice now. You know, there you. You speak for other people. You advocate for other people. And, you know, I just finished my strategic plan for next year, and Presented it to our team. We're hiring some seven therapists next year.

Let's go.

And we already have eight therapists in the docket that we're working on creating relationships with consistently serving. Right. Because if and when. Right. And that strategy actually deliberately happens, you know, if things will change, sure, they'll merge along the way, but we have all these people that already attracted to us. They already want to come work with us. And we're just saying, we're ready. Let's bring you on. You know, this is the time frame. So we already mapped out when people are graduating, when they want to join our team. And we. We got to get our team ready for that. We got to. And the beauty is, you bring on seven new therapists. What happens to your current therapists? Yeah, they move into other leadership positions where they're mentoring these younger ones. So it's such a beautiful thing because you have these growth models internally where people are growing and they get more opportunity. And then you bring on these young people that are just super attracted to the company. They're super excited for the profession, and it just feeds itself. But it all starts with serving people. Just serve them and serve them well. Serve them deeply, authentically, and in such a caring way. And everything else takes care of itself.

Amen. I think of Bob Herman, Robert Herman, who owns the largest pediatric company in the country. He's in Arizona. I had the privilege of hearing him speak, and a lot of what you said is how he talks. And it's this idea of, like, you get momentum when you have the right alignment with purpose and values. And there's so many people who are listening to this episode right now who are possibly feeling a little less than as they're hearing this. And I want to speak directly to the PTOT SLP leader who. Or private practice leader who feels like, yeah, Brad, and maybe will have it figured out. I never can get there. I get what they're saying, but that's not me. And I would call them out very loudly because what I. This is true, almost. And the only reason I don't say every single one is because it's very rare. The vast majority of PT owners that I've met, OT SLP owners I've ever met, they're actually born to do this. That's why they chose what they did. They chose this because of their big heart. So I always say, if you're a PT OT SLP owner that gets treats from your patients, like they bring you cookies and, you know, you can make it rain with Love and improvement, then you were born to be the type of leader that Brad is. You just don't understand how to do it. Like it hasn't occurred to you that what you're doing for that patient and the way you think about money is actually transferable to how you grow your business. Because, you know, part of the reason we're in the position we're in is because we don't really think enough about money when we're treating our patients. And that there's a degree of that that's useful, meaning we're serving so much that we're not like, you know, charging every second of our time in the way that we really should be if we're being accountable. So if. What if we served openly to the next generation? What if we showed up as a therapist treating the. The next generation of patients, assessing their pain points, analyzing their limitations, implementing plans of care that we will be in terms of education and knowledge and then support them along their way? Well, that right there is a blueprint for the most powerful recruiting strategy of all time. If we can just present it in that way. So everyone who's listening who's like that, I don't think I could ever be like a Brad. No man like you are your version of that. You just haven't experienced it yet. And the more. And the reason Brad and I want you to get there is because if you can get there mentally, you can join us in that movement of changing the profession. Because at the end of the day, if we can free up the owners and get paid what we're worth, we're going to make the patient care experience so awesome that we are going to net save billions of dollars, not to mention countless hours of suffering for people who needlessly go through opioid addiction, needless surgeries, and so on. We can unite in a way that's going to move the tide of healthcare globally. So it's not just nice for you to make profits, listeners. It's not a good thing for you to make money. It's essential that you get the time and money for the value you provide so that we all collectively can make tomorrow what it was meant to be for healthcare.

Amen to that Will. I would add that it's our moral duty to do that.

There's so much that we can provide that can change people's life, that can reduce suffering in the world, that can literally take people from where they are and get them to live the life they always wanted. And we have. We were born for this. You know, it was just a day or two ago. You know, it seems that I felt the same way of what you're describing. I appreciate the compliments there, but I felt like I didn't have a voice, and, you know, I didn't. Wasn't going to make a lot of change in the world. But then I realized, if I'm not going to do it, who is?

Like, I have this knowledge. Am I gonna just sit on it, or am I actually gonna go share it with the world? So many people don't know what we know, and if we share it, it can literally save lives. And I tell our team that frequently, like, we literally save lives. I can't tell me. Your patients have told me that I was getting close to taking my own life because of the physical, mental suffering that I was in. And I'm so grateful for what you have done to give me my life back. But just think about those people as you are thinking about your voice. Think about how many people are suffering, who speaks for them, who advocates for them. I think both me and you can agree we're advocating for our old selves. Right. The little boy that was suffering, that didn't get the care that they deserved or, you know, was given their life back when it was taken away by some accident. And we got a second chance. And now we get to go speak for all those people on the value that we can create and that you don't have to be reliant upon all these other things that may or may not create that value for your life. But we can really change lives with just the simple physical therapy techniques that we know.

Yeah, because when we change people physically, temporally, we can move them permanently, emotionally and spiritually, and that's why you and I decided to join this industry. It's what everyone knows deep down, even if they can't articulate it as to why we do what we do. So, man, Brad, it's been phenomenal having you on the show. People are going to want to get. Are going to want to reach out to you. Number one. How do they advocate. They're going to want to reach out to you. People are going to want to work with you, are going to reach out to you. Patients are listening. That's going, where do I get care from? Foundation physical therapy. And again, that's not why we did the show, but I also know that's exactly what's going to happen. How do they get a hold of you?

Yeah, so we, we have all social media accounts. Our. The podcast is called the Healthcare Revolution. And our company is Foundation Physical Therapy. And it's just foundationptutah.com you can message us there. You can message us on Instagram. My email is bradoundationptutah.com you can email me. But I want this, this profession to just, I want to use the term blow up, because blow up in such a good way. Like, I want to go across the world of the value. I want to be the primary role for pain and injury. Like, there's no one that should be at the front lines more than us. And I will help anyone in our profession or any other profession to succeed, because I want all of us to succeed and really to create that value for the world.

Thank you, Brad. Such a pleasure to get to be with you again. Thanks for being on the show.

Likewise.

Will.

Thanks so much for having me. Sam.