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May 17, 2023

Evolving the Field of Physical Therapy with Dr. Mike Giunta, PT, DPT, CSCS

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Dr. Yoni Rosenblatt: Welcome back to the True Sports Physical Therapy Podcast. We got Mike Giunta with us today, one of my favorite dudes in the space, so I'm really excited to have you on. I've known you for a few years now. I don't even remember how we crossed paths. Oh, maybe I do. It was about the PLL, but just always handled yourself and carried yourself so professionally. There's just... It's just so easy to get along with you, Mike, and so it's been great, kinda stayed in touch over these years. I want you to share with this audience of sports PTs, how you got to where you are.

Dr. Mike Giunta: Yeah, absolutely, man. It's always great to connect with you. And we definitely formed a friendship over the bunch of years that we've known each other and been able to do some cool things professionally. And I think that that, really the crux of just believing in what we think physical therapy should be and working towards that every day, those important things. When I think about being a sports PT and being involved in this practice, it's really just kind of always going towards that heading and making sure that we don't sacrifice anything else, so great to be here. Thanks for having me on. And to your main question about how I got to where I was today, I was probably like a lot of people coming out of school right now, where I wanted to work with a team, wanted to work in pro sports, that sort of thing, was near the tail end of PT school, trying to decide what I wanted to do, whether or not to stay on the East Coast, whether or not to move to a warmer area in California. And ultimately decided that I wanted to get involved with a small practice who wanted to grow and found a place called Evolution Physical Therapy in Los Angeles, which had one clinic, but definitely a big desire to grow and move this profession forward.

Dr. Mike Giunta: So joined up that group in 2011, and over the course of the next seven years, was able to help it grow to about five clinics. And in 2018, I got the opportunity to take over the clinic as a whole by way of acquisition, which was a super fun process to go through. And obviously, we don't go through a ton of business stuff when we're in school. A lot of people out there know that. So to dabble in that side of things and go through that process, I think was super interesting and certainly a learning experience. Simultaneously, I also partnered up with a group in Connecticut, where we started opening clinics there in 2018. And then in 2020, started having conversations with a group out in Denver, where I just loved the Colorado area. For many years, I've been doing the Burton US Open in snowboarding for about 10 years, and fortunately got linked up with this other group through my connections at the PLL and partnered with them there towards the end of 2020, which has been really fun. So been a cool pathway. Certainly did not make a five-year plan and then hit the nail on the head right on it, because two years after I acquired my business in 2018, we kind of went through a rough patch of 2020, 2021, which everybody is fully aware of, but everything has just been kinda going full steam ahead and going for it.

Dr. Yoni Rosenblatt: It's been awesome to watch from afar and then get some of the insight. Now, you went about it a little bit differently than I did, as you started talking about some of these acquisitions, but before you did that, it sounded like you grew from one to five. Walk me through that. What was the secret to your success in taking one clinic and growing to five before you went even further?

Dr. Mike Giunta: I think it was really listening internally to our physical therapists and the people who are involved in the company and growing organically. I think that that was really important. It was never kind of putting a finger on a map and saying, "We need to open up a location here because we want to." It was always opportunistic, going to a place that somebody else in our company lived near or had a community that they wanted to grow and be a part of, and we just kind of supported and invested in people that were really important to us. So our first expansion in fact was into the Beverly Hills area, and then from there, we went... Actually teamed up with a physician in the Brentwood, west LA area, a really good situation there of people who really believed in physical therapy, then we opened another flagship down in the South Bay area, just south of LAX Airport in Hawthorne, California where we were really able to establish ourselves as kind of a really solid sports PT clinic down there in the area, which didn't have a ton of that going on. And then just rinse and repeated that model of really making sure that we had a good solid base to go off of culturally. I think that it was just really important that we didn't lose that side of things by growing too quickly.

Dr. Yoni Rosenblatt: Yeah. You mention developing a name as being the go-to sports PT, and what culture looks like and what that practice looks like. Tell me what it's like when I walk into Evolution Physical Therapy. What's the model? What's the feel?

Dr. Mike Giunta: And it's one thing to be passionate about being a physical therapist, but it's another thing about be finding what you're passionate about in the world of physical therapy and then doing that. There're so many orthopedic physical therapists out there, there're so many people who call themselves sports PTs out there, but the percentage of their actual case load that's working in sport is actually very minimal. And so if you're going to do that, we really wanna support you in finding that population that you wanna work with and trying to get it to a point where 70% of your case load is really treating that type of person. And so that doesn't... For us, that doesn't have to be athletes, and that's totally fine, but we really want our physical therapists to figure out what that is and then go for it.

Dr. Yoni Rosenblatt: That's really cool that you're able to support your staff and your clinicians like that. Tell me though, boil it down and make it clear, who is Evolution Physical Therapy and who is Mike Giunta?

Dr. Mike Giunta: Yeah, I think we're... Evolution Physical Therapy is a group who really want to change the perception of physical therapy, and that's kind of what our motto is when we talk about it at most of our meetings and how we're gonna do this. I think there's a very particular idea of what traditional physical therapy is, what that looks like. We look like, we smell like, we feel like when you walk into one of our clinics, much more what people would traditionally think of as a gym, and that's how we want it. We wanna really push those boundaries and obviously be in the medical space because that's really important, but have a look and feel of a place where people know that they can get better, they're having fun, they're listening to music, they're enjoying themselves. And that's not just the patient. That's the physical therapists themselves. So at the end of the day, that's what I am, that's who I am. I had my roots in strength and conditioning coming through PT school, doing speed training with Parisi Speed School, getting guys ready for the NFL combine, that sort of thing. Just kind of being in that atmosphere, being around it all the time, and certainly wanted to bring that to any clinic that I was involved with.

Dr. Mike Giunta: I also let go of the idea of working for a team and figured out how to basically bring those athletes to me in my clinic. I felt like that would be a much better lifestyle going forward. And those people who have traveled with a team, which I have to, I traveled three straight summers with the Premier Lacrosse League, that travel is growing. People know about, they talk about it. It's no secret, and I commend every person that wants to do that for long periods of time. For me, I think it was really important to figure out how to balance the in-clinic stuff with the working with those top-level athletes. And I've been very fortunate in my career to travel all around the world doing physical therapy, travel all around United States doing physical therapy, but still had my home base and never really had to be really stressed out about that.

Dr. Yoni Rosenblatt: I knew you would have an awesome answer for that because it's so clear that you know who Mike Giunta is, and your ability to say, "Hey, what do I want? And how do craft that?" And you did a great job of explaining that. Like, you want that professional athlete, that elite-level sports rehab, but you also wanna be you. You wanna have time to be you and you wanna be in your home base, and I think that really bleeds through. Holy cow, I wanna work at Evolution Physical Therapy. It sounds awesome.

Dr. Mike Giunta: Yeah, man. And, Yoni, to be honest, at this point, I tell all my physical therapists, "This is... " I tell them that same story, I've been fortunate to do these things that I've done in physical therapy. I'm actually more passionate now about helping them find what I was able to find, and that is being you, that is being true to who you are, true to who you wanna treat. And for me, it just... It's so exciting when that the physical therapist gets involved in that group that they're really interested in being involved with and they start seeing patients from them, and they're really enjoying what they're doing every day, or they're telling stories about this case that they had, because they went and they started coaching a soccer team, and now they're seeing patients from that team. It's just really fun, man. It's a fun way to go about the business side, because at the end of the day, you can only treat as many patients as you can treat personally, but when you have this company of like-minded individuals who are doing that, I think you get to experience at a whole different level.

Dr. Yoni Rosenblatt: So these career ladders that you've created within Evolution Physical Therapy to allow the therapists to achieve their desired goals or their stated goals, walk me through how you came about, number one, the need for that, and then number two, how did you start acting upon those things and creating those ladders?

Dr. Mike Giunta: Yeah, I think it was experiential for me as I was going through being a part of a growing company and realizing that there was a lot of different hats that you have to wear. And also when you look in the mirror, you realize that you're not necessarily great at every single one of those things. I read a book a long time ago. Well, a series of a couple of different books that really helped me get to the ultimate idea of doing what I've been doing as far as building these career ladders. First and foremost was some of the Jocko Willink books as far as understanding decentralized command and how that really works. And that's really how I've built my company throughout the course of the years, is by finding what people are really good at, allowing them to do those things, but also understanding who they're not, who I'm not and making sure that we get really great people in those roles as well.

Dr. Mike Giunta: And so over the course of the years, I just kind of realized that, number one, can't do this all myself. Need really great people around me. Need to find people who are better than me at a lot of different things and make sure that we're elevating those positions. And then also understanding that not every position is for every one person, and if we hit roadblock as far as putting somebody in a position that either they just thought that they should be in that position, 'cause they've been with the company for a long time, where they feel like that's the only way to grow, that that's gonna be problematic for a growing company as well. And so to put a few more specifics on that, I don't believe that the only way up in a physical therapy clinic should be to be a clinical director. It's just something that I fundamentally disagree with. I think the clinical director really should be somebody who enjoys managing, who has obviously the desire to understand the business side of things, how things work, the ability to lead other people, the ability to understand and be empathetic towards, not just their patient, but also their employees. And I think that those are certainly a different... That's a different skill set that some people have and others don't.

Dr. Mike Giunta: And I think what you find if that's the only way up, you get a lot of people who have really no business being managers who are the managers of the clinic, and that just frustrates everybody else that are around them. So we're very crystal clear with our employees that, "Hey, listen, don't think that the only way to grow at this company is to be a clinical director. We have other things for you to be able to do. Let's figure out what those are, and let's make sure that we have them." And people in our company can attest, a lot of our... For example, we have people who are really taking a mentorship path. A lot of those mentors would say like, "I have no desire nor want to be a clinical director." And same thing with clinical directors. They say, "Hey, I have no desire nor want to be a mentor." So in that way and the way that we use it contextually in our company. So I think it's really cool to create these different ladders and pathways so people never feel stuck.

Dr. Yoni Rosenblatt: Yeah, I've definitely seen that and very transparently totally made that mistake before where it was like, "Oh, you're a great clinician. It must be you're gonna be a great CD or a clinic director." And that has blown up in my face. And by the way, blow up in the space.

Dr. Mike Giunta: Not the case.

Dr. Yoni Rosenblatt: Yeah, and it's definitely not the case. So I definitely had to learn, unfortunately, that the hard way. Give me another career ladder. So say, I'm working in Evolution Physical Therapy, I'm a great clinician. You don't think that I'm the ideal clinic director. What else can I do for you?

Dr. Mike Giunta: So there're several others, so I alluded to one there a minute ago, but that's our mentorship pathway. We call them all pathways. I mean, it's a... We're always adding to this and having people come up with things that we... There might be something really cool out there that we don't even know about. To take that Wedding Crashers line, that is freaking hilarious.

Dr. Yoni Rosenblatt: I'm so glad you referenced that.

Dr. Mike Giunta: But the first one is that mentorship pathway. This is something where...

Dr. Yoni Rosenblatt: Thank God you said that, 'cause I'm like, "Am I the only one thinking about Will Ferrell?" This is a safe space, right? This is safe. Okay, got it. No one's listening.

Dr. Mike Giunta: This is a safe space, yeah. Yeah, so that mentorship pathway and a really important one, really important one for the company is people who want to mentor less experienced physical therapists, people who are really taking the educational side by the horns, they're obviously very skilled clinicians, they're people who love to teach. I can tell you from my experience, I've taken students in my career over time, and it's certainly nothing against the students that I taught, but it's not something that I was really drawn to. I just felt like I was always kinda doing my own thing and then I had this other person there that I also had to help along, and I felt like I was... My time was better spent doing some other things at the time. So I have a lot of respect, trust and admiration for the people who want to enter that mentorship pathway because they just have this selflessness about them that they wanna teach others, they wanna help others grow and do these things, and they're willing to sit there and spend the time, especially when it's super frustrating, when somebody is just not getting something, to teach them and help them along the way. So that's a really cool one. We have an analytics...

Dr. Yoni Rosenblatt: Mike, is that... Sorry, is that different than a clinical instructor, same thing? They're just taking students. You just call them clinical mentors?

Dr. Mike Giunta: So I think it's under the same roof. Certain physical therapists would rather take students than have a actual less-experienced physical therapist. And I think that those are also two skills, two different skill sets. Taking a student is one thing. We actually have a formal mentoring process in our company. So if you're entering our company as a new grad, we have a very particular thing that you're going through over the course of the first year, and then we kind of tail off after that and do some different things, but we make sure that the people who are our mentors really are passionate about that. And then the same with our clinical instructors. You have to want to take a student. You really do. And I think that some of those clinical instructors can actually mature into more of these mentors down the line. As they develop those skills on students, then they can transfer those skills to the more less-experienced physical therapist as they gain their own experience.

Dr. Yoni Rosenblatt: Yeah, yeah. I think that makes a lot of sense. Okay, I'm gonna ask you a question that I think is burning in the listeners mind, and that is, Mike, if I'm working for you and I become a CI or clinical mentor, do I make more money?"

Dr. Mike Giunta: Doesn't make a difference. In both ways, it really...

Dr. Yoni Rosenblatt: Is that a no, is that a no?

Dr. Mike Giunta: Yeah. You do not necessarily make more money or less money depending on what pathway that you choose, and that goes for the other pathway too. We have people who just wanna pursue... They just wanna see patients all day, right? They don't like... 'Cause we give people out of their time... Time out of their schedule to do this, and so everything has an importance, everything has a value. There's people who are like, "Yeah, I don't wanna mentor, I don't wanna be a clinical director and manage people, but I like to see patients all day and I wanna pursue my OCS, I wanna pursue my FTS, I wanna do all of these things." Again, super valuable to the company. If you can be loyal to the company and be with us for 10 years, that's awesome. And that might come with the same pay rate as somebody who is a clinical director or a mentor or an analyst, or any number of these positions that we might create throughout the company. It's really working to eliminate that feeling in what is physical therapy as far as salaries go. I think we need to drop this stigma behind talking about that. It shouldn't be a secret that physical therapists make between $70,000 and $100,000 a year, right?

Dr. Mike Giunta: Certainly, there's outliers on both directions, but we need to make sure that we're talking about that and then talking about some pathways. If you wanna earn more, great, let's talk about how you can do that. If you're kind of cool where you are, okay, then we're gonna talk about how you maintain that. So I think this is about that transparency in your company and making sure that you're having sometimes difficult conversations with people. I think that they're better off for going through and having somebody give them that real talk.

Dr. Yoni Rosenblatt: Yeah, I love the way you say that 'cause I think it's so important and I think we gotta get out of the mindset of a therapist saying, "I feel like I am worth X." Right? Well, I always ask the question, "Okay, why do you feel that way? And why are you worth more than someone else who's doing the exact same job?" So we pay for roles and responsibilities. Now this role gets paid this, that role gets paid that. You wanna come up with a different role? Thank you. That is awesome, and I'm totally flexible and open.

Dr. Mike Giunta: Yeah.

Dr. Yoni Rosenblatt: Just bring value. I would love to pay you for the value that you're bringing, and it sounds like that's what's going on at Evolution, where the value... You're absolutely right. The OCS, the ACL, all that stuff is bringing value, so is mentorship. I'm sure the analytics, and you're gonna tell me exactly what that means exactly, but it's bringing a certain type of value, and so with that comes reimbursement or compensation, right? Tell me about this analytics position. That sounds cool.

Dr. Mike Giunta: Yeah. It's again, another one that we've kinda developed over time based off of we've done some just, I guess, personality testing. No, personality is kind of the wrong word. Professional development testing with most of our physical therapists, especially the ones in leadership roles in our country... In our company. And starting to understand a little bit more about how they work and what they're most suited towards. And so we had kind of this analytics role come up and it's really somebody who really likes to dig into the numbers, just somebody who just wants data in their face all day, is really comfortable using Excel spreadsheets and that sort of thing. And it's been a role that's been very useful in helping us understand all these different reports that our EMR system spit out at us. They're not all just clear like, "Use this for X, and then do this for Y." You kinda have to dig into them a little bit more and understand them a little bit better. And to me, there's no better person to do that than a physical therapist because they can understand it from the clinical side of things and how that relates back to the business.

Dr. Mike Giunta: So we use this analytical position, both for our physical therapists and kind of how they develop them, how to identify if maybe there's problems in their clinical skill sets that we need to go over them a little bit more, increase their mentorship, something like that. We also use it for our front office staff. How are we performing there? How can we do a little better? How are we talking with patients? And I think it just helps us identify those things a little sooner than what we have in the past. I'm not shy to say, for myself, as a physical therapist, and I'm pretty open with this about... Even in my interviews, I'll tell new grads the story that, it took be about four years, man. I don't know how long it took you, but there was a very pivotal point in my career where so many patients were canceling off my schedule and I would overload my schedule because I knew people were canceling and then I kinda like figured out how to get to a certain number of people that I was comfortable seeing. And I used to blame the patient like, "Oh, I just got a bunch of shitty patients. Like, what's going on?"

Dr. Mike Giunta: And then I looked in the mirror and I was like, "No, Mike, it's something that you're doing that's causing this to happen and causing people to cancel off your schedule." And there's a couple of little tweaks that I made in my evaluation process, in my treatment style and all of a sudden nobody was canceling off my schedule. And I didn't get any formal mentorship. I was kind of just learning from the people around me. I'm sure... I don't know if you went through that or if you got mentorship, but I know there's a lot of people out there who didn't. And so if there's any way that we can close that gap for people, whereas if it took me four years, but it takes somebody else a year or two years or something like that, that's such a big win, because it's not just a win for the company, but it's a win for the patients. It's how many people who'll... Do I look back where I'm like, oh, crap? Knowing what I know now, I would have done X, Y, and Z, and I would have got so much better so much quicker. But hindsight to 2020 and we just have to learn and then go through that process.

Dr. Yoni Rosenblatt: It is. You're describing what Tim Stone, one of my favorite physical therapists refers to as the Snow Day Test which...

Dr. Mike Giunta: Awesome guy.

Dr. Yoni Rosenblatt: Happens in California, right? But when... Awesome guy. When it snows, are your patients showing or are they just so quick to fall off? And how do you develop, whether it's the clinical acumen or the interpersonal acumen, how do you be in that part between those people's ears to say, "Man, I wanna be there, I wanna be at True Sports or at Evolution with Tim, with Mike, so that I'm getting care." So I think that's what you're describing. I love the way you put it with, how many more patients are you gonna help if they actually show? And also how much are you gonna help that therapist, Mike? If you can teach that therapist how to lessen that learning curve as to how to get to the Mike with four years experience, what a service you're doing to your therapist. So that's really awesome. I'm dying to know those tidbits. What did you change?

Dr. Mike Giunta: Yeah, I think a lot of times it comes down to soft skills. We all take the relatively similar exams as your entry way into physical therapist. You kind of learn your processes, you learn your rules that you follow as you're going through, but what you're talking about, that Snow Day Test, I think that that really comes down to instilling that confidence in your patient that you're their person, you're there to help them get better, and they need to trust you. And I think that that comes down to a lot of soft skills that unfortunately we don't really develop much in school. I think you start to develop them a little bit in your clinical rotations, but experience is what does that for you.

Dr. Yoni Rosenblatt: But you looked in that mirror four years in, you said, "I gotta change a couple of things." What were those things? How did you build that trust? Do you remember?

Dr. Mike Giunta: Yeah, absolutely. It started in the evaluation, and for me, it was laying out the plan of care on day one for somebody. I think that that was the single most important thing that I did, because I think before that I was... Not that I was guessing, but I was kind of taking things as they come. And you hear quarterbacks or point guards talk about this all the time, whether they're in the NFL or NBA, the game slowed down for them as they get more experience. I think that that's what started to happen for me. Like the game slowed down for me a little bit, and I was able to see past that initial... Past the first pass, so to speak. And I would explain that to patients and I would say, "Hey, here's what we're gonna do on day one. Here's what we're gonna do in the first couple of weeks. When you hit this milestone, I'm gonna move you on to this, and then we're gonna keep on going from there." And that for me, actually led them all the way through joining one of our fitness services. And again, for the people out there that don't know much about Evolution Physical Therapy, how we work, but we're not...

Dr. Mike Giunta: We're generally not just the physical therapy side. We're also the fitness side as well, where we have group memberships, personal training, poolaties, bunch of different ancillary services. And I would walk people through that whole process, so by the time we got there, and it was time to say like, "Hey, I think you should grab one of these fitness memberships and continue on with our personal trainers," I had already pre-programmed that in their mind that that is actually what success meant. Success was not just getting out of pain. Success was actually making it all the way into one of our ancillary services that now they continue on forever. I walk into some of my clinic now, and I see patients in there who I treated in my first, second, third year out of physical therapist who are still coming as a group class member, and that's 13, 14 years ago, right?

Dr. Yoni Rosenblatt: Yeah, that's awesome.

Dr. Mike Giunta: That's such an awesome thing to see and stay connected to those people.

Dr. Yoni Rosenblatt: Yeah, that's great advice, man. That is great advice, and I think if there's... Those listening at home, if there's one thing you can take away, that explanation and the way you encapsulate the entire plan of care is so crucial. I would add one piece to that maybe, which would be, if you can tell them, "Here are the potential obstacles to your success. You don't get that knee straight, here's what could happen," and then they can then recall. They could see it coming, right? It's almost like you're predicting and because you're predicting what's gonna happen, you're gonna pull down those barriers to get in. That just further enhances, and increases and lets the patient know like, "Hey, it doesn't have to be a straight line from pain to no pain." Right? I think goes a really long way.

Dr. Mike Giunta: Absolutely. Yoni, you just gave the physical therapists out there a cheat code, right? That's what it feels like when you get... When somebody tells you these things, a physical therapist or another physical therapist and how you can use it with a patient, it's a cheat code, and I think that that's what you're giving to your patients when you're identifying potential barriers, potential issues, because as soon as they start coming up with those excuses, they're like, "Oh no, PT already called that one out. Now I know that I can trust them. They knew this was coming. I'm at the spot and I'm gonna choose a different pathway for myself so I can continue to get better." So I love that. It's huge.

Dr. Yoni Rosenblatt: It's awesome. Okay, so you have your mentorship, you have your analytics, which is a super cool position. Any other recent positions kinda open up in the Evolution tree?

Dr. Mike Giunta: There's people certainly dabbling in a few. There are some people who are dabbling in some politics stuff, policy change, that sort of thing. So I see them popping up on our internal communication devices saying like, "Hey, sign this bill, send this out to your Congressman," like that kind of stuff. I think that's a really important one for private practice and how we're continuing to go through this thing. So we'll see if that develops into something larger for that particular person and how they kind of work through that. Leadership positions, and when I say leadership positions, I don't mean from a clinical director perspective or from a mentorship perspective. I mean people who are helping teach leadership to our company. I think that's, again, something that is pretty innate in some people. It's not innate in all people. It's learned in a lot of people. Some people just have it, and I think using those skills... Again, I don't care if you're not the clinical director in the clinic. You can still be a leader in that clinic, and that means a lot of different things to a lot of different people. So identifying those people, identifying those skill sets and trying to figure out how we level set that across the company is really important. And then I think that there's...

Dr. Yoni Rosenblatt: Your company at this point is across the country, so it's not such a bad slip.

Dr. Mike Giunta: Yes, it is. [laughter] And oddly in states that start with the letter C, I don't know what complex that I have that decided to keep that going, but Carolina may be our next.

Dr. Yoni Rosenblatt: Yes. Oh, it's Carolina. So I was gonna go Chicago. Okay, okay. So tell me this, well, answer me this, what happens when a clinician says, "Mike, I'm gonna be an awesome clinic director, I'm gonna be an awesome analytics," and you're like, "You're not good for that position." How do you handle that?

Dr. Mike Giunta: Yeah, I think, again, it's the importance of having really regular conversations with your staff and knowing a lot about them, because if it got to the point where somebody really felt like they were awesome for that role, and I hadn't intervened before that to try to help steer them in a different direction, I would think that I missed something in that process. So I think that there is a lot of importance of regular check-ins. I think maybe it's the norm. And a lot of companies do like a yearly review or something like that. We make it a point to check in with all of our physical therapists once a week, and then we do a little bit more of a serious check-in every quarter with them to really make sure that we're establishing goals, making sure that those goals are obtainable and making sure that we're working towards them. So I feel like we would catch some of that a little early on and then kind of relay that up the chain, down the chain, whatever it may be and start to come up with an intervention strategy to figure out what that person could do instead, because I think that's the thing.

Dr. Mike Giunta: It's like it's never a no. I think it's like, "Okay, well, if you want to do that, here's some books to read. Here's some training that we need to do with you to see if that happens." Again, you said it before, I've made mistakes at putting people in the wrong roles, and sometimes that happens, and I would assume that that's going to happen again, but the key is how do you... If you make that mistake, how do you pivot out of it? How do you stop from making the mistake? Those are things that I think we're learning every day, and just like our identification process of that. I'm not sitting here and saying that we're spot on, saying that we're making the right decision every single time. But I think we're... Even if we make the mistake, we're able to identify the mistake and then start to figure out how to get out of it.

Dr. Yoni Rosenblatt: Yeah, I'll give you a very clear example of the mistake that I made, was hiring specifically because a therapist played a sport at a very high level. I used to think like that was the most important thing in the world. I wanna hire a D1 basketball player so he can treat that other basketball players. I look for it, but it's not an end-all. So that was a clear mismatch. Another thing was graduating from highly ranked institutions. I think I learned that even quicker what a mistake that was, which is why I almost cringe when I call someone's reference and they say, "Oh, they're so smart." I'm like, argh. I'd rather dumb. Tell me they're dumb 'cause they're gonna do better. [laughter] But those are mistakes that I've made. I share that to hopefully make it a safe space for you to tell me a very concrete mistake that you've made, either business wise or clinical wise.

Dr. Mike Giunta: Yeah, this is fun, man. It's... We get on here and we just talk about all the mistake that we made out there.

Dr. Yoni Rosenblatt: How crappy we are.

Dr. Mike Giunta: We're very... Yeah.


Dr. Yoni Rosenblatt: It's easy. I just think it's easy.

Dr. Mike Giunta: Yeah, it is. When you identify them, it's gonna... And honestly, also creating that space, it opens up for people to understand like, hey, mistakes are gonna happen. It's okay. It's how you get out of them that really, truly proves how you kinda make the next thing work for you. So I think putting people in positions that we talked about before is certainly a mistake, but I'll tell you probably the main one that I've made when it comes to the hiring process and it's hiring out of need versus out of want. And I think that those are two very different things that, again, different spaces that your company can be in and because the majority of the PT hires that were mistakes that we've made, when I look back, it's like we just needed a physical therapist so bad and then we just pulled the trigger on somebody because we're like, "Oh crap, we're losing money because we have all these patients that we need to get in and we need another physical therapist." And first person that comes down the pipeline, we're like, "Hey, if you're gonna say yes to me, I'm gonna say yes to you, and we're gonna kind of get you in this fold."

Dr. Mike Giunta: And that honestly has every time bitten us in the ass, and I think now from a recruiting perspective, we try to actually stay a couple of therapists ahead of the game. We don't necessarily need a physical therapist, but when we find the people that we want, we're like, "Hey, join our team. We think that you're gonna be great. Hop on board." Because I think then we get a better product in the end. Again, it's sometimes a little harder in the wallet. It's a little harder in the growth trajectory, but I think when you look at that over time, you're always happier that you had somebody who you wanted in a place rather than trying to figure out what to do with somebody who just doesn't fit with your team, and figure out what the next steps are there.

Dr. Yoni Rosenblatt: Yeah. I think that's really good advice. I've definitely been there. When you're telling out this priceless advice, what advice do you give to maybe a smaller clinic that's just beginning to think about offering other opportunities, larger career ladders or other career trajectories? What should they be thinking about first and foremost?

Dr. Mike Giunta: I think that they should be very introspective in what they want. I think that that's important. When you're thinking about even a passion project for yourself, I think it can take time to develop that. So we're not normally asking people who are three months out of school, like you need to identify the passion project right now, and you need to figure out which wrong of this ladder you're gonna climb right now 'cause I do think it takes time to develop that. So I do think that they need to be really introspective with themselves about understanding what they really like. And I like this question 'cause it was asked of me in the business space, but it's, how do you want to spend your day, right? Asking yourself that question and figuring out the answer to it, that might mean like, "I wanna treat these types of patients." It might mean like, "I want 20% of my staff to be working on management and business stuff, or 20% of my staff to be working on mentorship and education." Figuring that out and how you want to spend your day will be mentally important to how you carry yourself throughout your career. So those are the main things that people should be thinking about as they're starting to develop into, I guess, the career trajectory that they're trying to accomplish, and then they need supportive people around them to help encourage them to kind of lean into that stuff. So those are probably the full circle things that they need to go through.

Dr. Yoni Rosenblatt: Mike, the reason I like that answer from what you just said is it's exactly what you did when you were starting out. You looked at all the things that were kind of available to you, you looked at what you wanted, and you made the decision, "Hey, I wanna go down this path," and that is all you're asking your therapists to do, that's all you're asking your team members to do, is just that, take a step back and realize where you wanna go with your career. And then the only thing maybe that I would add to that would be, figure out how you're gonna get there and not just expect it to happen. And it sounds like you do a great job of... And I don't mean this in a denigrating way. You hold the hand of the therapist to help them get to whatever it is that they wanna get to, and that's the beautiful thing about what you've created at Evolution with these career ladders. Does that sum it up? Don't let me put words in your mouth.

Dr. Mike Giunta: Yeah, no. I think you said it right there, is we give them the tools that they need to make it happen for themselves, and then we support them to make it happen. And I've said this for so long that I feel like there's so many really great physical therapists out there in the world, in this country, all over the place, but I don't think that there's a lot of really great physical therapy systems out there who help encourage their therapists how to continue to grow. A lot of them help them grow in the way of being a physical therapist, but how do you grow in these other ways? How do you make your life really fulfilling and meaningful and all of those things? That means something different to every person, and so if we can be a small part of that, if we can be even just kind of like the open ear saying like, "Let's talk about it, let's figure out how to make this happen for you," then I'm all for that, I'm all for making that happen for people. Not everybody is the same when you have a big company. We're up to maybe 60 PTs at this point. Not every one of them wants to do the exact same thing, so I think it would be a disservice to our physical therapists if we weren't trying to do this and weren't trying to figure out how to allow them to keep growing. And again, I'll say this, and I mean no disrespect to physical therapists who are a bit older out there, but I don't see too many 65-year-old physical therapists, right?

Dr. Mike Giunta: What are they doing? When you get 15, 20 years into this career, you see so many people transitioning on to other things that are outside of the clinic, or they're only doing top level management, that kind of thing, and it's like, how can you continue to grow as a physical therapist? If you still wanna be treating patients, like let's have you keep treating patients. If you only made that other decision because it was gonna affect you in the pocket book, how can we change that for you? How can we make something different happen? How can we build a different company that allows you to do that? So those are all really important things for me.

Dr. Yoni Rosenblatt: Yeah, that's really clear. That's really cool. Mike, I always like to wrap up with a little bit of a lightning round. So just give me those answers as soon as I'm done asking the question. You ready?

Dr. Mike Giunta: Yeah.

Dr. Yoni Rosenblatt: Who is the best Lacrosse player you've ever seen play? Mike, no deep breaths, no pausing.

Dr. Mike Giunta: God, that's so hard.

Dr. Yoni Rosenblatt: Just you answer. I ask, you answer.

Dr. Mike Giunta: Argh! Yeah.

Dr. Yoni Rosenblatt: One name.

Dr. Mike Giunta: Paul Rabil.

Dr. Yoni Rosenblatt: Argh. Okay, fine. Okay, biggest celebrity you've ever met? Don't say Paul Rabil.

Dr. Mike Giunta: Yeah, no. God, Sean Kingston.

Dr. Yoni Rosenblatt: Sean Kingston. Everyone knows Sean Kingston. Famous for... You know Sean.

Dr. Mike Giunta: "Beautiful girl" Jamaican hip-hop. Let's go.

Dr. Yoni Rosenblatt: Jamaican hip-hop. Okay, should've known that. Okay. I figured like California, you would have pulled like... I don't know. Like Steven Tyler or Mick Jagger. I feel... Okay, Sean Kingston, Mike?

Dr. Mike Giunta: Sure. No, not... That's a pretty big rapper. We gotta also stay HIPAA compliant here right now.

Dr. Yoni Rosenblatt: That's fair. Okay. Fair. Also, shame on me for not knowing Sean Kingston. Apologies. Okay. Best...

Dr. Mike Giunta: You're gonna look up his song and you're gonna be like, "Alright. Now I know."

Dr. Yoni Rosenblatt: I'm doing it right now. Okay, best advice to a new graduate physical therapist?

Dr. Mike Giunta: Figure out what you're passionate about and do that every single freaking day.

Dr. Yoni Rosenblatt: Love it. Best advice to a new private practice owner?

Dr. Mike Giunta: Learn what you're not good at and put other good people around you that can help you figure that out.

Dr. Yoni Rosenblatt: Yeah, create a team. I love it. What does PT look like in 10 years?

Dr. Mike Giunta: I think it's a big blend between strength and conditioning and rehab services. I think you walk into a place and you don't know who's doing what, and people are respecting each other both ways and everybody's doing it for the best interest of the athlete.

Dr. Yoni Rosenblatt: Love it. Best book you've read in the last five years not written by Jocko Willink.

Dr. Mike Giunta: "The 4 Disciplines of Execution."

Dr. Yoni Rosenblatt: By?

Dr. Mike Giunta: By whom? I'm looking at my bookshelf to see who the author is. I'll have to get back to you on that.

Dr. Yoni Rosenblatt: Great. Okay, advice you would give to a 26-year-old Mike Giunta?

Dr. Mike Giunta: Stay the course, work hard, say yes to opportunities.

Dr. Yoni Rosenblatt: I love that. Say yes to opportunities. Okay, parting advice. The last thing you wanna share with all of the sports PTs across the country that are listening to this.

Dr. Mike Giunta: Learn multiple systems for treating patients. Don't pigeonhole yourself to one way of thinking because you miss all the people that don't fall into that system. So I definitely encourage you to develop your own system that's made up of all these different ones that you learned over the course of your career, and never stop learning. Keep on, that you can learn something from every single person. Multi-disciplinary approach is always key. I take something from every single situation that I'm in. I'm so thankful for all the other physical therapists out there that I've learned from. There are certain physicians who have taught me nothing about the medical... They taught me about medical, but I think the most important thing that they've helped talk to me or teach me is how to talk to patients, and those were some of the most invaluable pieces of advice that I've ever gotten. So I think you just have to keep your ears open, listen to different people and make sure that you're taking something from every single situation you find yourself in, even if you think it's a waste of time, turn that attitude around and figure out what you can take from it.

Dr. Yoni Rosenblatt: Mike, powerful stuff, outstanding tidbits, unbelievable knowledge that you just shared with me, shared with the entire audience, hearing that you are up to 60 physical therapists with practices across the entire country, and that you still sound hungry as ever to grow and to improve. And really your approachability since I met you, just unbelievably approachable, open, transparent. Speaking of transparency, I just went through an hour of technical difficulties and there's Mike Giunta just patiently waiting for me to return once I get the internet back up and rolling. The humility really knows no bounds, and I really appreciate. I appreciate your time, I appreciate all you've taught me, all you've taught the audience. Where can everyone find you on social and how do they get a hold of you?

Dr. Mike Giunta: Yeah, definitely. Always open to email, is my email. Super easy. My Instagram for the company is @evolutionptfit. My personal one is @mikegiuntapt, so all super easy ones to find. DM me, shoot me an email, all those sorts of things. We're kind of paying attention to everything at this point, and DM will come through. I love connecting with new physical therapists and even if nothing else, just kind of learning about their stories and understanding more about them. I have this philosophy that none of us physical therapy companies out there should be really competing with one another. We should really just be out there helping teach people what physical therapy is, because if we do that and we do that really well collectively, there's gonna be plenty of patients out there for all of us to treat, because there's so many different things that we can work on with these people.

Dr. Mike Giunta: So that's really important to me so that the more people that I can get in front of and kind of share that vision, share that understanding, even if they don't work for my company or a company like True Sports that I obviously really respect and admire you and everything that you've done, and all your physical therapists that you have there, maybe they can take that philosophy to a different company and help some more people and help some more people understand how we can really enjoy this, 'cause the PT profession it's a weird thing. It's a weird world that we've gotten ourselves into, but it can be really fun if you let it.

Dr. Yoni Rosenblatt: Yeah. Good advice, dude. Mike, as always, thanks for your time. I can't wait to keep learning from you. As always, I'm gonna ask you for a favor. Please listen, learn and share our content and leave us a five star review wherever you consume your True Sports Pod. That little act of kindness will go a very long way to helping us and helping our profession. You can reach out directly to me with feedback on the pod, what you loved, what you didn't love, and who you wanna hear from. Also, if you wanna join our team of outstanding sports PTs, shoot me a DM on Instagram @truesportspt, or email me directly, Yoni, because after all, this is what sports rehab should be. Look forward to hearing from you also.


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