E501 | What The Heck Is The Aggregation Of Marginal Gains

 

If you are trying to improve anything in your life or in your business, I want you to think about the concept of the aggregation of marginal gains. If you know what you are trying to improve, you have to look at the component pieces and improve them individually. This will almost always lead to a better outcome. Enjoy!

• Having some self-awareness to know what you may be bad at
• What may have led nobody to come to your in-person workshop
• Understanding what is and isn't predictable as a business owner

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Podcast Transcript

Danny: So one of the best ways to improve your customer experience, which we know will dramatically improve your business, is to have clear lines of communication with your clients. And that's something that can be really hard with these multiple channels between email and text. And what you really need is to centralize that in one place.

And that's something that we've been able to do as we switched over to PT everywhere within our client's accounts. We can actually message right back and forth with them. They can manage their home exercise plan within there, and it allows us to really compartmentalize the community. That we have with those clients, instead of losing an email in the inbox or missing a text and then you're, it's very hard to dig yourself outta that hole because they feel like you're not very responsive, with them.

And for us, it's made a really big difference. It helps make our staff more efficient. It helps us not miss things as much with the volume of people that we're working with. And it's a really smart way of really compartmentalizing your communication with your clients so it doesn't interfere with the rest of the channels.

You have communication with family and friends and things like that. So I think it'd. Huge for your practice to centralize it the way we have. Head over to pt everywhere.com. Check out what our friends are doing over there. I think it's really cool and I think you really.

What's going on guys? Hi, Danny here with the PT Entrepreneur Podcast, and today we're talking about the aggregation of marginal gains. That is a difficult thing to say and understand for me at least. And I had a mentor of mine that I heard talk about this on a podcast, and I was like, God, aggregation of marginal gains.

That just sounds so complex. But when he talked about the topic of making these small changes over time and iterating on things over and over again, I thought to myself, man, this is something that we do all the time. This is not what we call it, if you're trying to improve anything, I want you to think about this idea of the concept of aggregation of marginal gains.

This should give you a lot of comfort in the fact that you can do and improve basically whatever you want. You can apply this to really any area of your life, any area of something you're trying to improve. I'm gonna give you two, two sort of reference points for this. One being more clinical and then one being on the business side.

So the way I look at this is if you know what you're trying to improve, you have to just look at the component pieces that go into that and then try to improve those, and then the outcome will improve inherently because, Things that lead into the outcome are getting better, right? We see this in sports all the time if you wanna be a better basketball player, you could just play more basketball.

You could also realize, wow, I suck at dribbling. I keep having issues where I'm turning the ball over because I'm getting the ball stolen from me. And every time I try to run fast with it, I lose it and I have a turn. So yes, if you play games, you'll get better, but if you work specifically on individual dribbling drills, on working on, maybe it's even as specific as your opposite hand because you're not very good there.

If you go to switch hands, you lose the ball more often, or people can defend you easier because you can only drive one direction. All these things can be improved in the sports setting. It's just a matter of being self-aware enough with ourself to say, oh, okay, I'm bad at this. And then understanding how do I get better at that?

And that's usually by testing things or doing things that a coach tells you that you can do that are improving those in basketball is a perfect example, right? So in the clinical world or how you can apply this with your. Outcomes in your office. I like to think of this in terms of small adjustments to things that you're gonna be doing on a regular basis.

So when I was at Baylor, we had a a partnership with the Fiam program that was run by the Army as well as a local practice that did a lot of fellowship training for people all over the country. So what happened with us was we got to. Just be a part of the fellowship training in particular when it came to manual therapy.

And I remember as I'm going through some of these techniques, for instance, let's just talk about some sort of neck manipulation of some sort. That's a, I think for a lot of people sketches 'em out a little bit. Like they don't really like their head being, jostled around and they think you're gonna Ninja, twist their head off or whatever, like a, like a finishing move or whatever in mortal Combat and that.

Like you want, how you want be able to feel. And the way you can do that is a few things that we would practice that I always thought were redundant, but it made sense as we were improving these because my overall ability to, get a outcome from this manipulation improved as well.

So when we look at aggregation of marginal gains here, None of these things in isolation are gonna create a massive change for me. But if I know where my limitation is and I can start to slowly chip away at improving those, then the outcome I want, which is a effective manipulation with the corresponding outcome that I'm looking for there is gonna happen.

So I remember. We would get together and we would go over like the tedious little details of this stuff. For instance, we would work on hand placement and skin locks associated with that. So how do we get the best sort of like hand grip position and placement based off of the reference points of the anatomy that we were looking at?

How do you create tension? With the movement, how do you create like force and tension by while still maintaining your hands, feeling soft? And those of you that know what I'm talking about that have gone through a lot of manual training, And you know what it feels like to have somebody, they should call 'em pillow, hands.

Somebody that can like really gain control of a limb, but yet you feel relaxed at the same time and somebody that's has like really hard hands and they like force things more and that feels very uncomfortable, especially when you're talking about like the neck or something like that. Control.

How do you gain control? How do you. Body contact. How do you use less direct force and more sort of full body force as you're going through things and how do you put people in positions that you're using the leverage of the internal mechanics. Over your external mechanics to create a safer, more effective manual therapy technique and then explanation of those things.

So like little things talking about what's actually happening? What can you expect? Here's how I want you to breathe. Here's the way I want you to look. This is what I want you to do with your eyes. Like these little things. Didn't make a big difference. And I remember drilling these things over and over again and I was like, God, why is this, why are we doing this so repetitively?

And it's because we were trying to accumulate the aggregation of marginal gains. So then when we went off and we were, in the military, seeing however many people a day by ourselves, we were very competent when we came to certain things that we needed to do on a regular basis. Now that's a clinical sort of example.

If we think about. This for me is what we do on a day-to-day basis is try to get this aggregation of marginal gains over a long period of time and honestly shortcut it as much as we can, which really comes down to knowing what work you need to do. For instance, whenever I was going through all my training and I had all these fellows that are giving me guidance on here's what you wanna work on.

This here's where it feels like you're missing the mark with this technique. And for them to lay down and me to do a technique and then them to stand up and say, okay, here's what I want you to think about, or for them to work with me and have another student they're using as like the person they're doing the technique on.

And then for them to say, okay, what felt different about what I did and what they did? Now we're closing the gap by having. Direction on which things we're trying to improve, which makes our efforts of gaining the aggregation of marginal gains to go up significantly, cuz we're just moving in the right direction.

Versus hospitals try hard to improve things, but they're trying to improve the wrong things and they're not focusing on the right work. So this is, in my example, assuming you're focusing on the right work. So let's say you wanna get better at education, marketing let's call it like in-person stuff.

So maybe you're doing lunch and learns, you're doing something at like a networking group. You're doing a workshop just locally educating people on your business. This. Important skill. Very important skill. If you have a local service business, you don't necessarily have to do this every single week and weekend.

Some people can build an entire practice off of this if they're really good at it. Other people, it's an element of their marketing plan and locally in particular. So let's say you do an education event and it bombs. Nobody comes up to you afterward. Nobody has any questions. Nobody really seemed like they were into it or paying attention.

Maybe nobody even showed up, so what does this tell us? Let's just take the example that nobody showed up because this has happened to me. And it sucks. It doesn't feel good. But it's probably gonna happen to you too if you start trying to break into a new market. So let's talk about, nobody's showing up.

What does your pre-marketing look like? How did you reach out to people to set this up? What kind of information or what kind of marketing materials did you give the group that's running this? Before the event to really help drive people to the event. Do you have your own list of people you could drive to the event?

Are you missing some of these things? If so, cool. Next workshop we do, I'm gonna try to create some sort of marketing materials that I can then send the. Let's call it like a business owner who is bringing you in to give to their people, to email to their people to give them example of what it is they're gonna learn.

Maybe you do a q and a in like a Facebook group or on a Zoom call or something like that for people prior to the workshop so that they know what's going on, like educating them on what you're gonna teach them there. So like how do you get more people to show up? There's many things you can do.

It's just about testing those things. Seeing if it improved your end result outcome and then iterating on that to make that better, more efficient, systemized to then work on something else. For many people, it's how they teach. It's what they teach. So let's say you're teaching at a gym and you're going over your frameworks for dealing with back pain, right?

Let's leave it at that. So you realize, okay, I've got 10 people. I got no patience after this. I'm getting feedback from coaches. They said they really liked it, but it seemed like maybe it was a little bit too high level for people that you are talking to that are not coaches. So what do you know now?

Now I have to improve my ability to bring information down to a more simplified level, and now I have to go back and I have to look at. Education format that I have, and I have to look at what I need to drop and what I need to add and how I need to make this easier to understand. For the average person, you, she says, same workshop again.

This time you have one person come up to you after the workshop, they ask you a question and they decide not to come in and see you. So you're making strides in terms of improving your education. F. But now your pitch sucks and you're bad at communicating the next steps for people of what they need to do.

So you start to work on, okay, what am I gonna say in roleplaying? Those things and chipping away, getting better at that. The next workshop you do, 10 people show up, two people talk to you afterward. One of the two ends up coming in to see you as a patient. All of a sudden, boom, you. One new person that you've generated out of three workshops.

Terrible conversion percentage, but making progress in the right direction. This is the aggregation of marginal gains. I've never really heard somebody put it this way, but now I've actually heard multiple people say this. It's funny. It's if you buy Toyota Tacoma. All of a sudden you see Toyota Tacomas everywhere, which your reticular activator is now locked in on Tacomas.

I guess mine is locked in on the aggregation of marginal gains, and I think that this is something that you know is an incredibly important skill, whether you know you're doing it or not. Definitely better if you can be intentional about trying to improve these things. And the key. To focus on what skill you're trying to improve and then what component skill sets underneath that are sub-skills lead to success with that specific skill.

So in this. Local marketing example with workshops, it's how you're relaying information, it's how you're pitching yourself. There's a number of different things that go into that. And pre-marketing, all of that. So as you get better at those things, the end result improves. Versus if you just say I gotta get better at workshops, but you don't know what things you're trying to improve and you don't systematically chip away at those.

You really don't know if you're making progress in the right direction or the wrong direction, or if you get lucky sometimes, or if you don't and it's not predictable for you as a business owner to be able to say maybe I'll get some patients at this event. Maybe I won't. Cuz how do you know it's worth your time?

How do you, how can you predict that if you have staff members that you are also, trying to help grow their schedules and fill their schedules up? This is why we have to be very focused on not just the outcome that we're trying to improve, but also the component skills that then lead to that skillset itself improving, and then us getting more of the outcome that we want.

So hopefully that makes sense. If you're struggling with a task, my advice is think about what sub. Tasks, sub components or sub skills lead to success in that variable that you're trying to improve? Start a chip away at one of those, improve one of those, test it, retest it, and then make improvements in as many of those skill sets as you can.

You can figure out that you need to improve. Underneath that skill to then lead to more of what you want. In this case would be more new patients, better at manual therapy, better playing basketball, you name it. But what should give you a lot of confidence is the fact. Any skill that you want to improve, you can improve.

I'm not telling you necessarily that you're gonna play in the nba. If you're five nine and you can't jump and maybe you're, you, you're not that you don't have that great of hand-eye coordination. Can you improve and get better? Yes. Are you gonna play in the nba? Probably not, but maybe, I don't know.

It just depends on how hard you work. It depends on your circumstances around you. But it's a heck of a lot easier to play in the NBA if you're like six foot five and you can jump outta the gym, and you have amazing hand eye coordination. Got it. But those people can improve as well. It's just a matter of whether they want to.

Now this is a difference between somebody like LeBron James and somebody that's built just like LeBron James. But it's in LeBron James. It's the aggregation of marginal gains over a long period of time that then snowballs, snowballs until you eventually are world class and better than every single person around you.