May 14, 2019

Triple Your Marketing Efforts By Improving Your Patient Experience with David Self, PT of Keet Health

PTO 50 | Patient Experience


Some businesses struggle with connecting and keeping patients, especially in the PT industry. The secret to this is always being able to create an excellent customer experience. David Self, the Director of Product Strategy for the software company, Keet Health, shares what he learned from the internet software realm and how it can be incorporated into the physical therapy business. Focusing on making the treatment experience for provider and patient more comfortable, basic, and easy, David uncovers the top hacks in achieving more exceptional results for your business and maintaining personalization without destroying efficiency. Discover how technology is positioned in the PT industry and learn why it is crucial to market your brand assets.


Listen to the podcast here:

Triple Your Marketing Efforts By Improving Your Patient Experience with David Self, PT of Keet Health

On this episode, I have David Self of Keet Health, which is a PRM that is used to improve the relationships and the interactions between physical therapists and their patients. You'll be interested to follow David's story. He recognized the dichotomy between the relationship and the experience that he had in working with some of his fitness patients versus some of the patients he was working with in his clinical internships in PT school. Thus, evolved the software program that he developed with another founder of the company. He works as the Director of Product Strategy for Keet Health.

We're focused on how Keet Health helps the customer experience for patients in their physical therapy settings. How that can help the physical therapist maintain the relationship and improve the customer experience of that patient so that they continue to be returning patients and customers of theirs. The great insight that he shares comes from not only his experience in the physical therapy realm but also the experience and things that he has learned from the internet software realm and how that can be incorporated into our physical therapy businesses. I’m excited to bring in his fresh perspective. Hopefully, it can inspire you to do more in terms of improving the customer experience in your clinics.


We have David Self of Keet Health. He is Director of Product Strategy. First of all, thanks for coming on with me David.

It’s my pleasure. I'm happy to be here.

If you don't mind sharing with everybody your professional story and I’m sure that's going to incorporate the development and growth of Keet Health. Do you mind going back and tell us a little bit about how you got to where you are?

I am a PT by trade though I’ve never actually worked at a PT practice. I’ll start from the beginning.

You’ve never been into practice? You've been business-minded the entire time.

Focus on the customer experience and your 'marketing' efforts will triple in potency Click To Tweet

I had my own while I was in school, which is a misnomer. I had it the first few years at Keet. I practiced PT and got paid for it, but I’ve never been paid.

I’m excited to hear your story.

I went to school at the University of Texas. When I was there, I worked with the basketball team. That was a great experience for me because I was heavily influenced by a PT named Gary Gray who became a close friend and mentor of mine. That's where I first got exposed to thinking about doing therapy for a living. I was going to do strength and conditioning. It’s funny because I weighed ten pounds. That’s where I got started with. Todd Wright was the strength coach there. He’s now with the 76ers. It was an amazing experience at a young age. I went from there. I went to a PT school at Texas State University right outside of Austin.

Right before I started that, I started my first business, which was called Austin Integrative Fitness. It was essentially aftercare, functional fitness therapy business. The niche was I’m going to be the smart trainer that knows how to deal with people in pain that the other people don't want to work with. I’m not actually into therapy. That was my first route in the entrepreneur game and it was successful. That was a fun thing. You can imagine being a PT student trying to market for PT practices within a square mile of that studio.

I can't imagine going to school and having business at the same time. That had to be a lot of work.

PTO 50 | Patient Experience
Patient Experience: Quality care has two components - getting great results and great customer experience.


I don't recommend it, but I was able to come out with not a lot of debt. It's primarily because of that. That part worked out. I was a founding member of the Austin Health Tech Meet Up and for those who don't know, Austin is a technology hub. I was a member there in my second year in PT school. In the first meeting, I was sitting at a table with about eight people. It was six venture capitalists and the Founder of MapMyFitness and some other big company. I introduced myself, “I’m David. I make no money. I’m into the ankle joint and that's about it.” I met a person there named Jason Bornhorst, who was doing this thing called Patient IO, which was a patient engagement startup. He was getting started. I was one of the first customers. I started introducing them to a lot of people that I knew in the fitness world, like some big box gyms.

I had a lot of connections from my time in Texas. That was my first taste of Neon technology, opportunities big. It's fun. It's exciting. That got my whistle wet if you will. My last semester of PT clinicals, I was at Texas Physical Therapy Specialists, which is now a customer of ours. I met my Cofounder at the time named Jon Read and we both collectively thought that there were so many things that we had to do as either a patient and/or a therapist that was not actually related to us spending time together and working on the recovery. I recall I had my fitness studio. I’d wake up and have a session at 6:00 in the morning, one-on-one, no documentation and no bureaucracy. I was texting patients. I was sending them YouTube videos. I was super close. I went to PT practice, which I thought would be much more advanced than that. In reality, because it's what everyone knows, it felt like I was going back in time.

I felt very disconnected. There was a particular day that I was driving home from my clinicals. I was seeing twenty patients, which like Armageddon when you're a student. I stayed on top of all my paperwork. I was like Johnny non-stop. I got out at 5:00. I was going to a happy hour at 6:00. I remember driving away from the clinic, I was at a stop light and I thought to myself, “I know half the names of the patients I saw and everything that I did was primarily to expediate the amount of documentation I have to do. I said, “I don't want to do this. I’m not making great money. I got to wear Dr. Scholl’s. It's not very motivating and I feel way more disconnected than I do in the mornings when I’m the studio. We decided to go for it. That's how we started Keet. That obviously has scaled and was successful and we were acquired by Clinicient, an EMR company in Portland. Now, I’m in the tech world.

Based on your experience, I’m sure you can see where a lot of frustration, even what you'd call burnout can occur for owners and for longtime therapists. The focus is so much less on patients and so much more on everything else, honestly.

It's spot on and it's not the provider's fault. Sometimes these days it can be a little bit their fault if they're not willing to adopt it to the new wave of healthcare delivery. By and large, it's by necessity and unfortunately, that necessity can decrease the passion of why you got in that in the first place. I’ve been at PT school for three years and about 50% of my class has either got out of PT or they went to home health. It's a big problem and it's tough.

If you can't implement it, then it's useless. Click To Tweet

Your main focus then with Keet, tell me a little bit about that. When you initially started, tell me about what your purpose was and if that's evolved over the past few years.

It certainly evolved in terms of what we ended up building and pivoting to like any startup company. Essentially Keet’s always for me had the same vision. The vision can be characterized as we wanted to try to reimagine recovery. We wanted to reimagine that primarily as a movement of being excited again, of being able to break a lot of historically, super outdated processes to the modern world. We want to rediscover that human connection in healthcare, which fundamentally was connecting the provider and the patient. The second part of that vision is that we want to be able to do that in a way that was scalable for practice owners and not just a call center for them. The margins are insanely low compared to other businesses in therapy. We didn't want to build the super cool thing, but then it was cool but there wasn't ROI to pay for it.

It's largely remained the same. We've always had two eyes focused on value-based care. We've always believed that the most fundamental level that quality care has two components. It’s getting great results, which isn't just relevant in value-based care, but in fee-for-service or any other type of payment model we ever come up with. You've got to give a great service to customers, but you can get great results and not have a great experience doing so. Particularly not have a great experience doing so beyond the walls of the clinic. Those are the two prongs of any business.

We wanted to be able to measure both of those things. You’ve got to be able to measure that you're getting great results and mention your experience. That continues to be our fundamental hypothesis that outcomes in patient engagement should never be separate from each other because they're intimately related. Most importantly, as healthcare changes to alternative payment models, they only become more and more important, those two things. That's primarily remained the same and still is what we are now.

For the person who maybe this is the first time they've ever heard about Keet, in a snapshot, what do you provide? What do you do for an individual clinician or an individual practice owner that helps obtain improved results and greater customer experience?

PTO 50 | Patient Experience
Patient Experience: When you get so wrapped up into putting out fires everyday into your to-do list, you slack on strategy and innovation.


I can talk about it in three buckets. One bucket is clinical engagement, to not get too detailed and you can visualize our Keet Patient App and then there's everything related to the patient's care. Home care plan, education, messaging and filling out their outcome measures. Generally speaking, it’s a connection to their provider when they're not there. We have a second component that is our basic automated marketing. We send out targeted emails and measure your patient’s experience via the Net Promoter Score. That doesn't require an account and that's bringing your practice in the modern age at the most, not table stakes level. We have a third component of outcomes registry. It's a qualified clinical data registry. It measures your outcomes via the engagement app if you're inside the clinic and then we report on that.

Going back to that same pillar, we're helping you get great results because we're connecting with your patients beyond the walls of the clinic. We also measure that so you can participate in other payment programs. We're making sure that we help you build a loyal following of patients. Sometimes, patient engagements become critical. It means a lot of things to a lot of different people. Sometimes it's like an excuse for marketing or email marketing. You go somewhere else and that's nowhere to be found.

It's important to sometimes transcend the label and to think about the problems that you need solve, but also how do you uniquely solve those problems there? Sometimes therapy is unique and so you can't do everything like any other business. Sometimes it's not unique and you can't do things like any other business. We've tried to focus on things that are unique because the things that aren't unique, those are commodities. It's better to use the best software for that than a “physical therapy software.” It's a pet peeve of mine when we started trying not to commoditize terms for physical therapy. The software’s such an odd tangent and we don't want to get on that.

You've recognized the benefit of not only improving results. This isn't necessarily about improving our technical skills but improving the customer experience and the interaction between the physical therapist and even the physical therapist's experience in that relationship. Developing, growing, maintaining and perpetuating the relationship between the patient and the physical therapist.

That's a huge component of what we do and we can focus on. There's obviously the other arm of the benefit of measuring your outcomes, improving your words and how that's absent sometimes in the patient experience. That's an accepted pillar, but that's all wrapped into the actual customer experience. I might sum it up even more simply and say that we're trying to scale and what you have to do with any business is a key. Any business, regardless of therapy, it's hard to scale personalization. It's in the word. Most businesses start very hand-crafted, everything hand-crafted, meaning you do it all manual. Even when Airbnb started, everything was hand-crafted. You hit a certain stage of scale where you can no longer maintain that.

You have to be clear on what you're great at. Click To Tweet

You come to this difficult challenge of, “How do I maintain personalization without destroying my efficiency?” If you’re seeing 1,000 patients a month or something, you can't text those patients every day. You can't write personalized emails every day. You can't do all that type of stuff, but you don't want to lose that part of it. You have to have systems in place to maintain your magic sauce that got you there in the first place. That's where the provider part comes in is to be able to help give great experiences to patients in a way that keeps them loyal and helps them get varied results. Also in a way that it's not just “another thing” that the therapist has to deal with or a provider has to deal with because you can never implement that. If you can't implement it, then it's useless.

As you've been through this journey the last few years, focused on the customer experience, improving that and improving the relationship between therapists and patients, what are some of the things that you've come across that helped the physical therapy owners and the physical therapist themselves improve that customer experience? Are there some tips and guidelines? What are some of the secrets you've come across?

I’m a big fan of Brian Chesky. He is the CEO of Airbnb. He had a statement, which I agree with. I’ve had some fortunate opportunities to know some early people there. Fundamentally, it's tough to get inspired by your own industry because you get capped into the group thing. I would say that the number one thing is to try to learn from consumer internet companies. They're such an amazing example for us. They're also very salient. We all have them on our phones and we all can observe it. We all go home and watch Netflix with our kids or whatever. I would say number one is thinking about the best experience that you've always had and try to learn from those people. How has that particularly influenced us? A few things that I think that we've seen been successful by providers. It goes without saying, we learned a ton from PT owners. One is access personalization is the way that it is now and the way of the future.

You have to adopt the simple truth that that's the way it is and that's the way it's going to be. Taking that example, if a bank didn't offer mobile deposit or even have an app on their phone, again, it's not about the app, it's about the personalization. Maybe you’d go out of business because consumers have a reference point now. The banks are the ones that adopted that early, even though the majority of their customer base didn't use it very much in the first couple of years. That's what it means to be on the bleeding edge of innovation. When you implement something or you want something, it doesn't have to be super high adoption rate off the bat, but you get to escape velocity from your competitors when they're trying to freak out and catch up five years later.

Do you find that it's hard for physical therapy owners to see that far in the future when it comes to technological stuff like you're talking about? You're talking about stuff in modern day, but you and I both know that the physical therapy industry is probably years behind. Is it hard to talk to them about what the next things are coming down the pipe, either because they're busy or they can't see it? Do you have a hard time coming across?

PTO 50 | Patient Experience
Patient Experience: It's impossible to reverse any mistakes you make in culture after you'd get over it.


For anyone that’s ever owned a small business or a big business, you don't have a lot of time. At the same time, you have to prioritize what matters. I do think that it's difficult for owners sometimes because you get so wrapped up into putting out fires every day in your to-do list that you can slack on strategy and innovation. You can't afford to not do it because then you'd become lackluster. The second thing is it is admittedly difficult because beforehand you didn't think so much about technology, so you've got to focus a lot more on other parts of innovation and strategy. Whether that was treatment, whether that was how you work with someone doing customer service things or barking at physicians, how your space is laid out and how to get great leases on your spots that type of thing. That's true with any business, but now we live in the information age and that has to be something that you prioritize. There's a firm in California and Andreessen Horowitz has a phrase that I love, “Software is eating the world and if you don't make it a part of your DNA,” and I don't mean software or a particular type of software. I mean the realization that it's when you went paper to computers. You're not going to back to paper and it's no different for many other technological innovations.

I think we can see some of the growth of physical therapy in that direction, whether it's through apps or software programs like yours or even Telehealth. Some of this is inevitable. We've got to learn a way to utilize it in our own practices or we're going to fall behind when people come to expect it.

That type of stuff is at the forefront of everyone's consciousness. One of the things I think is worth pointing out is primarily a posture of thinking and a posture of strategy that often includes technology, but it's not exclusive to technology. What I mean by that is when you walk into a spa, what is a spa characterized by? Aromas. Every little detail is thought through. What they say when they first see you and all that experience. That's why they have such loyal customers. Even for people that are going there when they should be going to therapy because, “I might not be getting better, but I feel so cared for. It's a great experience and in it talks to the other parts of my humanity that is my brain, my smell, my feelings and all that sort of stuff.” That's part of the reason that we make decisions. We don't do the thing that's best for us, we do it because we said so. Those are things that don't cost money. You can start thinking about that as a practice owner. Think about your music, lighting, carpet, layout and what people wear. There are so many stuffs that we can always constantly be thinking about of establishing that great experience because that's what's happening. This is how it is.

I love where you're going with that because I never thought about smells, but honestly, what does your gym smell like? It could be a big deterrent whether people want to come back two or three times a week for that.

You'd also be shocked if you ever studied the hospitality industry, the multimillion dollars they spent testing out the aromas and the people that they bring in and the studies that they do. All of those things as a consumer, you don't even think about it. It's subconscious. All of that stuff has been taken seriously. That could sum up largely. What I’m saying is that you have a choice to either make the things that you might historically use as commodities in your business. You can either choose to make them commodities or you could choose to make them brand assets. That's the difference between outstanding customer experience and a really cool.

People pay tons of money to stay at something, not because of the result, but because of the experience. Click To Tweet

A lot of time when we talk about niche practices and stuff like that, we think about how we're going to treat patients differently or how we're going to market ourselves differently. Thinking about what you were saying there, a lot of your niche can simply be the personal experience related to your brand. It could be the smell that you use. It could be the words that the front desk uses. It could be a streamlined paperwork system for new patients. It could be comfy chairs in the front office with lights and stuff like that. A lot of things can be done to become unique and niche that doesn't require you to change a lot of what you're doing on the physical therapy side. That's something that I’m thinking about as you're going through that. From my experience, I always found some of my greatest success with physical therapists who the patients enjoyed being with, not necessarily because of their technical skill, but because they enjoyed being with them.

My business partner back in the day has stories about guys who he would have work for him that were much better clinicians than he was, but patients would come back to him. He'd ask them why? They'd say, “I like working with you. I like seeing you. I like hanging out with you and find out what you're doing.” That was a testament to me that sometimes the patients aren't all about the best care. A lot of times, it's about the experience that you provide them. I like how you're talking about there are some ways we can differentiate ourselves beside becoming the back expert or becoming the ankle expert or the knee expert, even going to women's health or vestibular. Sometimes we can make the experience unique simply by improving what we already have.

A lot of that thought matrix as to what you decide to be great on and what you decide to let fall. Particularly when you're starting out, this is different as you get bigger, but if you're relatively smaller, you're still trying to hit one particular stage of scale. You always have limited resources and that includes people, time and money. You have to be clear to yourself, “This is what we're going to compete on, this is what we're going to let go.” Part of that thought matrix is that and then also taking a sober judgment of, “What's the situation around me? Is it a saturated market or is it a blue ocean? Maybe there are the people down the street that they're killing it on getting amazing outcomes. They have the smartest people, they are off our list and you respect whatever the reason is. Maybe that should have formed this, “I can compete on outcomes, but that might be harder. Maybe if I compete on experience, time or compete on anything that's not just that, maybe that's my strategy in my market or vice versa.

I think that's what we're getting at is you have to be clear on what you're great at. It's more fun to focus on and to have the experience be something that makes you different. For a long time, Walmart was not that. Their competitive strategy was they’re the cheapest. That's obviously been successful. With the factors, the consumerization of healthcare, the more choice that patients have than ever before, that I know we are fighting for attention. It's something that we don't want to neglect anymore. The good news for everyone is that once you get to a certain stage or scale, you can reasonably compete on both. Look at Airbnb or Uber, it's the most affordable, it's the best result and it's the best experience. It's not impossible, but usually it's because you're first to market. When you’re second, third, fourth to sixth in the market, you usually can't say, “I’m going to beat the person in front of me.” You’ve got to be very strategic about it.

I like what you said about as you're starting off you can become unique by differentiating your customer experience. The thing that comes to mind, I don't have any experience with it, if you do, go ahead and speak to it. I would imagine as you get bigger, it might get to a point that it will be hard to maintain that customer experience. It has to evolve at least, if you're increasing in square footage, number of team members, physical therapy providers and then multiple locations. You've got to work even harder at maintaining a customer experience for your company.

Without a doubt and it’s why companies fail. It's not unique to therapy. It's true for any business, whether you're a software company like us or you're an airline, a hotel or restaurant. When you're going from one employee to a hundred, that's where the biggest risk always happens because you have to be a culture warrior. The CEO of Workday, he's quite fond of saying that it's basically impossible to reverse any mistakes you make in culture after you get over a hundred. It's not like you can't, it's just so much harder work because there's so much tribal knowledge, habits and expectations. That's where technology can help. This is what we say a lot to our customers and it resonates a lot with people. When you're the practice owner or you’ve got two or three of four people under you, you know everything that's going on.

PTO 50 | Patient Experience
Patient Experience: It's a lot more meaningful to a patient when they have convenient access to their care.


You know what you're saying to the patient. You know how you're talking about pain. You know how you're paying attention to them. You know the results that you're getting with them. You know everything and you know those first few employees. When you have 100 therapists or even ten therapists, you can't control that. You don't know what the new grad’s saying to them. You don't know how often they're on the computer. You don't know that stuff. That is where thinking about as practice owners always think, “How do I establish the floor of the quality, the clinical care that I deliver?” Most people will mechanize that by saying, “Everyone in our practice is going to go to this particular education, this residency or this fellowship. This is what we do with new grads.” You've established that floor of clinical care, meaning that worst case scenario at least someone's not going to get killed.

At least everyone will do the treatment-based classification for back pain. They'll at least get someone there. You have to take that same approach to customer experience. You don't know if the new grad’s butchering something. If you can make sure that when the patient is beyond the walls of the clinic between visits and interacting with your brand digitally. That you're getting the message to them that you need to get at a floor level that can compensate for whatever things might be going on elsewhere. There's a real benefit to the technology because it can scale that part of your practice. You don't have to worry about that part. You can focus on coaching your staff members to ensure that you can sleep at night not having to worry about that.

That's where I see where Keet can be a backbone to creating that fundamental structure or fundamental customer experience for the patients that come into your practice. That's what you're going for.

We certainly hope so. That’s a big part of this idea to go back to our story, that's our vision. I would say one thing I’d like to comment on. There are some things that are unique to therapy and some things that are not. An easy way to think about that, if someone said, “We're an accounting software for coffee shops.” If it's a software, it doesn't matter. You'd say, “You're an accounting software?” There's nothing unique enough about a coffee shop and how they do their books. They shouldn’t think about what they could do that as the way anyone else does. They can also emphasize the same things in any other business. There are some common characteristics between a coffee shop customer and a PT customer. They come inside, they talk to someone, they paid for a service, they get the said service and they leave. You want to keep in touch with them, maybe you want to measure their experience and you want to remarket to them, that type of thing. That's the same.

What's different about therapy is that this is unique to therapy. You have this whole concept of the episode where you’re like, “Nathan is going to see me for eight visits, nine visits or ten visits.” Also, the difference is, “Nathan's locking in.” It’s like a mini-tragedy, if not a real tragedy. He has a particular goal in mind, which is his pain and his discomfort or his goal. You have to say, “That is unique about therapy.” Consequently, being a therapy customer is a lot more like being a hotel guest. I have this snapshot and that specifically on experience to blow their socks off. You're not coming here perpetually. You’re coming here as needed, as you go to a hotel as needed. You don't go to a coffee shop as you'd go perpetually. My perspective on that is that the most effective form of marketing to that patient of establishing a groundwork for remarketing later is actually the clinical experience. In other words, “Think less about marketing and more about giving a great experience and your marketing efforts will be tripled in potency.”

When you can't possibly do it by hand anymore, that's when you worry about how to scale your business. Click To Tweet

That's why we take the approach. If someone might see our apps for instance, and again, this isn't a key fit. This is a way of thinking about it. “We already have an AGP software. We use this for outcomes. We already educate our patients and people can email our therapist.” Those are commodities. They don't hurt you, but they definitely don't help you. It's a lot more meaningful to a patient when they have convenient access to their care. When you've reinforced, maybe I explained to you how pain works. By the way, I wake up in the morning and it's like, “I have a piece of education from Nathan and it's a video of him re-explaining what you already told me. I can click something to know a little more and maybe you send me a thank you note in the morning.” That is way more impactful than thinking, “Here you go, AGP to go.” I don't mean to slam those guys. I shouldn't say that, but I think you get my point in that. What your patients care about, is that when I send them a checking email six months later asking them, “Would you like to come in again?” You're building on top of the foundation that is amazing and much more potent than if you didn't do that at all.

I love the ability that you have to work with patients between visits because it's not easy to go away and make a phone call or sending a personalized email. If you can say, “How are you doing this morning? Make sure you don't do this. Make sure you do this.” Those things can go a long way for a patient and guess what they're going to do? As they see this experience that differentiates you from other healthcare providers, they're going to say, “These guys really care about me,” and share that with their friends at lunch or over coffee. “This is what my physical therapist told me to do. This is what you guys should do as well.”

The difference between getting great results and those results are making you a fan. I could stay at Motel 6 and it gets the job done. I get to sleep, I get to take a shower and everything's fine. I’m in, I’m out, that’s it. When someone says, “I’m going to go to Austin,” I’m not like, “You’ve got to go stay at Motel 6.” I don't say that just to have the job done. I went to the W Hotel here in Austin or Four Seasons or some cool boutique thing. Think about the difference that makes you. We all have those companies in our lives that some are like, “I’m going on a business trip.” “You know where you need to go? You need to go here.” Take a step back and see, “What is it that makes you say that?”

When you listen to people start raving about they need a thing, it's not like, “They had a bed. I can sleep on it.” It's about all the little details. “It was so nice and this and that. The decor was amazing. They called me to make sure every day was going well.” Here's the amazing part about that reality, then you say, “How much is it?” They’re like, “A lot of money, but it's so worth it, I’ve got to tell you.” People pay tons of money to stay at something, not because of the result, but because of the experience. Imagine when you send that person to ask you for social review, the commodity part is asking them for a social review. You don't need some type of crazy software to do that. You need to be able to help create that person’s need to begin with.

I’ve heard many podcasts where they talk about or interview Brian Chesky of Airbnb and that's all what they're all about. It’s that customer experience. Back in the day, I remember the stories about them actually visiting some of the people who were posting on Airbnb and seeing what the experience was like to go to these places.

PTO 50 | Patient Experience
Patient Experience: What gets in the way of getting inspired and feeling you’re doing meaningful work is when the ordinary things feel like mundane things and you feel like you have no purpose.


It's a great experience. There’s another podcast, it’s called Masters of Scale by Reid Hoffman and listen to the very first episode. You'll hear an amazing story, which I’m going to sum up. It's something that we should all adopt as business owners. Brian's very inspired by Walt Disney and so he was reading the biography and he was thinking, “What can we give outside of homes?” For those that know Airbnb, they have Airbnb Experiences. I’m actually doing this with my dad. I’m taking my dad on his bucket list trip to Europe and I’m booking all these Airbnb Experiences by locals, take us to the Pantheon, to the Vatican, show us the underground or new cool restaurant.

How that came up was he didn't study and go visit cool hotels. He didn't go to tourist companies. Do you know what he did? He hired someone from Pixar who had no product management experience of technology ever. He said, “Tell me how you write a great story.” The guy got up there to say, “This is the formula. There's always the super grand entrance. They think they know what they expect, then there's this moment where they re-discover themselves because they do something uncomfortable that they would've never done by themselves. They become this new person, there is something about it.” He was like, “Great. We're going to do that for one customer.”

They had a customer, go out of San Francisco by himself and said, “We're going to take your weekend, but we're not going to go with you the first time. Do whatever you want.” That's where he came back and said, “I'm pretty miserable. I’m not that enthusiastic of a guide. I went to some bars by myself. It was really expensive. I didn't know if it was okay.” They said, “Come back the next weekend and we're going to show you around.” They flew him in a private jet. They picked him up in a limo. There was a parade in the street that he was staying at the Airbnb. They welcome him in and he got an underground bike tour. He got on all these restaurants. He got announced on stage. He got on all this crazy stuff and sent him off on a private jet.

When he was leaving, the guy was crying, “It's the best weekend of my life.” What Airbnb says, “We can't scale that, but that is the ideal experience. That's what we're shooting for. What from that can we actually scale?” That is how Airbnb Experiences started. That's been a great lesson to how often do you hear that someone's in your company or you hear some great idea and the first thing you say is, “I don't know how that would work. I don't know.” It's the wrong way to do it. You don't ever start there. Start with an imagination. Whatever your reference Pixar person is, think about that. Remove all your constraints, then do that with somebody and then you will get so inspired to get out of your box and then say, “How can I fit those types of things into our business?”

What a great exercise you can do with your executive teams, even by yourself, with someone that you work with or even by yourself. On a scale of one to five-star experience ratings, what would a twelve-star experience look like for a physical therapy clinic or for a patient to come to a physical therapy clinic? It might include a parade and having them picked up by a limo from their home and whatnot. Some of those things aren't doable, they're not scalable, but of those things that make a twelve-star experience, what could we do? What could we implement? To brush that story off as, “It's cool for Airbnb.” I think it's something that we could definitely learn from if we took it back and said, “I can't do all that stuff, but of a twelve-star experience, what could we implement now? What could we implement in a month that makes the customer experience that much better?

Sometimes, prioritize that over efficiency. It’s something we get caught up in. “I don't know what’s going on with our EMR,” like all that type of stuff. Sometimes it's worth taking it on the chin as an owner for the sake of your patient, particularly when you need to compete. The biggest lesson here is that I’m a big fan in any process in your business, you do it by hand until it hurts. When you can't possibly do it by hand anymore, that's when you worry about how to scale it. Don't not do it because you don't know how it's going to scale when you open your next site locations. You’re never going to be able to take to innovate if you constantly obsess around operations.

I really appreciate you taking the time. It's been a great conversation.

It's been a blast. As you can tell, I am very inspired and passionate about it largely because we used to have a phrase early on in Keet. We got to an interesting crew of people and a lot of us are pretty big thinkers when it comes to the big questions of life. We had this phrase early on which was a vocation as an implication. What that meant is the word vocation has largely been a lost word in our culture, replaced by job or career. Vocation, historically, is a sense of calling. It's a sense of purpose as to what you're doing and it's beyond your job. It includes your job. As implication means you're implicated in the way that the world turns out and you’re implicated the way that your business turns out.

What gets in the way of getting inspired and feeling you’re doing meaningful work is when the ordinary things feel like mundane things and when you feel like you have no purpose in things. Think about it, no one likes to do the dishes or doing laundry. It always feels it's getting in their way of something. If you could somehow make that something that is inspiring to you, it would be amazing. That's what we're passionate about at Keet as people. That's what all business owners want too. You want to be able to feel every aspect of your business is something that you're excited about. If you focus on that, then it's the same thing for your customers. I appreciate you let me rail off and getting on some tangents. I think that's always the best way to get inspired. It’s the same thing with this show. You read and it's overwhelming, just start with the one thing you can do. Take it from there and go from there.

Thanks for taking the time and sharing with us. Is there any way people can reach out to you or contact Keet if they have questions?

In terms of the actual software, if you want to learn more, You can go there. In terms of me personally, my Twitter is my last name @SelfDM. My email is I will try to get back to you, to every person, but I can't guarantee how quickly. We’re always trying to make it a point that I can. I’m also on LinkedIn. When you’re at a conference or anything and you’re around, come and say hello. I love to meet and learn from everyone else. I certainly don't know everything.

Thanks for your time, David. I appreciate it.

Thanks, Nathan.

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About David Self

PTO 50 | Patient ExperienceDavid Self, PT, DPT is the Director of Product Strategy for Keet Health - a PRM for PT companies. He began his work in the healthcare industry as a strength and conditioning assistant while attending the University of Texas. He eventually opened his own fitness facility just outside of Austin, TX while also going through PT school at Texas State University. Upon graduation he and a partner founded Keet Health in order to improve the PT experience for both provider and patient, and eventually sold the company to Clinicient.


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