Dana Strauss (00:16) If you're a physical therapist feeling undervalued, underpaid, or wondering if your six figure education was worth it, this episode is for you. Today we're talking with John Lee, a PT who went from treating pro athletes to getting his MBA at Oxford to founding a healthcare tech company. We're breaking down the economic forces that keep PTs fragmented, why you weren't taught finance in PT school, and most importantly, what you can actually do about it. This is Future Proof PT, episode 18 with John Lee.

Dana Strauss (00:49) Welcome to episode 18 of Future Proof PT. We have a special guest today. John Lee. is a physical therapist with incredible background and story and I am going to kick it right to him to introduce himself before we start our conversation.

Jon Lee (01:05) Hi, I'm John and I'm a physical therapist. I'm currently the co-founder of Pickle and we're an employment data platform for the healthcare industry. My background is I'm a PT by training. I included my residency and my fellowship.

I out of school in the mid 2010s. I practiced in the pro athlete space before moving into community women's health in Portland, Oregon. I went on and got my MBA from the University of Oxford after the first wave of pandemic and moved into vaccine development and consulting for the United Nations during the pandemic before returning to the US about two years ago and starting Pickle with a few really smart folks I met over at Oxford. And I'm really excited to be here today with my friends Alex and Dana.

Alex Bendersky (01:46) Welcome John, welcome Dana, and this is a terrific use of the next 53 minutes to actually discuss the things that are pertinent. And as I was saying, thank you John for being here because I think one of the privileges of being an old geezer like myself is you just continue to meet interesting people. And there's interesting people and then there's smart people and then there's people like you who are both interesting and smart. So it really is a privilege.

So thank you for being here.

Jon Lee (02:15) No problem.

Alex Bendersky (02:17) So I wanted to discuss like the three levers of economics. There's that micro and macro economic points and then there is the massive economic lever that is controversial because like I think in economic terms, right? Like you would question whether it actually exists but for our purpose for Allied Health Field and for

value-based field. I think it's pertinent because the mass economic structure is all about networks, all about network effects and all about community and so all things considered we have this ⁓ allied health community that is poorly structured, that is somewhat siloed and not necessarily open. There is a way of potentially getting this out there and discussing

these more community-based events that can help us transition to the next iteration of our industry, which hopefully will be much more prolific and much more successful. So with that in mind,

I would like to ask you, about a specific term of the mass economic structure and how it relates to a current cohesive network of allied health and specific physical therapy. What is your view? How close-knit are we as a community in physical therapy? Is APTA doing a good job creating this environment? Or are we kind of all over the place? We just don't have that cohesiveness.

Jon Lee (03:34) Oh, there's a couple layers to that question. I'll break that into two things. I think the first thing will be like really high and I like to talk about socialized medicine. And the second thing we talk about is like cohesiveness as an industry. I remember when I was living in England, I was living in the UK, they have the NHS, National Health System, which is this, their national healthcare system that comes out of tax money that everyone can care for. And I remember being in that system.

Alex Bendersky (03:36) Mm-hmm.

Jon Lee (04:00) And I realized that the US already had socialized health care, but we weren't paying for it efficiently. So let's take a step back. If you're sick today and you don't have insurance and you go to the emergency room, will you get care? The answer is yes. Absolutely. You'll get it right. If you can't pay for it, obviously there are bad things that happen. You get a huge bill from a hospital. Maybe you go bankrupt, right? You fall off a bankruptcy. Terrible.

Dana Strauss (04:13) Mm-hmm.

Jon Lee (04:29) But on the back end of that, how does the hospital recoup those losses? The hospital reports those losses to the government, which gives back kickers or vouchers. And those vouchers ultimately come from taxpayers, right? So if you think about it, in a sense, the US's healthcare system is culturally a bit socialized already, but the payment structure is not. The way I like to think of the US healthcare system is like if I'm buying candy.

In the US, if I want to buy a Snickers bar, I buy them one at a time. If you buy one Snickers bar for $2 a piece, that's way more expensive than buying a box of 20 from Costco for like eight bucks, right? But in these socialized healthcare systems, what they're doing is they're buying a box of 20 Snickers bars and then rationing them out, right? For that cost productivity calculation, right? Now this is like a pretty general analogy, but that was the shocking to me.

It's like, yeah, we don't have socialized healthcare in the US by law, but typically speaking, because of how our practice acts are structured, we are allowed to get care. And if the nonprofit entities don't get paid by you for them, ultimately it back to the taxpayer, right?

Dana Strauss (05:41) it's the law called EMTALA that requires hospitals to care for patients regardless of their ability to pay. So it's the Emergency Medical Treatment and Active Labor Act. That's basically what puts hospitals in a position where they have no funding from a patient to care for them. But

they are required to provide that care. Thank God.