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July 26, 2023

How to thrive financially and clinically in private practice with Dr. Andrew Livington

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Dr. Yoni Rosenblatt: Today's conversation with Dr. Andrew Livingston is an eye-opening one. We cover how to afford life while treating elite level athletes in the outpatient setting. Andrew has done an awesome job of getting a very high level education and then getting out and trying to figure out and navigating the waters of how to pay off that education, living the lifestyle he wants to lead and achieving the financial goals he set out for himself all while treating the population that he's dying to treat. And he will talk very specifically about how he managed those things and then how he chose to grow within the company to take on more responsibility, to expand his earning power, and ultimately his job satisfaction. There's a lot of nuggets in here that are super worthwhile and I think is just great to hear from a vet like Andrew Livingston and super applicable to physical therapists of all levels, of all styles.

Dr. Yoni Rosenblatt: And the truth is, any graduate from any high level graduate program needs to understand the economics of what it takes to go into their desired field and to achieve at a very high level, Andrew's gonna help us out with that. Without further ado, here's my conversation with Dr. Andrew Livingston. Dr. Livingston is a graduate of Lebanon Valley College, both undergraduate and their doctorate of physical therapy program. He played defensive end in there for close to five years. We dig into that. He then moved on to a sports residency at St. Francis University in Pennsylvania. And then he completed his SCS certification. He joined True Sports Physical Therapy right around 2019 as a staff sports physical therapist, and now has grown all the way up to a regional director overseeing clinics in Bel Air, Maryland, York, Pennsylvania, and Lebanon, Pennsylvania.

Dr. Yoni Rosenblatt: With plenty more to come. A lot to learn from Dr. Andrew Livingston. Wanna thank him for his time. And thank you guys for listening. This show is growing by leaps and bounds. We're always excited to hear from you, so please leave us a review wherever you're listening to pods, shoot me an email yoni, Y-O-N-I A lot of our topics are designed based upon the feedback that I get via email or direct message on Instagram truesportspt. Find us, hit us up, give us show ideas, give us feedback, tell us how we can get better at this so we can better serve you the Sports Physical Therapist. You're gonna love this conversation with Andrew Livingston.

Dr. Yoni Rosenblatt: Welcome back to the True Sports Physical Therapy Podcast. I got Dr. Andrew Livingston here with us. Welcome.

Andrew Livingston: Thank you. Happy to be here.

Dr. Yoni Rosenblatt: Liv, there's so much I want to cover with you. And even just in our prep for the show, there's so much I've already learned from you both about the field of physical therapy as well as you specifically. So I can't wait for you to share some of this with our listeners. To the thousands of sports physical therapists across the country and really across the world. Shout out to our Israeli listeners. Let's start with a massive problem within the field of physical therapy that it seems like you've really figured out. And I think the way you have tried to figure this out and have figured it out is gonna be enlightening to all of our listeners. So here's the problem I see with the PT profession that the entire thing is upside down. You pay a tremendous amount of money to get your doctorate degree. You come out of graduate school and I don't understand how we are expected to pay off our loans or really just make enough money to support a given lifestyle with, it's just not straightforward and that's why I think the whole thing is upside down. Now, I was lucky enough to interview you for your first role here at True Sports and since that point you've kind of figured that equation out. So talk to me about how you solved for how much you can earn versus how much you seemingly owe to get this degree.

Andrew Livingston: Yeah, so like you said, the whole thing is pretty backwards and what is expected of us. So I don't know if I figured it out, but there's a different, there's a bunch of different strategies you can use to figure out what the game plan's gonna be for paying back loans. Really the two main strategies that most people work on right now are either living at home, keeping your expenses to zero, and then putting everything you have into those loans to pay them down as fast as you can. That's not realistic for everybody. The other end of it is push all those payments off as long as you can and take out a refinance to get shorter, I'm sorry, longer payment timeframes but lower out of pocket in the now. For me, I think early on I tried to do the first. So I tried to really live minimalistically and...

Dr. Yoni Rosenblatt: You did that amazingly. Give me an example of you living minimalistically. That's the word.

Andrew Livingston: So this was residence [laughter] In residency I was making 32K. I was living in Crescent, Pennsylvania. Rent for a one bedroom apartment was 450 a month. Different time. [laughter] It wasn't a great town. It wasn't the worst anyway. I knew I was getting paid. I had to also pay at that point, one of my private loans back 'cause private loans didn't care if you were in residency or not. You couldn't defer it. At least that, that one at the time. And a big piece of me living as best I could was keeping shopping to the minimum. Groceries, shopped at Aldi. Shout out Aldi. I need to get a sponsorship.

Dr. Yoni Rosenblatt: Big sponsor. They're a big sponsor of the program. Thank you. Aldi, [laughter]

Andrew Livingston: And I didn't do anything. I mean, at the same time with residency you're working 60 hours a week anyway, and then doing we stuff on the weekends too, so there wasn't time for me to actually spend a whole lot of money anyway. And at that point too, I didn't have a whole lot of knowledge on finances really at all. So that was also when I started learning a lot different podcasts and really through the internet on how to manage money at that point. How to plan for the future, how to take advantage of the money that you did have, make it work for you, and try to figure out the big ways to get ahead at that stage in my life.

Dr. Yoni Rosenblatt: So. Okay. Let's take even a step back further that, 'cause obviously you were figuring that out with residency. You go to LVC, you thought you wanted to be a PT but didn't get into a program right outta college?

Andrew Livingston: Correct.

Dr. Yoni Rosenblatt: Right? 

Andrew Livingston: Correct.

Dr. Yoni Rosenblatt: You get to LVC to play football.

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: Lebanon Valley, Division III Dutchman.

Andrew Livingston: Flying Dutchman.

Dr. Yoni Rosenblatt: Flying Dutchman. Everyone knows that. And so while you're there, you're a crim major. And then walk me through what happens there. 'Cause I think that's an important beginning.

Andrew Livingston: Yeah. I went in, didn't get accepted to any programs, so I went to play football really, and tried to figure out what I wanted to do at that point. Everyone on the team was a criminal justice major, so I figured I would just join that.

Dr. Yoni Rosenblatt: Okay, but Liv, you're a smart ass, dude. You went to residency, you're an SCS. How is it possible you didn't get into a program outta college? Or, sorry, outta high School? 

Andrew Livingston: I was in a smaller high school. I wasn't top of my class. I was probably 20, 25th. Other than that, I know I had observation hours.

Dr. Yoni Rosenblatt: How small is this high school? 30, 30 people. And you're 25th?

Andrew Livingston: 250 in my class.

Dr. Yoni Rosenblatt: Okay. So not bad.

Andrew Livingston: So not, not huge, but not small. I don't know. I had observation hours. I don't know why I really didn't get accepted. My SATs weren't super high back then. Everyone really relied on SATs before COVID kinda kicked that out. So I don't know. Anyway, I didn't get in so didn't know what to do. Just went to school to play football and figured I'd figured it out at some point. During my freshman year, I realized this wasn't what I wanted to do at all. And I didn't want to go through college not knowing, knowing that I didn't try to at least get into PT school in the backend. So I switched to biology major 'cause it was the most, closely that closely matched the prerequisites for PT school. And that was honestly harder than PT school itself at that point.

Dr. Yoni Rosenblatt: What was your backup plan? You come out with a bio degree, you don't get into grad school. What are you thinking?

Andrew Livingston: I don't know if I had one. Don't know if I had that.

Dr. Yoni Rosenblatt:
It's XFL.


Andrew Livingston: Definitely wasn't that.

Dr. Yoni Rosenblatt: Definitely not the XFL.

Andrew Livingston:
Definitely wasn't that.

Dr. Yoni Rosenblatt: Okay. So bio major start things start going well. You're like, Hey, maybe I'll be able to get into LVC. Are you thinking at that point? 

Andrew Livingston: No, because my GPA wasn't high enough. So my GPA at the time was like a 3.4, and most PT programs wanted a 3.6 or a 3.8 to even apply. Ended up applying to a few. Anyway, I got two acceptances. One was a new program, so it was kind of risky. The other wanted me to take a anatomy class in the summer, which was about $2500. I didn't wanna do that. And then LVC took a chance on me somehow. And I was one of the three, grad transfers that came into the program. And they based that off how many people they lose through their first undergrad portion of that program.

Dr. Yoni Rosenblatt: So they've already accepted a certain amount. If someone falls out, then they're like, okay.

Andrew Livingston: Correct. We have room for two more, three more. There's one year that didn't take anymore because not enough people failed out. That was what happened at that point.

Dr. Yoni Rosenblatt: There has to be some secret there or something that you did. Like, what advice would you give? There's so many people on that bubble. How do you push yourself to the front of that line?

Andrew Livingston: I think just make as many connections as you can.

Dr. Yoni Rosenblatt: So like what, who not who was that by name, but who was that by role that you were trying to connect with?

Andrew Livingston: I, when I was first there and I wanted to switch to biology, I wanted to switch to exercise science. You weren't allowed to fun fact at the time because it was reserved for PT students only. So I talked to a lot of the faculty at that point. So they knew who I was, they knew what I was trying to do. I think that helped. 'Cause they knew I was a motivated person three years later trying to get into the same program. I had recommendation letters from a lot of different people. A couple mentors that were PTs at the time too, that came from LVC that helped. I had one year of eligibility left. I somehow had a decent, junior year redshirt junior year. So I had another year to play. My coach maybe pulled some strings for me too. All those things I think led to me having the opportunity to get into LVC's program at that point.

Dr. Yoni Rosenblatt: So you played football your first year in grad school? 

Andrew Livingston: Yeah. Yep.

Dr. Yoni Rosenblatt: How the hell did you manage anatomy? 

Andrew Livingston: Well, anatomy was in the summer, so I had the anatomy class before all that started. But the semester itself was 8:00 AM to 3:00 PM was in class in lecture, and then from 3:30 till 6:00 was in practice and then went home at 8:00 and studied and did it all again the next day.

Dr. Yoni Rosenblatt: Which is a joke compared to what you do now. So that must have been really easy. [laughter] Okay. So you beg, borrow and steal your way into graduate school at LVC.

Andrew Livingston: That's a good way to put it.

Dr. Yoni Rosenblatt: But it worked. And your advice there, just to sum that up, is you started networking from a really early young age, you realized it's not what I know, it's who I know. And you started just trying to know people and you happen to be really good at that. That gets you into LVC. At what point, do you realize how am I gonna pay this off? Or, did that not cross your mind? 

Andrew Livingston: So coming through high school and even to college, everyone was very much like, oh yeah, you'll pay it off later. Like, don't worry about it now. Everyone does this, they pay it off later. I didn't really understand it until I was taking out grad school loans on top of the loans that I already had. And at this point I had a little more wherewithal from being 17 to being, you know, 21 of, wow, that's $35,000 every single year now that I'm pulling out at a six and a half percent interest rate. And oh yeah. I had a $75,000 loan from four years ago that had a 6% interest rate that I haven't touched to, not to mention, I forgot, not forgot, but didn't realize that the government also had, when they say you have, you know, federal student loans, those are loans too. And so those that didn't really cross my mind until I was in grad school either. So while I'm in grad school, I'm considering all these things as I'm paying rent and working at the same time and coaching and playing football and a lot of these things are going on trying to figure out how to start getting ready for those bills to hit because I knew at some point it was gonna come.

Dr. Yoni Rosenblatt: Yeah. But then you make an insane decision to make 32 grand a year doing residency.

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: So I guess my question around that was, what the hell were you thinking? How's that for, is that a good question? 

Andrew Livingston: That's a great question.

Dr. Yoni Rosenblatt: Thanks. Were you thinking?

Andrew Livingston: Really open-ended. Yeah. I knew my passion for wanting to be in sports was stronger at that point than it was for the thought of paying off those student loans for better, for worse.

Dr. Yoni Rosenblatt: Okay.

Andrew Livingston: And I knew where I was in my career at that point. I didn't have what I needed to do that well. And so residency for me was kind of the only in my mind at the time, the only answer for me or else I'd be stuck in a mill that I didn't wanna be in with no way to separate myself from Tom, Dick or Harry.

Dr. Yoni Rosenblatt: Did anyone try to dissuade you from residency? 

Andrew Livingston: Yes. I had a lot of people wanting just to get me into a job. Connections that were around me just wanted to get me into a job, which I appreciated. But didn't have passion for. I was one of the only, I was the only one in my class that did residency I believe, coming out. So it was very like me talking to a couple mentors on what the heck do I do next? And how do I apply? Like what is this? That was kind of where I was.

Dr. Yoni Rosenblatt: Okay. So far you've only spelled out the worst case or the best example of how upside down the system is.

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: Because you just keep accruing debt. Right? 32 grand. You're paying, for 32 grand, you're making in residency. You're paying 450 bucks in rent, you're living real slim. What the hell is your plan then? 

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: How do you get out? 

Andrew Livingston: So my plan at that point I wanted to obviously get a job in sports. I had a couple offers the best fit and honestly the best offer was here at True Sports. So that made the most sense to me and I was really passionate about that opportunity and was really good fit. So that's where I kind of started with, well now I just doubled my income this is luxury now. So then it was like, what the hell did I do with all this "Extra money" that I wasn't living with before.

Dr. Yoni Rosenblatt: Gotcha. What are you doing with the loans at that point?

Andrew Livingston: So all but one loan was loans were in deferment. Because When you have a residency you can go into deferment. My one provider didn't care and they wanted their payments anyway. At that point, all of my loans turned on activated to start repayment. And I was paying at the time probably as I started here probably $1500 to $1700 a month in student loan payments.

Dr. Yoni Rosenblatt: And what's the length of that loan?

Andrew Livingston: And those I mean that one was 15, the others were 20 year loans.

Dr. Yoni Rosenblatt: So you're looking at about 20 years of paying, let's call it 1500 bucks a month.

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: And your thought process then is to do what?

Andrew Livingston: My thought process then was to throw as much money at that as possible to either A, shorten that 20 years to maybe 15. But also another point that I didn't mention is I didn't have, I wanted to refinance to get lower interest rates.

Dr. Yoni Rosenblatt: Yep.

Andrew Livingston: The messed up part is they look at your debt to income ratio and every answer that I kept getting was, your debt to income ratio is too high. So you don't make enough money to get a better interest rate to get yourself out of a financial situation even though you're making your payments and you're trying to do what's financially responsible and right.

Dr. Yoni Rosenblatt: So they see the future, they see the title of this podcast that the entire thing is upside down. The entire ratio is upside down.

Andrew Livingston: Yes.

Dr. Yoni Rosenblatt: They're saying we're not gonna support that. What do you think their rationale is on that? 

Andrew Livingston: Who's they?

Dr. Yoni Rosenblatt: They being the banks that wouldn't consolidate.

Andrew Livingston: I mean, it's riskier and if I'm looking as a bank perspective, it's riskier, right? I mean all this debt, how am I gonna make these payments? This guy might not actually pay his loans. Why would we give him an easier time? I think, you know, which it sounds backwards. It sounds kind of crooked, but if I look at it from a financial standpoint, I guess that makes some sort of sense.

Dr. Yoni Rosenblatt: It must, the banks are never wrong.

Andrew Livingston: They're never wrong.

Dr. Yoni Rosenblatt: They never make a mistake.

Andrew Livingston: They're the reason the world turns.

Dr. Yoni Rosenblatt: Yes. So, okay, so you cannot consolidate. You're making 75. You owe...

Andrew Livingston: Roughly 280 at the time.

Dr. Yoni Rosenblatt: 280. You're paying 1500 bucks a month. You're paying 1800 bucks a month for the foreseeable future. What's your game plan? Were you okay kind of going to sleep at night knowing that this was the arrangement?

Andrew Livingston: It wasn't so much that I was okay. That was the reality. There's no escaping that. You can get, you can go buy a car, you can't afford. You can buy a house you can't afford and you can get, you can go bankrupt and yeah, it ruins your credit for 5, 10 years, but you can get rid of that. You can, unless you die, your student loans are with you. So for me, my plan was, alright, I'm gonna hustle, make as much money as I can, pay these down to where my debt to income ratio is manageable. Refinance gives me more flexibility to have different strategies. And go from there.

Dr. Yoni Rosenblatt: What was that number that you had to get to?

Andrew Livingston: I don't know, every three or four months, I would try again. I would like dump and so that was what I had to pay. That's 15-17. That was what I had to pay. I would then, I would do Rover on the weekends. I would do random stuff. I'd watch people's dogs and houses. I would dump probably another couple hundred every paycheck, trying to get that number down.

Dr. Yoni Rosenblatt: Tell me what rover is?

Andrew Livingston: Rover is where you, it's an online service that you watch people's dogs or animals or whatever they have.

Dr. Yoni Rosenblatt: My wife had a dog at this point and I remember thinking in my head like, what if I just get leave to take care of this stupid ass dog and just bake it into your salary?

Andrew Livingston: I would've done it.

Dr. Yoni Rosenblatt: I know you would've done it, sicko. Okay, so you're hustling like crazy. Adding onto that 1800 bucks, then what happens? 

Andrew Livingston: So then I was able to finally refinance these loans. And so at that point there were six and a half, 7%, a lot of them. And I was able to spin them down into, I got lucky when I was refinancing, the market was really good. They were able to gimme like 3%, 3.5% interest rates, still it's an interest rate, but with half of what I was paying before. So at least it slows the bleeding on the return, the payments that you're making to the principal versus interest.

Dr. Yoni Rosenblatt: Yep. And then you keep contributing at the same amount? 

Andrew Livingston: Yeah, I kept contributing at the same amount. Knowing that I can always make it less and lengthen it if I needed to. But I didn't have any obligations at the time and so I knew I wanted to pay down as much of that as possible. My philosophy on that is changing a little bit now as I learn more about passive income and time and compounding interest and things that I wanna take interest in. So, but the nice part is because I put that work in four or five years ago, I can have more flexibility to do things now that I couldn't then. As much as I complain about having to make payments now at any point I can switch to making a lesser payment, take it out to a longer interest rate, have more cash flow on hand to do different things with that. So if I didn't do that earlier, I wouldn't have the flexibility to do that now.

Dr. Yoni Rosenblatt: Okay. So that makes sense. Let's get a little bit more granular, 'cause I went through this one time. Yeah. One time with my student's stuff. When you say, "Hey, I would try every however many months to consolidate my loans." What does that mean? What does that look like? What do you... Who are you calling?

Andrew Livingston: Rephrase that for me.

Dr. Yoni Rosenblatt: Okay. Who are you calling to consolidate your loans?

Andrew Livingston: Honestly was online. It was online with a bunch of different websites. So SoFi, Earnest were two really good ones. LendKey was a good one that helped me out early on. Those were the big three that I found really helpful. Early on, they were more flexible with PTs. They worked a lot of PTs.

Dr. Yoni Rosenblatt: And you just found them Google searching?

Andrew Livingston: I actually found them through... I can't remember the name. There was this guy that came into PT school and he was helping with this problem.

Dr. Yoni Rosenblatt: Cool.

Andrew Livingston: That's gonna kill me, I can't remember what it's called. He's expanded that business now and that he's doing really well from my understanding. His name's Joe, Joe something.

Dr. Yoni Rosenblatt: Find it in the show notes, Joe.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: We'll put it in the show notes.


Andrew Livingston: And he did all the... His wife was a PT. He told us his wife was a PT, had the same issue.

Dr. Yoni Rosenblatt: Yeah.

Andrew Livingston: He had connections with all these lenders that were "PT friendly." They gave more lenient interest rates on different things so, I found those lenders through his website and his services at the time, which were free at the time. I think he might charge a little bit now for them, but it's still pretty low monthly, like payment for what you're paying for.

Dr. Yoni Rosenblatt: And he... Or someone like him can guide you kinda through this process and has the hookup on the other side.

Andrew Livingston: Correct.

Dr. Yoni Rosenblatt: And maybe he's just like the middle man. Okay. So you get... You find that now you're working here and then you're thinking in your head what's the five year financial plan here for you?

Andrew Livingston: It was to either... It was to make as much money as I could in a sustainable way. Whether that was... At the time I didn't think about it. But moving up the ladder from a corporate standpoint, it wasn't on my mind but that's the route I ended up taking. I was also prepared to treat like crazy because I knew that's also part of our model too. Is if you wanna treat, you'll get reimbursed for the time that you spend on that. And so there was a point in my career where I just treated like crazy and I loved it. I love what I do, so it made that easier. I was ready to do either or both of those things to make that happen.

Dr. Yoni Rosenblatt: Okay. So that's unique. Did you compare it to, should I get a part-time job?

Andrew Livingston: That was a very short time. I looked at doing home health, like living here all my hours that I was out and just doing home health. I just... I hated the thought of that. It's good for some people. Some people do it and they do a really a great job of getting extra income from doing that. I just couldn't do it with where I was at mentally and...

Dr. Yoni Rosenblatt: Did you ever think of... Was there ever a crossroads where you were saying, with an outpatient salary, I'm not gonna be able to make a dent in these loans.

Andrew Livingston: Oh yeah.

Dr. Yoni Rosenblatt: Let me go home health or something like that.

Andrew Livingston: Yes. I thought about that and... But then I thought about how, well the residency would've been kind of at a loss for nothing. I would not have enjoyed what I do. I don't think I would be where I am now professionally. So for me it was... The thought was there, but I never wanted to pull the trigger on it 'cause I figured I'd find a way out, somehow another way.

Dr. Yoni Rosenblatt: And what's interesting is you did find the way out definitely at that point in our trajectory or history, I guess. We didn't have a clear delineated growth structure, right? It's not like, "Okay, here's a ladder you can climb and here's what you're gonna make and here's how you're gonna be incentivized." We didn't have that. You were kind of just like, right man, right place, willing to do anything. I feel like we had a clinic director leave and I called you and you're like, "Yep."

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: I'm like, "yeah, but it's in a clinic." You're like, "I don't care." So you... I think you just kind of saw the opportunity and just kept jumping on it. So now describe where you are today, what you do, and essentially how you earn a living.

Andrew Livingston: Yeah. So, my current title is regional director. I have also staff... Or I'm sorry, Sports Physical Therapist. That role is still important to me as well. I oversee facilities in our Bel Air office up in northern Maryland. And then our clinics in Southern Pennsylvania as well. So New York and Lebanon currently and growing. What was the second part of your question? 

Dr. Yoni Rosenblatt: Second part of my question is how do you earn a living?

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: Like, how are you compensated? What's the structure?

Andrew Livingston: The structure now is...

Dr. Yoni Rosenblatt: Whoa, you should know this.

Andrew Livingston: Yeah, no, I know. I'm trying to verbalize it in a way that is more concise. So I'm compensated now by improving the growth of our clinics and the efficiency of how we run things in the clinics that are in place now and the ones to come in the future.

Dr. Yoni Rosenblatt: Yep. Do you make a salary?

Andrew Livingston: I do make a salary.

Dr. Yoni Rosenblatt: Okay, good.

Andrew Livingston: Do make a salary.

Dr. Yoni Rosenblatt: Do you have a bonus structure? 

Andrew Livingston: I do have a bonus structure as well.

Dr. Yoni Rosenblatt: Okay. And then talk to me about medical, retirement, things like that.

Andrew Livingston: Yeah, all the great things about, obviously the bonus structure and then vision, dental, health insurance, all that's included, PTO, which is awesome that we have in place now that increases as you gain seniority in the company. Con Ed, which is fantastic. And then I know we're working on some different things in-house for Con Ed too. So there's a lot of pros with being where I am now.

Dr. Yoni Rosenblatt: Yeah. And my reason for highlighting that obviously is selfish because I'm very impressed by what True Sports does. [laughter] But also this is part of an entire comp structure, and it's one that doesn't really have a cap on it, right?

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: You have the ability to just keep... 

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: Earning and putting things under your umbrella appropriately. I like that because how the... How else are you gonna pay off or have a chance to really wrap your arms around this thing.

Andrew Livingston: And that was a big piece of it too, is having the ability to expand that. There's only so many hours in a day.

Dr. Yoni Rosenblatt: Right.

Andrew Livingston: So being able to do more with that time is what I'm banking on as we continue to grow obviously.

Dr. Yoni Rosenblatt: Yeah. And just to spell that out a little bit further. No longer, like you've done a great job of putting you in a position where no longer are you just compensated by treating the patient in front of you by your 24 hours a day, but now you're able to be compensated for management. Right? And so you earn more, as your PTs earn more. And so based on the entire profitability of all of those clinics underneath you, you're able to just create more opportunities for wealth aggregation.

Andrew Livingston: Correct. Correct.

Dr. Yoni Rosenblatt: Fancy way of saying, making money.

Andrew Livingston: That's a great way to put that.

Dr. Yoni Rosenblatt: Thanks. Well thanks for helping me design that type of plan. Now, what allowed you to have this growth mindset in trying to develop these roles with me? 'Cause that's what transpired.

Andrew Livingston: Yeah. I think a lot of it was just collaboration, right? It was the open expectation that we knew what we wanted to do, but how do we put it into a system that worked? And I think there was a period of a year or two where we had some growing plans with like, where do we take this thing? And how does it make sense for everybody involved? And I think we've gotten to a point where it works well. There was a lot of work that went into doing that. There was a lot of trial and error.

Dr. Yoni Rosenblatt: Yep.

Andrew Livingston: I think we hit a really good spot now with where we're at in terms of the structure of that, where it allows for, like you said, that exponential growth and now we have a good structure underneath of it.

Dr. Yoni Rosenblatt: Yeah. And I think credit to you and a lot of our therapists, which is having that growth mindset of saying, Hey, there's something bigger on the other side of this. And the patience to kind of see it through and being part of the solution versus being like, screw this crap.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: And so I think that has gotten to us, gotten us to a good place. I also hope couple years down the road we're gonna look back and be like, man, we're so much better off than we were then hopefully, 'cause we just continue to grow and have that mindset. So let's jump backwards a little bit towards your residency, because now you're, you, Andrew Livingston, starting to get back into the world of education, mentorship, you're starting up a sports residency within True Sports in collaboration with some other entities. So tell us a little bit about what you gained from your residency experience and maybe what you would've liked to have seen more of.

Andrew Livingston: Yeah. I had a really great opportunity to be in St. Francis University's sports residency programme. Back then it was on campus, so I got to do probably 35 to 40 hours a week in the clinic treating. And it was on campus, so a lot of their athletes as well as some gen pop. And then the rest of the time I spent either doing research, which was part of the residency, teaching in their PT programme and on the sideline with their division one sports. So I got a really broad experience with doing a lot of different things. I loved that for where I needed to be in my career. I wasn't ready to treat sports coming out of PT school, and I knew that full well. And so what it did for me...

Dr. Yoni Rosenblatt: How'd you know that? 

Andrew Livingston: Because I went to Exos. I had a rotation to Exos and I walked in the door and had no idea what I was doing. And people were talking about things that I didn't understand.

Dr. Yoni Rosenblatt: Like what? 

Andrew Livingston: Plyometrics and...

Dr. Yoni Rosenblatt: You're like, what's a plyometric? 

Andrew Livingston: Right. What's a plyometric? What do you do with an ACL who's outside four months? How do I progress them off of a banded TKE and how do I progress them off along our quad?

Dr. Yoni Rosenblatt: Yeah.

Andrew Livingston: And you have this, when I was at Exos, this was great. I had great mentors there, great staff, great performance coaches who I learned a lot from. And when I was, I started having a lot more independence there. And I had this really high level guy and he's like, okay, what's next? I'm like, I don't know. I don't know. And so those eight weeks there really opened up my eyes to understanding that I need more than what I had now. And I was only gonna get that with residency in my mind. I had a few mentors, but I needed to go through that in my mind to be where I wanted to be. And through that, I thought, and this is where I think some people fall into the trap of and not to talk down upon people who do this because I think it's, if you have the right reasons, it makes sense. I thought at the end of residency, I was gonna have all the answers.

Andrew Livingston: I quickly found out that I left residency with probably more questions than answers. But I think as a clinician and a professional, you'll always have that. You're always looking to find the next answer, knowing that you'll always have more at the other end of that. And so for me, I left residency with, in my mind a better idea of how to find answers I was looking for, know where those resources could be and if I didn't have them, I could find them. And so that's what in my mind for me, what residency did was it prepped me for the next step, even if I wasn't fully ready or knew everything that I wanted to know, I could get there. And for me, I wanted to get my board certification almost just more for me than, than almost anything else. And open doors later on for potentially teaching and different avenues like that.

Dr. Yoni Rosenblatt: Crazy to think that you don't get into graduate school first go. Right. You don't get into or you weren't necessarily prepared for sports world, so you kind of go the residency route. It just seems like the barriers to entry aren't necessarily predictive or indicative of the clinician you're gonna be.

Andrew Livingston: A 100%. 100%. Which is why when young clinicians and people who wanna do PT ask me about it, I'm super passionate about, look, I wasn't strong on paper. My GPA wasn't great, but I would do anything to get to what I had to do. I think that's a big difference on looking over resumes versus like getting into an interview. I knew that if I got to an interview, I would probably get the role or the position.

Dr. Yoni Rosenblatt: How do you convey that? How do you convey it on paper? How do you convey it in an interview?

Andrew Livingston: On paper I never figured it out, but, 'cause once I got, like I said, once I got, if I could get an interview, I was okay. In person, I feel like, I just connect with a lot of people. I don't know what it is. Not necessarily on a deeper level or anything, but I'm motivated. Like for me, I want to do a good job for me, the patient and everybody around me. I'm much more a team player than I am for myself necessarily. So I think people liked that. And so for me, it was way easier to get the role in an interview than hand my resume and I had a 3.4 GPA.

Dr. Yoni Rosenblatt: Right. I mean, I'm the guy who interviewed you, so I can definitely attest to that. And then watching you once you join the clinic, I think you're, you never want to jump to, "Yeah, I know that." And always willing to help out cover without your handout. Right. It's always, what do I need to do for the team? And I think that's made you a great leader too. I know those who report to you now would definitely attest that. Like, they see your grind and now they're gonna hear your financial grind on this pod if they ever listen to it [laughter], which is insane. But, I think that does go a long way. So it's just worth, it's worth noting man, like really the great surgeons that I have met, time and again, not all of them, they didn't get into med school the first time around. It's crazy.

Andrew Livingston: That's insane.

Dr. Yoni Rosenblatt: It's insane. And they're studs. And I see that a lot in the PT world also. It's not a given.

Andrew Livingston: Sure.

Dr. Yoni Rosenblatt: But it does happen. So I think it's like, don't be discouraged. They're just not testing the right things.

Andrew Livingston: A 100%. And that's the difference between academia and the reality of the real world is just, it's not always gonna show you what makes the most sense.

Dr. Yoni Rosenblatt: Yeah. And so, watching you kind of come along this journey, what year did you start here at True Sport?

Andrew Livingston: It was summer of 2019.

Dr. Yoni Rosenblatt: 2019. So you've been here four years.

Andrew Livingston: Yep. Four years.

Dr. Yoni Rosenblatt: And so I've gotten to see you number one when you first came in. I remember clinically, I think you were sound, you were rational. I remember giving you feedback like, dude, don't get too fancy. Right? Like, kill the basics first. And we had that conversation like once and then you started doing it, which is great. But then you started adding all this stuff that is not covered in grad school. The hiring, the mentoring, the reading a P&L, the understanding the business side of things. And that's been super impressive. So I wanna dig into that. You've made some really good decisions of therapists that you have brought on underneath you. What is it in those interviews that you're looking for to predict, this person's gonna be an awesome teammate?

Andrew Livingston: Yeah, I think early on when it was just one clinic that I was in, I looked for someone that could compliment what I couldn't do. And so I think that early on is how I built a really good team around what we were doing. As we start to scale and I'm looking for different people in different roles, I'm still looking for some of the same things that I think I looked for myself as I was interviewing. Passion number one, if you're not motivated to be here, I can't want it for you. Is it something that, is it a teachable thing or is it a non-teachable thing? I think I can teach you whatever you wanna learn from an academic standpoint, but if it's a social skill that's a little bit harder to teach, if it's a motivation thing that's hard to teach, unless I can figure out what you're motivated by. Those are honestly some of the biggest things that I look for. And then if you're from Lebanon Valley, you get some bonus points.

Dr. Yoni Rosenblatt: You got a lot of Lebanon Valley. It's crazy. I think you're right. I don't know where you got that, but I know I have struggled with clinicians or hires that I've made where I just felt like I wanted it more than them. And that's just, that is a massive hurdle to overcome. You're not gonna overcome it.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: I don't think.

Andrew Livingston: And I almost, I skim resumes just to see some background and start conversation points, but I almost get too hyped up over resumes because of the highlights. And then if I talk to someone, I'm just almost disappointed. Because it's not what I thought they were gonna be energy-wise. And I did that for a while, like when we were in White Marsh and I was looking for the right person at times. And I interviewed 10 or 12 people and none of them just made sense to me. I think it's 'cause I looked really hard.

Dr. Yoni Rosenblatt: How many of those did we hire?

Andrew Livingston: None.

Dr. Yoni Rosenblatt: Okay. Good. None.


Andrew Livingston: And it was because I looked so hard at the resume and I was so impressed by the resume and then I talked to them. And they were just duds on the phone and it didn't make sense. And so I was then in a negative mindset about that person. So I look a little bit now, but I want them to tell me about it as I'm like reading through it as I have it up on my computer and I'm on the phone with them or on a Zoom.

Dr. Yoni Rosenblatt: What do you have to see to call them back on paper?

Andrew Livingston: A DPT degree.

Dr. Yoni Rosenblatt: That's it? Do you care where they went to school?

Andrew Livingston: Not really. No. 'cause I, no, I don't care where went, where they went to school. Sure. The CSCS is nice. I think there's validity in that. But I've met CSCSs that weren't impressive. I like to see sports backgrounds just because it gives you an idea of what the athletes that we're treating go through. I think to be able to relate to that helps you, helps them, helps everybody makes that thing, makes that process easier. But again, we have some therapists that haven't played team sport, not a lot of them, but we have some therapists that haven't played team sports growing up, but they can relate so well with the patient in front of them that, and have the wherewithal to ask them, Hey, what is it, what is it that you do that I need to help you do better to get back to your sport spot? And I think if you can have someone, again, that's a soft skill, I think if you have someone that can do that, it doesn't really matter what their background was at that point.

Dr. Yoni Rosenblatt: Yeah. I think you're absolutely right. It's like do they have feel and you don't know that until they're on the phone. And I think it takes a while to get over the credential obsession Especially for a dude who works so hard for his SCS. Like you gotta imagine. I have to imagine that you're looking at a thing like. Okay. They gotta have ATC, they gotta have CSCS something. It's just not the case. Man. There's so many clinicians that we have that don't necessarily have that. That are absolute rock stars. And so I would encourage... Lemme just think about how I would frame this to those listening. Is you need to relay your level of passion upon application. 'Cause you only get that first glance, right? That first glance of an email. So how would someone do that? I'm thinking cover letter. Even though I've actually been reading like, newer grads like, cover letters are antiquated. I just think it's an awesome ability to shine and show that you're different. Like to have your personality come through. Or also maybe there's something that doesn't show up, in a line item. Like as a highlighter. Career highlighter has a cert that would go a long way. I think there's room and if it's not a cover letter, then it's gotta be a resume. I hate when I just get resumes.

Andrew Livingston: I see... I don't. 'Cause it's just... I'm not a great writer here Peter.

Dr. Yoni Rosenblatt: But there might be more.

Andrew Livingston: There might be more. That's why like I'm always doing phone calls and then I'm always... I like to have people in person. But that takes a lot of time. But if you wanna find the right person, you gotta do that. I think. I love a follow up email.

Dr. Yoni Rosenblatt: Yes. Fair.

Andrew Livingston: Like a thank you. Follow up email or call or a text or something like that. Just because it shows thats on their mind. They care. They wanna hear back from you. I've had plenty where I end the call or and in person interview and I never hear from that person again.

Dr. Yoni Rosenblatt: Yep.

Andrew Livingston: And maybe it's on me. Maybe I need to send more follow-ups for good, bad and different. But that means a lot to me too.

Dr. Yoni Rosenblatt: Yeah. I mean. Listen, I've gotten that, I've also gotten, follow up emails where my name is spelled wrong or, like I'll get crazy questions like, how long have you been working at True Sports? Or how do you like working at True Sports, addressed to me? So I do my best to kind of hide my role within the company, but still dude like, do a little bit of work and realize your role in the company. Also even if I'm just a regional director, I'm pretty happy. And I'm interviewing you [laughter] So the point is being able to learn from people and all their levels of communication, during the interview process. A it all matters. B gives us insight as to their professionalism and really their vigor and excitement to be a part of it.

Andrew Livingston: 100%.

Dr. Yoni Rosenblatt: What are some other questions that you ask within that interview process? 

Andrew Livingston: One thing that I ask both for residency and for just the straight job as a staff PT or contractor, is what's your rationale for wanting to do it? Especially for residency, you don't want it to be something where you feel like you should do it. Whatever your reasoning is, that's fine. But it's a commitment from a financial standpoint and from an effort standpoint, it's a grind to be in residency. So to do it 'cause you feel like you have to, is different than I'm doing it 'cause I wanna be a board certified specialist. That's awesome. That makes sense. If you're doing it because your buddy did it and now he works for a pro team, maybe that's not the best way to go about it. Maybe it's leveraging that connection versus going to residency. Maybe you're a better clinician than he was and he needed residency. Just understanding your why, what you're doing it from a residency standpoint. And then same thing, flipping it back to, just as a staff PT, why do you want this job? Is it, you love working with athletes? Is it, the one-on-one? Is it. You plan on being here for a year and then moving on after that. Let me know what your motivation is for that. That helps everyone down the road. You, us the entire team.

Dr. Yoni Rosenblatt: Yeah, for sure. I love hearing about, not just, here's why I went through residency, but here's why I chose this residency. I know that at Methodist I was gonna work with Astros. I love baseball, I love shoulder mechanics. That's why I chose that versus, I wanted to be SCS. I wanted to prepare for my SCS. I didn't think I was ready. Staff like that, because I know local sports "residencies" you're not with athletes and you're not working with high level athletes or you're not in a training room. And I have a hard time believing that that was your first choice for sports residency, if your goal was to treat high level athletes.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: So don't tell me that you working at the high school is helping you treat these elite level athletes. Do your homework. I think there's a lot there that you can glean the way you manage. So now you're a regional director, so you're managing a whole bunch of physical therapists. You are prospecting and looking for areas of growth. You are developing relationships to increase referrals with inside of those clinics. You're also pretty financially astute. You also do a good job of staying fit and healthy. And my question to you is, how do you manage all these things?

Andrew Livingston: That's a great question. One day at a time. No. I think it ebbs and flows. There are weeks where I get to the gym once or twice. There are weeks where I'm at the gym four or five days a week. Same with, keeping up with Con Eds. There are a few months where I'm not really into a whole lot of newer information. And then there are a few months where I'm really diving into different research and really participating in our journal club and things like that. So it's definitely ebb and flow and I don't have, by no means perfected that, but I think that's where I live, as semi type B type A, I think I'm becoming more type A.

Dr. Yoni Rosenblatt: Yeah. But you...

Andrew Livingston: For better or for worse.

Dr. Yoni Rosenblatt: Yeah. But I do feel like you do a good job of kinda dancing back and forth. Any mental health practices or meditation. What do you do to keep your minds right?

Andrew Livingston: Exercise for me has been that way. It's kinda like an escape. That's why I don't work out in the clinics that I usually treat in, just because it's such a mental place where I still have to be working to a degree. I'm always thinking about it. So I try to work out in places that I don't work in necessarily, just to help get that separation. But exercise for me is a big piece of it. And then sleep, weirdly enough, like I can sleep pretty well, which is surprising at times.

Dr. Yoni Rosenblatt: That's amazing that you can do that. What's your secret there?

Andrew Livingston: Shut off. Just, I don't know. I've always been a good sleeper. I don't know.

Dr. Yoni Rosenblatt: What a blessing, man. That is a blessing. I don't have that. That's amazing. Okay, so keeping up, like you've proven this financial literacy. What kind of resources can you recommend to achieve that? 

Andrew Livingston: I have a list of some of the ones that I used early on. BiggerPockets, Real Estate, How To Money, was a great one.

Dr. Yoni Rosenblatt: These are books or pods? 

Andrew Livingston: These are podcasts. And I'm looking scrolling through my library now. The Stacking Benjamin Show. It's a lot of just like common sense stuff that I didn't know. And then after doing some of these things for a few years, it makes a lot of sense. I got a financial advisor.

Andrew Livingston: Hell yeah.

Andrew Livingston: That was a big help for me. I remember the first day we met, he was like, Hey, do you have X, Y, and Z in place? And I'm like, "Nope." And he is like, alright, well, before we can really even do anything, you gotta have X amount of dollars here, a Y amount of dollars here. And a backup, like a safety net essentially. So those were some of the big things early on financially that helped me just get established that I didn't know about. And I think for me it seemed like everyone else knew these things and I had no clue. So, I don't know. I feel like I'm back on par with a lot of people. Maybe I'm not I think it's different for everybody and everyone's baseline is a little bit different. But I'm always trying to learn more about what should I be doing if I wanna do this, if this is my goal, how do I set myself up to be able to do those things in, 5-10 years.

Dr. Yoni Rosenblatt: How'd you find your advisor? 

Andrew Livingston: Actually he's the advisor of a buddy of mine who's also a PT. This guy deals with a lot of PTs.

Dr. Yoni Rosenblatt: Oh, cool.

Andrew Livingston: So, and he deals with a lot of PTs that are in PA and Maryland. So, and because I'm now in both, it makes a lot of sense to take advantage of different tax things and things of that nature.

Dr. Yoni Rosenblatt: Anytime I mention the ideal of having a financial advisor, everyone's like, duh, I don't wanna pay for that. So how do you kind of cross that bridge and how do you pay for it...

Andrew Livingston: So I have a really good, one of my best friends he's in he's really good with money. He's in industrial real estate does really well for himself. And him and I talked for a long time about me just doing it myself. And I learned a lot, but I won't get into too much detail about what it was. But then I was talking to my now financial advisor about something very specific and he said, well, did you know that you can do this to avoid the taxes on X, Y, and Z or make it legitimate. And I'm like, "Nope." So now like you just sold me on, you're my guy.

Dr. Yoni Rosenblatt: Yeah.

Andrew Livingston: Because I didn't what I didn't know.

Dr. Yoni Rosenblatt: Sure.

Andrew Livingston: And he's been doing it for a long time. He doesn't get freaked out with different trends. He knows what works, works and to stick. He's kind of my opposite. I always tell him people, he's my opposite of I wanna be aggressive.

Dr. Yoni Rosenblatt: Yeah.

Andrew Livingston: And he's very much like, I hear you. I'll let you be aggressive with this. But 85% of everything else we're gonna be conservative with. 'Cause you know what works.

Dr. Yoni Rosenblatt: Yeah. How do you pay him?

Andrew Livingston: I believe he gets a percentage of what I generate over the course of the year. So that's the fee.

Dr. Yoni Rosenblatt: Okay. He gets a piece of profits?

Andrew Livingston: Yes.

Dr. Yoni Rosenblatt: What if you guys lose? God forbid.

Andrew Livingston: That's a great question. I need to ask more of those questions.

Dr. Yoni Rosenblatt: Okay. Yeah. Ask those questions. I know a lot, it's kind of runs the gamut. A lot of advisors will charge a given percentage of what they manage.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: Period. So it still incentivizes them...

Andrew Livingston: Sure.

Dr. Yoni Rosenblatt:
To win. Whatever that means because they get a percentage. Usually that percentage is in different buckets. The more they manage the less percentage. It's kinda like agents and draft picks. Like the higher draft picks give their agent a lesser percentage.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: So standardly you look to be in that 1% and below.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: As a fee. So just think about that. But then there're also, and I have this conversation a lot how worthwhile it is to have a planner not necessarily take that percentage of whatever it is he's managing. But if you don't necessarily have the monies, you're not gonna be investing actively with him to just pay for a plan. And that's the first thing that you kind of had, which you mentioned, which was, you gotta put money here, gotta put money there. Here's how you get saved. Here's where you can be risky. A lot of advisors will sell that plan.

Andrew Livingston: Right.

Dr. Yoni Rosenblatt: And I would highly advise it. Same time I have a buddy who's a dentist who laughs at me for paying the percentage because he's like, why don't you just manage it yourself? I said, 'cause I work more than four days a week. You don't 'cause you're a dentist. 'Cause his margins are way better. So the point is he has time to dive in. I really don't, I wouldn't be able to sleep if I was doing my own finances. So, okay. If that's your, where you get some financial information and thanks for those resources. Talk to me clinically, where do you go to get smarter? 

Andrew Livingston: Yeah, I mean, thankfully I'm surrounded by a lot of PTs that are really hungry for information. So I get a lot of it from just being in the clinics with them. Whether it's different styles of treating different methods here and there. JYS PT is a great resource that I get pretty frequently different papers from that. Again, I'm fortunate enough to have the ability to read those pretty well thanks to residency, in my opinion. I wouldn't be able to read that before residency. I just don't understand a lot of that verbiage a lot of times, if I was coming straight outta school. I have a lot of podcasts I listen to best PT podcast. What else do I have here? Strong By Science is a good one. The Mike Reinold Show was great. I know he has another one on, that he has now. I can't think of the name of it.

Dr. Yoni Rosenblatt: I think it's The Sports...

Andrew Livingston: The Sports PT Podcast. Whatever it was.

Dr. Yoni Rosenblatt: Yeah. Not to be confused with True Sports.

Andrew Livingston: Exactly. And honestly, with being in the residency world, just being so close to the academia side of things, you're still getting whispers of all those from students. I'm like, "Hey, what do you think about this?" And I have time to dive into those papers. So it's coming from a lot of different places. And I think that's how it should be. I think it should be from physicians, it should be from PTs, it should be from all these different outlets because in the grand scheme of things, your treatment method is a combination of all those things too. And if the patient doesn't buy into what that is, none of it matters. So I think meeting the patient where they are based off of your experience and the things that you're learning are, and an art that eventually you kind of figure out how to do.

Dr. Yoni Rosenblatt: Yeah. It's just an art and you get better and you're gonna make mistakes.

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: But having that humility and growth mindset around it to kind of bounce back. You ready for a lightning round?

Andrew Livingston: Oh boy. No, but let's do it. Let's do it.

Dr. Yoni Rosenblatt: What sport has the best athletes? This is not a hard one.

Andrew Livingston: It is. Because I think there's two answers to this. There's an all-around great athlete, and there's an athlete who's great at what they do. I think some of the best athletes are Lacrosse players, and I hate to admit that now, but being in Maryland, a lot of them move really well.

Dr. Yoni Rosenblatt: Okay.

Andrew Livingston: At the same time, if you look at a defensive end, they're pretty athletic in the NFL now. They're 6'5", they're 300 pounds, they run four sixes. But they can't shoot a Lacrosse stick. They can't shoot well.

Dr. Yoni Rosenblatt: We don't know that.

Andrew Livingston: That's true. So, I think, I'm gonna say probably an outside linebacker.

Dr. Yoni Rosenblatt: That's neither of the two you mentioned. [laughter]

Andrew Livingston: I know it's not, but as I thought about it more, I'm gonna say outside linebacker.

Dr. Yoni Rosenblatt: Why?

Andrew Livingston: They have to cover, in space. And they're also in the trenches at times too, depending on the defense that you're running.

Dr. Yoni Rosenblatt: Okay. Here's my counterpoint. Athlete isn't just bigger, faster, stronger. It's also coordination. Now is there some of that there? Yes. But to your point with the shooting the Lacrosse ball, not a stick, there's far more dexterity, there's far more fine motor skill in something like that. There is no fine motor in outside line backing.

Andrew Livingston: That's not true.

Dr. Yoni Rosenblatt: Come on, tell me what it is. What's the...

Andrew Livingston: Hand placement.

Dr. Yoni Rosenblatt: Get outta here, dude.

Andrew Livingston: Hand placement.

Dr. Yoni Rosenblatt: Yeah. I've heard this argument, but that's still gross motor. You're punching.

Andrew Livingston: Fair.

Dr. Yoni Rosenblatt: You're striking...

Andrew Livingston: Fair.

Dr. Yoni Rosenblatt: As, my linebackers teach me. I think, just keep that in mind. That's why the right answer to this question is, I think it's the NBA shooting guard.

Andrew Livingston: Really?

Dr. Yoni Rosenblatt: Big long rangey offense. Defense, reactionary, fine motor skills. Gross motor skills, you gotta be springy. Court vision, knowhow.

Andrew Livingston: I like that answer.

Dr. Yoni Rosenblatt: Thank you.

Andrew Livingston: I would disagree though.

Dr. Yoni Rosenblatt: Yeah. But okay. But you haven't said why, who's better?

Andrew Livingston: There's so many subjectives.

Dr. Yoni Rosenblatt: What can't they do? What can't they do?

Andrew Livingston: There's no contact involved. I shouldn't say that. There is not as much contact involved as other sports. I think you talk about motor control and strength.

Dr. Yoni Rosenblatt: Yes.

Andrew Livingston: It means less of it that gets in, that's relevant to that. I at that point, looking at martial artists, grapplers, intrinsic hand placement. Again, maybe not as fine dexterity wise as shooting a lacrosse ball on a stick.

Dr. Yoni Rosenblatt: Yeah. Very good.

Andrew Livingston: Conditioning is fantastic. Mixture of contact, strength, footwork, movement.

Dr. Yoni Rosenblatt: Okay, I hear that. The only thing is that another point to your point or support of your point would be, have you ever seen an elite level shooting guard squat? They can't move.

Andrew Livingston: No.

Dr. Yoni Rosenblatt: They're so stiff and it's because they're so goddamn springy. But that would be the knock.

Andrew Livingston: That would be the knock?

Dr. Yoni Rosenblatt: Not the contact or the strength. These guys are giants.

Andrew Livingston: What was your question? 

Dr. Yoni Rosenblatt: Best athlete.

Andrew Livingston: What's your term for athlete? Is it someone who's good at anything?

Dr. Yoni Rosenblatt: I think it's fine and gross. Yes. Fine Motor skills. Gross motor skills. And that's a great combination.

Andrew Livingston: It is.

Dr. Yoni Rosenblatt: I mean, the really high level, I think long poles.

Andrew Livingston: Yeah.

Dr. Yoni Rosenblatt: I mean they're just, they're big. They're fast, they can hit.

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: And to have, I guess the proprioception to know where the head is on top of the that stick, it's so far away from them to just throw it up in the air and just know where it is. Some of them score. Like that's pretty impressive.

Andrew Livingston: I can get them on board with that.

Dr. Yoni Rosenblatt: There just aren't that many, there aren't that many of them.

Andrew Livingston: Right, right.

Dr. Yoni Rosenblatt: And we live in Maryland, so I think it's just like this silo. No one else plays lacrosse.

Andrew Livingston: True.

Dr. Yoni Rosenblatt: Definitely not in Long Island. Okay. That was question one. There you go.

Andrew Livingston: That was lightning?

Dr. Yoni Rosenblatt: That was lightning fast. Yeah. That's my level of athleticism. From a PT perspective, what is the biggest misconception of outpatient physical therapy? 

Andrew Livingston: I think the biggest misconception is that you need heat, ice, and stem.

Dr. Yoni Rosenblatt: I freaking hate that.

Andrew Livingston: That's just not skilled care. And I think it takes away from what we do. I think it dampens the profession. And you're seeing... It dampens as a profession, this is a bigger topic in my opinion. And you're seeing strength coaches start moving into this realm of injury prevention and addressing injuries. And so it's like, if we're not advancing and we're still doing heat, ice system like we did in the '80s and '90s, what's our profession doing? Insurance isn't paying for it as much anymore, if at all.

Dr. Yoni Rosenblatt: Right.

Andrew Livingston: And they can do it at home.

Dr. Yoni Rosenblatt: Do you think it is the conception of let's say applicants or new grads that yet that is a part? Like have we broken that stigma yet, or no? 

Andrew Livingston: We as True Sports?

Dr. Yoni Rosenblatt: Yeah. We as sports PTs or PTs?

Andrew Livingston: Yeah. I think in the world that we're starting to live in, yes.

Dr. Yoni Rosenblatt: Yeah.

Andrew Livingston: There are some patients that are like, Hey, where's heat, ice system? But I'm getting less of that.

Dr. Yoni Rosenblatt: That's patients, Yeah.

Andrew Livingston: And same with with PTs, like where I'm, I used to get, well, where's the.

Dr. Yoni Rosenblatt: You're right.

Andrew Livingston: Where's the ice and where's the heat? I'm like, we don't have that here. And I'm not getting that anymore. So I think people are either A, doing their homework more, or B, understanding that's not part of what really we're doing in this world anymore. In the sports realm at least.

Dr. Yoni Rosenblatt: Yeah. I also think maybe a close second would be that it's impossible to find a place that does one-on-one.

Andrew Livingston: It's very hard.

Dr. Yoni Rosenblatt: And is a network, right? 

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: So, I think that is a misconception.

Andrew Livingston: Yep.

Dr. Yoni Rosenblatt: They are out there. You just gotta search. It is doable and still being in network. I just had a great conversation, with, Danny Mateo, who's a consultant, a business consultant for cash PTs. Dude couldn't believe that we treat 101445. He couldn't believe it. He is like, yeah, that's a problem for cash PT. But, but we are out there like constructs like us are out there, we just have to finesse it a little bit. We have to figure out how do we afford the facilities and the talent and like figuring that out and finding talent that cares more about quality of care, more about time with our patient than necessarily every single goddamn dollar, but we're here trying to create both. Next, what are you reading?

Andrew Livingston: I just finished Gary V's. Twelve and a Half.

Dr. Yoni Rosenblatt: Good.

Andrew Livingston: It was very good. Yeah.

Dr. Yoni Rosenblatt: Because.

Andrew Livingston: It was really introspective on a guy who was a big name in the business and media world, and I appreciate that. And it was easy for me to apply what he was talking about in this his book to what I do on a day to the Day-to-day day basis when it comes to managing people and working with people.

Dr. Yoni Rosenblatt: Give me one example of what you took away and added to your management style.

Andrew Livingston: So the book's called Twelve and a Half, and he talks about these 13 traits that are required to, in his mind, be a good leader and to the half is the one that he's not good at. And so through the different traits, he talks about how, what he, why he thinks it's important, and then why he thinks and how he uses it, and just for me, I think some of the things that he's good at I'm not great at and vice versa, so to to hear someone say why they're good at what you're not good at just helps me figure out how to be better with the trait that I don't feel like I'm great at.

Dr. Yoni Rosenblatt: What are you not good at? 

Andrew Livingston: I'm not great with, I'll be very upfront with confrontation. I don't like confrontation. I think for me it's, I try to be, I'm a servant leader, and that's my negative is like, I can't do something for someone. Basically with that a book. It's good to see how someone else addresses their weaknesses and you can see maybe that you're good at that and how they handle not being good at something else to get ideas on how to become better at the traits that you're not.

Dr. Yoni Rosenblatt: Because Gary V is good at a lot of freaking things.

Andrew Livingston: He is.

Dr. Yoni Rosenblatt: What'd he say he's bad at? You don't remember?

Andrew Livingston: There was one word. I can't remember what the trait was, was it tact? I think... It wasn't tact. I don't think what the word was, but, no, but he went into detail on like why he feels, the way he feels about that, how he handles that, how he acknowledges that he's not good at this trait and he's upfront about it.

Dr. Yoni Rosenblatt: That is pretty amazing to such a overachiever to have the wherewithal and the, even the humility to come out with something like that and just say, Hey, I'm not perfect at everything. I think, I wonder if he would've done that 10 years ago or so, just, man, he has just been hard charging for year, forever.

Andrew Livingston: A while now.

Dr. Yoni Rosenblatt: Yeah. Forever. Yeah. It's amazing. And the heights that he's reached. So you did pretty good there with the lightning round despite all of our tech difficulties. Okay. So tell the audience of sports PTs how they can get ahold of you.

Andrew Livingston: Yeah. So you can get ahold of me on Instagram. I have a really long handle. It's Andrew J. Livingston PT, on Instagram. That's really the biggest platform I'm on. I wanna get an in into TikTok now, but, I'm holding off on it for now. That's the best way to get ahold of me is on Instagram, again, Andrew J. Livingston, PT. That's really it.

Dr. Yoni Rosenblatt: Where can they send you a resume? Give them an email.

Andrew Livingston: Resume. My email is Feel free to send me a resume there or just even, email me the chat. Always looking forward to it.

Dr. Yoni Rosenblatt: Watching kind of your evolution through your career thus far has been awesome to see. You've taught me a ton, both from the financial literacy standpoint as well as the clinical standpoint, what it's like going through residency. And what I've gained most both from this conversation and just working with you in general is your ability to just stay even. It's awesome. And, it's something that I strive to kind of put in my arsenal 'cause that is not my nature, but I'm trying to learn from you, and that's just a that really did come across in today's conversation. So thank you for your time. Thank you for your patience. Thank you for staying even because like the sky was falling in during this podcast and you're just like, chill during the whole thing. A testament to who you are. It's a great skill. So thanks for everything you have brought to True Sports. Thanks for making yourself available. Thanks to everyone who listens. Hopefully you gained something. Let us know what you love. Let us know what you want us to improve. You can always reach me I wanna see your resumes, but I also want feedback on today's episode and what you wanna hear more of. Thanks so much for listening guys. Bye-bye.


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