Post knee surgery rehab now has a new machine to increase range of motion (ROM) and strength in a matter of 3 weeks. That leaves you with more functional rehab with a physical therapist. Learn about the x10 knee therapy machine with PJ Ewing.
The X10 is a specialized knee rehab equipment co-developed by his dad and a coworker of the orthopedic surgeon who invented knee replacement surgery. The x10 machine is about the size of arecliner and goes usually into a patients home for 2-5 weeks. It helps prepare the knee for surgery butusually is used to regain Range of Motion post knee replacement , patellafracture or ACL surgery as well as rebuild the strength.
He discusses how the computer and the knee apparatus can sense the resistance in real time, pain and end range of motion, ROM, and then adjust in real time to maximize where you are and then increase it all in pain free motions. The company has coaches and doctors that oversee each treatment and can tweak the program for each person each visit.
The machine can sense the resistance decrease and it has been programmed to know that might be because of pain. So it holds it there for 10 seconds and alternates to flexion and extension terminal end points.
Usually a patient is doing this pain free treatment 35 minutes a day, 3 times a day so it doesn’t take but a couple weeks to get your range of motion (110-115 degrees) back (without having to have a MUA of knee scar tissue) and so your physical therapy is now on walking and strength instead of regaining painful ROM.
Continuous Passive Motion Machine vs x10. Why is one shown to do just about nothing but still being recommended like crazy.
X10 knee is covered by some insurance companies in Michigan but they are working on expanding coverage in other states.
Does this tool / machine replace the Physical Therapist? If not, how do they work together?
Remove the ROM component and utilize your PT visits for more comprehensive and fine tuning of the knee rehab.
X10 is rapidly expanding with a new model this year and learn why they lease instead of sell these machines and how they plan to compete in other state market places.
They get plenty of calls everyday for people to do telemedicine and medical vacations from other countries and states because of the limited reach at the moment. They plan to change that in 2019.
As a startup company about to hit massive expansion, why is growth a key factor to consider and be concerned about managing properly?
What type of videos have been far and away the most viewed and impactful for x10?
Book: The Soul of a New Machine by Tracy Kidder 1981 Pulitzer Price Winner
Hear his take on why now is a great time to podcast and why he started his own.
We both have Chinese mixed babies and are trying to raise them bilingual… hear his two cents on that topic and how after school language classes are helping.
PJ Ewing grew up in Michigan. He worked in marketing and advertising for the first 20+ years of his career. Beginning his career at Leo Burnett Advertising he worked on many large brands including McDonald’s, Kraft, & Pepsi before moving to media sales. Mr. Ewing developed an expertise in helping people solve difficult communication problems.
In 2012 PJ joined the executive team at Halley Orthopedics as Chief Marketing Officer. “Never has there been a bigger opportunity to improve the outcomes of knee patients. I jumped when I first heard about the X10. Now I love every minute of the work we do,” said Mr Ewing.
In 2013 PJ earned a certification as a Certified X10 Patient Recovery Coach. He has coached hundreds of patients to a successful recovery after knee replacement and other surgeries since then.
PJ received a bachelor’s degree from the University of Michigan and a Masters in Business from the University of Notre Dame.
Show notes can be found at www.adoctorsperspective.net/103 here you can also find links to things mentioned and the full transcript.
ALERT: Also never before released, if you want complete blueprints to manage your knee pain head on over and download my No Needle Acupuncture Knee Blueprint now.
Justin Trosclair 0:05
Episode 103 post knee surgery rehab range of motion and string therapy she I mean host Dr. Justin shows for today we are PJ it was perspective, joint 2017 and 2018 podcast Awards Nominated host as we get a behind the curtain look at all types of doctors and guests specialties. Let's hear a doctor's perspective.
Justin Trosclair 0:31
thanks again for tuning in. It is almost Christmas time, hope you're excited. And I'm definitely excited because that means the end of the month mean the family going to head back home to America for like a month and get the paperwork finished, hang out with my family, my dad's retiring. So that's awesome way to go Dad. And I think they're gonna come back with me to China for like a month, maybe two really happy to be able to share my life with them in a different way for time. It's going to be some be good, real good. You haven't left a review, please do it. I know ask every now and then. So if you could please do that. Let me know on LinkedIn, send me a message on LinkedIn about if you review it, or if you post it on Facebook or anywhere is Instagram if you'd like a show, and amen. Yeah, I'll put the show notes picture on my Instagram account or on Facebook and put the episode number tag somebody all that let me know. Because I've got three different Bluetooth speakers that I'm trying to give away. The content is by Jay lab audio, or my favorite speaker companies on multiple different products from them like for and took advantage of some good deals that they had. And I want to give them to you. So write me a review. And let me know about it. And we'll get you entered in conjunction with this special episode about knee pain. I decided to release my own need pain protocol for no needle acupuncture. It's a doctor's perspective, net slash neat. And you can download it along with the other ones. Okay, today's show is about the X 10 therapy machine. Now, I didn't know much about this thing when I when I first saw it for this interview with PJ and I was kind of excited. And I said you know instead of just going back and forth to him on social media or whatever, let me just interview because it has amazing results. fast results get paid for your range of motion fully restored after different types of knee replacements, patella fractures, things like that. And so this episode is going to be explaining this technology, they're going into a rapid growth over this next year. So kind of cool to hear about that what the machine does, how you can make money off of it as well. Lots of good stuff, lots of good stuff. You may have heard PJ on episode 100. He likes to show a lot. I like him a lot. And even at the end, we both have something in common. Maybe I'm not going to spoil it. Go on listen into the episode, you'll know it when you hear it. All the show notes can be found at a doctor's perspective, net slash 103. Let's go hashtag behind the curtain.
Live from China and lower Manhattan, New York. Today on the show. We got a guy who grew up in Michigan, he went to the University of Michigan for his bachelor's. He's got a Master's from business at Notre Dame who's doing really good in the football this year if y'all care and but he works in marketing and advertising for more than 20 years. And he worked at this place called Leo Burnett advertising, which deals with like McDonald's craft and Pepsi's and then it moves on to media sales. Those are some big names. Now, in 2012, he joined the executive team at Haley orthopedics as the chief marketing officer, and they had this product All right, it's called the X 10. That's what we're going to talk about today. But he also became certified in how to do the recovery coaching part of it he's already coach hundreds of patients how to have a successful recover after knee replacement plus other types of surgeries. I'm really excited. Mr. PJ Ewing, thank you so much for being on the show.
Oh, wow, I thank you for the introduction. And I am your biggest fan, then I am truly very excited to be here having listened to many of the episodes and just again, Meyer what you're doing so very glad to be here. Oh, perfect. You know,
Justin Trosclair 4:05
we were having a little pre taco, I'm pretty sure I have a red face. Sometimes I'm pretty sure I got embarrassed because he was gushing on it.
From the heart man,
Justin Trosclair 4:14
truly, truly know really do appreciate that.
So there's a few things that we could talk about today. We haven't had anybody specializing with knees, especially with like, post surgery type of stuff. So give us a little bit of the background, what is an X 10. From what I know, it's this big machine, it goes into people's houses. And it looks like it puts motion into the need for however long and of course motion into the knee that the that range of motion is what's really important. So they have have pain future in the future. So give us a bit about the background about yourself and the company. And then we'll just kind of dive in based on what you say and we'll ask more questions.
Absolutely. It's funny, it looks big to you doesn't it on that on our website? It actually isn't so private a little bit the X 10 really was created by my father, Paul Ewing, and an orthopedic surgeon kind of unbelievable orthopedic surgeon, Dr. David how, who worked with the man who invented joint placement. Believe it or not, john Charlie? Yeah, right. I mean, right to the building back in the Dr. Charlie was creating tools and doing the first tips and Dr. Holly let his practice or is your school actually graduated from Ohio State, went to England writing to in England, worked with Dr. Kenley for six, came out with all his ice hole in this huge opportunity to start replacing joint and did thousands of hips and knees over his life in Columbus, he met my father because of an Ohio State Michigan rival real thing, believe it or not, down in Naples, Florida, you know, became friends. And these lifelong friends then retired and said let's do something together. And they look to need rehabilitation has had a lot of expertise and complaints, to be honest about the state of rehabilitate and and the fact is that the variability results, sort of the wild west of everyone has that sort of a different approach and different attitude towards recovery. And they ended up working this is a 13 years ago, starting to develop, you know, first in the garage, and then in of space, and then with engineers from University of Michigan, and then when more concerted efforts kind of pouring money into the development of this product, bit of money in the end. And they emerged, you know, seven years ago with a very large, weird looking thing kind of reminded me of the Loch Ness Monster had a big body and a little head and little face. And it was a machine that you know, was intended to help, you know, people recover from these surgeries. And over the over the time, it's become smaller and smaller and smaller, to the point where it can go in the home that takes about the size of an easy chair. And what it does, is it helps people recover a range of motion, rebuild their strength, and even prepare for surgery. Depending on the timeframe that you use, this device is connected to our next to an oracle database. It's you know, interactive, it's a touch screen. It's very user friendly. It's taking the wild west of very, you know the variability of recovery and standardizing it but not trying to treat everyone the same. It actually feels the need adjust to the body helps you make decisions on you know, range of motion games and the ability to pull pull some out of the knee and to rebuild strength or maintain strength or avoid atrophy. It puts the control in the patient's hand, but gives them throughout the whole timeframe. So you're not sitting there alone in your house with the next 10 machine. Good Lord, what do I do with this thing? That's actually priding with insight and advice as you go. Because it's feeling your life, it's feeling the resistance, the tightness, the we call it pressure, the pressure that you're exerting on the machine, and providing recommendation based upon how you're doing it at every second of time on the X 10. And that's being reported digitally wireless links to our coaches, who then can consult one on one every day with the patient saying, Hey, I know what you've been doing, I see your data. Tell me how it felt. Let's talk about what was going on in your second session. Let's see how the results were in your third session, but see what your games are. Let's talk about the swelling, let's care for you with telemedicine. And suddenly you've got a sort of a pain free, comfortable at home path with a coach on board, you know, path to recovery, or you know, just to fix whatever's going wrong with your name.
Justin Trosclair 8:56
Okay, so this machine's got lots of pressures, sensors, right. And so when you push it, it's given feedback, and it can tell it has some kind of program in there to match. If you're pushing at 50 pounds per square inch, it'll match that 50 pounds per square inch, or maybe it's a little bit less so that you can actually move through it. And then if in the last 10 to 15 degrees of motion, they notice Wow, you really went from 50, the only 10 Okay, we got a problem here or at any point in the in the arch, they can figure out okay, you're not pushing very hard in this area. Was it painful? Is it catching you know what's going on, and then the coach can program the machine to work in that range
it better in not not a bad description, it's feeling you and it's been pot, your knee. So when we set the patient, and throughout the recovery, we continue to teach the machine was comfortable and what's kind of getting tight, right. And when it's kind of getting tight, that means that you're approaching maybe a place your body isn't ready to go to. And so the machine says, oh, we're moving up. Let's say we're going back towards flushing of the knee, right, we're moving from 70 degrees down to 80 down to 90, which is straight down or sitting in a chair 90 degrees is straight down on the way that 90 degrees, it's a post surgery, you add your knee replaced, or you had to tell a fracture repair whatever the condition and the nice, artistically you tightening up. And it said 8182 Oh boy, wait a minute, I've been taught that if I feel more than a certain amount of resistance from that a, that person could be in pain or a better stop. And the machine pauses and maybe it's a 10 second pause. But it's found that for you, based upon how you reacted how you were reacting to those degrees, and it turns out that 82 degrees is it right now. And so we're going to visit 82 degrees, we're going to give you 10 seconds, we're going to go back up to extension and maybe give you some time to work on straightening your leg. And we're going to keep visiting the terminal extension inflection points, again, you for right now a default of 10 seconds, maybe we change that. Or as you go in till je cache over the last five minutes. I've been at those maybe two and you know, I feel better and better. Darn it. I'm ready for 83 and the machine is it for a little while. Yeah, blue light blue blue arrow ready to go. Whenever you're ready, patient. Let's go to 83. And when you do very precisely, exactly in Scituate, 83. Okay, little tight, but fine, comfortable. Now the conversations about 84. And if you do that for 35 minutes, three times a day, with the advice of a coach, you find those points, you gain a two degrees three degree day doesn't take long without pain to find 115 degrees 130 degrees to get your range of motion, check that box salt value can you know consider going to outpatient care or not go to the gym, whatever you're going to do is your post acute phase recovery. And you're going to end up saying well i'm i've gotten a range of motion. I'm that was I'm straight? I'm at 130 degrees, all good, let's maintain it. But let me give me give me gate trading clinician outpatient therapist give me some balance some some stability that's focused on strengthening in my outpatient, you know, coverage, you know, cleared up so everybody insurance, I've got my range of motion solve that within 1417 days. And that's lightning speed. Most patients kind of range of motion until much later.
Justin Trosclair 12:42
Because usually you'd have to go say physical therapists office, they're doing it in house, maybe they have some other type of machine that they can send you home with to do it. Because like you said, three times a day for 35 minutes. That's not a joke. Like that's, that's not a lot of rehab. But yeah, but I think my buddy towards a CEO wants and he said you need to be in this little machine that would move his leg for like 10 hours a day. And that is our eight hours a day. And
that is the CPM continuous passive motion routine. It's about 45 years old. And it is out of favor. But But the thing is, so look, look at this little company x 10. You got a device that actually and I could send you 50 papers, Justin and that say yeah, you know, the CPM doesn't really do anything. It's it's a useful in the hospital to avoid thrombosis. But to be honest, we can't put any evidence that it helps range of motion. And this is this is I'm going to study after study after study at but yet it there it is, it's still out there, they're still making new CPM machine, I can't tell you how many CPM machines we found on the floor, or then the cries when we are living x 10 machines. And the patients are discussing that thing, what a piece of junk. But it's still out there. And so you got a little company x 10, and you've got this product, it's sort of everywhere on the internet, it's still being used by some or some older school surgeons, and it's just kind of move your leg, it doesn't do these wonderful things that I've been describing. And the opportunities enormous for extent. Because our, you know, we compare this time and there really isn't comparison, this is light years ahead of that bit. So small. So it's not very well known. It's only being prescribed really in Michigan, where we have insurance coverage. So everyone else is sort of finding it for the first time. Obviously, there's an enormous opportunity for this, that is proven Now, take on the world. And so our company is, as we sort of mentioned in our little pre interview, is at this inflection point of small company, not a lot of machines doing great work, ready to kind of explode. And that's, that's going to be really the story for next year, as we add many, many more pieces of equipment to our inventory.
Justin Trosclair 15:01
And I want to hit on there. But let's I want to first go with I need it, I think I need to take a step back here should be a lot of doctors listening to this, who are like, I'm not really up to date with a lot of the new protocols, what are we supposed to be looking for. So maybe generally, you might go to physical therapy, they might work on your leg somehow, some way that might be kind of painful, trying to get that range of motion back, not very comfortable. Maybe it takes six to eight weeks or 12 weeks. And you said maybe two weeks, three weeks with your x 10 machines. So you happen to know any of the basic protocols that are typically used success rate percentages, any of those type of little statistics that we can compare and see that Oh, wow, this x 10 is really going to blow your mind.
Sure, sure. I mean, a couple things come to mind. The first thing that everyone's really trying to get his range of motion, quickly, faster rather than slower because the body overtime with all falling in the knee right will create scar tissue. And so it's a little bit of a race against time. And if you can get with or without the extent mind you this is not PJ's philosophy, this is just general generally know that you want to get your range of motion to let's call it at least 110 to 115 duties sooner rather than later to avoid the complication, the bigger complication that many people experience which is called going back in going under anesthesia, adding the surgeon manipulate the knee and break the scar tissue rip through the scar tissue that informed and then start to recovery over it's called an M you a manipulation under anesthesia. Now that rate, although the numbers are kind of you get a different number of different places, probably is in the six to seven may 8% of all people didn't do really well in the meeting this manipulation. Okay, well, that's expensive. It's expensive in time for the patient, because it was anesthesiologists you needed to book the doctor and then you have to do your recovery all over again all those home PT or outpatient P times there may be the need for a second manipulation or a third is a place you just don't want to know what the
Justin Trosclair 17:15
long term is you don't get that range of motion back. You're not going to be walking around the street without what a limp.
Well, yeah, long term you may never get it back and be because you're you're you've been compromised. You know for so long. You've lost all your strength your muscles atrophied and now you're in a this has been a disaster this knee replacement that you had all these hopes for this knew he knew you knew life. Let's go, you know, that's been completely sidelined by a dumb thing. Bangor need it just infuriating and up saying these are the phone calls for getting you know 15 to 20 calls a day from people all over the United States. And please, can you help me I'm six weeks post surgery they're going about an M you can you can you fix it with us? I don't want to overstate but it's half of 1% and I'm being generous, that have this complication who use this right out of surgery I'm it's almost non existent. This manipulation under anesthesia when you use the X 10. Right out of surgery. We're actually finding ourselves not just that great solution for two to three weeks for surgery, or that great solution for preparing for surgery. We could talk about that. But we're finding that we're the the calls that we get our I found you on YouTube, I watched a video I saw you on Facebook.
I'm six weeks, I'm eight weeks, 10 weeks, I'm five months post surgery, can you still help me but it This has all been a big disaster and and now we're getting other conditions because it's all been knee replacement for us a number of years, four or five years. Now it's patella fractures. Reading ACL we're getting a lot of arthroscopy is we're getting younger patients are world of just knee replacement has dramatically changed this past year, really, because of word of mouth. For me telling one to the other I, I just said a patient from Australia that flew to Merrill to use the extent for three weeks, and she gained at 50 degrees of range of motion in a very short period of time. You know, it was in she went back to Australia. So you know, it's and that's not perfect. That's no good for her to have to come all this way. But there we were. And we've had, you know, you've had guests on your show, talk about travel tourism and telemedicine and we're fine. We're it's not by strategy, Justin, but we're backing our way we're finding ourselves in the business is just by the virtue of this distance.
Justin Trosclair 19:43
Someone who's who does have like a knee replacement, or like he said, past patella fracture, they still are going to have to do some kind of physical therapy for the muscles for the spasms for different reasons. It's not just x 10 boom, don't even have to see anybody else. They'll hear you poser
right? knee recovery, you are absolutely correct. This is not trying to replace a physical therapist at all we hire physical therapist or physical therapist recommend is they use it, we have home care companies that actually you know, bring the extent of the helmet provide a physical therapist, the therapist is absolutely instrumental to this whole thing. Because let's pretend you're in a you know, either the X 10, you got it in your home, you've got your coach, you've got our team, but you need to go work on a whole bunch of other things. If we intake range of motion off the table for the therapist, the therapist in the outpatient setting is freed up. They don't need to spend time sitting there bend in the knee. And they all How's that feel you okay?
Well, right, and that's no fun. And if they have a short period of time to work with a patient, which you know, their schedules and you know, there's a way to run a business and an outpatient clinic and it doesn't involve two hours of sitting on Asian, it's, you gotta get your requirements. Sure. So you know, they're there. But if you've got them working on the finer points, let's go heel to toe strength, that's work on those quads, let's do let's do some work and some great training, as I've mentioned, and stability work. That's where the beings and the talents of so many awesome physical therapist skin, great us versus sitting there, kind of bend the knee. So we're bringing, we're sending patients from x 10 at home for a couple of weeks to a clinic, and their range of motion is great. Now they get to do the they could take a couple weeks, three weeks, four weeks, whatever they need, but they can walk out of there. I mean, done back like yeah, wrong, you know, thinking about tennis, playing golf, you know, driving around off the opioids, like we're, we're really happy land and a great recovery is just happened. And we were part of that. Yeah, in some cases. Okay. Excellent. can be full solution. But that's not the goal. Here the goal is and wonderful tool. Guidance we provide but then handing to physical therapists, you know, patients that are again, I keep using the phrase, but light years ahead of where they might have all been otherwise.
Justin Trosclair 22:08
Yeah, I guess we're not stepping on toes. We're not turf war here. And that's what I want to you want to talk about, I said you're kind of a startup you're gaining this year is going to be expansion mode. And we talked about I was like, can you Dr. By this? Do you need to be a chiropractor or PT, an ortho? Like who would buy these tables? And like actually, you don't buy a new lease them? So how is your model? Because if you're kind of in New York, but like in Michigan, and I guess that's where they're built, right? But Michigan has insurance coverage, but everyone else kind of doesn't have it? So are you guys shipping them across the nation? Are you if you only live in a certain area, you can get this? Like what's going on with that?
Right? Well, okay, remember, small company emerging? Right? So if a company is based in Michigan, I happen to be in New York and I do have writing for this see, okay, I'm in Michigan, I'm in Florida, we, we are, you know, we have nodes in the right, we've opened up Texas recently, we have Florida well developed, we have the Northeast, well developed in terms of at least coverage, let's call it. And then we have the bulk of our machines in Michigan, where our home base is. And that's where, you know, we've got home care companies were covered by Blue Cross, and we've got, you know, the businesses well established, it's, it's on the lips of the doctors and surgeons there. It's not a no, never heard of it sounds great. What is this x 10, it's actually, you know, we were knocking on their doors, and we're building partnerships and relationships, and we have them in a few clinics in Michigan. So it's, it's our home base, we're not selling them, we can enter into least three months. With clinics with surgeons, we're generally I mean, almost, not exclusively, but I would say 90 95%
of our business is in the home, to usually in the home for a short period of time. So that, you know, it's tolerable least from, you know, 14 days for many patients to get them over the hump. It's almost like an intervention, I would say. But for surgeons that wants to bring on a tool that could live in their in house clinic, wonderful applications there that they can use for certain patients that are having a tougher recovery, we can fit in, they could step in. And with a much larger manufacturing initiative coming next year, we're likely to have machines that we would be much more willing and able to provide conditions, you know, farther for our four locations really right now. So you know, as we grow, our interest is to not have fly from California, or Australia or wherever to get on the darn thing. But actually to provide it more locally, that it's ready to be honest, for me to be your calls from far away, right nodes, it's, it's unlikely that they're going to be able to go next 10. So, you know, that's the mission, if you want to talk about passion, you know, at the more patients that I speak with, or with whom our team speaks with on the phone, about, you know, please help me please help me, I need your I need the X 10, the more that pushes us to hustle up here, and a lot more equipment out there.
Justin Trosclair 25:08
Let's talk for real for a second, some doctors, they're like, Look, the patient needs this, I'm not gonna make any money on it, they need it. So contact x 10. Take care of it, is there a way that doctors are able to have their hand in the cookie jar a little bit as well, when they do referrals for these product? You know, can it be a piece
of profit generator? I know that it could I know that we have gone there yet. So that opportunity is, you know, that can be sorted out where there's a lease of this marvelous equipment and the surgeon, you know, has it now available and that can be can be offered as an add on. And I know many, many if you think about a clinic, there are add ons going on all the time special massages, and other things that are private advocate. Yeah. So you come into the facility and say she was that she I have any problem? Well, you can you can we have a package have two weeks best 10 time, you can come in and unlimited basis to come in one day or whatever, by you know, by the hour, and you get on the machine provide guidance. And now you've got a profit generator for a clinic, in the surgeon, many surgeons have, you know, affiliations with rehab facilities or they have their own. And there could be, you know, again, this is an add on since it's not covered by Medicare yet. And we're certainly on that path, you've got a product that can be treated like equipment, and can be used for a price and there's a model right there. We're not trying to sell them, really not we but there are opportunities for students to say would you shoot, if this is the space age about the latest, most advanced piece of rehab equipment, I am the latest most advanced type of surgeon, I don't know why I wouldn't met up with x 10 and find a find a way to do business with this company. And I will I will say Justin, you know, each surgeon right now is almost a comment quest. You know, the the patient walks in I used and this has been amazing doc you need to learn about this thing. And then that the conversations with the surgeon start really and in our patients are it's I think of it is like a Trojan horse, right? It's tough for us
to get into a doctor and make a call it takes funds to work every day they see their patients. And when the patients are walking in walking in just fine fire in their eyes saying doc this x 10. You got to look at this thing. Where do you go? Right? Well, with that, what a Salesforce. Yeah, our patients are our biggest advocates. We've got Facebook groups, and you know, they're making testimonials. And now we've got our little podcast and our patients are so passionate about this thing, that they're out there going on the drop, I'm taking this by Dr printed out all your materials, you know, how does he not know about I mean, it's a it's an army. Yeah, it's a small army. But it's an army. And it's a very, very potent group of people who we're getting started. And in fact, we have patients calling patients working with patients online just just provide their own like experiences
Justin Trosclair 28:07
every day, but you know, you're on
a little bit of a family? I think so. I think so this is okay,
Justin Trosclair 28:12
because we all got to know when our wheelhouse is, is finished, and we have to pass them on, you know, so it's not uncommon to go, Hey, I need to refer to you to somebody else, or to accompany or whatever, because you're going to get the best results. And that sounds like what this this company is doing right now. They're, like I said, You're branching out a little bit. So you just have to hope that you have a extend center or an ability to get the patient that piece of equipment in your area, and they just need to contact you and you guys can figure out the details of Yeah, you're at and what is actually a possibility.
It's it's business, right? It's part of how do you how do you, you know, I we're not out advertising. And we're doing every kind of tool that we can to, to communicate with prospective patients. We're not out there knocking on doors in Tulsa, and Texas, even though we now have some equipment there, because their machines are generally full. But there's a moment where you're, you're actually need to reach out and need to build scale, and delivery and care. And you need to do that smartly. So you're not disappointing people I I it's really painful. As I mentioned before, when people are knocking on our doors, and please going to have the machine and we all come to the conclusion that it's just not doable. It's a expensive because of insurance, lack of insurance or too expensive for them. Or it's just not too far away, or I'm asking them to, you've had so many Canadians flying to Michigan to get any x 10 that rotten? Yeah, that's right. I get Oh, that's no, that's, I mean, I love that we're helping them. But that's not what we're all here to do to help people you know, so I've got I help people side of this got the business side, which is controlling the growth, but yet, grow as quickly as we we can manage. Managing growth is really the story for us, you know, going forward, because we figured out the technology. And we've got the care model, and we've got great coaches, and we can scale it up, but it'd be the you know, it, it's going to be scaling up I guess is going to be the key on this thing. That's really the challenge. You know,
Justin Trosclair 30:17
part of the having your own podcast is you can kind of delve into whatever you're interested in to interested in as well. And part of me is like you have this huge blog, your blog for a while. And then you have the podcast, which is sort of I won't say regurgitating. But here's a really good popular blog article, let's talk about it on the podcast, and just give you more avenues to reach more people. So you guys are doing it right there. But I like also the manufacturing. So you're getting these things built. Now all of a sudden, I don't know, let's pretend you need 1000 or more machines to meet the demand that you guys have. How does that look? Or your is it built in America you're having to like learn how to outsource different countries and all this kind of stuff. Like if you want to talk about that? I'd love to hear about it.
Sure, sure. Well, let's go back to my debt. Right my dad whole Ewing, who invented this and a bio technologies that he invented for a completely unrelated industry. And his story is fascinating and how this thing actually came to be as its own episode, right but but you know, he was able to think of, you know, Affleck apply that into another ideas and other from other industries to this knee rehab world.
And it's been for him and the manufacturing side, about great partners. In Michigan, it's made in the United States, it's made in Michigan, there are a couple parts that have to come from far afield, and the software is developed, you know, certain certain relationships we've had to build, but it's having a great partner who can work on ideas with you and sit around a round table and develop the the next edition, the next advancements on the technology, many, much of which has come for patients experiences, learning from patients and then adding that application that tool or that that ability to the machine. But when you finally get your product, then the question is, can you make them at scale. And that's really the step that we're going through right now. We haven't needed to make more than 25 at a time. Well, those and you do that in six weeks, eight weeks, and you're fine, you know, as a limited hamburger demand. That's tiny, that's tiny, right? Oh, you have to go and everyone's ready, the right partner established, are ready to go. And we're locking down a model, it's the X 10, 5.0, which we will have in we're building now. And those will be ready in in 2019, early 2019. But now you need to knock out 100 at a time. And now we're ready to scale this company up in in a much larger fashion. And they're ready to pop in there. You know, the literally, it's the same group of people that say, Well, we've been replicating these wonderful machines, we're making small batches, we're ready to make 100. And so that's a big step. And that costs court costs a lot more, because now you're talking about larger spaces, that underlying kind of work. And that's
Justin Trosclair 33:04
massive, you know, at one point, you could like a cell phone, you can get like a bank loan, and then you get customers and everything kind of, but now we're like, No, no, we have to borrow a ton of money we have to get now we need to make the business part of this thing really work because we are investing a lot of capital into this.
I guess yeah, I mean, I can see the stress level going up a little bit you like Alright, guys, keep the marketing going.
You're so right about that I've treated you know, from the marketing, which is a lot of my responsibility. Also, I'm treated this like a big brand from day one logos, right kind of tools and marketing and output and YouTube. So you know, it's been really, you know, fun. But you're right, the stress level goes up behind because the dollars are very different. It's been in a lot of ways, pretty easy. you're managing the small number, you know, 120 hundred and 30 machines, you know, okay. That's, you know, that's pretty easy to do. Now, when we're talking about thousands, and a much larger team, and you know, it's the game is turning the stakes are higher. We've spent, mind you getting where we are right now, but yeah, this this becomes this becomes a business leadership question. Yeah, going forward, I think how well we do that,
Justin Trosclair 34:24
you're gonna have to have someone there full time job is logistically where all these machines that and then scheduling them. And I mean, that's going to be who knows how many people it's going to take to get that?
Well, we're building those tools, we have the tools now. And we have a wired connection with those machine. Remember, they're they're tethered to our end. So we know where they're where they are, when they're running when they're not, you know, but you know, you're not discounting your point, it is, I think, to me, the pieces in place now. And it's trying to be a catalyst for growth and to be the catalyst for growth are really going to be insurance coverage. When you get adoption, like we have in Michigan, a Blue Cross Blue Shield in that state, that company that has backed us in terms of, you know, coverage, wonderful coverage for us for a number of a couple years now, when you start to add Florida Blue, and then you add an app now or you you move on to the mother of all bridge in the United States, Medicare. And now you've got people that can just have it covered broadly across the country. That is the achievement that will transform this company in terms of demand. Right now. It's it's using word about in social media, and then of course, surgeons and Michigan, prescribing it to the lacrosse population. But when you start add insurance coverages to this, that is what that's where the infusion of energy and capital and stuff starts to happen. So we're again, we're at that we're approaching that that really big inflection point. But I know that, you know, I know that there are other factors that are just going to propel us to basically double or next year, for certain I know that
Justin Trosclair 36:05
will Blue Cross give you like statistics of saying, This is what we were covering our pain before. This is what you know, like comparing all the X 10 versus the normal patients and saying Yes, actually, there's a cost savings, there's a time savings, blah, blah, blah, so that you actually could have like a
pitch to the next Blue Cross and this and that. That's what we're in the middle of a bunch of studies. Right now. It's a surgeons that are in exclusive groups in Michigan kind of thing. So we are we are going down that path right now. And gathering that data. We have done research for years. And we we've been able to prove all kinds of wonderful things about the efficacy of the machine. We haven't even talked about and I will go into it, Justin, but we haven't even talked about strengthening this machine solves the strengthening question new patients. It's a huge problem. It's not just about bending your knees. It's about you, your knee. And it you don't have to think that you've lost all your strength through a long recovery. You can bend all day long, but you can't walk up stairs, because you don't have any quad. And so the truth
Justin Trosclair 37:08
is earlier you said it begins but it's based on street.
Well, that's so well, no, no. And they're actually different modules on the machine. I've only really, there's only so much time in a wonderful podcast like this. And I don't want to, you know, overstay my welcome. But but there's a whole other story about a strengthening, we've got a ton of data, were being paid by Blue Cross to do pre habitation as well as rehabilitation, you know, we're getting people back to their full strength, which is our tagline, back to full strength, we're getting the back to full strength by week three post surgery. By week for they're stronger than they were going into surgery, their rehab and rehab program, that Blue Cross is really behind their incentives, surgeons, encouraging them financially to use the X 10 right now. So we are strengthening stories, then the range of motion, we feel we've seen your range of motion, figure that out. But now it's how do we quantify a string story? Because you're not fully recovered until you're, you know, on the pickle ball court? You know, playing your game, feeling strong, bending great, I mean, recoveries of you know, I'm done. I'm fully recovered. Yeah. Well, let's talk about a real recovery where you're satisfied, happy, I've got patients, you say, you know, forget that I had my knee replaced. That's when you know, you've got it. Right. You've really recovered? Always. One was it was in my left or my right. Oh, wow. That's a full recovery. Yeah. And that's not universal. But you have that opportunity. But it's not again, it's it's pre have with or without the extent it's pre have before surgery, strengthen a range of motion, and then it's going to be a smart, quick recovery, of range of motion get right to strengthening, you can do that within weeks now. it to the clinic, and let them do their find work, you know, and the finer points and whether you get out an exponent, a clinic where you're just using the talented pts, now Now you've got a shot at it. And just it just the opportunity for recovery. Today 2018 is so much better than it was three years ago, five years ago, 10 years ago, from the surgery to defection rate going down to the you know, the quality of the care to this this device. I mean, this knee replacement was used to be a big, big deal. We're down into just a boom in and out of the hospital, get on the next 10 company in a couple weeks about patient and your your back to back to your thing.
Justin Trosclair 39:33
That's pretty wild. needed. My goodness.
Justin Trosclair 39:36
Pretty cool is neat. It's neat. And I know I know, people might be listening like oh my goodness, they got this for I'm really happy for you. I know some people are like they're turned off when it feels like a product, promotional podcasts or whatever is is not paid or anything like that anybody This is just a instrument that I saw that was like this is really cool. This is got a lot of potential had questions. And instead of just sending an email know, like, let's do a podcast and learn more about this. Because there are plenty of people out there that deal with knees, and are kind of very frustrated. And like you said, I don't want to spend all that time doing range of motion in the clinic, I want to get into the strength, I want to get into the you know, preventing the atrophy and all that kind of stuff. So they're looking for a solution so they can free up their own time. So I'm really excited about this episode, I'm really happy that you were able to come on and share these things.
I feel like I have became a sales guy didn't mean to do everyone Forgive me. I'm not trying to sell sales. I really, I guess it's my nature to kind of go go at really aggressively with my you know, I think I
Justin Trosclair 40:39
think if there's anything you have anybody that has a product that you're trying to learn about, it's gonna it might sound like a sales pitch and, like, this is what we're experiencing. So I guess I'm enjoying it. And I'm pretty sure some people out there definitely gonna enjoy this.
Do you happen to have any favorite books that are bog blogs podcast that you would recommend? It could be about nice. It could be about anything that you find interesting these days.
I knew this coming. Because I've listened to your wonderful work and I enjoyed some of your other podcast, I do have one and I actually have to Notre Dame and my one of my classes, an MBA School, which is all the soul of a new machine. Just ring a bell not for me all the soul of a new machine now, by Tracy kidder seen at one it was a pure what's your prize winning nonfiction thing? It's I've listened to and I've read it, it is one of those rewrite, it is one of those great moments. And it's about developing the piece of software in the era of mainframes. And it's a company that's under the gun that if they don't get it right with this new big mainframe computer, they're building a new computer, right? And if they don't get it, right, they're going to fall behind their competitors. And they're going to, you know, boost their business. And it's a thriller. It's true, it's a real thing that happened. But it's a story of teams coming together to develop new mainframe computer, they all say at the end when they you know, I won't ruin it. But when they come to the conclusion that, you know, in six months, those start over because you know, these things are so short lived, but but it's just I remember that I did since then back in school, one of the week about grassroots innovation and about ideas and where they come from and how you pull them together. And I guess there might be some parallel to our company and where we find our inspirations. But yeah, Tracy kidder, the solo new machine is the one that I would bring up, I am a voracious podcasts consumer. I listened to those that you listen to Jeff, and I'm sure the Tim Ferriss and all the big shots in podcasting. So I, I listened to a lot of audio, it's been a big thing of mine. So I say my, my mate, one of my matrix, it was of information. It's really coming through podcasts. Basically, maybe that's a lifestyle thing. And when I have had to listen and stuff,
Justin Trosclair 43:06
so much information that you can get, I mean, it is unbelievable. In every niche that I started, like, have questions about there's multiple podcasts. What am I Wow, I didn't
know. There it is your time this so right with your podcast, because there are those I look at some of the big guy surgery. And they did eight years ago, two years ago, and the audience was so tiny, that they just kind of just gave up their major. I won't name them, but their major hospitals, major institutions that have weekly podcast, and they went nuts. They finally just said I don't do this actually working. I don't know, they kind of just All right, that's it pulled the budget for the punch. I think that was you know, it was great that they got in early. But the audiences are scaling right now. MSNBC, Fox, and CNN, all of the pudding recently, within months, they've added all of their TV, programming, their news programming, almost instantly, this podcast with no commercials. I mean, when you've got major media, throwing all this energy into podcasting, and scaling that. Wow, welcome to a doctor's perspective. I mean, what a great time for you to sort of get into this space, because I think it's pretty smart. So we
Justin Trosclair 44:19
you have another minute or two? Of course, my goodness. Okay, so on the pre chat, I found out a couple of things that we have in common. We have a we have some mixed babies, yeah, with some Chinese ladies in our life. And I'm just curious here, I want to raise my kid bilingual. She's in China now. So it's going to be I think, hopefully a little bit easier, because your mind will speak you know, mostly Chinese and her grandma and then you know, means English. any hints or tricks to try to get her to be as bilingual was, quote, fast as possible? Or do we need to worry about reading is that like, some we should just worry about later on and just get the verbal best, but what's your thoughts?
Sure, I do not speak Chinese. But my wife speaks to the children. Often, which is a little funny for me, I'm like, What are they talking about over there, I have a five year old and an eight year olds who are both in the bilingual, you know, Chinese, West east, you know, mixed children. And so there's a lot of Chinese beings plugin there. But it's not enough. You have to, in your case, being in China, you know, the opportunity for just hearing a lot of Chinese and that's going to be wonderful. And I wouldn't worry about the English, I know that your daughter is going to learn English, it's just going to happen. But in our case, we're in an English environment and the the nanny and the early days really easy to all be in Chinese and the child hears and starts to understand and speak, once they get to school, in our tradition in English here in the States. Everything goes south, the kids don't want to speak Chinese, they want to speak English and now you're in trouble. So when they hit three to four years old, and it's all in English, your it become the big challenge. We solve that with after school programs in Chinese, this is a little later, right? This is for five years old. And that is supplemented and helped hearing Chinese in the household all the time has been really beneficial. But you have this enormous advantage of being in China, and for whatever length of 10 years, they're shorter, long term, you're going to have just exposure, listening, you know, the key is going to be just sort of time and sort of putting putting her time in and I i would i would be just that you have an advantage over my children because you know, you're going to she's going to hear it Ruby's going here. Just all mean, she's going to your Chinese wherever. You know,
Justin Trosclair 46:38
how are you? How are you? When you speak Chinese to your kids? Oh, yeah, I know. She's, she's not always but I would say 75% of the time. She's speaking Mandarin to the children. Yeah, that's that's her, her. And I don't understand that as I mentioned, but you though Do you speak anything mentoring at all? No, hardly, man. It's so bad. Like, I'm so sorry, boy, or whatever. I'm doing podcast and instead of learning Chinese, and I know I'm going to regret it. But especially with the kids. So we actually got a we plan to label everything. So you know, pinion, you know, so I can when I look at a fridge, I can say it's a refrigerator. It's a being something.
So we can all learn it together. Because Yeah, they can have conversations behind my back.
right and right. Oh, yeah, they already do.
Justin Trosclair 47:26
This pluses and minuses.
Yeah, yeah. No, it's good. Good. I love that we have again, you have a chance right now right? To learn the basics. It's hard.
Justin Trosclair 47:37
I got Rosetta
computer in the background. I don't think you worry about the writing, of course until later kids are doing now that you know, they're starting over and that i think that you know, like my children to be able to go hang out with your child someday and in China and feel really comfortable and at ease and you know, it will a verse and and be able to read and it's we have China Town right near me and lower Manhattan. So we're seeing Chinese signage, and a lot of the people in China don't just speak Mandarin or Cantonese. They do not speak English. So, you know, it's just take advantage of your, your environment we have we're lucky here. And you were to, of course, so pretty much
Justin Trosclair 48:22
the kids too young to have the I heard there's usually like an identity crisis, or, you know, am I Chinese and my into my American? Am I am I both? How do I incorporate both cultures into my personality? And like any of that happened yet? Are they little bit too young?
I think they're a little too young. Here. I don't think they feel they feel like American kids, but they're very proud of their child, Sarah Jane. And, you know, it's I mean, when you're immersed 24, seven in America, in New York. Yeah, you're, you're going to feel just a part of that culture. But I think they look at Chinese with fascination and great interest. And, you know, they throw themselves at it and proud of their scores and their abilities to learn. And, you know, I, it's, you know, it's going to be you, and your support of your daughter, to encourage her to throw herself at Chinese. I do that even though I know that I'm creating little kids that will be able to speak like that I can't speak I still really, really that advantage. Like, no you do. I did grow up with two languages, you know, like little Italian and that helps with our Italian family. But I never really grew up just grew up with two and two languages. And it was a huge advantage. Just I don't know about business, but just push will lead to be the other half of the world and feel comfy in the leg. enormous, enormous. I mean,
Justin Trosclair 49:46
there's so many people to the biggest economies in the world. And to the you know, the one of the biggest country if not the biggest country in the world. It's China. So many people. Anyway, man, that was fantastic. I we went on a tangent off of there. got bored apologize. But that's a whole nother podcast right there. Oh, and other genres to talk about? Yeah, raising. But man really appreciate you PJ. All the kind words, of course, bringing all the good knowledge about the X 10. out before we go. Did you miss anything that you needed to talk about? You know,
it's so funny. I had, I was ready to go and talk about all the social media and marketing and all the stuff that we did, which is totally fine. But no, I think we did a good job. Sorry, everybody, again for overdoing this x 10 side of this button. But um, I guess I will just say I will let me make one little comment. And that is, I think that little companies that have technology like ours, or Nickelback, there has never been a time for a better time for little companies to succeed, and get the word out and share and grow as it is right now. I mean, we are not spending marketing dollars, we're not out there, you know, advertising. And yet, through the things that are just presented to us the things we all know, the YouTube's, and the Facebook's and all those wonderful tools, we are growing our audience will increase our ability to communicate getting better as a company every day, just because the world is the way it is right now. So I am so thankful the couple days before Thanksgiving here in the US. so thankful that we we have all this development of technology, education, because it otherwise I don't think the half as far along as we are right now. And and I mean that it's not just communicating the product benefits, but learning enough and hearing the voices of the patients and being improving ourselves, based upon the reactions in the input of the patients, I don't think we would, we'd be half away as far as we are, you know, in a relatively short period of time. So I guess I just feel like, I spent a lot of my time on that side of things. Working with our teams care side of things, I I'm really focused on spreading the word in whatever the world gives us. And it's, it's plentiful without there.
Justin Trosclair 52:11
It's funny, because, you know, we're talking about over doctors we want, what's the proof? Where's the stats, and other hand, patient testimonials are pretty strong, too, as far as getting the word out and pressuring doctor's prescription drugs on commercial TV, hello. But there's like functional, that's a big thing right now functional movement, can I go back and play golf? Can I go do the things that I was doing before, you know, because I had knee pain. And if you're getting those results, like that's a huge piece of our our doctor repertoire nowadays is not just checking boxes, but getting the patients the results that they're looking for. And so those types of stories on social media are going to really resonate with so many more people. You know, and this is the thing that you're doing a good job with that
well, and I'm learning to this, whatever we did last three or four years will be produced what everyone can that's what you wonderful, very smart. Good guy, Ben Baker said recently, 90 seconds, one minute, people have a short attention span, you got to make sure and we've done that, like crazy. We make these short videos, testimonials, you know, and help share people's stories. And they're great, wonderful. But guess what happened? I believe in the last two years within the era of our political leadership and in the area of of Facebook scandals, and in the area of doubting lots of things is still don't believe anymore. And they're there. They don't they don't need these. Oh, yes. Some editor gotten in at any moment took an interview with pick the good parts. And that's what I'm watching that are the truth. Is it fake? What are we have everything's fake every one of our most successful videos, and we've got seven or eight of them out of the hundred and 60 that we've done their iPhone, push record, listen to someone speak for seven in it. They're made by the agents. They're just point and shoot unedited, truthful pieces, Bowser and they're long they're not the one minute and a half there eight or 10 minutes. Our best video is 10 minutes long. And it's it's evergreen it just produces new inquiries every single day. It is it is not beautifully shot just be truthful. And when I did that recent podcast episodes which were longer and form and spirited conversation with a patient just like you're doing I'm taking your your card you're playing here those are the most successful buyout dramatically long just I think people are willing to sit there if they're really believing they're only getting the truth is that some some patents thing that's what's actually working people are looking for you know, I need help I'm looking at you know, various ways to help my dernie what what can I do and they're looking for the truth not some sort of package things So anyways, I guess I'm getting not nodding so perfectly I did invite all of these logos and you don't necessarily have to build that people to communicate with people and really provide help and then provide help for your business. You know, I had heard some earlier was I think
Justin Trosclair 55:17
mas are a lot of these like these software companies that like millions and millions of dollars are now It all started with like a free tool. And the same thing goes with you might have 100 videos but you only have that 10% that actually creates almost all your traffic you know that whole 8020 rule statement and Yep,
that's just how it is it's crazy podcast episodes it's just keep rockin the people wrote love to to know that will drive a lot of inquiries and interest I mean nice I'm sure so anyway
Justin Trosclair 55:48
once your website sir oh god how can people get in touch with you? Oh my goodness Yeah, forget it'll be on the show notes page anyway but but but let's give it let's hear it but yeah,
it's for me it's PJ Ewing. So it's people Hey, not a wi n g. x 10 therapy calm x one zero therapy calm. And then the website is extender, calm and the product is the accent. So pretty straightforward. We're you know, and all those places, we private discussion groups, and you know, a lot of our work is just to help people, Justin It's nothing to do their machine just to provide them with insights and email series and advice. But yeah, excellent therapy is really where you go to learn about us.
Justin Trosclair 56:28
Absolutely. Perfect. Thank you
so much. Well, thank you. Great, great, really enjoyed it.
Justin Trosclair 56:37
That wraps up another episode want to remind everybody that we have some great affiliate links available if you're into instrument assisted soft tissue manipulation, we've got the edge tool and we got the hot grips, sage about 10% also with the edge you've got the like blood pressure cuff restriction system, you've got the G sweet inexpensive Mr. In case you'd like to in cash practice. You want to know what hosting us for podcasting, blueberry, pure VPN, that's one of those ones I use to help keep my payment secure as well as access the internet more safely. You've got the primal paleo grass fed protein bone broth style, save 10% on that no sugar, allergy free, gluten free, dairy free all those types of things mentor box get taught by the author, we got set preset for those floss bands that you may have heard about on one of the episodes really like those in the Amazon products that you might want, click the link in the show notes pages. And of course, I got my own electric acupuncture pin to go with the needle acupuncture book on time, you know have a bundle set where you get them all together for a great price muscle have the free downloads at doctor's perspective, net slash blueprints. And more lately I've been doing is substituting a fifth one like I've done a neat and depend on the guests, I might do a different type. So check back there. So all those resources can be found a doctor's perspective, net slash resources. There's also t shirts at.net slash t shirts, put up some new designs from time to time, like Megan lemons, lemonade, Trump, oh boy, plus all the Chiropractic and podcast swag that you could want. If you have any ideas for guests, please send an email Justin at a doctor's perspective. net, I'd love to hear who you think would be good or a profession that you may not have heard yet. If you can send me review that's dot net slash subscribe, Apple, Google stitcher Android devices, you just click that button it'll take exactly that a page you need to you can write a review, hopefully a five star review. I said it does help for other people to discover what we're doing here. And we've got over 100 episodes is gonna be like our third year super excited. We're going a little mini series like we've been doing, which has been fun. I hope you've enjoyed them as well. That's that's the feedback I've gotten. And one thing I haven't really talked about too much is the doctor's perspective. NET slash support page. If you were about to host a cup of coffee, go for it. If you want to pledge a little higher fee there's buttons for that there's even monthly recurring for those who feel like wow, this is like the cheapest mentor coach program I've ever seen because you interview so many different kinds of doctors and and have been able to implement things that I've heard and it works well monthly recurring payments, which also you can get you my books for free t shirts for free. The first book, you know that deals with health and exercise, getting on a diet, getting your financial health in order as well. things to learn in China, you know that books is available as well. And one thing that I don't have I don't have like a full blown page about coaching and things but there's a little button there. I've had people request Hey, doctors and non doctors asking me can I do more than just answer a couple of questions or could you be my coach for a little while and say, yeah, we can do that. So something I haven't really advertised but it's something that I can do and do whether it's marketing strategies for new patients growth, those types of topics. If you're interested just email me Justin at a doctor's perspective. net. As always, listen, critically think and implement Have a great week.
We just went hashtag behind the curtain. I hope you will listen and integrate with some of these guests have said by all means please share across your social media rather review and you go the show notes page. You can find all the references for today's guests. You've been listening to Dr. Justin shows Claire giving you a doctor's perspective.
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