Why Healthcare Professionals are Shifting to Cash-Based Practices | Dr. Eric Abramowitz

Show Notes

In this episode, Dr. JJ Thomas sits down with the insightful Dr. Eric Abramowitz to discuss the fear and challenges of transitioning from insurance-based to cash-based practice. They emphasize the importance of a quality over quantity-focused mindset in a cash-based practice and share insights for a successful cash-based practice to inspire and guide healthcare professionals considering a similar transition.

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What is The Dr. JJ Thomas Podcast?

Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.

Dr. Eric Abramowitz: 00:00

If you replace the I in illness for we, you get wellness.

Dr. JJ Thomas: 00:06

Oh my god. That's amazing. And I just again, I was, like, re confirmed that your values were the same as mine.

Dr. Eric Abramowitz: 00:14

Welcome to the doctor JJ Thomas podcast.

Dr. JJ Thomas: 00:19

Hello, everybody. Welcome to the doctor JJ Thomas podcast. I'm JJ Thomas, and I'm so happy for this episode today. I've been really looking forward to this because it's the first episode we have a guest. And I couldn't think of a better guest than my friend and colleague, Eric Abramowitz, doctor Eric Abramowitz.

Dr. JJ Thomas: 00:37

It's super fitting that he's here as my first guest today because he was my first, physical therapist that I hired in the CAST based practice, that, you know, has been with me so long and and has just been amazing. So, Eric, welcome.

Dr. Eric Abramowitz: 00:52

Thank you. Happy to be here.

Dr. JJ Thomas: 00:53

In this episode, I'm so excited to be here with Eric because, honestly, I've been talking for 15 weeks about all the things, all the nuggets that have made this practice a success, and I realized that Eric, you know, is another person who's come in and taken his practice and grown it exponentially, in a way that I couldn't be more proud of, and I I think you're pretty happy with. So I wanted to share those things with you guys. Eric, I wanted 1st, I wanted to tell them a little bit more about you, and I thought I'd start with how you and I first met and how this relationship this professional relationship kind of grew. Sure. So I love this story because it's, I don't know.

Dr. JJ Thomas: 01:32

It's one of those things one of those moments that I look back on, and I'm like, wow. Sometimes have you guys ever been in the situation where you know like, there's a moment in time where you're it feels like things stop, and there's clarity, like clarity of vision. And you don't necessarily know where that's gonna go, but you have a distinct moment that you remember that you're like, wow. This is a important moment in my life. When I first met Eric in 2012, it was probably late 2012, I was working at ATI at a large, insurance based company.

Dr. JJ Thomas: 02:11

Great company. And Eric I'd never met Eric before, but he'd he'd been working there a good bit. And at the time, I was doing dry needling. And, my mentor, my PT mentor, had sent Eric to me for to consult with a patient that he was having a hard time with. And so that moment, that time when Eric came, it was funny.

Dr. JJ Thomas: 02:30

The interaction was very, like, on surface, very, you know, obviously professional, but it was not very intense in terms of our interaction. But his the way he held himself, the values that he portrayed in that conversation working with this patient, there was multiple things that I looked at Eric and I was like, Wow. I remember the distinct moment we were recapping after the patient left, and I remember thinking, wow. This guy's awesome. Like, I'm gonna remember him.

Dr. JJ Thomas: 03:00

And, I'll tell you in a little bit how that came back to me, you know, in the next year. But at the time when I had that thought, I wasn't I wasn't even intending on opening my own practice yet. I really I I had dreams of it. You know? But I wasn't there yet.

Dr. JJ Thomas: 03:15

I wasn't ready to take that jump. But in that moment, I was like, this guy's awesome. I'm gonna remember him. Literally, I remember saying those things. And I would love to hear your perspective on that first on that first

Dr. Eric Abramowitz: 03:26

day. Yeah. I mean, for me, that was maybe a year or 2 into being a PT. And, Paul Schweitzer, who was one of my mentors, you happened to work for him for a while. And, you know, I've been in a year, I've been trying to follow Paul around the office as much as I can.

Dr. Eric Abramowitz: 03:40

You know, some of his for those that know Paul or don't, his his treatment techniques, you know, he had been in the physical therapy game for for a while and, you know, all of his methods seemed somewhat far fetched and out there compared to what you you were taught in PT school. Right? In PT school, everything there's a lot that goes by the book and there's there's particular methods of doing this exactly this way. This is the precise way. You're gonna be tested on it this way.

Dr. Eric Abramowitz: 04:06

And you walk into the office and see Paul doing something so unconventional, Standing on a table doing a hip mode with his foot. You're like, what is this guy doing? Yeah. And I just had this this this interest in something this guy is doing is different, unique, and and special. And his patients loved him.

Dr. Eric Abramowitz: 04:23

He got results. Docs loved sending patients to him. So I knew there was something about his methods and his personality and and something was special. So I'd always follow him around and I had a patient, an athlete, a high school crossfire who's was dealing with an injury and, you know, we might have been 6 weeks into the the treatments and weren't getting the results I wanted. And I went over to Paul, ran through the case and I said, hey, what what can I be doing here?

Dr. Eric Abramowitz: 04:47

And he goes, go over to this this chick, JJ, down the street. She does dry needling. It's kinda crazy but, I promise you'll get some results. So I, you know, jumped on it. I said, okay.

Dr. Eric Abramowitz: 04:57

Reached out to you. I think I emailed you. I said, hey. I work with Paul. Wants me to come take a patient over to you.

Dr. Eric Abramowitz: 05:03

Do you mind doing a consult? You know, we I walked in the office watching you do that treatment that first day. I had never seen dry needling. I don't think we were taught about dry needling in PT school at the time. So it was new different, you know, invasive.

Dr. Eric Abramowitz: 05:18

So I was very intrigued and honestly, the patient was fixed in 2 sessions. So I had been working with her for 6 weeks. 2 sessions, seeing how you interacted with her, seeing how you tested and retested, and the movements and things you looked at was so out there for what I've been used to and what I've been doing. And just my personal desire to, like, grow and change. Like, I just had a feeling that this was a path of some sort that I needed to pursue.

Dr. JJ Thomas: 05:45

Yeah. That's awesome to hear that because, to be honest, those are the things that I saw on you that day. Like, the the passion I think this is important. I I wanna bring this to you guys as an episode because I think it's important for you guys as professionals to self reflect and ask yourselves what impression you're portraying to the people, to your coworkers, to people that you wanna have a relationship with, but maybe maybe or maybe you don't even know you wanna have a relationship with with them. That's that's the best thing about, like, this interaction with Eric and I is, at the time, I had no idea that I would want to have a professional relationship with you other than the fact that I was like, wow.

Dr. JJ Thomas: 06:19

I'm gonna remember him. But all those things you just said are exactly why I had that defining moment where, like, in my mind, I literally outside in my mind said, I'm gonna remember him, and it was that. It was it was your passion for learning. It was your humble but respectful questions. It was your genuine interest, and and I knew right away that our values were gonna be aligned.

Dr. JJ Thomas: 06:40

And I just was like, this is somebody that I wanna work more with. So, I don't know. I just when I was thinking about this episode today, that was one of the most important things I wanted to share is because I think you never know when you never know when you're gonna affect someone else. Like, I think that we all sometimes run around this busy life so so busy and, like, we think we're in one direction, but there may be a whole another direction that's gonna come our way if we just keep our eyes open and are and are looking for it. The other cool part about when you and I first started working together, like how that transitioned from me having this moment where I was like, I gotta work with this guy.

Dr. JJ Thomas: 07:15

He's amazing, to actually bringing you to my clinic, I think happened so 20 so 2012 late 2012, we met, and I had that moment where I was like, this guy's awesome. I have to we have to work together somehow. And then middle of 2013, I I'd hit my limit. Like, I just was done. I was fried.

Dr. JJ Thomas: 07:34

I'm I'm that way in general. Like, I'm, like, very patient, and I'll work hard and I'll work hard. And then all of a sudden, I'll hit a limit where I'm like, like, screw this. I'm totally done. And that was it in 2013.

Dr. JJ Thomas: 07:44

And I, you know, I left ATI on good terms. They're great people, as I've said a 1000 times. But I left ATI. I opened my own practice. And I've discussed this on the podcast before, like, how I actually did that, which isn't my intention for today.

Dr. JJ Thomas: 07:58

But remember, I kind of did it I didn't have a brick and mortar shop the 1st 2 years. It wasn't till 2015 that I actually went and got my own, you know, brick. And then so 2015, I had I was busy enough. I had my own clinic, actual location, and it just was snow like, snowballing in a good way. Things were just cruising, and I was busier and busier.

Dr. JJ Thomas: 08:21

And around 2017, I was like, shoot. I'm having a really hard time getting my patients in now. I am like like, I've got into this because I wanna help more people, and I am helping more people. But now I'm pretty like, I was coming in. I was treating patients at 5 AM.

Dr. JJ Thomas: 08:35

I was coming in a lot on the weekends, which I don't mind doing for the good of the patients, but, like, I was just hitting a point where I was like, oh, if I don't do something about this, I'm gonna burn out. Then all of a sudden, that moment of us reconnect of us talking after we had that patient, that moment came back into my head, and I was like, I wonder what Eric's doing. And just for you guys to understand, like, Eric and I, we didn't work together at ATI. Like, we that we had that one time, and then we had some interactions through Christmas parties or whatever, but and Instagram. But mostly, we didn't.

Dr. JJ Thomas: 09:06

And then so but I well, we were following each other on Instagram. And in 2017, you came back into my head because of something he posted on social media. So I was literally, one of those days, I had a long, long day, and I was like I was like, oh, my God. I love what I'm doing, but I need some help. Who can I hire that's going to be great in this?

Dr. JJ Thomas: 09:26

And then I saw this post. Oh, actually, first, there was a jiu jitsu post. So I had just started jiu jitsu then too. So and then Eric posted that he did a competition, and I was like, oh, Eric does jujitsu? He's totally perfect for this.

Dr. JJ Thomas: 09:38

And then right after that, he posted this he reposted a, a a phrase.

Dr. Eric Abramowitz: 09:44

It was if you if you replace the I and illness for we, you get wellness.

Dr. JJ Thomas: 09:52

Yeah. And I saw that. I was like literally, it was it was I think it might have even just been on your story. I don't know. But it was like a brief like, it was like, If you replace I with we, illness becomes wellness.

Dr. Eric Abramowitz: 10:04

Yeah. That's

Dr. JJ Thomas: 10:04

it. And I was like, Oh, my God. That's amazing. And I just, again, I was like, reconfirmed that your values were the same as mine and that this had to happen. So so I reached out to you on DM, and I was like, Eric, how you how have you been?

Dr. JJ Thomas: 10:20

And he's like he's like, I'm so great. They just made me director at ATI. Yep. And, I so I thought, okay. I'm not gonna I'm not gonna disrupt his world.

Dr. JJ Thomas: 10:30

Like, he's very happy. I'm not gonna interject him from that. So I I just let it go. I was like, congratulations. That great.

Dr. JJ Thomas: 10:35

Meanwhile, I was like, But then so I survived. I did try a couple helpers here and there. Nobody quite was the same as Eric. So then 2019, I was, like, struggling again, very busy. And I looked I literally went back to my DM to see when the last time I asked you was, and it was 2 years before.

Dr. JJ Thomas: 10:53

And my exact thought was 2 years managing a busy insurance based clinic. He's done. I texted you, and I was like, hey. How you doing? Are you ready to come work at Primal now?

Dr. JJ Thomas: 11:06

And then we got on a phone call, and it was and and that was it. Then we just figured it out, and that was, like that became into COVID times. So it was, like, a bit of a risk, I think. Like, a lot of people weren't growing during COVID times, but I knew it was right. I was still pretty I was still really busy, and I knew that in order to grow, I needed other awesome people that were following the same vision and mission that I wanted to.

Dr. Eric Abramowitz: 11:31

Yeah. It was it was, it was definitely a risk. But like you said, I mean, I had been the clinic director of a of the office that I started at with Paul and, you know, that was in my mind starting out at ATI and, you know, I always envision like, man, this is my this is my goal. I wanna be a clinic director of this place that we're doing. You know, it's a 140 visits a day.

Dr. Eric Abramowitz: 11:52

We've got 30 staff. I'm like, if I can manage this monster, like, I'm good. I got it. And I it took me a few years. I I got my first office to be clinic director, smaller space.

Dr. Eric Abramowitz: 12:04

They bumped me to another one. I had done a good job and then that third office was back to Pike Creek being clinic director where that's when you texted me the fur that first time and I said, hey. I got this job. I'm super pumped. This is gonna be a great opportunity.

Dr. Eric Abramowitz: 12:18

And, you know, that's a that was a tough job. I definitely learned I learned a lot being the clinic director of that office. I don't want it to seem as though that was all negative, because there's a lot that came out of my experience having to manage people, interact with staff, and be supportive of their goals and their mission and what they wanna get out of their career Mhmm. While also still taking care of patients and feeling like I'm fulfilling my job and why I became a physical therapist. Yeah.

Dr. Eric Abramowitz: 12:52

But, yeah, 2 years of of all of that, like you said, like, it it gets overwhelming and you start, I started to feel the burnout. So, you definitely caught me what felt like at at exactly right timing, and it was certainly a risk to to take the jump, and I I did it systematically and and little by little, but, when it was time to take a jump, I felt it felt very right.

Dr. JJ Thomas: 13:16

Yeah. Yeah. I would love like, that's part of what I wanna get across to these guys today is, like, to share your perspective on on that exact thing. Because I think when I'm getting feedback from the podcast and from people that are just reaching out to me asking about the cash based practice, I think that's the biggest fear is that jump from the insurance based world and then transition into a cash based practice. And I would love to hear more about how you felt during that, like maybe some of your fears that you had before coming over, and even while you were first starting to transition, some of those fears that you might have had and how you dealt with them.

Dr. Eric Abramowitz: 13:51

Yeah. I think yeah. That's great. I think to understand the fears, you know, for for the physical all our all us physical therapists that start in the insurance based world, for the for the most part, I think we all start with the same drive, passion, and intention to say, hey. I I wanna make a change in people's lives.

Dr. Eric Abramowitz: 14:14

Mhmm. And that is everything I want out of this career to to show up to work every day and make a change and and have the time I need to dedicate to to each individual patient to make sure they're getting what they need from their time with me. Mhmm. So what what ended up happening at least in my experience, you know, you get into some of the insurance based constraints. You know, I don't necessarily think it's an individual company constraint, but that's the insurance based world.

Dr. Eric Abramowitz: 14:44

The constraints were the only way to be successful seemingly in that environment because of reimbursement is for you to see volume. Right? So it's not it's no longer you have the opportunity to go see patient a, Mary for all the time she needs from you. And And then when Mary's done, you're gonna go to to Bill. You really have to see Mary and Bill.

Dr. Eric Abramowitz: 15:07

They're gonna both come in at the same time, and then you're gonna see Bob and Jane Right. 30 minutes later. So, you know, that starts to take at least for me, it started to take the passion and the fire, and it felt like it felt like all of that was being muddled down to where my focus and attention and energy was being taken away from the patient care and being put into these other these other these other buckets of make sure you hit this number, you gotta get volume, and don't forget the notes on the back end.

Dr. JJ Thomas: 15:39

Yeah. That's what I remember seeing. And and that was something I didn't like like I said, I already knew because my instincts told me that you'd be an amazing therapist and that you would be amazing addition. But one of the things I didn't I didn't necessarily, anticipate was that when you came over, I do remember you were so conditioned to think about the numbers at first, even though I knew that your heart was like, I want to get people better. But you were so conditioned to think about the numbers.

Dr. JJ Thomas: 16:05

I remember at first, you were like you were like, Jay, like, how do I fill my schedule? How do I fill my schedule? And I just kept saying, Eric, just get people better. Just get people better. And you're like, okay.

Dr. JJ Thomas: 16:15

Okay. Right? Yeah. Do you remember that?

Dr. Eric Abramowitz: 16:17

I do. I do. Yeah. And I think, you know, that was that was very challenging at first. You know?

Dr. Eric Abramowitz: 16:22

The things about the insurance based world, they they instill these at least for me, they instill this drive of, like, go meet this person. Try to see how many patients you can get them to refer to you and then your how do you get your your schedule busy? How do you make the time that you're investing here profitable? And I wanna do right by you, the business owner. You brought me on.

Dr. Eric Abramowitz: 16:41

How do I show you that I'm Yes. I'm being I am putting back into your company the the effort and energy investment that you put into me. So my mind is like, I gotta get more patients in the door. How do I find this person? How do I get to that person?

Dr. Eric Abramowitz: 16:56

Right. And it was a hard it was a it was a hard transition, but the the constant reminders of, dude, slow down. Yeah. Focus on the patient. When they're here, just get them better.

Dr. JJ Thomas: 17:09

Yeah.

Dr. Eric Abramowitz: 17:09

And then things will start to snowball and and you'll see it. And once that once I could shift that thought process in my mind, honestly, like, it I don't think it took me more than 2 months to get.

Dr. JJ Thomas: 17:19

No. It was definitely very fast. You you were great.

Dr. Eric Abramowitz: 17:21

Yeah.

Dr. JJ Thomas: 17:22

I think that what you just said is, is so true. It's like we're I think that's the biggest difference I notice is in our world where I think our cash based practice in particular, like, the model that we use may be slightly different from other cash pay cash based practices, but it's for sure that quality over quantity game. Right?

Dr. Eric Abramowitz: 17:41

Yeah.

Dr. JJ Thomas: 17:42

So and I think I didn't realize that there was gonna be a little bit of a transition from for you for you, and, actually, we've seen it with some other employees too. Like, coming over and realizing that the whole mindset of it's it's really conditioning. It's like the conditioning mindset of what your focus are. And and I believe in metrics. Like, you know, what gets measured gets done.

Dr. JJ Thomas: 18:02

And so I'm not, again, I'm not faulting the insurance based world. You have to measure things, but it's just you you have to really measure what's most important to you. And so it was. It was definitely like a just kept I I I'm sure I drove you crazy. Like, just get people better, Eric.

Dr. JJ Thomas: 18:15

Just get people better.

Dr. Eric Abramowitz: 18:17

Yeah. Yeah. It was hard to it was hard to, like, adopt that, but, it it definitely works.

Dr. JJ Thomas: 18:23

So now, Eric, is just to, like, give you guys an update of our practice. You know, this this practice, as I said before in other episodes, we 2013, I opened opened the non brick and mortar. 2015, brick and mortar. 2019, Eric came on. And then now, since then, we have 3 full time and 2 part time therapists.

Dr. JJ Thomas: 18:41

And and we're busting at the seams. Like, Eric, as he said, he's only been here three and a half years, and, and his schedule he has a consistent waitlist now. So the method, you know, it works. Right? So now, it's funny because, transitionally, you're, you've gone from coming in a director role from an insurance based world to now being, then moving into cash based practice and being a little bit more of a of a less director role and and then earning your spot again.

Dr. JJ Thomas: 19:10

And now you're going to be opening your own office, own primal office. I'm super proud. We're We're working I mean, I don't wanna jinx anything and talk too much about it, but I am excited. Like, Eric's schedule is is slammed, and our place is big, but we're, you know, we're looking for a new fishbowl. Like, not here.

Dr. JJ Thomas: 19:25

This place is staying, but Eric needs a new fishbowl. Otherwise, we're we're not gonna grow. You know? Fish don't grow if they don't have big enough space. Yeah.

Dr. JJ Thomas: 19:33

Yeah. So, tell me about that process. Now you're, like, transitioning again into more of a leadership role, and how's that feel?

Dr. Eric Abramowitz: 19:40

Yeah. It feels great. I mean, I definitely enjoy and love the management side of things being able to, you know, allocate some of my time and effort and energy into not just growing my business, but helping lift others around me. So I think being able being fortunate enough and and having the success I've had to to feel comfortable ready to take the risk to open up another office. One helps me get a new community established where I can help more people and then hopefully make that office busy and big enough to to support the growth of other PTs.

Dr. Eric Abramowitz: 20:12

Awesome. So, yeah, it feels great.

Dr. JJ Thomas: 20:14

So I'm having a ton of fun watching you grow into your own like, grow into you know, look for right now, Eric's currently looking for a space that he can grow his side of the business into, and, it's a lot of fun for me to watch, like, your own personality come out of that. And, I think what would be cool for the audience to hear is is some more about what makes you you. Like, what do you think the 2 if you can you can give me, like, 2 things that you think were or it doesn't have to be 2, but a few things that made you really successful and grow in this practice and made you to the point where you are, where you're now opening your own office?

Dr. Eric Abramowitz: 20:52

Sure. Yeah. If I think about it, I think that one of the one of the key components of success in the cash based world, is figuring out a way to become an expert in whatever it is you wanna be doing. So now in the cash based world, we have the time to put everything into each individual patient and each individual case. So the more knowledge, skill, and expertise you have, the more of an impact you're gonna have on that person.

Dr. Eric Abramowitz: 21:24

So I think one of the one of the key components of my success, you know, when I first started on even part time here was was going through I've been dry needling for since 2016. And getting started, I I knew I was having a ton of success with dry needling and, you know, under some guidance by you, it was like, hey. If you're if you're gonna succeed, you gotta be the best and the expert. So, I went and took that functional dry needling certification, did that. And then even from there, you know, if you wanna be the expert, you gotta start teaching things.

Dr. Eric Abramowitz: 21:57

So from there, I started teaching dry needling, and that just instilled even more confidence in my abilities, the ability to deliver the actual treatment, deliver the expectation, and the education to the patients. And it really made me feel like I was the expert. And when I have that skill and that knowledge, I think that's portrayed across to the patients and that that holds true. You know, I'm continuing to do that with some of my running, clientele and patients as well. Taking some running gate certifications, going in and getting this 3 d motion analysis equipment to try and make sure that as far as the community is concerned, we are and I am the expert, and that can't be fraudulent, so I need to do my end to make sure I'm educating myself on those things.

Dr. JJ Thomas: 22:41

I love that. That's that quality over quantity, like, 100%. I think I I think for me, that's one of the biggest differences in the cash based world is and and so it's not for everybody. Right? Like

Dr. Eric Abramowitz: 22:50

Right.

Dr. JJ Thomas: 22:50

Like, if if you just wanna clock in and clock out and you wanna, you know, have a very anticipatory schedule, then then maybe cash base isn't for you. But if quality is more important to you than quantity, and then I think that's that's right.

Dr. Eric Abramowitz: 23:03

Yeah. I think the other the other big picture component of this that I felt made me really successful, it has to do a little bit more with the ability to connect and and create that relationship with the patient. I I've through some trial and error and and experience started to create this framework on how I wanted to approach each individual case and making sure that that patient understood what my my big end goal plan or expectation was for whatever they're coming in for. Right? An example would be a patient coming in.

Dr. Eric Abramowitz: 23:36

She's had knee pain for 2 years. She's seen 5 physical therapists. No one's been getting her better, and she was starting to get depressed. She's, like, I don't think I'm gonna be able to walk normally ever again. I'm gonna have a cane for the rest of my life.

Dr. Eric Abramowitz: 23:50

And just having, again, having the time, the cash based world, having the time to sit down and listen during the eval, get everything out of her, you start to actually hear some of these details that help you diagnostically internalize. You're like, there's there's really no reason why we can't get you better. Right. And being able to sit there and look her in the eye after 2 years of pain and say, you know, in my end, I'm like, alright. Let's paint this big picture.

Dr. Eric Abramowitz: 24:14

What's my expectation, and I'm gonna be clear with it? Here's the mountaintop. You're gonna get better.

Dr. JJ Thomas: 24:18

Yeah.

Dr. Eric Abramowitz: 24:19

I am gonna get you better, and what we're gonna do is take this day by day.

Dr. JJ Thomas: 24:23

Yeah.

Dr. Eric Abramowitz: 24:24

So once we establish that mountaintop, what's the mountaintop? And and when you when you set these lofty goals, and if you only focus on that mountaintop, it becomes a very daunting task. Mhmm. So, you know, the the the the message is, I know the mountaintop's up there, but we gotta take that first step. Yeah.

Dr. Eric Abramowitz: 24:42

So when we when we start looking at each individual appointment now, this is where our test retest stuff comes into play because, hey. We're gonna take step number 1, and I'm gonna make sure the way I'm treating you, we're gonna test what's wrong, what I think is going on. Yes. And then literally in that moment, in that session, we're gonna retest because I need you to feel that we're making a change so that you we can instill some trust, some hope, and realize that, hey. If we do this one step at a time Yeah.

Dr. Eric Abramowitz: 25:11

Day after day, we're making a change day 1, we're gonna get to that goal. And I feel like establishing that framework and expectation and plan with patients, has been very helpful.

Dr. JJ Thomas: 25:25

I love that, mountain. There's so many things you just said that I love. One, that mountain top analogy is amazing because that is what people who come to us feel. Right? People always ask like, what's your number one patient type?

Dr. JJ Thomas: 25:38

Right? Our patient types are people that failed treatment somewhere else or people that wanted to be better yesterday. And to all of those people, it's exactly what you said. It's it's reaching that mountaintop, and and it's overwhelming to think about that journey. But what you said that had this, like, very big visual in my head when you were saying it is all those test retests that we're doing, that we're establishing in this model that we practice is we're basically pulling out a compass.

Dr. JJ Thomas: 26:00

Like, we're pulling out our map. We're pulling out our compass. We're like, test, retest. Hey. You know what?

Dr. JJ Thomas: 26:06

That gave us the outcome we wanted. We're going to continue on this path. Or, hey. You know what? Oh, we're a little bit off course here.

Dr. JJ Thomas: 26:12

That didn't give us what we wanted. We're going to maybe veer to the right a little bit this time. And the coolest thing that I've seen, I'm sure you have too, is that patients, they they're engaged and they they immediately understand the plan. Like, they're looking at the compass with you. They're looking at the map with you, and they're like, okay.

Dr. JJ Thomas: 26:31

That makes sense. Like, I don't feel any different after that intervention and that retest, so that makes sense that we'll try something else. Or, wow. I can't believe my neck's moving better even though you just treated my left hip. That's great.

Dr. JJ Thomas: 26:42

That I'm gonna use that mountaintop analogy. That's awesome. Yeah. The other thing that you said that I think was, you know, just screaming in my head when you were talking is is back to that, like, that vision emission that you getting your patients better. Like, you having that moment where you're identifying with patients and being like, Oh, my God.

Dr. JJ Thomas: 27:02

How has she been to 5 other PTs and 2 years of PT and nothing's working? Like, how have we how have we done her this disservice? That is I I haven't mentioned that enough on these podcasts, but I think that is a lot of where where the podcast has come from is, like, this new mission of helping more therapists get more patients better. Because now, 10 years into the practice, I've seen that too many times. Right?

Dr. JJ Thomas: 27:26

Yeah. And that's also goes back to when I first met you, and, like, that is what I saw in you in that 30 minute session with an with a patient is that vision and mission of, like, yeah. I just wanna help people.

Dr. Eric Abramowitz: 27:36

Yeah. Yeah. You wanna help the patient and, you know, at at least for me as a when I think about myself as a new grad PT or even an experienced PT, like, there might not be a worse feeling. I think we were talking about this the other day. We were.

Dr. Eric Abramowitz: 27:49

There literally might not be a worse feeling than than being like, I don't know that I'm helping somebody. Yeah. I don't know that what I'm doing is actually making a difference.

Dr. JJ Thomas: 27:56

Yeah.

Dr. Eric Abramowitz: 27:56

And you're like, this treatment feels like gut wrenching because I'm just not sure I have the answer. Yeah.

Dr. JJ Thomas: 28:05

That's when Eric and I will, like and even in our team meetings, like, we our team meetings of 5 therapists will anytime anybody's having I'm sure this is typical. Right? But anytime that we're having a hard not a hard time or we're not sure we're on the right path, we pull out the map together and we're like, hey. What are we missing here? Are we missing anything?

Dr. JJ Thomas: 28:22

That's it for today. Like, I just I really appreciate you joining me on the podcast and kind of showing them firsthand how it works, how the model works. I am looking forward to growing this more and more with you and with any other, you know, all the therapists that are working not just at Primal, but interacting with us on the podcast, through the courses that we're offering. So I'm just going to end you guys with, you know, if this is something that seems like a passion for you and seems like something that you want to work through in your own life, then make sure you're subscribed to the podcast. I'm literally sharing every single tip and nugget and, like, secret that I could.

Dr. JJ Thomas: 29:01

It's not a secret. It's to be shared with the world so that we can help more people. So subscribe to the podcast. Keep liking and and, making comments because that helps me give you better content. And, I just I look forward to being with you guys, and thanks again to Eric for being awesome, number 1, and just for coming on today.

Dr. Eric Abramowitz: 29:19

Yeah. Thanks for having me. It's been fun.