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00:00:01
Palak Shah, Luna Physical Therapy
42 Plays1 year ago
In this episode Steven sits down with Palak Shah Co-founder/Head of Clinical Services at Luna Physical Therapy.
Learn more about SaRA Health at:
https://www.sarahealth.com/
Check out Luna Physical Therapy:
https://www.getluna.com/
Recommended
Transcript
Introduction to The Disruptors Podcast
00:00:01
Speaker
Welcome to another episode of The Disruptors, where we're arming you with the tools you need to innovate within the physical therapy space by highlighting those who have come before you. I'm your host, Stephen Cohen. Now, let's get into it. Welcome to the next episode of The Disruptors.
Meet Pollock Shaw: Healthcare Leader
00:00:19
Speaker
Today, I'm so blessed to be joined by Pollock Shaw.
00:00:23
Speaker
Pollock is a passionate health care leader with orthopedic specialist board certification and been a physical therapist for 15 plus years. She leads clinical vision and strategy with focus on operational excellence and patient experience. She excels in data and technology driven approaches for scalable clinical products and program design that improves accessibility to quality health care.
Pollock Shaw's Career Journey
00:00:46
Speaker
She started out as an outpatient physical therapist and obtained orthopedic specialization from the American Board of Physical Therapy Specialists in 2014. She then spent four years at Stanford Hospital as a senior physical therapist, treating complex musculoskeletal conditions and co-lectured at the Stanford PT residency program. Pollock is currently a co-founder and head of clinical services at Luna, a leading provider of in-home outpatient physical therapy services.
00:01:15
Speaker
And with that, Paul, I'd like to welcome you to the podcast and thank you so much for taking some time with me today. Great. Thank you for having me.
00:01:24
Speaker
Absolutely. We're going to go right into it with a question, right? So that was your intro, but how would you describe how you got here, right? I could look at your LinkedIn from our discussions, right? Four years at PRN, four years at Stanford, now a little over five years at Luna. I'd love for you to talk us through and the listeners through like how you made those transitions and how you got here.
Driving Change in Physical Therapy
00:01:49
Speaker
Great question. I mean, and also a great one because self-reflection always helps you appreciate the opportunities that you have along the way, right? And I have to say one very high level way of thinking on how I got here is believing in yourself.
00:02:07
Speaker
believing in what you want to do and being open to the opportunities that come in your way. Because if you have the potential and you find a platform that supports your vision, then you can bring your vision to action, right? So I would say by being a practitioner in outpatient physical therapy,
00:02:29
Speaker
Definitely helps us understand the gaps that are existing in the industry and the things that you want to change. And if you are passionate and you want to change something, it puts you on a drive to find how you can bring that to action. So as a clinician at Stanford,
00:02:45
Speaker
Definitely, I think it was a great foundation on being evidence-based, bringing the best patient experience and the highest level of quality care to our patients.
Weighing Practice Size vs. Impact
00:02:57
Speaker
It was a great challenging environment and I feel challenge is another thing we should never shy off, right?
00:03:03
Speaker
If you're not being challenged, you're not on the path to getting yourself in an uncomfortable situation, you're stagnated, you're not growing. And you should ask yourself, is this where I want to be? And is this going to help me get to where I want to be?
00:03:19
Speaker
I think that Stanford gave me a really great, challenging platform to see complex patients, to work alongside really accomplished clinicians, to work around really established physicians and surgeons in a community that expects nothing less than the best and the excellence.
00:03:37
Speaker
So I think that was really exciting. I'm very grateful for that. And then from there, I thought about, is it my own practice? And starting to work on that journey. And when I had the opportunity to have my own practice, maybe have 15, 20 therapists on my clinic versus today having a potential to impact 3,000, 5,000 clinicians across the country,
00:04:04
Speaker
That was the blank canvas that I was ready to start painting on. So that's kind of a nutshell of the journey. It isn't too long. It hasn't been... I think it was about looking for what I wanted to do, how I could bring value.
Entrepreneurship Challenges and Family Influence
00:04:23
Speaker
and finding the right platform that can help me get there and I believe Luna and the team at Luna is the best decision and the best organization that I'm excited to be a part of and I've co-founded. I love it, I love it.
00:04:40
Speaker
believe it in yourself, right, that you can actually do it, and there's almost two pieces of that, believe it in yourself, believe it in your mission, right, and trusting the opportunities that come your way, right, and I feel like both that, I really like that, and both first and third, really if you wanna bring it down maybe to a different way of saying it is,
00:05:00
Speaker
Don't let that no voice in your head win, right? Because I'd have to imagine that as you were making that leap to Luna, that voice inside your head was saying, oh, too risky, telling you all the things for why it couldn't work, right? And if you wouldn't mind even walking us through those early days of making that decision to co-found Luna.
00:05:29
Speaker
What are some of the things that don't get talked about, right? That some of those tough decisions, you know, maybe decisions or conversations with your family, right? I want to show that this whole entrepreneurship thing isn't just you start a company and then all of a sudden, you know, you're listed on the NASDAQ and it's all roses and butterflies because we both know it's not.
00:05:51
Speaker
Yeah, I mean, I think it's never roses very quickly, right? You have to give it the time, you have to nurture it, you have to weather hard environments and hard decisions. So I would say nobody thinks this is easy. And if you do think it's easy, you probably are, you know, ready to experience, volunteer, shadow, listen to some leaders who have gone through their journeys.
00:06:21
Speaker
So if you're thinking it's easy, it's not easy. And I am assuming everybody knows that. I love the point of bringing family into picture. And I have to say that it did spark with my husband asking me this question, which is, Paulik, what are you going to do?
00:06:41
Speaker
with all this expertise that you have put together. And I have to say that that question really sparked in me a thought about, okay, how am I contributing to the physical therapy world? How am I bringing my expertise as not just the clinical expertise, but how I
Knowing Personal Strengths and Weaknesses
00:06:59
Speaker
approach
00:06:59
Speaker
my work, how I look at change, how do I think about bringing change and bringing that ability to execute and bringing that ability to bring those ideas, those vision into actionable things is definitely first a very self-reflective process. I mean, you should want to do this. I don't think it's everybody wants to do this. I don't think everybody is going to be happy doing this because as you said, it is not easy.
00:07:29
Speaker
So I just had a very interesting conversation yesterday with someone, just a regular acquaintance, but they were like, oh, I've been thinking about starting my own home health agency, just for an example.
00:07:47
Speaker
But that's not the why you want to do it. Like, do you really know the why you want to start your own practice? You really know why you want to. Is it just monetary? Is it because you want to bring about change and how you operate? You want to bring about excellence. So what is your why behind wanting to be an entrepreneur?
00:08:05
Speaker
And I don't think it's just about entrepreneurship. I also really try to ask this question to a lot of clinicians who want to transition from a clinical background to
Building a Diverse and Effective Team
00:08:16
Speaker
a non-clinical background. Yes, convenience and comfort, flexibility of working from home or
00:08:22
Speaker
Not doing patient care might sound exciting, but it's equally daunting because there are lots of things that a lot of PTs already know that they don't like. So knowing what you don't want to do should be an extremely important aspect of exploring entrepreneurship or exploring a non-clinical position.
00:08:44
Speaker
So what did I not want to do when I started with Luna, right? I knew I'm good at what I can bring, which is clinical expertise, operational excellence. I think I developed a data-driven approach, but the methodological approach to things. So I have a very systematic strategic approach to things.
00:09:05
Speaker
But what i'm not good at is i've never done sales or i've never done you know so knowing that i'm not good at those things is an extremely important recognition if you wanna see your organization be successful and i have to say luna is successful and has demonstrated this extreme growth because of its
00:09:26
Speaker
exceptional team. We all bring our expertise in different areas and that's how you create a ripple effect all around. It's not just starting in one place and going forward, it's about growing all across the board.
00:09:43
Speaker
So having that fantastic team, recognizing your strengths, knowing what you're not good at and either developing that if that's part of the requirement for that role or knowing that there is a team that's going to take your efforts and grow in all the other directions that the organization needs to grow. So there's a lot to consider.
00:10:03
Speaker
I think that simple things like delegation don't come easily if you've not been into management. You want to do it all. I've been there, I've done that, but I've learned along the way and I feel like you cannot exist without the fantastic people around you.
00:10:20
Speaker
With the scale, I think scaling is a whole different topic. Are you looking to start your own practice? That's the 16 PTs I had maybe thought about, or am I really thinking about how do I build an organization that supports 3,000 physical therapists?
00:10:37
Speaker
So much to consider, but that's what dreams are made of. That's what puts you to bed and that's what wakes you up every morning. And when people ask me, oh my gosh, you're going to be six years at Luna, I think it feels like my first day every morning. And I still say that to date because there's so much that we want to do and we're excited about.
00:11:00
Speaker
I couldn't agree more with the first day fervor that you wake up with, like, okay, perfect, there's something new I'm gonna learn today, almost assuredly, and a new challenge and new opportunities to go after. And I really like how you highlighted finding the things that you don't like, right? And when I was a Deloitte, they had this framework around things that give you energy versus things that take energy away from you.
00:11:27
Speaker
And I think if you can take those and balance those two things together, like, okay, I really don't like doing these things. And I know these things I don't mind doing, but they take energy away from me. And when it even though it sounds limiting,
00:11:43
Speaker
by just taking all that out. Like, okay, well, sales isn't good for me, marketing isn't good for like, right? So it helps you actually get much more focused and it limits the potential for analysis paralysis, right? And all of a sudden you're like, oh, okay, like there's this one specific thing and it's amazing how far you can niche down, right? It's absolutely amazing. And I don't think people should be worried about
00:12:12
Speaker
putting themselves in too tight of a niche because, especially in healthcare, it's a $4 trillion market.
Exploring Niche Markets in Healthcare
00:12:17
Speaker
The smallest of the smallest of smallest of niches is probably still $100 million, right? It's still, there's a lot to be had, even in the tiniest, tiniest niche within healthcare.
00:12:27
Speaker
Yeah, no, and you know, I think absolutely emphasize that. But at the same time, I have to say you don't know it all when you get started. So I do want you to believe in yourself. Of course, what I don't like to do is something you have to recognize, like, you know, even as a director of rehab in an outpatient clinic,
00:12:47
Speaker
you might be doing sales, you might be happy with that, but it's very different in different organizations. And you might be able to achieve the needed skills along the way. So I just want to even emphasize that interest is one thing, but you don't have to know it all when you get started. So I do want to encourage everyone to say, push yourself and be comfortable with being in the uncomfortable zone. And if you believe in yourself, if it's of interest,
00:13:15
Speaker
you can get there. One really good story about that is data. As a physical therapist, even on a teaching or the residency side or mentorship side, data was never a part of my clinical care journey.
00:13:33
Speaker
It's just a very simple approach. You either have it or you don't. And along the way, I've just realized that the simple things you do have really fancy names. Like, oh, what I'm doing is actually population health. I had no idea I was doing population health and I don't have a MPH degree, but I can do it.
00:13:53
Speaker
And so can you. So if you realize that you're naturally finding yourself asking the right questions, you're amongst the right group of people and have a supportive work environment, you can achieve and grow along the way. And if you are proactive, if you're not waiting for directions and you're taking on responsibilities to learn versus being my job, there is so much out there you can learn now that I feel
00:14:22
Speaker
Data was one of those instances which I think that really stands Luna apart.
Effective Use of Data and Exploration
00:14:28
Speaker
And I'm really excited because we are a technology-first company. We have access to all the data. But if you don't bring that data to action, there's no benefit to it. And you have to be able to tell a story. So Storytelling with Data is a book that I really enjoyed. And I'm like, that's true. You just want to be able to back what you're saying with data
00:14:49
Speaker
and things of that sort. So you might find that similar opportunity in any area, maybe technology, maybe operations, maybe sales, maybe marketing. So you might find excitement in some of these aspects. And if you just start pursuing and start taking action, you're going to know that you're you, I mean, as clinicians, we already have a very systematic
00:15:13
Speaker
approach to things and you're going to be able to apply to so many fantastic things. So I just wanted to say while you're trying to answer your no's, be comfortable in exploring more and just pursuing one thing after another.
00:15:30
Speaker
You dropped another little nugget in there. I have this saying, there's two types of analyst. You have pointers and retrievers. In there you said how helpful it is, and I completely agree with you on this, how helpful it is to be looking for and be proactive for those opportunities. Don't just be the pointer, be the retriever.
00:15:54
Speaker
of like, Hey, I saw this in the data. And so I dug in a little bit further. And this is the thing that I found is this makes sense to you, right? It's so much better conversation when someone says brings that to you, then hey, that looks weird. Like, okay, well,
00:16:10
Speaker
Let's take this a couple steps further. That was another nugget that was in there. If you can become more of a retriever, and it doesn't have to be right, just have put a little bit of thought through it, and all of a sudden you're gonna see some pretty amazing reactions by those you work with, by just taking that extra step, especially if you're passionate or interested in the area. It's a beautiful thing.
00:16:39
Speaker
100%. Absolutely. There's so much to learn. Even if it doesn't get implemented, you learn how to explore that data or you learn how to explore that opportunity. It's practice and that's how you're going to learn more. 100%, I think. Let's be the retriever, Stephen. Let's be the retriever. Thank you for listening to this episode.
00:16:59
Speaker
This would not be possible without the sponsorship of Sarah Health. Sarah is the relationship operating system for physical therapy practices, driving better patient outcomes, improved arrival rate, and improved financial margins. If you'd like to learn more, check them out at sarahhealth.com. If you'd be interested in advertising with us and helping us produce even more great stories, please let us know at
00:17:31
Speaker
Now, back to the episode. Okay, now we've talked, how you got here. We'd love to know your why behind physical therapy, right? So what got you into, what made you want to become a physical therapist?
Empowering Patients Through Therapy
00:17:48
Speaker
Great question. I don't think I knew I wanted to be a physical therapist. I knew I wanted to be in healthcare when I started.
00:17:55
Speaker
So, for anyone who doesn't know, I'm actually trained as a physical therapist in India, and the Indian way of approaching education is extremely different. There are like 10 XD applicants that you can even imagine, maybe even whatever, 50 XD applicants you can imagine for any position in the office or in the college.
00:18:23
Speaker
It's a pretty interesting environment. I knew I wanted to be in healthcare. I knew I was a very nurturing person from a personality standpoint, from the get-go. I believe I really enjoyed the opportunity to empower my patients to be independent.
00:18:45
Speaker
you know, along your personal experiences, one thing that really struck me was when I would go to a doctor, and the doctor would tell me, let's try this medication. And that word try really just bothered me all along. And, you know, I don't know, maybe even scarred me. And there was nothing else a doctor would do could do after a certain point. And again, those are
00:19:10
Speaker
like childhood experiences, healthcare's come a long way. But in general, I love the opportunity as a physical therapist to empower my people in order to understand themselves, be more dependent on their own understanding of their body, their own understanding of their function, their needs of their lives, and be able to carve their own path.
00:19:31
Speaker
So I think that's really empowering in my opinion. That's what I love about physical therapy. I've always been in outpatient physical therapy, so my approach to care has been very specific to musculoskeletal conditions that happen in our outpatient population.
00:19:50
Speaker
But I think the awareness about yourself and the awareness about how you can help navigate your conditions and manage your life has been the most important thing for me. And I think that even in a non-clinical environment, that's always top of mind. Like, is this technology, is this process, is this experience going to help patients
00:20:15
Speaker
be their best self, recognize and be more self-aware and take charge of their own care. So I think that it's come a long way and then I can implement it anyhow or in any manner in physical therapy. And that's what keeps me super excited, the opportunity, the impact that physical therapy has on people's lives.
00:20:36
Speaker
I think continues to be my why behind why physical therapy and why I still feel like contributing to the growth and expertise and the innovation that's happening in physical therapy versus just generic healthcare.
00:20:51
Speaker
I couldn't agree with you more. It's a very common thread on physical therapists want to empower their patients, right? And as we've seen it in some of our own studies and as well as others,
00:21:07
Speaker
Empowerment is a heck of a drug like it is an amazing, amazing quality that as a patient who is your person, right? A person can understand their body better, right and understand how to move better, understand how to take care of themselves better and the the impact of their actions, right? You're empowering them in a
00:21:32
Speaker
in a setting that is so different than anywhere else in medicine, right? Where else in healthcare do you spend, let's say, eight hours with a single clinician, a single provider, eight hours in potentially less than 90 days?
00:21:52
Speaker
It doesn't happen anywhere else, right? It doesn't happen anywhere else. And you're talking about some of the non-clinical opportunities. I think that's why I've seen physical therapists in particular be so, so strong in your broadly customer success world is because you're really good at behavior change, you're really good at empowerment, and you're really good at digging down to the bottom of an issue, right? And those are three
00:22:21
Speaker
especially packaged in the way that they are in physical therapist three, very powerful traits that lend to a super awesome human to view around. Yeah, 100%. And that's the second question we're answering, which is how, right? How are we planning to empower? So why behind PT is yes, because we can empower our patients, but truly how we're empowering our patients
00:22:47
Speaker
is limitless. There are so many fantastic trainings. There are so many fantastic concepts, maybe choice architecture, maybe in-person care versus virtual care, maybe the behavior change. How many times does a physical therapist say that
00:23:07
Speaker
We believe we're psychologists and we're trying to really work with our patients. But what's really important here is, to your point, we have the opportunity to bring the human component to our care. And in a fashion that can relate to them, that can be evidence-based, but at the same time, very real, very practical.
00:23:31
Speaker
implementable, relatable to our patients. And I think that to that point, how we use those eight hours, and I'm assuming the way we're thinking about eight hours is an average of eight visits with our patients, how we leverage them, how we guide our patients, how we communicate with them really impacts how they perceive
00:23:54
Speaker
their condition. And I think that it's extremely important responsibility as a clinician that how your patients are perceiving their own condition, what you say makes a big impact, how you communicate that condition, how much medical jargon we use, they're all so important things. So you can think about leadership level impact, and if you're not in a leadership position,
00:24:19
Speaker
you are still a leader for that patient's care. It relies on how you bring change, one patient at a time. So when you start reflecting on something that's very generic, you'll still just find the essence and the meaning to really what empowerment means, to really how you change the life of an individual. And it's very, very rewarding. I mean, physical therapy in general may be in management, may be in patient care.
00:24:48
Speaker
It's extremely rewarding. You are impacting patients' lives day in, day out. You have full autonomy to do that. Nobody's standing over your head telling you, do this or that. So please take charge and take responsibility. Don't do the normal trends we see in your documentation. Figure out how you can be innovative in your patient's care. So I think you can drive impact at any
00:25:14
Speaker
opportunity you have, maybe with patient care, maybe in management, maybe at population health level. So it's extremely rewarding if you look at what you have in front of you and make the most of it. I couldn't agree more. I couldn't agree more. This is
00:25:32
Speaker
There's so many rabbit holes we could go down on that front, but I'm going to hold off or else this could be a 270 minute recording. Well, that's great. Maybe one day. Let's see if people think about it for 270 minutes. That would be great goal achieved.
00:25:51
Speaker
I think, I mean, goodness, just in the last two or three minutes, there's so much to think about, and I really like empowering the empower-er, right? And so as a physical therapist, you're leading 30 to 60 patients at any given time, right? You are in management whether you know it or not.
00:26:15
Speaker
And so you're getting the chance to impact 30 plus lives at any given point in time that are on some trajectory that you can positively impact. And how cool is that?
00:26:30
Speaker
There are very, very few people that are able to say that, and yet that is your daily job, which I'm sure like any job can sometimes be a little bit tougher to go to, right? Maybe Monday's a little bit tougher on some weeks, but it's a really remarkable opportunity to be able to impact that many people and then repeatedly do that over the course of a year.
00:26:57
Speaker
Maybe getting into it a little bit and why I think there's with the impact that is delivered.
Innovating Payment Models and Advocacy
00:27:04
Speaker
I think it's the current reimbursement model and everything is such an injustice to physical therapy. I can't think of another word and I thought a lot about what I would describe it as.
00:27:17
Speaker
Yeah, I hope to see it get better. I think the new CPT codes that are coming out, or have come out and are coming out, are a step in the right direction. Do you see it as a way to give more autonomy back to the therapist? That's how I see it, right?
00:27:37
Speaker
Here's more autonomy back. It's not just, oh, here's a way to, to build more. It's no, here's a way to get your autonomy back. So that way, you know, it doesn't have to be the like Henry Ford, right? His, his famous quote about the model T, uh, you can have it in any color you want, as long as that color is black, right? And it felt like PT was for a while constrained to this. Yes, we can give you any type of care you want, as long as that's in person.
00:28:03
Speaker
For 12 visits, over six weeks. I think that just this allows for just more autonomy to come back to the world of physical therapy and like, oh, well now I can actually, could we do some of this? Could we do some of this remote? Could we do some more monitoring? Could we do engagement here?
00:28:26
Speaker
I get really excited about that because I think it'll allow for way more access. I love what Luna is doing and increasing access there as well because there's people that simply aren't going to come in for a physical therapy appointment. I'm sure you have data behind those patients being extremely important to treat. I'm sure you have plenty of data behind that. If you can share any, please do.
00:28:52
Speaker
I'm excited and just so encouraged by conversations like this that there are leaders like yourself that are trying to right this injustice. And luckily, there are some macro tailwinds that are leading and headwinds. But luckily, there's both. I really, truly hope. And we'll keep fighting for a better future for PT.
00:29:15
Speaker
Yeah, I mean, advocacy is extremely important. It's a responsibility, in my opinion. And I think that
00:29:24
Speaker
One thing that I really think I love about the Luna team is having a clinician on a co-founding team member, as a co-founding team member. The fact that the voice of clinicians is incorporated from the get-go, and I believe I'm just a liaison, and I always want to try and do justice on ensuring that it is reflected accurately, it's reflected in a timely fashion, that it is a part of the consideration of what we are building
00:29:53
Speaker
And I have to say that I respect the fact that that is an opportunity at Luna because that's not something that happens across the board.
00:30:02
Speaker
I'm really grateful that what we're doing for the physical therapy industry has really the voice of a clinician, the voice of a patient, the voice of the gaps of physicians or stakeholders really built into what we are putting together here. But talking about fee-for-service, Stephen, I do think that we're...
00:30:26
Speaker
I don't know. I feel like there is no doubt that fee for service is not the best way of justifying the care that we provide. But at the same time, I feel like Medicare
00:30:43
Speaker
really has it established very cleanly. What gets reimbursed? What doesn't get reimbursed? Over time, it's actually started to become one of my favorite payers because at least it tells you what to do, or at least there are established guidelines. It's a federal payer. But long story short, I think there is a transition happening from fee for service to value-based care to managed care to lots of different names of how care is paid for. And I think that
00:31:14
Speaker
The crux of all of those payment models is actually outcomes.
00:31:21
Speaker
Right? How can somebody not be an expert, but still say, okay, we'll pay you something, right? So, with fee for service, you're billing for something, you're getting paid for something, you're billing for something, you're getting paid for something. With value-based care, they're saying, we don't know how to do this, you know how to do this, but we can afford to pay you this much, please can you manage the patient's care for this much amount.
00:31:43
Speaker
So I think that it's new, it's very ambiguous, but at the same time, I think as clinicians, what we have to identify is, are we able to demonstrate our patient's outcomes and our patient's experience?
Data-Driven Outcomes at Luna
00:31:59
Speaker
And one thing that we've really done well at Luna is make that data available to every clinician, to every partner, to every therapist, to every physician that we work with. These are your patients' outcomes. These are your patients' experiences. Luna's NPS score is at 87 and has been consistent over the last five years. We've published a blog, but being able to maintain that as we've scaled across 828 states,
00:32:28
Speaker
has not been easy feat, but we have dedicated focus on listening to our patients experiencing, converting learnings and insights into action. And that systematic approach really is what will bring value to your care. You're listening to your patients and you're identifying the gaps and you're making change and implementing that change. Of course, you can't change everything at one go, prioritization's important, roadmap planning's important, like how you go about achieving that
00:32:58
Speaker
It has to be practical, but it cannot be ignored, is all that I'm getting at, Stephen. Again, coming back to the pavement models, I think there is a lot of change happening at every tier. Clinicians want to be at the forefront of deciding.
00:33:19
Speaker
advocating for the change that they want to see. It's happening across the board, maybe orthopedic surgeons, maybe physicians, maybe physical therapists. I would say that trust is important. The leaders are trying. I have to say APT is doing some fantastic work, lots of great advocacy.
00:33:41
Speaker
You know, you could always say, all right, we don't like this, or we can trust the leaders, do something towards it, but do our best in the place where we can drive impact, which is be data driven, be outcomes, focus on your patient's outcomes, focus on your patient's experience. So one thing we've done at Luna is as a therapist, if you are seeing, you know, 10 patients, you know, are those 10 patients improving in their outcomes?
00:34:06
Speaker
Are they having a great patient experience? If they're not improving in outcomes, that's an opportunity to up your skill, up your understanding. What are your gaps and how can you do better at that? So as you were mentioning, the management of your own patient caseload. If you have your own clinic, you're going to have to do that. So why wait till you start your practice? Do that now. And I think I'm pretty proud that at Luna, we do make that data available to you. So if you're not using it,
00:34:33
Speaker
start there. I think fee-for-service, value-based care, payment models are going to be challenging. They're going to be an ever-changing landscape, but we got to do what we can do, which is demonstrate the quality.
00:34:50
Speaker
And if we can, our patients are going to stick to our care. If our patients stick to our care, we're going to be able to justify the value of physical therapy. We're doing so much advocacy to say physical therapy first. If we have physical therapy first and our patients haven't made the improvement and end up going to an ER or to get more imaging, are we taking responsibility for that?
00:35:16
Speaker
Did we do good enough job that my patient ended up getting an x-ray, which I know is not going to tell them anything?
00:35:23
Speaker
I think there's just so much room for opportunity in terms of taking ownership for your patient's care, to being evidence-based, to really ensuring that you're making the patient's care more cost-effective. If you're saying, I need 10 more visits for this patient, really justifying the cost of care for those 10 visits. I mean, all the leadership questions, if they can be asked at a clinician level,
00:35:47
Speaker
I think that's the change we should be working towards versus just trying a top-down approach of trying to make change at the top level and the therapists are doing what they do and they're not being empowered to bring that best foot forward. So it's so much work to be done. Let's wake up every morning, be excited. So yeah, Steven, I think there's so much that would be great to achieve as an industry, as a profession.
00:36:16
Speaker
Thank goodness, right? Or else this would be really boring. There wasn't anything to do. That's what gets us going. I couldn't agree with you more that having a clinician on the founding team is a superpower for any company in this space. We've definitely felt it with Paul on our team.
00:36:40
Speaker
To me, it's a must-have. You're missing out on so much value. I love how you're down to the therapist and down to the therapist-patient level. No, not only outcomes, but experience. I think that's so valuable.
00:36:56
Speaker
I'd imagine, if I had to guess, you collect it in ways that is not directly reported through the physical therapist, which gives it some likely higher level of validity and authenticity of that feedback and not confrontational or just being like, oh, of course, it's amazing. Now you can go tell your boss that.
00:37:20
Speaker
You automate things, you make it technology driven. They can be modified. Our NPS score was gathered based on or calculated based on 100,000 plus inputs, data inputs, and nothing was filtered, nothing was scrubbed, nothing was cleaned. It was as is. So yeah, I mean, I think technology and automation makes a big difference to some of those things, Steven, and I agree, not everybody has the luxury to, but Luna is a technology first company. So
00:37:46
Speaker
I think we have some really exciting opportunities to make change.
00:38:03
Speaker
I think that's a very good point, Stephen. I mean, I have to say, I don't have to fight as hard anymore. But it is an important aspect of any clinician thinking about moving from clinical roles to non-clinical roles.
00:38:16
Speaker
where you might think this is a great idea, but it not necessarily is the needed idea in the time and the moment. So don't be discouraged with that. Really aligning your exciting ideas and opportunities with the company's North Star is extremely important.
Unifying the Physical Therapy Community
00:38:34
Speaker
But what I really wanted to say here is don't be discouraged with your idea being not implemented in the moment.
00:38:40
Speaker
Work on putting the right story and how are you presenting that information to your management. So just thought a quick little nugget. It's never easy. But if you strongly believe in something and if it aligns with the company's goals, that's how you can drive change.
00:39:00
Speaker
I couldn't agree more. I couldn't agree more. Now that we talked about a bunch of payer models and everything else, we get to my favorite question, which is, if you had a magic wand and could fix something within physical therapy, even if it put both of us out of a job, what would you fix with your magic wand?
00:39:22
Speaker
I'm never worried about being put out of the job. Physical therapy is like the safest profession. There are only 300,000 PTs in the United States. That's all that you've got and the World Health Organization's identified, we're underutilized. So don't worry about that at all. And I think that we have lots of value to provide here. But okay, if I have a magic wand,
00:39:52
Speaker
I would really want to do everything possible to bring the physical therapy community together, make it better, make it stronger. I think that's the number one thing. As a profession, there's lots of fragmentation. There's lots of different models. It's a very complicated model of care. And if I had a magic wand,
00:40:21
Speaker
I think I would just want to make magic happen in the community, bringing people together, really being able to identify the next big steps and have opportunities to drive change and be together, like really be united.
00:40:36
Speaker
I like that, right? Because you could look at it from an outsider looking in and say, well, how can this cash pay practice that's inside of a chiropractic clinic in Maine relate to this Medicare, like 85% Medicare or maybe even more inside of a senior living facility in Washington?
00:40:58
Speaker
How could they all work together? It's so disparate, but I would agree with you. The magic wand would only need to be to create the space for it because I think the similarities would come through very, very quickly. It's, yes, different on the surface.
00:41:19
Speaker
But not really. I would imagine when it comes to a lot of the core concerns, I would imagine there's the top three while they may be ordered differently in different settings and different payment models and all that. I'd imagine the top three, the VIN diagram is pretty tight, if I had to guess. Yeah, yeah. And what I also mean by some of the community aspects is
00:41:46
Speaker
Exactly this visibility between clinicians and management and simplifying what we're doing for our patients. I have to say that it's really exciting that at Luna, it's a very normal world that you're spending
00:42:03
Speaker
45-55 minutes with your patients and there's lots of conversations about is that needed, is that not needed, but based on the outcomes, based on our MIPS performance, based on our patient satisfaction scores, we know that we're driving what patients need as compared to a 20-minute session, a 30-minute session, you know, 16, 17, 18 patients a day.
00:42:25
Speaker
So, if you are in that kind of an environment, and I think that there are better opportunities out there, I think it's really important to understand what puts you in an environment to bring that change to your patient community, bring that change to your own work-life balance, and find opportunities that give you the empowerment to drive impact.
The Importance of Community and Advocacy
00:42:50
Speaker
I was also just even thinking about the direct access advocacy that APTA is doing.
00:42:54
Speaker
I mean, that's amazing. I think a lot of great work is happening and maybe the magic wand just makes it a little bit quicker. I have to say, there's already a lot of amazing stuff. I've been at the practice leaders meeting at APTA, which was hosted last year. Very, very exciting.
00:43:15
Speaker
you know, inspiring, motivating to see the kind of work, the kind of advocacy, the kind of challenges that the profession faces and really think about, you know, supporting that, contributing towards that because those are the change drivers for our profession. So yeah, when I think about community, it's also about not just thinking
00:43:40
Speaker
your job, not just thinking, this is not in my job description, thinking how this is working, your profession, come together as a community, support your profession, support the change you want to see. So yeah, I think that's the magic one. Let's get everybody together, let's fight towards the same cause.
00:43:59
Speaker
I love that. And to finish up, it probably will be a restatement of what we started out with, but we are creating this space and these dialogues to help people who want to innovate within physical therapy
00:44:15
Speaker
you feel like it's one degree closer than when they started listening and so you already mentioned believing in yourself, believing in finding your mission and also thinking about maybe what not to look at and being open to the opportunities.
00:44:35
Speaker
As you think about helping that group of people that is on the edge of innovation, and I think you've already given a lot of really, really good stuff around, hey, if you are managing your patients, you have leadership, go be amazing at patient care, or go and try to do some things within data. You've given so many nuggets throughout our time together, and so I'm very appreciative of that.
00:45:02
Speaker
But in wrapping up in final, if you wouldn't mind giving maybe one to two things that you think are the most important for a person interested in innovating in the physical therapy space.
Advice for Aspiring Innovators
00:45:20
Speaker
I think the most important thing in mind is, again, I'm going to say, ask the why. What do you want to innovate and why do you want to innovate this? Is this truly relatable to our patients? Because you might be building something because you're passionate about it, but it might not speak to your patients the same way. Or you might experience the hurdles because you want to innovate something that's an uphill battle.
00:45:43
Speaker
It's not the most important aspect in their lives. It's a thought process. It's the adoption. So with that, of course, if you ask your why, the second thing is scale. That if you're innovating, ask yourself how you're going to scale this because you're not going to be the only person who can be doing this ongoingly. So is your innovation truly scalable? And I think scale is
00:46:08
Speaker
not easy to crack and I think we're very excited of what we're doing here at Luna and I'm just going to say that it was such an amazing journey to understand scale and understand how are we going to grow, how is this process cost effective as we kind of put it together. So I think if you're an entrepreneur, if you're innovating
00:46:29
Speaker
absolutely your product market fit, which is the why of what you're innovating on is important. And then second, how you're going to scale it. I love it. Well, thank you so much for this great time together. I know I've learned a lot in talking with you today, and I truly hope that our listeners and viewers will as well. And with that, we will sign out. Thank you, Paul, for joining us. Much appreciated. Thank you for this opportunity. Have a great time.
00:46:58
Speaker
Thank you for listening to another episode of The Disruptors. I hope that you were able to take one or two things away that you can apply immediately to your own innovation journey. As always, I'm your host, Stephen Cohen, sponsored by Sarah Health. Let's keep moving.