As we peel back the healthcare industry's facade, I, Dr. Jake Berman alongside co-host Jenni Berman, tackle the hidden motives driving Western medicine and Big Pharma. Our discussion isn't shy about questioning the cycle of medications and side effects that too often leads to an endless loop of prescriptions. We channel the eye-opening insights from Bring Him Brulers’ recent Joe Rogan podcast appearance, with a rigorous commitment to fact-checking. Personal tales from my physical therapy practice shed light on the struggle between quality and convenience, urging you to weigh the real motivations behind your healthcare choices.
We then navigate the complex labyrinth of insurance coverage and the financial tug-of-war between out-of-network and in-network healthcare. Debates unfold around the true cost of your health investments, as we compare the value of personalized care with the limitations imposed by many in-network providers. This episode unveils how insurance restrictions can dictate patient care, and we share how, in our own practice, we strive to treat patients holistically. Our candid conversation will leave you contemplating the long-term benefits of choosing healthcare that prioritizes wellness and prevention over simply managing symptoms.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - https://www.bermanpt.com/ https://www.bermanpt.com/wellness/ https://bermangolf.com/
As we peel back the healthcare industry's facade, I, Dr. Jake Berman alongside co-host Jenni Berman, tackle the hidden motives driving Western medicine and Big Pharma. Our discussion isn't shy about questioning the cycle of medications and side effects that too often leads to an endless loop of prescriptions. We channel the eye-opening insights from Bring Him Brulers’ recent Joe Rogan podcast appearance, with a rigorous commitment to fact-checking. Personal tales from my physical therapy practice shed light on the struggle between quality and convenience, urging you to weigh the real motivations behind your healthcare choices.
We then navigate the complex labyrinth of insurance coverage and the financial tug-of-war between out-of-network and in-network healthcare. Debates unfold around the true cost of your health investments, as we compare the value of personalized care with the limitations imposed by many in-network providers. This episode unveils how insurance restrictions can dictate patient care, and we share how, in our own practice, we strive to treat patients holistically. Our candid conversation will leave you contemplating the long-term benefits of choosing healthcare that prioritizes wellness and prevention over simply managing symptoms.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - https://www.bermanpt.com/ https://www.bermanpt.com/wellness/ https://bermangolf.com/
Speaker 1:
This is the Berman Method Podcast, featuring Dr Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy.
Speaker 2:
And we are back. How's that for some high pitches there Pitch perfect Seven. Here I come, the Berman Method Podcast, where we're focused on treating problems and not symptoms. We do not believe Western medicine. Big pharma has your best interest in mind. We believe that they are focused on client retention and not curation. And we prove that with. Every single pharmaceutical has at least one side effect that requires another pharmaceutical to treat that side effect, and so on and so forth. Dr Jake Berman here with my beautiful co-host Jenny.
Speaker 1:
Berman, physician assistant.
Speaker 2:
What is happening, jbb?
Speaker 1:
You see it. Happy Monday, everybody. Hopefully you're listening to us on Monday, starting your week off on the right note.
Speaker 2:
Yes, we both just got done doing some burpees and push-ups and squat jumps because we are all jacked up for this episode.
Speaker 1:
Hoorah.
Speaker 2:
Oh man, just a quick recap. If you did not listen to last week's episode, please go back and listen to last week's episode. We actually referenced another podcast for most of the episode. It was Bring Him Brulers. He's the owner, founder of Ways2Well, which is a clinical compounding pharmacy out in Austin, texas, and he was the guest on the Joe Rogan podcast. So please go back and listen to it. It is one of the best uses of your three hours. It is a three hour podcast. However, oh my goodness, does he expose some things that are happening to you every single day and it's all fact checked. We all got references.
Speaker 1:
Yes, very good podcast. I know you've listened to it more times than I have, but I've listened to it now a couple of times. I have sent it to my staff to listen to, so we've been chatting a lot about it within the office as well.
Speaker 2:
Yeah, he's essentially saying the same stuff that we've been talking about for two years now. Have we been doing this for two years? I think so, almost three years. Yeah, are we going on three?
Speaker 1:
Yeah, not yet, but I think we're hitting that two year mark.
Speaker 2:
Yeah, so it's the same thing that we've been saying for two years now, and it's just said from somebody completely different. So it's nice to hear the same thing said by somebody else. But, more importantly, it's all fact checked. You can reference every single thing that he says for the entire three hours, versus what we say on this podcast. This is just like my opinion, man.
Speaker 1:
Right.
Speaker 2:
There's any big Lebowski fans out there.
Speaker 1:
Yeah, yeah. So we say everything based on our opinion. However, our own research, our own research, right, exactly, I was just going to say that. So, yes, we do our own research and I'm researching all the time, and in fact I've already mentioned that I'm doing a fellowship through the Academy of Anti-Aging Medicine, so A4M. So we're doing a lot of our own type of research. But, at the end of the day, if we're saying it without posting our references, then it's our opinion.
Speaker 2:
Yeah, it's our opinion. Take it as you will.
Speaker 1:
Yeah, not used to treat you or to tell you what to do. You should always consult the right provider to talk about you specifically, and that kind of gets into what we're going to talk about today is who is the right provider.
Speaker 2:
How do you know what the right provider is? How do you start? How does everybody or let's say it this way, how does 95 plus percent of Americans start to find the right provider?
Speaker 1:
Google. No, oh, primary care yeah.
Speaker 2:
See their primary care, and then? How do they find their primary care?
Speaker 1:
Oh, the insurance tells them who to see.
Speaker 2:
Yes, are they in network?
Speaker 1:
Right, are they in your network?
Speaker 2:
Yeah, so 95 plus percent of Americans start to find the quote-on-quote right provider. You're being told who the right provider is by your insurance company. The insurance company. Who's what are they thinking about? Who's interest is your insurance company thinking about? Are they thinking about you, the patients?
Speaker 1:
No, their own making money.
Speaker 2:
They're thinking about profits, because that has been proven time and time again over the past 50 plus years. These companies and pharmaceutical companies will time and time again, choose profits over patient outcomes.
Speaker 1:
Right, Right. So you go in on your insurance, figure out who's in your network. Then you get a list of the people in your network and you look at them geographically to see who's closest to you. And then you might check the Google reviews and see if it's good or bad. But a lot of times it doesn't really matter what the Google review is. You get three choices of who you're going to go see and you're probably going to pick the one that's the closest.
Speaker 2:
I'll tell you what I mean over the past. I don't know, I guess I've been doing this eight years now a Berman physical therapy eight years now. I cannot tell you how many times I'll get a call from a brand new lead, a brand new potential client. I say how did you find me? They said Google and I'm going okay. When you type in physical therapy in Naples, florida, and Google, 11 billion physical therapy clinics pop up and I say why did you choose me? And the answer is always 50-50. Or I don't know. I guess I should look it up. I think it's close to 50-50. 50% of them say well, you're close to me.
Speaker 2:
And I'm going really, that's the reason why you called me, because I'm close to you. Because, again, if you're not familiar with Naples, naples is a small town. You can drive from the tip of Marco Island to four mires in less than an hour.
Speaker 1:
Right.
Speaker 2:
I mean, that's small.
Speaker 1:
Right, Whereas in Jacksonville it takes you 45 minutes to get anywhere.
Speaker 2:
Yeah.
Speaker 1:
I mean from one neighborhood to the next neighborhood.
Speaker 2:
Yeah, so yeah, 50% of the people say I called you because you're close to me, but the other 50% say I called I Googled physical therapy. You popped up and I said, okay, why'd you call me? They said, well, you had the best reviews, Like okay, so you actually did a little research. You actually at least somewhat care what other people think about proven track records.
Speaker 1:
Right, exactly, exactly. But that's, like you said, not always the case. And then the thing comes down to do you take my insurance? That's the very next question they ask you when you pick up the phone what? Because, they're used to physical therapy being covered by insurance.
Speaker 2:
They're used to it being covered by insurance. But it goes deeper than that. It goes much, much deeper than that on a psychological level, and this is what I coach my staff on, year after year after year that people ask that. That's the first question that people ask because they don't know how to ask are you the right place to help me with my specific problem?
Speaker 1:
Right. Well, you know, being out of network and more concierge alike quote, unquote, because that's what they're called now wasn't a thing five or eight years ago. I mean, you were the very first out of network clinic, physical therapy clinic, to come to Naples and at that time, or to open in Naples, at that time, concierge primary cares weren't even a big thing. I think there were like two in town that were concierge medicine and even me, being in Western medicine, was like who's going to pay for that? Now, look at us number one but number two. Now there's tons of concierge physicians in Naples as far as primary care goes.
Speaker 2:
I love it, absolutely love it, and we could spend an hour talking on each one of these touch points. To go back to what you just said there, when I first opened in 2015, I know for a fact that there was not more than five concierge doctors in this town, and I know for a fact that I was the only one that was 100% out of network, with all insurances, only physical therapy clinic. Fast forward to today the majority of the good physicians are concierge in this town. We're not even talking 10 years later.
Speaker 1:
Right, and that's even not just for primary care. I mean, the good cardiologists in this town are concierge now. The great endocrinologists in town are which there's not many endocrinologists in all of Naples or Fort Myers are concierge now, which is putting a lot of people in a tough situation where they're like, well, my endocrinologist just went concierge, now what do I do? And that's where we have to have the conversation of you have to pay for your health, you have to invest in your own health and if your insurance isn't gonna give you, get you to the right person, then you might have to invest a little bit more.
Speaker 1:
That might you have to.
Speaker 2:
You have to. That was one of the biggest take home messages that I wanted people to get from last week's episode with the Ways De Well references is he said the quote on there and I'm taking this and I'm running with it forever. He goes you have to look at health insurance like car insurance. Car insurance is only there for that catastrophic accident. Health insurance is only there for that catastrophic accident. Car insurance is not gonna pay for your oil change. They're not gonna pay for you to get your tires rotated. They're not gonna pay to change your air filter. They're not gonna pay for those things, but you pay for them because you wanna keep your car running as good as possible for as long as possible.
Speaker 2:
You don't even think about it. Same thing with your health. It's the same exact thing with your house. You've got home insurance that covers hurricane Ian or at least that's probably a sore subject because I know a lot of people didn't have coverage. But just go big picture. You've got home insurance to cover floods, hurricanes, catastrophic events. You don't have home insurance to pay for your AC service.
Speaker 1:
Right right.
Speaker 2:
Or the handle on your microwave breaking. Yeah.
Speaker 1:
That we've been dealing with.
Speaker 2:
You don't call your home insurance carrier and say I need to get my septic tank drained. You don't call them for these things.
Speaker 1:
Right, but then for our own healthcare, we're expecting our insurance to cover our blood testing other than just the basic three lab tests that our primary care doctor does. That doesn't give us any real insight to what's going on internally inside of us. We expect our insurance to pay for our nutrition counseling. Okay, yeah, your insurance is gonna pay for you to see a dietician three times over the next 12 months. What good is that gonna do as far as keeping you held accountable and actually giving you the information and the guidance that you need? You can't learn everything about your own personal diet in three visits. It's gonna be a cookie cutter meal plan.
Speaker 2:
Absolutely so. The best way to look at this is if you don't make time for your wellness, you will be forced to make time for your illness. Now, that is a high level, 30,000 foot view of what we're talking about here. If you do not make time for your wellness, you will be forced to make time for your illness, and this is what you and I see in our office at least on a weekly basis. Where you've got all of we both have all of these really successful people in the business world that are coming in. They've retired CEOs of Fortune 500 companies. These are retired founders. They started a business from nothing and grew it to multi, multi, millions national or worldwide businesses and then, all of a sudden, their body gives out on them and it's like I don't know what happened. As soon as I quit working, everything went to crap.
Speaker 1:
Right.
Speaker 2:
Well, no, it didn't just go to crap. You just weren't focusing on what was happening while you were working.
Speaker 1:
Right, yep, and we see it all the time. It's like retiring. You know, kill, ya, I'm never going to retire, but that's not that's not what it is.
Speaker 2:
That's not what's happening at all. So if you don't make time for your wellness, you'll be forced to make time for your illness, and now there's nothing going in the right direction as far as health insurance goes Nothing at all. It is only getting worse and it's been getting worse since the 1990s. There's still. I still occasionally run into PTs who are in practice back in the 80s and 90s and they reference the 80s and 90s, like my mom will reference the 60s and 70s. It's like, yeah, man, those were the, those were the good old days. It's horrible now for in-network providers. You just can't do it. Insurance reimbursement has continued to go down across the board for every provider as far as physical therapy, medical nursing, whatever it is, since the 90s.
Speaker 1:
And so what does that mean to our listeners? The ream go ahead.
Speaker 2:
That's why your favorite physician is going concierge, because he can't afford to pay his bills anymore. They can't afford it.
Speaker 1:
What they're pushing providers have to do, whether it's in primary care or in physical therapy or into chronology, it doesn't matter the field. They're pushing providers to have to see more and more patients in a day, more patients an hour, in order to make the same amount of money that they were making 10 years ago or 20 years ago or 35 years ago.
Speaker 2:
Yeah, that's why the people that they'll reference back to the their doctor visits from the 70s and 80s, where your doctor would actually spend an hour with you regularly and listen to you and see what's going on. Right now They've got six minutes max. Usually it's two minutes. They walk in, they barely even look at you. They look at the charts and they say, okay, this is the symptom you're dealing with. Here's the prescription make a follow up appointment.
Speaker 1:
Right, right. There's not enough time to listen, not enough time to educate. That's the biggest thing. It's not even the listening issue. They don't have the time to educate the clients on what they could actually do to improve the symptoms that they're having, or to educate on nutrition counseling, or to educate on physical therapy exercises that they could do. They don't have the time for that. It's just. Here's the prescription. It's going to make you at least feel better.
Speaker 2:
Yeah, and again, we've said this so many times over the past couple of years. It's not because they're being malicious, it's because of the system that they're in. They've got to see X amount of patients per hour, per day to generate the revenue it takes to pay the bills.
Speaker 1:
That's another thing I want to make on. When individuals think about out of network pricing or they don't take my insurance, sure, the first thought is, oh, I have to pay them with my own money. Well, yes, but too, a lot of times they don't recognize that they're not going to get billed $20,000 because that's what they see on their insurance bill, that their insurance bill got paid $20,000 for this visit they just had, or the one night hospital stay that they had to have, and that's automatically what clients think about. But that's not the pricing that you get when you're a self-pay or an out of network practice.
Speaker 2:
Right, it's not even close, and that is a rabbit hole all in itself, right there, where being in network means that you're only going to get paid a percentage of what you bill the insurance company for the service you just provided to the patient, and in order to get paid what you should be getting paid, you have to bill two or three or four or five or 10 times more than what you would bill somebody who came to you out of network.
Speaker 1:
So pay. And so when clients again, I think it's more of a fear factor of when clients think, oh, you're not going to accept my insurance, they just don't understand what the investment actually is. Yes, it's still an investment into your health, but naturally it's going to be less than you would have. Your insurance is paying for you.
Speaker 2:
Let's look at it this way, because so many times we nobody, or we choose not to look at things from a time investment and we look at it from a monetary investment, meaning that let's just use physical therapy. For example, if somebody calls me up and I tell them we don't take their insurance, they can choose to go somewhere else that does take their insurance, because that other clinic takes their insurance. That clinic has to see multiple patients per hour and, right out of the gate, your one-on-one time with the treating therapist has just got cut in half immediately, instantaneously. You haven't even showed up for an appointment and your one-on-one time with the treating physical therapist just got cut in half, at least by half, because if they're seeing three patients an hour, then it just got cut by 66%. If they're seeing four patients per hour, it just got cut by 75%, just instantaneously.
Speaker 2:
So now do the math. If it takes me, jake Berman, 20 hours of one-on-one time to figure out what's wrong with your back and help us together fix the reason why the back pain started in the first place and then make sure that the pain never comes back again, if it takes me 20 hours to do that with somebody, now go to your in-network physical therapy clinic. You're right out of the gate. You're only gonna get 30 minutes max with that therapist, so something that might take me 20 sessions that are an hour long, it's instantaneously gonna take you 40 sessions at the cookie cutter. So we're talking about time. How much is your time worth? Yeah, you saved a couple of thousand dollars of money, but what did that cost you? Because it took you six months or 12 months longer to fix the problem, and you probably won't even fix it.
Speaker 1:
Right right.
Speaker 2:
So you're just kicking the can down the road. You might get some temporary relief and you're like, oh yeah, my back feels better. And then, 18 months later, there's the car accident again Right. Dis blows out, need surgery. Whatever it is, it's like what did that really cost you? You saved two or three grand.
Speaker 1:
No, you didn't Right right In the long run? Absolutely not. So it's several things that we've touched on so far is just the amount of education that you can get with having more one-on-one time or longer visits, more investment into your health. It's the education, it's the ability to be able to treat problems and not symptoms, and that's something we've talked about in the past. Actually, that we haven't even touched on today is the fact that when you're seeing an in-network provider and they're billing insurance, they can only look at you for one thing.
Speaker 1:
So in a primary care world, I went into internal medicine for a little while, between switching from Dr Cedarquist practice to opening my own practice. I went into functional or into internal medicine in the hospital and if I had a patient's schedule to come in and see me for a urinary tract infection, they come in the office, we do their urine, they have the urinary tract infection. I go in there, I'm talking to them about the treatment and they say oh, by the way, can you check my ear? I'm having some ear pain. I would have to tell them no, I'm sorry, I can't look at your ear, because that's not what I meant. That's not why you were scheduled today.
Speaker 1:
Because of insurance, you're gonna have to go back to the scheduling counter and get back on my schedule for another day. You can't even come back today. Come back on another day so that I can look at your ear, because this is what you scheduled for and this is what insurance is gonna pay for. Today. Only, I couldn't even help them with whatever else they needed help with because of what insurance was telling me that I could help with. And you have the same problem with physical therapy. If they go in for a referral for their back pain, that therapist cannot look at their hip, they cannot look at their feet, they have to only stick to the back and treatment for the back, versus with you guys. You're able to actually look and say, okay, your back is hurting, but it might actually be coming from your hip or it might be coming from your feet. You can figure out where the problem is and treat the problem, not just the symptom.
Speaker 2:
Exactly. I think a good summary to say about all this is insurance dictates the care that you'll get, because the provider will only give you the interventions that are covered by insurance. It's that simple. I'll never forget it. The last clinic that I worked at that was in network.
Speaker 2:
This is no fault of the owner at all. This was just the situation. I remember that I was billing units. I forget what it was. I was billing either manual therapy or yeah, it must have been manual therapy, and this particular insurance reimbursed more for neuromuscular education. I think is what it was. So these are just codes that you bill for the actual intervention that you should be doing or should have done.
Speaker 2:
And he goes why are you billing X amount of units of maniotherapy versus X amount of units of neuromuscular education? Don't hold me to these codes because I don't remember. This was 10 years ago, but I do remember that I was billing more units of the lower priced item than the higher priced item and I said well, that's what I did. And he looks at me and he goes well, maybe you don't need to do that much of it and you could do a little bit more of this other thing. And I just couldn't understand it.
Speaker 2:
I'm like the patient doesn't need that, though, and he's like, are you sure I mean the way I see it they could actually benefit way more if we did it this way. And again, this is no fault, no fault of his own, and he is very right. In hindsight, now that I'm a business owner and I see all these things, there would have been no difference in the patient outcome had I chosen to do this one thing versus the other thing, because it really didn't matter at the end of the day. I had to see multiple patients per hour, so it didn't matter to the patient. What it mattered to was the business.
Speaker 1:
Right.
Speaker 2:
And I'm going what the hell is the point of this? We're supposed to be doing this for the patient, but at the end of the day, the it doesn't do the patient any better or any worse, whether I choose this or that. And I'm going this just does not make any sense at all. And my brain was in a pretzel. I'm going this is not right, this is a broken system. And now I'm looking at the business owner being stressed out, every other payroll going where's the money going to come from? Because insurance didn't reimburse us for all those visits, whatever it was.
Speaker 1:
Yeah, it's something that we talk about regularly on this podcast. I mean, we've we've said similar things on past podcasts, but it's just the the point that you have to find the provider that's going, that is able to do the right thing for you. Not only can do it, but it is actually able to do the right thing for you. Treat your problems, not just treating the symptoms. Have the time for the education.
Speaker 2:
Yes.
Speaker 1:
It's going to require you to invest in your health.
Speaker 2:
If you want to avoid illness. If you don't make time for your wellness today, you will be forced to make time for your illness later. There is no way around it.
Speaker 1:
That's it, yep, I agree with that.
Speaker 2:
Good yeah, happy.
Speaker 1:
What else Was that it?
Speaker 2:
Yeah, we're already at 25 minutes.
Speaker 1:
Oh, my goodness Time flies.
Speaker 2:
See what happens when we're all jacked up. All right, so make sure that you like and subscribe this podcast. Leave us some reviews. We should get start getting some more reviews on this thing to help us spread the word a little bit more on this. Share this episode with somebody else. That is hardcore. Maybe a family member or a parent that's like we're not going anywhere else because this is our in network provider. Okay Well, I'll see you sooner or later. Right, you can't outrun me forever. I'm not going anywhere. Go to the cookie cutter's RS down the road. I'll be here year or two down the road when it doesn't hold.
Speaker 1:
That's right. We'll see you when you come back around. Good, all right Chat for now.
Speaker 2:
All right.
Speaker 1:
Thank you for subscribing on your social media and podcast platforms to the Berman method Dr Jake Berman with Berman Physical Therapy and Jenny Berman, physician Assistant, with Berman Health and Wellness. You can find more information on our website wwwbermanptcom for physical therapy. Wwwbermanptcom forward slash wellness for the health and wellness. You can also find us on social media, facebook, instagram and on your podcast platforms, so be sure to follow us, like us, subscribe to us and, if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.