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Transcript
Marla: [00:00:00] Well, welcome to the Practice Growth Podcast, Chuck. It's such a pleasure to have you here today.
Chuck: I'm so excited to be here. Well, I'm glad we finally found time.
Marla: And I know this is a very important discussion that we're talking about, one of the big topics that's everyone is really focused on and talking about, and it's the future of our profession and the students of the future of our profession.
So, you are a perfect person to be discussing this with because you are the chief clinical and strategy officer of ATI for the last 17 years, and have held many, many roles, um, where you're leading the clinical part of ATI, you have been working with the students, you have been leading the IMSKA research arm, and a lot of relationships where you've created a, a tough spin and ATI relationship as well.
So can't wait to pick your brain and talk about this topic today.
Chuck: No, excited to share a little bit of my journey and what I've learned over, uh, pushing 25, 30 years now in the profession.
Marla: And that's a great place to start. I'd love to hear just your journey being a clinician all the way through to a chief clinical and strategy officer and what that was and what drove you.
Chuck: Sure. For, for sure it's not what I woke up one day and go, "Oh, that's what I'll be doing in 25 years." Uh, so I started maybe like a lot of PTs at outpatient PT, wanted to do sports, and clinic was a, got hurt playing sports and was an athletic trainer, uh, early. Uh, and then really got, [00:01:30] uh, had an opportunity at University of North Carolina to...
This was before there were advanced degrees, so you went and got your master's and, and advanced master's they called it, to kind of specialize. And so I learned about research and kind of got the, the bug there. But, um, you know, as I came along then, uh, there, I spent some time in academia and then had an opportunity in 2008 to come to Greenville for a private practice at the time, ProAccess Physical Therapy, and, uh, s- helped, uh, join Craig Garrison, who's down at Memorial Hermann now, and, uh, Ellen Shanley, and we just had a really, a great group there.
Was able to start, uh, kind of build on the residency. It was beginning there. We started some research, and then later acquired by ATI, and next thing you know, look around and been at the same place for, uh, you know, 15 going on 16 years.
Marla: Yeah, that, that is a long time to be at the same place, and, and like we said, you've held many different roles.
So would love to know, with all of the different roles that you've had, how has it shaped your vision and experience with students, um, and how much involvement you've had with them?
Chuck: So, you know, um- When I early started, I, I know for me, my early mentors, like a lot of us, sets our path. And so it was always really important for me to try to give back and try to connect back to students when I got out.
And, um, early on with our residency, and then we had a, uh, really strong relationship with, uh, Duke University, uh, when I first came to Greenville, uh, I would take four students at a time. [00:03:00] Uh, so they'd be in pairs, uh, and come down and spend kind of this jumbo clinical as-- So actually it'll play later with tops Eric Hegedus and Chad Cook were there at the time.
Jan Richardson was still there. And so we're gonna try this different thing to get students this really robust experience. So they came, they spent time in clinic with me. They, uh, we would do some research and some other administrative quality improvement projects over a six-month period. So it was a really interesting time, though, that I think I began to appreciate what it really means to mentor and, and bring a student along.
And then we have the students that transition to our residency and then kind of experience that. So I think for me, um, giving back and bringing folks along like I was mentored has always really been important, uh, uh, over the course of my career.
Marla: Wow, four students at one time. It's changed a bit.
Chuck: Changed a bit.
And, and for sure, the two-on-one model, right? They would kinda be two at a time with a clinician and spend some time with me, spend some time with some of our other clinicians. But I think it really opened my eyes to a different way to learn. It's not all this and learning how to learn from other people, um, really became an quite important thread of even how I think about, uh, education and, and development, uh, uh, clinically.
Marla: Yeah, and you've been a huge part of the evolution of how it's changed, especially at a big company where you see thousands and thousands of, um, patients and students a year. Um, and one of your newest parts that you've added is this IMSK arm, which is the research nonprofit [00:04:30] arm. Would love to hear about how, how you think with students and how research really comes into play with them as well.
Chuck: Yeah. So, um, you know, we've always since I came to ProAccess and then even, um, you know, after, uh, became a part of ATI, stayed, kept the research piece going. We had relationships with universities. We'd do clinical studies. Um, had a great opportunity to begin to leverage our ATI patient outcomes registry really from the inception, um, of collecting outcomes, uh, as sort, sort of a baseline.
And that sort of was always going on. And I think what became clear is that and then the residency and fellowship pieces where a lot of students are looking and professional looking for like, "Hey, how do I really get off to a strong start?" And, um, we were kinda internally looking, how do we, uh Coordinate, organize that in a way, uh, to be beneficial, uh, for the organization, attract great cl- uh, therapists to, uh, come and work with us, and give us some better ability to partner externally.
And so, uh, that really drove the creation, uh, of, uh, the Institute for Musculoskeletal Advancement. Tom Deninger, who's our VP of Clinical Development, uh, leads that. He's the executive director. We have a separate guidance board. We're really fortunate to have a number of distinguished faculty that were kind enough to, to, to be on our, uh, advisory board.
Um, and really, um, are off to a great start. We're about 18 months in now, so we've got our kind of first full year [00:06:00] under our belt. Uh, they've got, uh, I think 14 publications this year, so really of just, uh... It's a reflection of the team and, and stuff that's working. We've got, uh, a number of, uh, fellows that have, you know, paid 10 hours a week to work on research, and we've found a way to kind of generate some funding to do that.
Um, and then we've got our residents and fellows that we've always had. So it's kind of tying all together. It's really nice, and I think it allows us then a way to, um, partner with universities in really their educational mission and creating a, a different way to clinically develop, uh, clinicians.
Marla: Yeah, and, and the research is so important, especially in the outpatient area and sector, because a lot of research is done at the university setting or in some of the hospital settings.
So it's great that you've been able to foster that and have students access it too while they're there on their rotations, Tim.
Chuck: Yeah, I think giving students a chance to just see, I call it real world, uh, you know, uh, just what's actually happening out there, I think probably the thing we, uh, spend a lot of time thinking about and talking about within our team and really w- that's our probably sweet spot, is what actually happens.
What, what does it happen just in a normal day in a PT clinic? If you consistently collect outcomes, you watch how patients improve. And we've been able to do a number of things, uh, you know, mostly retrospective, um, but allow us to look at really evolution of what real world practice. I was really fortunate for a period of time to, um, work with the Center for Effectiveness Research in Orthopedics at the University of South Carolina and learned all about, um, health effectiveness research, and [00:07:30] really, uh, leveraging a comparative effectiveness model.
And there's a lot of folks now in PT that do that and do it much better. Trevor Lentz, uh, lead, and Steve George at, uh, DCRI, who we've been fortunate to work with, do a lot of, lot in that area, and, and of course others. But I think really understanding how do we evaluate real-world clinical practice and see what's working and what's not working to give, you know, areas for opportunities to, to help our patients better.
Marla: Yeah, and, and the real-world clinical practice and looking at the research, looking at the data, and just again, also subjectively, um, is so important as we're trying to grow this profession, and we know there's a lot of issues potentially happening right now, and we, we wanna make sure that we're-
Chuck: A few headwinds
Marla: always on top of them, few headwinds. Um, so we'd love to talk about that, too. Where do you see some challenges that are occurring that you've noticed through the past few years you've seen the evolution? Where are we at where there's some headwinds and challenges that we should be alerted about?
Chuck: Y- yeah, you know, look, I, I think, um, clearly some of the guests you've had recently have, uh, spoken very eloquently both around the, the headwinds on the payer side and just the cuts.
I don't know what it is now, at least for next year, we're not going backwards for the first time in a long time. It's not a big raise, but we're not going the other way. Um, but I think really what you see is in the milieu of both payer challenges just around the rates of reimbursement, uh, for most physical therapists, and then on the other side, um, you've got the staffing shortage, which I know we'll, we'll talk about.
I, I think it's interesting because in between that, demand [00:09:00] is higher than it's ever been. So we know physical therapy in the outpatient setting, uh, for musculoskeletal is the most consistent, high quality, high value, low cost way to improve patients. Um, and lots of people are doing, pushing that in different ways, and what's interesting is, how are we gonna meet that challenge?
Um, really it's more about creating the capacity to see more patients, um, both 'Cause you don't get reimbursed as much per patient, and there's more patients to see. So I think that's the interesting, um, conundrum or challenge in front of us. It's both an opportunity and a headwind.
Marla: And as you're saying, there's a lot less clinicians to the demand of the patients, so we are seeing that challenge as well.
Um, and you guys are, are seeing even more challenging with hiring, um, but also maybe even having them on board and, and get treating quicker and faster.
Chuck: Yeah, you know, so when I think about, uh, obviously, I, I think it's pretty well documented at this point, PTJ this year came out with their updated workforce study, uh, the APTA pulled through, and I think it's really important to understand that what we thought was true four or five years ago is not true today.
And, you know, honestly, we probably missed the mark about kind of what was gonna happen and number of therapists and demand, and like many things, COVID changed everything. Uh, you had, you know, about 10 to 15% of the workforce just disappear. I don't know what they're doing, uh, but they [00:10:30] left the workforce, and so, um, that gap in the workforce we're, we're barely in place to replace, and that doesn't capture the demand side.
So I think that's the urgency that, at least from our view of the ability to serve patients that need care, uh, in their communities that we're trying to think about. I know there's a lot, you know, we're, uh, we're here at the private practice meeting, and you've got a lot of folks here with APTQI and others who are facing the same challenges.
I think probably on average, we've got, like, 450 openings across the country.
Marla: Yeah.
Chuck: Um, and, and it's not- Yeah ... unlike for, for other companies that have probably per, per capita, you know, more, more opportunity or jobs than they have, uh, therapists to take care of patients.
Marla: Yeah, and so those, those students are gold.
You know, you want to transition them into your workforce and grow them and develop them. Um, but what I know you've, you've alerted that there's been some problems getting those students up and running too. Uh, I'd love to hear a little bit
Chuck: more about- Yeah. You know, I think it's interesting both, I, I, I'm fully now, like, the old guy on his lawn, and so like, I, like, shake my cane at people going by.
I think there for sure is the cultural piece that we hear largely around, you know, the younger generation, and just it's really interesting. They love the gig, gig economy, if you will, of just pick up here and there. Maybe I'll have a full-time job. Maybe I won't and move around is a very interesting cultural phenomenon, not just within PT.
Um, but I think within PT, what we see is probably, I think of three things. One, the cost of education relative to [00:12:00] salary is out of whack, depending on where you go, right? I think the average, um- cost of education is just over 100 grand. And so that's sort of in my mind is sort of the watermark of that's kind of the line you're trying to stay under to get a reasonable...
I've got a daughter getting ready to go to college, so we're looking at how much does it cost to go to college and what are you gonna make when you get out? Uh, and so I think it's the same thing, you know, how long is it gonna take to pay back those loans, uh, if, if you do that. So I think, one, the imbalance in the cost of education and just what the ability to, uh, pay individuals.
And then from a preparedness standpoint, I think, um, as the DPT has come along and we've really elevated the skill set of our therapists to, um, you know, see a wider range of diagnoses to really lead the plan of care, to fully diagnose, maybe even order imaging and some other things depending on the state, we haven't actually changed the policies of how we practice.
Like I've 30 years essentially, give or take, at this point I've been in clinics. Clinics aren't that different. Like, there's a few new fancy toys, but like it's not that different, honestly, right? You got a plinth, you got some exercise equipment, put your hands on people, and you get them to move better in some form or fashion.
And I think we have stayed at that technician level in much of our practice. So I think the dichotomy for us is, um, other professions have rapidly progressed through this. Nursing [00:13:30] comes to mind 'cause I think it's pretty analogous around both the training and background, um, and how they work as a, a, you know, advanced practice, um, practitioner, and what does that look like of extended care and managing caseloads, um, and delegating everything else.
I'm not sure we've gotten very comfortable with that. And so you kind of add Really smart kids that know way more than I did when I got out with my bachelor's. Um, and they're not fully equipped to walk into a busy practice, and they need to evolve how they practice. So it's an interesting conundrum that the young students are.
So I think for us, we think about how do we set them up early just to have, have people alongside them. We have a mentoring program. We call it First 50, that they've got somebody anchored in with them for their first 50 days, um, and really have a very sequenced onboarding plan. And then we have, um, what we've developed kind of residency-like.
We've had a o- orthopaedic residency forever, but offer a, we call it MSK certification, that they can go through a one-year cohort with other peers. It can prep for the OCS, but really to help give that, uh, musculoskeletal specific content that allows them to, to sink in and, and that really seems to be, uh, helpful for, for those that do that.
We've had about 1,500 folks over the last three years go through it and, and really seems to, uh, help folks settle into practice in that first two [00:15:00] or three years.
Marla: That's great. I mean, and, and that's great opportunity for them because they-- it sounds like they come out with the education, but maybe the reality of what they're doing, they weren't fully expecting, um, and helping to level them up and experience that.
Chuck: Yeah, you know, I think it's just interesting, um, you know, so with, uh, DPT education being very broad-based to kind of do all the different types, you don't necessarily get as much hands-on in the specific area you go into. And so the reality is their level to walk in day one and practice, it isn't there.
And so I think that's probably the opportunity we think about is how do we help both when we're the CIs and we have students in clinic to give them that experience to kind of get up to speed, and then that's where we see, you know, our residencies playing an important role for some that want to go that path to really get that Uh, mentoring on, on steroids, if you will, for a, for a, for a year to really accelerate their, uh, clinical skills and, and, and level of practice
Marla: And what do you recommend on the university side, on the clinic side for small practices, large practices?
What could, what could they all be doing better to help solve some of this problem?
Chuck: You know, I think the most important thing that we've done is just listening to what the challenges are, um, and understanding on both sides of what are they trying to solve for. Is it number of placements? In outpatient, that's not it, uh, right?
Like, there's not, there's plenty of outpatient clinics in general, so that's usually not the problem the university s- uh, [00:16:30] is solving for. So I think understanding what is the university solving for, what are their challenges around that, and coming alongside as a partner. And then from the clinic side, I think, um, honestly it's equipping the CIs.
We, we've spent a lot of, uh, time and effort over the last few years to just, uh, ensure all of our, uh, CIs are, you know, credentialed, have gone through the APTA or similar course. They understand how to mentor students. They really, um, are, uh, are committed to that process because I think that, that gets a good experience for the clinician, and then not surprisingly, right, student has a good experience, your chance of hiring them, uh, it's pretty good.
So I think that's the give and take. Like, we all wanna take students because we wanna hire them, but I think you've got to put a little work in to, to get the return. I think understanding what the partner on the other side needs, and it's different, right? If you're a large university or maybe a more, more regional one of kind of what they're looking for
Marla: Yeah, and, um, with that, in terms of the mentorship and, and guiding them, what do you, what have you guys put into place to help level up your, your clinicians or, um, to help get your students really having that experience?
Chuck: Yeah, so I think just w- we have someone that coordinates and sort of, you know, uh, navigates the ship, if you will. And I think just really, um, our, our university team spends a lot of time working with CIs to understand what their expectations are, because every program's a little different. Um, you know, which rotation are they on, and what are they looking to accomplish?
It's actually interesting. We just, uh, one of the research projects we just finished with [00:18:00] some of the faculty, Craig Wasinger and some others at Tufts, looking at, um, productivity and outcomes when you have a student, and there's a wide variety of opinions, and the headline is doesn't change it. If you're a productive clinician and you get good outcomes, you have a student, you still can be productive and get good outcomes.
So I think, um, that's a really positive story 'cause that, that shows that students can come in and see what good practice looks like, see what getting patients better looks like, and see what it looks like in the real world of, of efficiencies that, that you have to operate at. So I think, um, modeling that, and I think it's just reinforcing those behaviors.
So, you know, we do the, um, uh, CI course. We have a consistent way that we onboard, uh, the students, uh, so they kind of get a consistent experience and make sure that they feel welcome and they're not some random, you know, person sitting at the side of the clinic. Uh, really seems to be, 'cause i- it's why most of us are in PT.
Like, we generally like people, and so you've got to kind of help bridge that relationship gap. Uh, and frankly, in particular with The young kids, uh, if you will, because I, I don't know that it's just, it's different of how they relate and, and how they, you know, just how they communicate. And so helping them with some of those things has been really important for our young CIs.
Marla: Yeah. And, and I know a lot of students I've heard, um, or if you wanna hire them, you bring them on board, but maybe they haven't passed the NPTE yet. So what have you seen change in the last few years about [00:19:30] that, and what are you guys doing to combat?
Chuck: Yeah. So for us at least, pass rates are an issue. I know speaking to other, um, practices that hire a lot of people, um, it's inconsistent is what I would say.
It's, it's not, and there's for sure, um, some pockets where you're like, "Oh, that's concerning," maybe programs here and there. But I think overall we see the decline. I think there's a couple of challenges. One is, um, there's a little bit of laissez-faire for the students of like, "Ah, if I don't pass it the first time, I'll take it in three more months."
And I'm like, "Really?" Like, when I got out, my dad was like, "Look, tick-tock, kid. You are on your own. You go get a job." But there's ... So that's sort of that cultural piece of the gig, like they're kinda okay to ease into practice. Um, but then I think also, um, the prep materials that are available, they're there, but they're very self-driven.
And so I think we've, um, we've taken, we now offer, she signed on, we do a kind of a cohort prep class 'cause kids are looking for that sort of guidance, which is a whole larger thing about how we've taught people to learn. But, uh, very s- uh, sequence segmented way is kinda how most students are so kind of providing that path to prep.
And then, you know, the opportunity is probably to begin to work with CAPD, uh, and, and the, uh, FDS, uh, and, and accreditation, see if we can offer the exam a little more often. So there's a little bit of gap right now of if I take it, uh, in July Tick, tick [00:21:00] October. So, so now if you think graduation, different schools handle it differently to be able to get to sit for your...
So you could have a six, nine-month gap from when you graduate to when you pass your exam. And then, so now if you think about the number of students coming out on hold, get some of those gaps, you get a, call it a 10% drop, uh, pass rates. That's a material change in number of clinicians available in the workforce.
Marla: Yeah, and, and obviously some states you cannot practice until you pass. Some- Right ... you can have a temporary license. Um, and when you're trying to fill those 450 slots, that's really challenging- That's a problem for sure ... because you've got that person, but they can't treat, right?
Chuck: Yep, for sure. That's exactly it.
Marla: So what, what do you recommend or w- for clinics that are listening that could help with that pass happening at their clinic? Look,
Chuck: it's not,
Marla: uh,
Chuck: it's not a complicated test, right? Like, it's basically don't kill anybody. Know how to show up. And so I really think it's a great opportunity to have the student come in, there's good resources, and walk through them with that to prep them and offering that.
And what we found is it may be a good tell if that student's gonna be a good match for your environment, um, and maybe a good early tell sign if they're like, "Nah, I'm good, I'll figure it out." Maybe that's a tell that that's not somebody you wanna spend a lot of time recruiting, which is a whole other discussion.
So I think just that would be my biggest thing is are you willing to put your arm around somebody, say, "Hey Marlo, let's sit down and study. Let's work on this together. How can I help you?" And really engage them in that. I think sometimes the [00:22:30] students are like, "Well, I've done my DPT, like, I don't need any help.
I got this." But I think actually breaking down that barrier of understanding it's okay to ask for help. Like, when you get done with your DPT, you're not magically ready to go, um, right? There's still a whole other process that's gotta happen to really, um, mature. And I, I think for me it was probably- Five years, honestly, if I really think about the evolution.
I think a lot of folks will say that is you get out, you kind of think you know what you're doing, and then all of a sudden you're like, "Oh, I have no idea." And I, it, at least me, I think a lot of people I know have gone through that period of not having any clue how to treat patients because you're trying to kind of rethink and, and, and, and evolve.
So I think understanding, helping people understand that early, um, is really important.
Marla: And is there anything the universities could be teaching them a little bit about just, um, for when they graduate? Anything else they could be adding?
Chuck: Yeah, you know, I, I, from my view, I think it's really the practical side of things.
I think, um, really defining what is good. Uh, from our view, it's getting patients better. Can they get... You know, we, we use the MSK measure set that, um, Limber and, uh, a number of other partners, have kind of helped co-create together that are used to, to measure MIPS. And so it's super simple, like relative to your patient, can you get better than you should?
Um, and to me, that's what the simple part is. I think we mix up good practice of what I want, what's my preferences. I wanna only do this. I only wanna see this kind [00:24:00] of patient versus can I get people better? Um, so I think in my mind, it's pretty simple. Can you get patients better or not? And then how do I do that?
So I think, um, we often end up with, well, that's good practice, that's bad practice, not based on patient progress, but based on practice styles or if you do, you know, therapy A or therapy B, um, part, which I, I think we pretty much know now isn't it. It's terribly disconcerting when you, you know, you see some of the therapy alliance pieces and like, does the patient think they're gonna get better?
Do they think therapy was gonna work? Do they believe that you can help them get better? Like all those things are as important as degrees and all the other pieces. It's really disconcerting when you've spent, you know, $100,000 eight years in school
Marla: Yeah, yeah, absolutely. I mean, I think that's a good way to start, and as you said, looking at the outcomes, and you guys have done a lot with, with Limbur and a couple other companies to be able to, um, pull that together.
Uh, tell me a little bit more about the, the research and the outcomes that you've been doing and what you guys have been utilizing them for.
Chuck: You know, I think, um, you know, we started with su- a super simple idea of every patient's gonna get a baseline outcome, and then we're gonna do the best we can to get a follow-up.
And really we've sort of stuck with that. And I think now, um, you know, it's not perfect, but 95%, uh, of patients have a baseline outcome. Um, and then, you know, we sit north, well north of 70, [00:25:30] 75% of patients get a second outcome. So I've got a pretty good sense of what gets better. And so we've been able to look at and, um, kind of patterns of practice.
So, uh, Adam Lutz has, has been with us for a long time, has done some nice things not only with risk adjustment, but looking at what is the effectiveness of manual therapy and how much matters. And, um, you know, I think that's one of the papers I'm really proud of that we've been able to do because I think it's real world.
It kind of shows that it's not any magic trick. It's a mix of, um, a mix of approaches based on the patient's complexity, which really resonates with me, right patient, right time, right treatment. Um, and then I think, um, you know, we've been able to dive into a lot of specialties, uh, and different... We recently had a word pop paper published looking at the effectiveness of physical therapy to help patients return to work and reach improved functional status.
Um, and then, uh, you know, we, we've been able, um, to do a lot of early PT work. And I think probably if I think about things, you go, "Hey, I'm really proud of that," is some of the work we've been able to do that mirrors others' work that shows that when you implement early physical therapy, patients get better, it costs less money, and it is good for everyone.
So I think it's, uh, it's one of the few stories that I know you go, "Hey, do more of this, and it's gonna cost less down the line, and patients get better and happy." So I think those are the things that, um, I think about we've been able to do with our patient repository and partnering with other super smart people that know how to do fancy stats that I don't, don't really [00:27:00] know how to do anymore.
Marla: All, all stuff we knew, we just had to prove and research. No,
Chuck: that's, those are the, those are the things I like to do. I like to prove what we already know. Okay.
Marla: Exactly, but the insurance companies need to see it, so, so that's very valuable research to be adding. Um, and tell me a little bit more about your relationship with Tufts and how you are bridging the gap between students and universities.
Chuck: Yeah. So I, you know, I'd mentioned, uh, Eric Heggness, who is, uh, the dean of the program and, and over at Tufts hybrid program. And so, uh, Eric and I have known each other for ever, I guess now at this point, 20 years. And, um, as he came to Tufts, he's like, "Hey, we're starting this hybrid program, da, da, da. You guys are in Seattle.
You guys are in Arizona. You know, what can we do together?" And so as he's, he's always had a very forward-thinking way of clinical education and clinical preparation, and it just, uh, led to really good discussions about how we might work together. And so, um, you know, because we're co-located some of the-- their core campuses, um, we found a few ways to work together.
We're super excited. Um, their approach is to really identify Uh, sp- a more diverse, uh, representative workforce, and that looks like coming from places you're at. Um, and so I think because they're regional, they're able to pull in kids that maybe otherwise wouldn't go to PT school. And so those are folks that stay at home, right?
They, um, I think about, you know, uh, anyway, some of the markets we have where you're like, "Hey, who wants to move there?" [00:28:30] Nobody wants to move there unless you're from there. That's where you want to go back home. And so I think, um, identifying those kids and being able to help them, we've been able to sponsor, uh, they call it their ADEPT program, but it's really a preparation program for maybe students that they didn't go to the Ivy League school, or they didn't have a 4.0 and everything and need a little help to ensure their graduation rates are there.
They're doing a really nice job with that. We're able, we're excited to partner there. And then, um, we've got a program that if you're a, a tech or a rehab tech with us and you want to go to PT school, we'll help support you to go to Tufts. And so I think we've, uh, we're super excited. I think we had 30 last year, and I think we're on track to have 45 or 50 this year, uh, opt into the program.
So I think it's an opportunity to, to help kids get a, a, a manageable cost of their education, and it's where they're from, right? They want to come back home because we all, we've all known. I mean, I, I was a tech at one point. Like, we all did that, or all, most people, that's kind of the path in. So I think there's a natural progression, uh, for these, uh, students and hopefully a way to kind of fill that.
And so Tufts' been really good to do that, and we're doing some oth-other interesting ideas. We'll see what comes of that. But those are kind of the main two things we're doing, and we're super excited for that. And then, uh, you know, working with their faculty do- on some different research projects.
Marla: Oh, that's great.
So you're taking techs and PTAs and helping actually support them to go to school- Yeah ... PT school, and then bring them back into the workforce. Correct. That's great. Um, for a small clinic who maybe can't do that- Yep ... because they don't have the funds and the large [00:30:00] size of an ATI, what do you recommend?
What, what do you recommend they should be doing to set themselves up for the future?
Chuck: You know, I, I, I think coming back to it's how most of us started practice. Like, I, I got out, I went, hung my shingle up down the road, and I went and knocked on somebody's door and like, "Hey, can I help your patients?" Um, I think it's the same way for the universities, is understanding what are the universities trying to solve for.
Usually, they need clinic instructors. Um, they need support in other areas. Their faculty may be trying to do research. So I think looking for other ways, um, that you can support the program, um, to do that. Now it's a partnership. It's just not, "Oh, send me all your students because I want to hire them," or vice versa.
On the academic side, you know, write me a check and fund this or that. So I think understanding what each other needs allows for that opportunity. I think that's, in general, what's been really good about PT. PTs are pretty local and kind of figure out how to network and connect together. And so I think that's really at the core of building those relationships and being willing to partner with, uh, folks across the aisle
Marla: Yeah, and, and potentially even getting involved and maybe offering their clinicians a little bit of research time- No,
Chuck: that's right
Marla: to jump in and help
Chuck: too. To, to, to do other things with the university, for sure, 'cause right, that, that gives some diversity to what folks are doing and, and find a way to evolve, uh, your clinicians and give them paths to grow, uh, as they're coming through.
Marla: Yeah. Yeah. Great. Uh, and, and what do you just see as the future of this emerging profession with, you know, the students and new clinicians and new grads?
Any thoughts?
Chuck: [00:31:30] Um, you know, I, for me, I, when I think about it, any time there's tons of chaos and headwinds, there's also an opportunity buried within them. So I, I'll go back to kind of where maybe at, early I started is, the demand for PT has never been higher. The reimbursement's never been lower, and we don't have...
So I think there's, and we have a crisis of staffing, so I think there's an opportunity there to do things differently. It's gonna be a forcing function, um, just the way things are happening, it's gonna kind of crash together. And so I think, um, it's exciting for me 'cause I think it's gonna give us a way to actually solve healthcare and s- you know, for me, solve musculoskeletal.
I think we bring a ton of value, um, to that, and it's gonna give us an opportunity to do that. And so I think the question for us all is, how are we gonna step up to do that? Are we just gonna go back and still practice like it's 1980? Yeah. And I think that's the tension, right? That we can't practice like it's- They, we just can't.
And so I think that's, that's the conundrum we're all in 'cause the reality is how we got paid in 1980 is sort of how we get paid today. And so how do we transition from there to, you know, what, we talk about practicing at the top of our license, right? We're 24 years now into, you know, this journey of, um, being a doctoring profession, so how are we gonna actually embody that?
I think that's super exciting. We're equipped to do it, got the education. Um, we've got lots of opportunity, but I think are we gonna adapt how we practice and deliver care to, [00:33:00] to meet the, to meet the moment?
Marla: Yeah, I definitely think the clinics that are not innovating, that are not looking differently and outside the box and adopting some of the new technologies and techniques out there are the ones that, that are gonna struggle a little bit more.
We, we can't do the same thing over and over.
Chuck: At, at some point, right? I mean, I, whether, you know, I, I know, uh, Dr- Drew says often, you know, those that ... See if I can get his quote right. But tho- those that don't, uh, adopt tech or are enabled by it'll be replaced by it. And so, you know, I think our ability to, whether it's technology or a different practice model, to adapt and evolve how we're practicing or what's gonna lead.
And I think what's exciting for me, um, we've got a lot of great people in the profession. I think because of some of the forcing function, people are coming together. There's not as much of finger-pointing and, "Oh, I won't work with that person." I think a lot of that, um, has passed, and so I think that really gives a, an exciting opportunity to have the impact in society I know we can.
Marla: Yeah, yeah. And the students will come out, and they'll be more excited because they're not going back into an old practice model. You know, they're, they're, they're working towards- Into something
Chuck: new ... something new. For
Marla: sure. Yeah, yeah. Well, awesome. This was, this was such a great conversation. Really appreciate all of your insights and all that you're doing, um, and just the s- the, how many years experience of clinical- One or
Chuck: two
Marla: clinical care- One or two ... and, and evolving and developing our next generation of
Chuck: students. Well, thanks for having me. I really enjoyed it.
Marla: Thanks, Chuck.