Telehealth Talk with Dave Townsend

Telehealth Talk with Dave Townsend

{Ray Berardinelli} Make sure we're live in the group.

Really looking forward to talking about this with everybody. Hopefully it's going to help a lot of people out here. 

(I'm sure it will.)

We are doing another edition of the PT business builder show here. 

(Give everybody a minute or two to file in.)

If you guys have questions, I'm going to try to answer them to the best of my ability. We have multiple systems going on here, so you'll just have to kind of bear with me. 

Dave Townsend is my guest today. 

Welcome to the PT Business Builders show where we believe EMRs suck; that systems and software should actually improve your practice and your life, not consume it; and here, the only measure of success is systems and software that will give you the time to enjoy your life and the financial freedom to do that. 

Without further ado, Dave and I are going to talk a little bit about telehealth. 

(I'm sorry if you guys hear anything in the background. I'm at home now, so my family's here. The kids are off school. They're playing with the dogs; there's tons of noise in the background -- sorry about that.)

We have already talked about this telehealth before and he started sharing some of the things that he was working on with me and I'm like…

“Hey, would you mind sharing this with other people like I think that this will help a ton of people that are out there.”

Dave is a private practice owner and has Switchback Health (he's not here for this.) He didn't want to mention it, but I'm going to mention anyway.

It's an exercise platform where you can actually record yourself or the patient and share that information with them in a HIPAA compliant means so that they can gain that. 

Before we get started, the thing that came to me after we talked last time (and I'd really like to share with everybody) is if you want to be successful at anything in life, you have to find a problem, right?

If you find a problem and solve a problem, there's going to be success on the other end of that. 

(I'm sorry about my dogs.) 

In every crisis, there are a lot of problems -- that creates a huge opportunity. We just have to look at this thing the right way. 

Because there are problems here. People are having problems or patients are having problems. Physicians are having problems. 

There's a lot of problems out there that people are having. If you can figure out how you fit into them, there's a huge opportunity and that kind of came from Dave. 

That's why I wanted to have him on and talk about what he's doing, how he's working it right now. With him his own practice. 

{Dave Townsend} Thanks Rey. Glad to be on and it was great talking to you yesterday. 

I feel like you helped me a lot too. Just kind of flashing out ideas and given me new ideas. 

I'm a private practice owner here in Santa Rosa, California. I have a five-therapists practice and created up an app for physical therapists to just quickly take video and do it in a secure way just to kind of make life easy. 

We don't have to hunt around for generic exercises and things like that just super easy. But that's not why I'm here, even though that's helping us a ton here in our practices, more of just kind of sharing the war stories of  -- How do you save a PT practice right now? 

And so that's a little bit my background and that's what I'm trying to do. So glad to share any ideas of what we're doing here with telehealth of which we were doing zero telehealth. And now we're just like, going crazy with it. 

I got (hopefully) a few tips to help you guys out. 

{Ray Berardinelli} Yeah, please. If you just share what you shared with me, I'm sure it's going to help a ton of people.

{Dave Townsend} Yeah, yeah. So essentially we got shelter in place orders. I believe that was early last week. 

And we as a clinic just decided that the essential aspect of the service is really keeping track of the patient and that can be done by phone or video in most cases. And so we just decided it was safest and best for everyone to just stay home. 

So we just sent out a mass email to all of our patients as we do for our regular email newsletter just said…

“Hey! Safest for you guys to stay home, but we want to stay connected. So please call and  we'll switch you guys over to video visits…”

Pretty much ever since we've just been on the phone calling people, they've been calling us. And the attack that we took was that when we called somebody, we would just go ahead and and say...

“Hey, sorry this is all going on, but we just want to switch our appointment over to a video visit. Is that okay?”

And we got a ton of resistance and took a lot of talking. Each conversation was probably minimum, like 15 minutes, 20 minutes or more, just to tell them what it is and educate them on how much we could help them out. 

And so that's pretty much what it's been. It's just all hands on deck to get people the help they need. And then also, it's a business thing too, you gotta keep your practice going so you're striking that balance.

{Ray Berardinelli} If you don't mind me asking what kinda…. 

Ok not to get off on a tangent here but that this guy is probably not even on here, TJ, he was in another group. He was saying that he had shut everything down. 

He had tried to get his people to convert (I hope he doesn't mind me sharing this) to telehealth, and they were getting a lot of resistance, but they were having a lot of difficulty. 

You said it was like a 15 minute conversation, like, what happened in that conversation?

What objections were there? And how did your staff or you go about overcoming the objections that you were getting from your customer? 

We're switching them from an in person, hands on type of treatment to I'm going to talk to you over the computer.

{Dave Townsend} Yeah, it's all over the map immediately. Kind of two main categories. 

One is the existing patients. And so those conversations were different than like new patients on the schedule or people that have called in  and we’re expecting to do in person visits that we didn't have the relationship with yet. 

So the patients that we already had the relationship with was sometimes a little bit easier and sometimes harder because you have this relationship to this person, and they just say, “Oh, yeah, since I'm not going to get the hands on work, let's just go ahead and wait till this blows over..” 

And it was more of with those, if appropriate, just educating them on how we could help them out. Essentially saying that we could advance their exercises or just kind of talking about their particular case. 

And we honestly didn't have our office staff call. We just had all of our PTs just all hands on deck to do that because we knew that was going to convert that would be much, much harder the other way.

{Ray Berardinelli} Right. Yeah. Which you are. 

We've done some internal research that showed the same thing like with drop off save. If you're going to get after your drop offs, the PT is the one that should do it. 

They own the relationship, your conversions are gonna be much higher I'm sure that this is going to be the same way that the person that owns a relationship with them it's gonna mean more coming from them than it is coming from somebody in the front office just calling that they don't have a real strong relationship with maybe or maybe they do. 

The therapist kind of owns the relationship at this point. They're the person who has now been trusted them, with our health care. 

So them calling you're going to see a lot more in the way of conversions. 

That's really, really interesting. I always loved the dynamic between what the patient thinks they want, and what exactly it is we have to offer and how to bridge that gap between the two.

How to make the patient understand it -- what I am offering you is what you're looking for. Even if they don't understand right out of the gate, how it is and that.

If you have the patient's goals in front of you and you can talk about the real reason that they're seeing you in the first place. 

They're not seeing you because they like me because they like you. They have a problem that they want to fix. Right? 

So that problem is where your focus needs to be. And now, if you wouldn't mind sharing, you had mentioned this to me, you were saying about like right now, literally right now, there's somebody out there that might have gotten hurt. 

How do you see us going about engaging with them? 

How do you see us going about finding them and letting them know that you and your practice exist and are still there in a capacity that you can help them right now? 

Because they have a problem right now and they're lost. They don't know what to do.

{Dave Townsend} I think just using all the communication channels to your disposal -- Facebook, Instagram. 

Even if we haven't done it yet but we were thinking about just doing some Facebook and Instagram ads that are really not so much ads like “Hey! Get our service…” but just more like, “Hey, we're here to help…”

And as you and I talked about being willing to give services away for free at this moment and so that's what we're doing at our practice just using everything to our disposal and having to tap into some of our company reserves in order to serve patients at this time. 

Meaning that as much as feasible, we're going to be paying our PTs to be there and treat people whether or not we get paid or not for these few weeks because we know we can survive that we don't know we're gonna do long term, but week by week.

We're just going to be reaching out and even just going through our list of people and even just checking in with them, too. 

Because we all have time, we're at home, we're sheltering in place with as much energy as possible just reaching out to these people. And I did want to talk about the new people when you're establishing that new relationship. 

So you have somebody on your schedule or a new evaluation coming up. And I think the best way to have that conversation is maybe not even to talk about the telehealth things right away. The way our conversations have gone is, “Hey. How are you doing with all this craziness?” 

And having that conversation, get a sense of where they're at with it, and then taking it from there and more. 

I think Jerry probably used this phrase that I really like, it’s just like, “Tell me what's going on.”

It's just like that open question (what's going on) in regards to their particular problem. Now they're talking, now they're open to what's going on. And then further on, you can say...

“Hey! If you feel comfortable doing a video visit, let's do it. Let's go for it.”

{Ray Berardinelli} Something that you and I discussed previously and this is back to that problems thing -- finding a problem. 

You and I talked about on our call was there are not just patients with problems, there are physicians out there that now have huge problems. 

If this thing explodes in your community, they're gonna have a really big problem. They're going to be overtaxed. They're going to be running themselves ragged, trying to keep up. 

And we had discussed how we could fit in using telehealth as a muscular skeletal specialist. 

How can we go about doing that? How do you think we should go about letting those physicians know that we're here, we’re open?

Or this is the service that we can provide to you if you want it? If you don't, no big deal, and we'll offer this service like what you’ve said you're doing right now -- for free.

{Dave Townsend} Yeah, I think the obvious thing is just calling the physician offices, especially the ones that you have a good relationship with, but I did want to just say from a total transparency standpoint.

When we were talking about it yesterday, I was like, “Oh, yeah…Let's send little facts sheets and things like that and call those positions that you know…”

Yesterday, I was a little tattered because I had done telehealth and I'm doing all these calls and stuff and I forgot to eat and I was like little pretty tired. 

And, I was like, “Oh man, I got to call this doctor's office…” and I know him really well and all that and I went to call and I honestly couldn't call because I felt nervous that I was going to be bothering them when in reality, I was going to be helping them. 

If anybody's getting those same feelings of like, “oh man, it's like I don't want to…” 

These physicians are probably overloaded, their offices are overloaded. They don't want to field another call about something else. 

And so I'm fighting that resistance. Myself, inside of like, okay, I just need the courage to go ahead and do it -- call because it's going to help them out. 

Take a lot of pressure off of them. We can just handle their back pain, neck pain. 

Just right before this call, I got a call from a former patient that she's slept on her neck wrong and she's just in a lot of pain and in that and got her right on the telehealth with one of our other PTs.

These people are out there. It's a real deal. If you're stressed out already about your job and everything and you all of a sudden reach down to pick up a paperclip and blow out your disc, you're calling your doc. 

And if they can just know that somebody's there to help.

{Ray Berardinelli} It’s like a triage. Just offer yourself as a triage like hey, musculoskeletal problems. 

If you want I'll do this free telehealth visit with them. And now you're going to get denied that's going to happen. I mean, that's just the nature of it. 

And there's fear in that. None of us like to be rejected. You've got to push into that uncomfortable zone that you don't like, but that's life. 

Everything you do, you have an uncomfortable zone that you don't like that’s uncomfortable. 

And you're going to hear no, you're going to hear a lot of “No”.

You're going to hear a lot of people that don't want to give you a “No”, they don't want to waste the time with a conversation. 

But if you're persistent, if you're faxing and then they start to see the problem that they're having and how you can fit in to that problem. 

I do these little mini shock and awe things like I just did one previously. I got a little dice from Hobby Lobby, and I put a little thing sticking out of it, there was a lid on it. Just a little cardboard thing sticking out with my name on it and said….

“Healthcare Physical Therapy: Don't roll the dice with your patient care. Thanks a lot for trusting us with your patients.”

You've got to come up with some little thing to get past that. I don't want to bother with this, that little thing to make yourself stick out. 

Even if you mail this thing to them. Do whatever you need to do. If you don't want to walk into the place, just let them know you're there. 

And there's a huge opportunity in my opinion right now -- with referral sources that you might not have been able to get into. 

If you can help them when they have a problem; who are they going to refer to when their problems are gone?

If you're there for them and you help them when nobody else is there for them and help them. If you're there for their patients and help them when nobody else is there to help them. 

That says something about you to them. And you're saying, I don't even need to get paid out of this. It says something to them about you. 

And people remember that; people remember when somebody genuinely just does something just like what you’re doing here today. You told me before don't even mention Switchback, that's not what this is about. This is about trying to help some people.

That means more and builds more of your credibility than any advice that you could give on this call. Just the fact that you're like, “Hey look, I'm not in this to sell something. I'm in this to try to help people that might be a need right now and and try to get out there and let them know that I am here for them. And that you know, we're all in this thing together.”

That will carry through to them. You said you've got some and May actually said the same thing. 

(I was just looking down here. I hope you don't mind me looking down.) 

I'm trying to keep track of what everyone… May was saying that she went to the local hospital, see if they were interested and she said that went nowhere. 

And that's going to happen. 

Row facts called there's no response to my favorite positions. They're just overwhelmed.

Just stick with it like at this point what do we have to lose? 

A lot of us we've got a lot of free time right now. So just just stick with it, just keep fighting the good fight and eventually somebody's going to take you up on it. 

Maybe they don't even understand it; maybe that needs to be part of the cell. 

Telehealth is a great option right now. I know that you might be overwhelmed and talk about their problems first (you, you, you.)

The first word and all the copy or everything you say are the calls you probably have a huge problem right now. 

Acknowledge the other person; acknowledge what they're going through because let's be honest, that's what they care about. 

One of my favorite books, Dale Carnegie's “How to Win Friends and Influence People.” 

He said, ``If you aren't sure that you're all about you or you think you're different. When you pick up a picture, who's the first person you look for?” 

And it's the truth. We all look at how something affects us first and if somebody else is talking about how it affects us first we feel like they get us, like they understand us. 

So make sure you're starting with that. 

And also, like I said, do unconventional things. The mailers, do it. They call them shock and awe. 

Figure out a way right now that you can relate to it, put some toilet paper in it. Send them toilet paper (because you can't buy toilet paper.) 

Send them a couple rolls of toilet paper and say we've got you covered. 

And maybe on the toilet paper even right what you're doing on a couple sheets of toilet paper and just the sheer shock of the thing is going to get them to look at what you're doing. 

You’ve got to be a little unconventional right now. I'm telling you guys there's a huge opportunity, there's new referral sources that are just waiting for you to come and disrupt them. 

So, Dave, any other problems that you've run into? Words of wisdom on how to deal with some of the stuff that you're running into? 

Like the objections you're running into? Any other words of wisdom that you'd like to share with everybody?

{Dave Townsend} I think that one of the biggest things early on and continues to be is just making it easy for him. 

One of the biggest barriers of course, is they just sort of put it out of their mind like a video visit, like that's too complicated, especially for older patients. And we don't know what's going to happen with Medicare but still we need to be in contact especially with our older patients. 

I actually had a gal I think she’s about maybe 75 years old or so. Brand new patient, I had never met her before and got her on the phone. 

She was needing some help with her hip. She's having difficulty walking around just not doing well at all and doesn't have a computer. But she had just got an iPhone, maybe just like a couple of weeks ago. 

I was calling on my landline. So I grabbed my cell phone real quick and with her permission, I just said.. Because she was just totally confused, like, “I don't know how this is going to work...” to like, “...get me on video.”

And so, I just said, “Okay. I'm going to ring in and it's going to pop up on your screen, on FaceTime, just answer the call, just like you would a normal call.”

And so right then in there, boom, FaceTime happened, my face popped up, her face popped up and then it all set at that point. Once you get them on the call, with video face to face, then you're set, then you're able to help them. And you get a new patient.

{Ray Berardinelli} Jerry is on here. Scott, Captain, four others...I've been horrible at keeping track of everybody here because now I've got this and this going on.

I'm trying to listen to you. I'm trying to answer over here. 

That's some of the stuff that you told me about. This is what everybody kind of needs to hear right now. 

{Dave Townsend} I also wanted to say, if you've never done telehealth before just go ahead and go for it. We had honestly never done any telehealth visits at all. 

And I think we've done like 50 or 75 to this point. I just set it up like this. 

I'll just turn it so I got my computer here. I'm just doing FaceTime or whatever on my laptop and then I have a little bit of space that I can move around. And then I put Switchback on there.

When it's time to record the exercise, I either grab the phone and then actually take a screenshot of them doing the exercise, or I hit it, and then just do it on myself.

{Ray Berardinelli}  Yeah,it's pretty cool. That's awesome. 

Then you can give them the exercise right in front of them that you actually talked to them about over the telehealth. That's a really need ingenuitive idea of how to use it. 

And one of the things that you and I talked about, and I didn't get to do it, and I don't know if you did, but I don't want to put you on the spot here. 

But I'm just gonna throw myself under the bus and say, I totally forgot Dave, we wanted to look at how easy it was to get somebody on Google meet that was maybe on an Apple device. 

I didn't get to do that. I don't know if anybody else has tried that. If not, I'm going to give it a go. And if you haven't done it, nobody else has done it, i'm going to give it a go.

I might even record it. Put it in here to show even if it's difficult. The difficulty that there is in trying to use Google Meet to make this happen. 

I know I got to get on with Mark. Talked the process of how exactly people are going to use his platform, anywhere in healthcare, to make that happen because I love the way you overcame the tech objection. 

Hey, your phone's going to ring. Just push the green button. 

It's gonna say just push the green button and bang, there they are. They're doing a telehealth visit. 

Right now the standards are relaxed. You could do that. 

I loved that thought, that ability and we've got to figure out ways to make this usable for people that aren't tech savvy. I know just like the pushing, go live on these things the first 20, 30, 40 times with, awful and then I was so nervous. 

What am I gonna say?  What am I doing? What if I screw up?

And then I figured out nobody gives a shit if you screw up. 

But they have the same fears, they don't know what to do. They don't want you to see their houses messy. They don't want you to see that.

Nobody wants you to see that.

{Dave Townsend} I'm laughing because last night it was like 8:30 at night and I'm finishing up my calls and I called one of my patients and I was like, “Oh, sorry, it's taking so long to get back to you. Sorry, I'm calling so late…” 

And she was resistant to video visits at all. And so I was going to try to do the same thing. 

I go, (permission based questions, of course.) 

“Hey, is it okay if we just try the Facebook right now real quick?”

And she's like, “Ah, no, I just got out of the hot tub…” 

There will be times where they won't be up for it. Ee just kind of keep going for it. 

So that's my opinion and also I've heard some good advice, I don't know if it was on NPR or something, but the best advice at this point in time with everything going on, is for all of us to forgive ourselves. 

And that just means that like, we're going to screw up, we're going to make mistakes. When I say the wrong thing, hour by hour we have to kind of forgive each other and ourselves of the mistakes that we're going to make and then just try to have that energy and, and just keep pushing it you know? It's hard.

{Ray Berardinelli} I'm with you. Make the mistake, just go headlong into this thing with the patients, with physicians, with the referral sources.

Just go in, dive in. 

Just keep going, keep going. Tell employers, “Hey, look if your people are stuck at home and they're having any aches or pains, and they kick it out, I'm still her…”

Just any way that you can and I gave this idea in one of my previous lives. Get to your garage sales sites, get to your local Facebook page, get out there, just offer the thing for free. 

I know a lot of people are stuck at home.

“Hey, if you're sore if you're hurting, if you're having problems, this is what I do for a living…”

Joey Galvatron you got a good idea going change your personal Facebook profile to say I help people over the computer or over their phone to and show exercise how to improve. It changed your Facebook profile in a couple of minutes. 

So that it says that you do the thing that you're saying that you're offering so that when they look at you, they're like, “Oh, wait, this is what he does or this is what she does…”

Just these little things. Keep pushing guys. Keep making the small changes and it will really go a long way to helping you on the other side of this because this thing's a mess. 

You're going to lose money right now. Like there's no way around it. If you own a practice, you're losing money. 

If you're a physical therapist locally in your community, heaven forbid, you're going to lose your job. 

My wife lost her job. She's a nurse. She's an RN and she lost her job.

She works in an ambulatory surgery center. So they're not doing those right now. A lot of elective procedures. 

Just get out there. Put yourself out there. Try to help in your community and this thing will all work out. 

It's all going to work out. You just got to keep pushing. 

If anybody has any questions, just let us know. I

f not, you know if you're on here on the replay, just let us know in the replay. I have already seen everybody that's on live. 

Thank you. Dave, anything else you want to share, parting thoughts?

{Dave Townsend} No, just hang in there everybody. 

As you said, we're going to get through it. And for me, yes, just hour by hour. 

You’re going to get discouraged. I mean, I was this morning, I was just kind of like, “oh, man, what's what's going to happen? How are we going to do this?” and then I just walked into the clinic and sure enough, patient calls.

We’re chatting and now my energy's up because you're helping people. The more people that you can get on the phone, the better.

Keep your energy up, and then when you're down, you're down. But just get yourself back up the next hour.

{Ray Berardinelli} Great, great and well just keep fighting the good fight brother and everybody. 

Hey, thank you for checking in. 

If you have any questions for me or for Dave, you can just put it in the comments below. And I'll be sure that, you know, one of us gets to it and helps you out there. 

So I guess thank you guys all for coming, sharing your time with us. Even though you might not have anything else to do right now. Your time is still valuable. 

And thank you for sharing it with us. Thanks, everyone for checking in and I hope everybody has a great one.

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