EP165: “I’m Stuck & I Don’t Know What To With My Patient”

[00:00:05] Are you a motivated healthcare or fitness professional?

[00:00:08] Are you looking to work with more athletes, become a sports specialist, or even get a

[00:00:11] job in a sports setting so you can finally enjoy the career that you've always dreamed

[00:00:15] of?

[00:00:15] If so, you're in the right place.

[00:00:17] My name is Chris Garcia, physical therapist, business owner, entrepreneur and residency

[00:00:21] trained sports specialist.

[00:00:23] I've been fortunate to work in professional sports and travel around the world working

[00:00:26] with elite athletes throughout my career and I've learned a lot of lessons along

[00:00:29] the way.

[00:00:30] I created this podcast to share my experiences and give you everything you need to know

[00:00:34] to help you become a sports expert.

[00:00:37] Welcome to the Sports PT Academy.

[00:00:43] Have you ever had the feeling of what to do when you don't know what you're doing?

[00:00:48] What about when you're stuck and you're stumped and it's a complex case or it's a new body

[00:00:53] part or a new procedure that you've never had to manage?

[00:00:56] Well in this episode I'm going to share what to do when you don't know what

[00:01:01] to do as a cash based physical therapist.

[00:01:03] Hi everyone.

[00:01:04] Welcome back to the episode and welcome all new users and welcome back to those who

[00:01:08] heard my content in the past.

[00:01:10] Today we're going to be talking about what to do, the confusion between not knowing

[00:01:16] what the next steps are, where to start, where to begin, how to begin a program

[00:01:21] for a cash pay patient and I'm going to dive into that.

[00:01:24] Before I do that, what is new in life?

[00:01:28] What is better?

[00:01:29] My back is actually feeling amazing for those who have followed.

[00:01:32] I'm still not 100% pulling from the ground just because I don't want to go back to that

[00:01:37] same feeling.

[00:01:38] It doesn't feel great.

[00:01:39] It's not what I want to do in life again.

[00:01:42] It took me about a good three months to really start to feel good again and that's

[00:01:47] with like really modifying a little bit of everything.

[00:01:50] What else?

[00:01:51] I went on date night with my wife.

[00:01:53] That was fantastic.

[00:01:54] A local restaurant in San Diego, my kids were doing fantastic.

[00:01:58] We're a few weeks away from our Disney cruise.

[00:02:00] Those who have been following, I'm just excited about life.

[00:02:03] Life is really stable and nothing too crazy and on to kind of all these new projects that

[00:02:09] have been going on.

[00:02:10] For those of you who asked last week, we did release our new project on Instagram.

[00:02:15] If you don't follow me on Instagram, Chris Garcia, DPT.

[00:02:19] We now are helping stem cell clients all over the world.

[00:02:22] So if you don't follow that, do that at stem cell recovery experts on Instagram.

[00:02:27] And what we're really trying to do is help providers and help patients have a resource

[00:02:33] for the proper recovery because we just had a physical therapist reach out to us personally

[00:02:38] and saying that they went through stem cell treatment and they themselves are stuck.

[00:02:44] And this is very, very normal.

[00:02:45] We see this all the time because it's not like a PRP injection.

[00:02:48] It's not like a post-surgical procedure.

[00:02:51] And so you have a lot of these variables.

[00:02:53] And so we've been doing it over the last few years.

[00:02:55] So we're just excited to share it with the world.

[00:02:57] So go ahead and follow there.

[00:02:58] All right.

[00:02:59] Why are we talking about, I don't know what to do.

[00:03:02] So this week I was very fortunate to present online to a DPT class at Weidner University.

[00:03:12] And during that time, we had a couple of questions from students.

[00:03:17] And one question, his name is Jared.

[00:03:20] I'll call him out.

[00:03:21] Jared is a great question.

[00:03:22] He asks, what do you do to help conquer your weaknesses?

[00:03:27] And one of the things I've learned in leadership and helping people become just better within

[00:03:33] themselves and better clinicians is help them be more introspective versus giving

[00:03:38] responses and giving answers.

[00:03:39] And so I asked Jared, I said, what's your weakness?

[00:03:41] What are you concerned about?

[00:03:42] And what are you fearful of?

[00:03:45] And he said, I am concerned that I'm not going to know the answer for a patient

[00:03:50] right in front of me.

[00:03:52] And I'm not going to know what to say.

[00:03:53] And I said, you know, that's a legitimate fear.

[00:03:55] But the reality is as you go through your practice, I still encounter things.

[00:03:58] I'm 15 years in, gone through a sports residency, did pro sports.

[00:04:04] I was a concierge physical therapist.

[00:04:06] I traveled all over the world managing athletes.

[00:04:09] I've done the NFL combine training.

[00:04:11] I've been in scenarios where I don't have the answer.

[00:04:13] I've been in tournaments, in live tournaments with dislocated fingers, hip displacements,

[00:04:19] tibial plateau fractures.

[00:04:22] You name it.

[00:04:23] And there's so many different scenarios that you don't know exactly what to do.

[00:04:27] But you do have to follow some guidelines.

[00:04:29] And I'm going to share that with you today because each and every one of you listening to this

[00:04:33] have those same fears and apprehensions.

[00:04:35] And in some of you would call them weaknesses, I call them area of improvements.

[00:04:38] But the reality is throughout your process throughout your entire career,

[00:04:41] you're going to have these things.

[00:04:42] So sooner that you can develop a process to conquer it or know how to manage it,

[00:04:46] that's where you're going to actually just surpass all of your peers.

[00:04:50] And that's what you're really looking for, how to develop that confidence.

[00:04:53] Some people say, I don't want to have imposter syndrome,

[00:04:55] but it has nothing to do with that.

[00:04:56] It really comes down to how do you create a better framework within yourself

[00:05:00] to be able to manage any case that you don't know what to do?

[00:05:03] And I've been able to do that successfully and I want you to be able to do the same.

[00:05:07] So that's why we're having this podcast.

[00:05:10] So thanks, Jared at Widener.

[00:05:12] And it's been great to be able to help students.

[00:05:14] But also clinicians because you share the same concerns.

[00:05:19] So, all right.

[00:05:20] So let me give you a little bit of an outline.

[00:05:23] So we have, you might have a patient who just came to see you for a very complex post-surgical

[00:05:29] procedure or maybe you've never seen a lot of sciatica or lumbar disc herniations.

[00:05:36] And I'm just making this case up.

[00:05:39] And this person's a very active individual and they're asking you, you ready for this?

[00:05:45] Should I have surgery or not?

[00:05:47] All right.

[00:05:47] Somebody has a complex case and they've gone to numerous clinicians, numerous specialists.

[00:05:54] They've been to massage therapists, chiropractors, physical therapists,

[00:05:57] done everything in the wheelhouse.

[00:06:01] Now they're consulting with you because you're a cash-based physical therapist.

[00:06:04] They're looking for something different.

[00:06:06] They're assuming you have more skills, you have more experience and history.

[00:06:10] And now you're stuck with, oh my gosh, what do I do with this?

[00:06:13] This is a very tough case and on textbook, on paper, it might sound a little easier,

[00:06:18] but when they're right in front of you, that's where we all have these nerves.

[00:06:22] And I'll show you how to settle these down and go through it and really

[00:06:25] be confident through the whole process and doesn't make you're making things up and

[00:06:29] being truthful.

[00:06:30] And when you can do that internally without practice,

[00:06:34] it shows that you have that confidence, whether you know everything you're about

[00:06:38] to do or you know nothing.

[00:06:40] And when you look at this case, you probably spoke to them more the phone or you had

[00:06:47] somebody on your team answer that call for you and now you know what's coming in.

[00:06:51] And now they're at the initial evaluation, they're right in front of you

[00:06:53] and they're going through these things and you're asking all these questions,

[00:06:56] what have you been through?

[00:06:57] What are you still suffering from?

[00:06:58] What do you want to be able to do?

[00:07:00] And they say, I want to be able to walk.

[00:07:02] I want to be able to pick up my kids.

[00:07:04] I want to be able to get out of bed without numbness and tingling going down my leg.

[00:07:08] I want to be able to do it without this atrophy I have in my leg.

[00:07:11] I haven't been able to bend forward.

[00:07:12] I can't sit for long periods of time.

[00:07:14] And so you look at this, you're like, wow, that's a long plan of care.

[00:07:17] This is going to take me a long time to get there because it's taking them

[00:07:20] maybe months to years to get to that point.

[00:07:23] So your question then becomes how am I going to help this person and what am I

[00:07:27] going to tell them?

[00:07:28] How long is it going to take them?

[00:07:30] Can I even help?

[00:07:31] And they're asking, number one, can you help me?

[00:07:36] Number two, what type of improvement should I expect?

[00:07:39] And number three, or should I have surgery?

[00:07:43] Wow.

[00:07:44] And now they're expecting an answer from you.

[00:07:46] And as a sports physical therapist, you're now looking at them blank stare

[00:07:52] in the eye, deer in the headlights.

[00:07:54] And this is where the confidence becomes a problem.

[00:07:57] And so you start back pedaling, you start over talking and they can sense that.

[00:08:01] You start rambling.

[00:08:02] And as you can see, most physical therapists don't feel confident in something

[00:08:06] to just keep talking.

[00:08:07] And so the patient is severely confused because you went one direction,

[00:08:11] you don't know what to say on the other.

[00:08:13] And the worst thing you want to do is say nothing because then that shows

[00:08:17] you actually have nothing to say and you don't have any confidence

[00:08:20] in what you're saying right now.

[00:08:22] So all right.

[00:08:23] So I'm going to go through this step by step process to be able

[00:08:25] to help you conquer this.

[00:08:26] So being honest and truthful is the best thing.

[00:08:32] However, you don't want to seem incompetent.

[00:08:34] You want to be able to help this person and guide them.

[00:08:36] So the first thing to hit right off the top of the head is I completely understand

[00:08:41] and you have an extensive medical history.

[00:08:45] And the great news is you're going to be in good hands.

[00:08:47] All right.

[00:08:48] So what that does is it helps the person understand that you are with them.

[00:08:54] You're on their side.

[00:08:55] And so the next step is all right.

[00:08:57] What are we going to do here?

[00:09:00] So if you don't know everything right there and then your next step is to figure out,

[00:09:03] okay, you know after this session tonight, the next day, that whole week,

[00:09:09] you're going to be reaching out to resources, right?

[00:09:11] So you're going to be reaching out to local surgeons.

[00:09:13] You're going to be talking to peers who've seen these type of things.

[00:09:16] You're going to probably be on PubMed.

[00:09:17] You're going to be on Google searching for everything and anything possible to look at.

[00:09:21] What do I do in this case?

[00:09:22] You might go to a mentor.

[00:09:23] You might go to an old professor.

[00:09:24] You might go to a surgeon and look at, okay, what are the outcomes?

[00:09:29] Which direction should I go?

[00:09:30] So you're going to look at clinical prediction rules.

[00:09:32] You're going to look at guidelines, protocols, all these other things.

[00:09:35] Here's the problem.

[00:09:36] You want to be able to get there tonight, tomorrow, next week.

[00:09:40] The patient wants to be able to get an answer right now.

[00:09:43] So here's how you buy yourself some time with being honest.

[00:09:46] All right.

[00:09:48] Hi, Jerry.

[00:09:50] Patient, I'm going to look at...

[00:09:53] I see your case.

[00:09:54] It's quite extensive.

[00:09:56] One of the things I want to do is, with 100% certainty, give you all the answers in terms

[00:10:01] of how long this is going to take, exactly what's going to happen in every process.

[00:10:06] And while I have seen cases similar to this, I don't want to give you poorer information

[00:10:13] or bad information.

[00:10:15] So what I'm going to do over the next week, because I'm going to see you on Tuesday

[00:10:19] or Thursday of next week whenever that date is,

[00:10:21] I'm going to do an extensive amount of research to give you the best answers possible.

[00:10:27] Today was really about getting an understanding of what you expect and what you want

[00:10:31] and where you want to go.

[00:10:32] Now that I have all this information, I'm going to do some back-end research,

[00:10:36] talk to my colleagues, talk to my experts, but just know by next week

[00:10:41] I'll have all that information to be able to present that to you

[00:10:44] to give you accurate information so you can feel confident

[00:10:46] that I'm the best person that's going to help you.

[00:10:49] What you've done there is you've outlined that, one, you're in good hands.

[00:10:53] Why? Because two, you genuinely care to do all the research behind that.

[00:10:58] Now the worst thing you can do is say, yep, no problem.

[00:11:02] I'll go ahead and take care of you.

[00:11:03] You don't necessarily put on an outline.

[00:11:06] You just tell them, yep, you're basically promising the results that they need

[00:11:10] and that you're actually lying.

[00:11:11] And you might say, well, I don't know what else to say.

[00:11:14] I think you have to be honest and say, listen,

[00:11:16] I'm going to do everything on the back end.

[00:11:18] And next time I talk to you, I'll give you everything step by step on what I expect.

[00:11:22] And that is genuine and it's honest.

[00:11:25] And because of that, you don't feel bad because you're telling them the truth.

[00:11:29] The problem becomes is that most physical therapists can't do that.

[00:11:33] They have that hard balance of, well, I don't want to seem incompetent in what I do.

[00:11:38] And because of that, you say less or you say too much.

[00:11:43] So I don't know what's worse.

[00:11:45] Taking your previous approach or saying nothing.

[00:11:48] And all you're doing here is you're saying something with intent,

[00:11:52] with confidence, with honesty, with genuineness.

[00:11:55] Now picture yourself in that same position.

[00:11:58] If you had that back pain and you were trying to figure out

[00:12:00] the final solution to what to do, what would you do?

[00:12:03] What would you want?

[00:12:04] You would want a surgeon or a healthcare provider to tell you exactly

[00:12:07] what you what I just outlined.

[00:12:10] Why? Because that's how you're looking for.

[00:12:11] You're just looking for a truth.

[00:12:12] You want somebody to give you an answer, point you in the right direction.

[00:12:16] And that's all this patient is.

[00:12:18] But your pride, the white coat in you, the maybe you have a doctor

[00:12:23] and now that that's like you're supposed to always be the best

[00:12:25] or always supposed to have the answer.

[00:12:27] It's your internal barrier that's limiting that patient

[00:12:30] from getting the service they need.

[00:12:31] I tell people this all the time, stop being the doctor of physical therapy

[00:12:36] and just be you.

[00:12:37] And the minute you can do that, you allow yourself this freedom

[00:12:41] to be who you are, let your personality come through.

[00:12:44] And that's all that patients really appreciate.

[00:12:46] They still want the technical skill and everything that you can provide.

[00:12:48] But the more human you are, it allows them to see how much you

[00:12:53] genuinely are passionate about getting them better

[00:12:57] because no one else has done that.

[00:12:58] So if they go to four or five other clinicians

[00:13:01] who took that same old approach, I'll call it the insurance-based approach

[00:13:05] that they give them a stereotypical answer.

[00:13:09] You're going to do great, you're going to do fine.

[00:13:10] They go through this whole protocol that's systematic

[00:13:13] and doesn't really go above and beyond.

[00:13:15] You probably got into cash-based physical therapy

[00:13:17] because you want to provide something different.

[00:13:20] You were willing to put in those hours after hours.

[00:13:22] You were trying to do the best possible thing

[00:13:24] to get the best outcomes and get patients better.

[00:13:27] So if you are, that's the intent of why you did this

[00:13:31] to become that provider

[00:13:33] who can do a little bit more personalized one-on-one care.

[00:13:36] The gap between being able to do that

[00:13:38] and having that patient in front of you, that's the gap.

[00:13:41] And the way you go overcome that gap is authenticity

[00:13:44] and using this exact same framework.

[00:13:47] And all you're doing is you're giving yourself some time,

[00:13:51] you're buying something, some time

[00:13:52] to find what the best answers would be.

[00:13:55] And so what you can do on the front end

[00:13:57] is tell if you are concerned about this in the future.

[00:14:00] So say you've had this in the past

[00:14:01] and you're like, gosh, I never want to do that again.

[00:14:04] What you do is you line up this initial valuation

[00:14:07] as a consultation.

[00:14:09] And what this allows the customer, the patient to do

[00:14:11] is understand that you're not going to get any treatment

[00:14:14] or maybe you do a baseline level of treatment.

[00:14:16] But it's more to figure out if we're going to find,

[00:14:19] be a good fit.

[00:14:20] And that way you're not concerned

[00:14:22] that you need to over deliver.

[00:14:24] And I think that patients would appreciate that

[00:14:27] if they know that this is a consultation

[00:14:30] and if there's no treatment,

[00:14:31] they're here to figure out, can you help them?

[00:14:34] If you were to go to an attorney,

[00:14:37] if you were to go to a dentist,

[00:14:38] sometimes they just do the consultation.

[00:14:41] Why? Because they don't want to over promise.

[00:14:42] They don't want to say, this is the best place for you.

[00:14:46] I'm going to do this treatment plan.

[00:14:47] I'm going to do all these different techniques.

[00:14:49] And if it doesn't work out, they look bad.

[00:14:51] So to protect yourself, what you do is say, hey listen,

[00:14:54] I want to make sure that we can help.

[00:14:56] So I'm going to do a consultation,

[00:14:58] which there will be no treatment.

[00:14:59] We're just going to go through your medical profile

[00:15:00] and give you a plan.

[00:15:02] And then we'll figure out from there

[00:15:03] if we're going to be the best.

[00:15:04] And what that does is it helps the patient

[00:15:07] with better expectations

[00:15:09] so that they can come in knowing, oh, I understand.

[00:15:13] You're not saying that you're going to be able to deliver this.

[00:15:15] You're asking if this is going to be the next step.

[00:15:17] That's perfect.

[00:15:18] And when you have two people who have

[00:15:20] the proper expectations

[00:15:22] and you can deliver on those,

[00:15:23] that's a great relationship.

[00:15:25] And that's where everything starts with patients.

[00:15:28] I think that you think that they want you to,

[00:15:32] or they expect you to deliver on everything,

[00:15:34] know everything,

[00:15:35] know every procedure that's ever come out.

[00:15:38] And you're over here saying, or thinking,

[00:15:40] gosh, I have no idea what I'm doing.

[00:15:42] And the reality is that comes through,

[00:15:44] especially as you speak,

[00:15:45] if you're speaking too much, too fast,

[00:15:48] you're not looking them straight in the eye

[00:15:49] just because you're not confident.

[00:15:51] And patients will read through that.

[00:15:53] So if you've ever felt that way

[00:15:55] and you never want to feel that way,

[00:15:57] use this framework.

[00:15:59] If you're a third-year physical therapy student,

[00:16:01] just like Jared,

[00:16:03] you just know these are very normal.

[00:16:05] And it's not experience that gets you through this.

[00:16:08] People say all the time,

[00:16:09] well, find a mentor, get some experience,

[00:16:11] and go get this under your belt.

[00:16:14] You can get this before you even have experience.

[00:16:16] Just use this framework.

[00:16:17] Be honest.

[00:16:18] I don't think you need experience to go through this.

[00:16:20] How about you just use this?

[00:16:21] And the problem is that one of my passions

[00:16:24] is communicating with patients,

[00:16:26] communicating with PTs.

[00:16:27] And the strength that a lot of great physical therapists have

[00:16:30] is that communication

[00:16:31] and being able to phrase things so simply,

[00:16:34] so eloquently that a six-year-old can understand that.

[00:16:37] And that's where physical therapists struggle

[00:16:39] because you want to get to the nitty gritty,

[00:16:41] the what I call the operational things,

[00:16:43] the technical skill.

[00:16:44] I just want to mobilize them.

[00:16:45] I just want to do this.

[00:16:46] But you have a hard time conveying that

[00:16:49] to the person in front of you.

[00:16:51] You're like,

[00:16:52] with this, the knee valgus and the

[00:16:55] inculometer angle of the superior dome of the tail.

[00:16:58] Like the patient has no understanding.

[00:17:00] So if you can simplify things,

[00:17:01] the patient doesn't want to know any of that.

[00:17:03] They just want to know,

[00:17:04] are you the person for me?

[00:17:06] And are you going to give me the results that I want?

[00:17:08] Absolutely.

[00:17:09] That's it.

[00:17:09] That's all they want to know.

[00:17:10] So if you don't know what to say,

[00:17:13] I highly recommend where I've always first started

[00:17:15] is writing it out either on a whiteboard,

[00:17:18] on a computer.

[00:17:19] Just write it out.

[00:17:20] And on a piece of paper, whatever it is,

[00:17:22] and read it out loud.

[00:17:24] And you'll realize the way you write is not how you speak.

[00:17:27] So then compare that with take a voice note,

[00:17:30] say it out loud and just speak through that voice note

[00:17:33] and then listen to it.

[00:17:35] And that's how you sound when you're talking to a patient.

[00:17:37] So the way you write and the way you speak

[00:17:39] are two different things.

[00:17:40] And just make sure that conveys that same authenticity.

[00:17:43] Now don't try and script it,

[00:17:45] but understand how you phrase things.

[00:17:47] Does that sound like you?

[00:17:48] And that patient, when listening,

[00:17:51] can they interpret that at a sixth grade level?

[00:17:53] And that ultimately will give you that confidence.

[00:17:55] So when you don't know what to do,

[00:17:58] this could be for any region.

[00:18:00] Neck, shoulder, knee, low back,

[00:18:02] it doesn't even matter.

[00:18:03] It doesn't even matter the condition.

[00:18:04] It's when you don't know what to do,

[00:18:07] here's what to do.

[00:18:08] So the next time you're stuck,

[00:18:11] get a whiteboard, get your voice notes out,

[00:18:14] say it out loud, communicate it.

[00:18:17] But what you don't have to say is,

[00:18:19] I'm not confident.

[00:18:20] Just say, I understand this is complex.

[00:18:23] I've seen things like this before.

[00:18:25] I want to make sure with 100% certainty

[00:18:27] that we can get you the plan that you need

[00:18:30] and in the hands that you need.

[00:18:31] So what I'm going to do on the back end,

[00:18:33] I'm just going to meet with several people.

[00:18:35] I'm going to do all the research.

[00:18:37] So by the time I see you next time,

[00:18:38] I'll have an exact plan of the right direction at all.

[00:18:41] And the next thing you have to do

[00:18:42] is provide one or two options.

[00:18:44] If you want to go surgery,

[00:18:45] this is what I would recommend.

[00:18:46] If you want to go conservative care,

[00:18:47] this is what it will look like.

[00:18:49] And now you have that patient who's looking at,

[00:18:51] well, one year of post-surgical care

[00:18:53] or six months to a year of nonoperative care.

[00:18:56] And now they get to make that decision.

[00:18:58] So now you've taken the uncertainty

[00:19:01] and the lack of confidence from yourself

[00:19:04] and given that to the patient

[00:19:05] so they can make a decision for themselves

[00:19:07] and you've not felt bad about it

[00:19:09] and you don't look incompetent.

[00:19:11] So if you're like Jared

[00:19:13] and you want to improve your weaknesses

[00:19:15] and seem like a confident physical therapist,

[00:19:19] no matter what hits you,

[00:19:20] no matter what type of case hits you,

[00:19:23] these are the things that you need to do.

[00:19:25] And if you're a cash-based physical therapist

[00:19:26] and you struggle with these things,

[00:19:28] you know this is going to be part

[00:19:29] of the evolution of your growth.

[00:19:32] It won't just be more skills, more experience.

[00:19:35] That's not going to be the case

[00:19:36] and you need help with that framework

[00:19:37] on what to do, how to do it

[00:19:39] when you know exactly what to do,

[00:19:41] refining when you don't know exactly what not to do.

[00:19:44] And if you're stuck and you're looking for a better framework,

[00:19:48] a better way to attack patient cases,

[00:19:50] both complex and easy,

[00:19:52] I want you to highly consider

[00:19:55] taking my Cash PT Clinical Elevation course.

[00:19:58] This is an eight-week online mentorship course

[00:20:00] where I take cash-based physical therapists

[00:20:04] week by week into what our initial evaluation

[00:20:06] looked like, what follow-up sessions

[00:20:08] should look like,

[00:20:08] what should your packages look like,

[00:20:11] ways to convey what you're doing,

[00:20:13] how to communicate with people,

[00:20:15] what to do when you don't know what you're doing.

[00:20:16] All of these things in a cash-based setting

[00:20:18] are very critical.

[00:20:19] Why? Because the customer is paying you out of pocket

[00:20:22] and they can leave you at any moment.

[00:20:24] Now while you were an insurance-based provider,

[00:20:25] everything worked because that customer

[00:20:27] had a low barrier of entry

[00:20:28] and it was very easy for them to come back.

[00:20:31] Why? Because you were cheap.

[00:20:32] Now that you've started charging

[00:20:33] reasonable prices for what you do,

[00:20:35] you have to understand every session

[00:20:37] is a critical session.

[00:20:38] And if you don't figure this out,

[00:20:40] you're losing revenue, you're wasting time.

[00:20:42] And I've said this before in previous podcasts.

[00:20:44] People can lose anywhere from $50,000 to $150,000

[00:20:47] in their first three to five years of being a cash PT.

[00:20:51] Now if you can streamline that

[00:20:52] and avoid those, that'd be a better position.

[00:20:55] And for those of you who are joining

[00:20:57] my Elevation courses here,

[00:20:58] I'm excited to see you in there.

[00:21:00] If you've been contemplating it,

[00:21:01] go ahead and head over to the website,

[00:21:03] Dr. Chris Garcia dot com forward slash elevation

[00:21:06] to get more information.

[00:21:07] And I'm excited to see you in the course.

[00:21:09] If I don't see you in the course,

[00:21:10] I'll see you guys on next episode.

[00:21:12] Take care.