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Flip The Switch Episode 62: Matt Bruhin

January 7, 2019
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AUSTIN: On Flip the Switch we have the CEO and founder of Apex recovery rehab Matt Bruhin sit down with us to discuss the ever-changing landscape of drug addiction and what it’s like to run a rehab in the 21st century. Matt is a licensed addiction therapist and doctor of addiction psychology with a passion for helping those in need. He tells us a great story about how he helped a man from committing suicide on a bridge. And we get into that.

We also chatted a lot about progressive treatments. And what’s being used instead of the 12-step program. We also chatted about his help and the work he’s doing in the opioid epidemic.

Let’s get into it.

01:10 AUSTIN: With us today we have Matt Bruhin, the CEO and founder of Apex recovery rehab. He’s also a client of ours here at Power Digital, and a great partner. It’s been a tremendous 2018 and Matt, thank you so much for coming on the show.

01:22 MATT: Thank you for having me, Austin. Glad to be here.

01:25 AUSTIN: Absolutely. So, we want to give the listeners a background on yourself give them an introduction as who you are as a therapist, as a doctor… And so please just explain the passion you have behind the medical field and how you got into this world.

01:37 MATT: Well, I got into this field in kind of an interesting way. I knew from a young age that I wanted to be a psychologist, a therapist of some kind… Just because I had a gentleman that I work with who was actually an ex-NFL football player. And then went back to school and became a psychologist.

And I was going through a significantly challenging time in my life, when I was a teenager. And was just very impressed by how he worked with me. And then his skillset.

And I think from that point on, I felt like I had a chance at maybe doing something along the same line.

So, I was fortunate. I knew kind of direction I wanted to head from a fairly young age. But I thought I wanted to go into sports psychology. I was an athlete, I always kind of had been a gym rat and really enjoyed that sort of thing when I moved to San Diego. At San Diego state, I put myself through as a personal trainer.

And so, I always wanted to go to sports psychology route. And it really wasn’t until I found addiction work that I found myself actually preferring that than going the more sports psychology route. And I think that reason is just because both through my own family of origin, and then just my experience in southern California, I was just amazed by what I saw with chemical dependency.

I had never been exposed to that. I came from a very white bread town in Colorado. Our idea of cutting loose was a keg of fat tire beer and maybe a puff from some bowls every once in a while. Hardest thing you’d ever get into was some mushrooms.

So, when I came out and heard about things I’d never even been exposed to… From crystal meth, obviously tons of cocaine, the ecstasy flood kind of came in about that time.

And so, I really just was very interested in how that affected society. How it affected the friends that I knew. And so, I kind of began to get exposed to that more in the mental health field. And found myself just being fascinated.

And also having kind of a natural talent of working in that field.

03:35 AUSTIN: Right. And so, you kind of discover this passion and understanding. And you become licensed in so many different areas. What does it look like and what does the process look like to become licensed in the rehab space?

03:46 MATT: So, I guess there’s two different things. I mean want to be a personal licensure and you don’t necessarily need that to be involved in the healthcare ownership field.

I would actually say there’s probably fewer clinician owned hospitals, clinician owned clinics than you might think. I think it actually ends up being more private equity and various business entrepreneurs that go into the healthcare space.

So, you have your personal licensing, which I have. Which basically requires someone to get an undergraduate degree, and then a graduate degree. Or possibly even a doctoral degree. And then there’s various licensing that you can obtain that way.

In terms of licensing an organization, there’s a lot of different ways of doing that. But it’s usually done at the state level. And it requires an awful lot of time, and effort, and oversight in order to get that done.

04:39 AUSTIN: Right and I believe you have four licenses at the moment? Marriage, family therapist, and then a doctor of addiction and psychology. And then two additional certificates as an addiction specialist. How do those all work together? And which one would you say is maybe the most important to your day-to-day? Or that more prominent role?

05:00 MATT: Well it’s interesting. At the stage I’m at now, I would say none of them are necessarily important to my day-to-day role. Except that I maintain a private practice in addition, so I own a couple different companies.

My private practice gives me a lot of personal pleasure. And I also really like helping I mean, that’s the nature of why I went into this field first and foremost. So, I couldn’t operate as a clinician, if I didn’t have those licenses.

In terms of running a… Being a CEO and running a corporate structure, I’ve almost had to go back to school in a way to learn how to be effective at things like accounting, management… I always had a knack for marketing, but certainly it’s been a lot of on-the-ground learning.

Which I think it is for a lot of people. So, I think that initially my licensure and my abilities of professional kind of led me into that. But I can be honest with you is that those skills and those licenses didn’t necessarily help me a huge deal in terms of owning and operating a facility now.

05:57 AUSTIN: Sure. And before we get into more of the business and marketing side, I do want to give the listeners a really good understanding of who you are as a person. And I know about an incident that happened where you actually saved a man from committing suicide on the Coronado Bridge. Which is very near to us. We’re here in old town san Diego.

So, yeah, I’m curious about that experience. And what it’s like going through it, and then what led you to be like “hey, I need to help this guy because it’s who I am as a person.”

06:22 MATT: Well I think no matter what my profession would have been our licensing I would have probably done that. I just… Even as a young person I guess I always felt a draw to help people that were in a place of need. Both from my own personal situations… I’ve had times where I’ve been in need and I just think that that’s just kind of innately who I am.

The cool thing about this incident from my standpoint though, is that because of the ability as an entrepreneur and a CEO to build a fairly large sized company in terms of helping people with substance abuse issues and mental health issues, I was in a very unique place to offer this guy a solution that I don’t think maybe anyone else would have been able to. I’m quite certain there’s many people that would have reached out and helped this man in a time of need, if they saw him up there. I’m not the only one. I know there’s been other people that have helped out on Coronado Bridge. So, I think there’s many good people that would do that.

The cool thing about this story, is the gentleman really needed the help that I could offer him. So, while the story up on Coronado Bridge was impactful and sounded really cool, it was really the backstory that was really the tremendous side of it. Because once we got him down from Coronado bridge, anybody else would have probably just been rushed into county mental health and probably would have been discharged at 24-48 hours back on the streets. Basically, maybe in the same situation or worse than when they were back up on the bridge.

This gentleman was able to get scholarship for 90 days. Really was in the best mental health and overall health that he had been in in quite some time when he was discharged.

And then we were also able to motivate government to help get him some resources that were needed and due to him. And so, I think that’s the part of it that was fantastic.

08:09 AUSTIN: Absolutely. And you mentioned there a scholarship program of some kind. Is that something that you offer through your rehab facility?

08:15 MATT: Absolutely. And in fact, we’re actually in process right now of formalizing a specific scholarship that will roll out in a little bit. But Apex always tries to scholarship those in need. We always have people that are in financial needs.

So, we offer partial scholarships I would say regularly. But certainly, in terms of full scholarships or ones in this situation, we also do that. There’s a kind of an application process. It requires motivation, but this incident was one of those and we’ve actually had a couple since. And they usually… Those stories actually end really, really positively. Because there are people out there who don’t have the financial means to pay for services. And if they’re intently motivated on getting their life fixed, our program is such that if you come in, you’ll get to where you want to go.

09:05 AUSTIN: Right. And that’s the passion behind it that you’re showcasing there. And the true love.

I’m curious about the way you practice and kind of your philosophy behind the programs that you offer. Talking a little bit about cognitive behavioral therapy and the psychological side of this. More so than something like 12-step program. So, differentiating the two.

Can you talk us through what the differences are between something like what you do and then a 12-step program?

09:29 MATT: Yeah. I’ve always been passionate about this subject, but I would say even in the last 12 months I’ve become much more passionate about this.

Historically in the united states of America we’ve always had substance abuse problems. In fact, in recent times our substance abuse program our problems are vastly larger than anywhere else in the world. And I mean significantly. I heard one statistic recently that about 98 or 99 percent of prescribed opioids are actually given out in the united states. So, it’s an enormous amount of issues that regards to substance abuse.

Over the last hundred years I’d say people have struggled with opiates, opium issues, alcohol issues… There’s always been those issues. And up until recently the 12-step movement–which was designed by the bills as they like to call him–really became embedded in both the criminal justice system, but also the medical model–the medical system–and just public awareness. I mean, if you had a substance abuse issue you had to go to a meeting. And you’d have to go to a meeting every single day, maybe a couple times a day, which was a lot of your peers that were also struggling with it. And you would kind of talk about your problem and gain some support which was really positive.

But there was no treatment really going on. The medical treatments–both from a medication standpoint, and certainly the psychological and emotional treatments, really hadn’t been exposed or even created in the large part.

And so, in the last… I’d say… Twenty years, we started to gain this idea in treatment called dual diagnosis. And dual diagnosis treatment is kind of the fusion between someone’s substance abuse issue, and then also their emotional or mental health issues. Because what we know now is that a large population, or amount… Percentage of population of people that struggle with substance abuse problems, also have a co-occurring mental health issue. Whether it’s depression, bipolar, anxiety, sometimes sleep disorders. And then more severe stuff like schizophrenia and whatnot.

And also, a lot of trauma. Which is what we’re discovering now.

And so, we really need to come up with good treatments for these. And so, over the course of time, the only options people were ever exposed to were these smoke-filled 12-step meetings.

Which again served a purpose. They were helpful. They made you feel that you had a friend. You had people that could understand and accept you for where you’re at.

But they did nothing for actually working through underlying issues. And so, for years and years there have been treatment programs that have used the 12-step system or method as a treatment model. Even though it has never been intended to be used as such. There’s never been any research done on it. There’s never been any really efficacy associated with it. In fact, to a great extent, it’s the opposite. We know that there’s a lot of trial and error and dropout rate and whatnot.

But it was time for a better process to be created. And so, what I did in my program and some before me was really go to work on finding evidence-based treatment programs that work and targeted substance abuse issues, and mental health issues where they lie. And you mentioned cognitive behavioral therapy which has been established an evidence base for helping people with depression, with anxiety, and also substance abuse issues.

When we first started out, we were very large users of motivational interviewing. Motivational interviewing is another model that’s evidence-based and very helpful in getting person from kind of a place where they’re not really considering utilizing treatment and getting sober–all the way to the place where they are. And they’re accepting those.

And so, we really embrace those elements of treatment. And what we found–because we study and research what we’ve done–is that when people come in and they receive actually evidence-based medical and psychological treatment, guess what?

They get better. And they sustain their sobriety rates much better. And so, while we don’t… We’re not opposed to people going to any kinds of meetings we also don’t try to delude our patients into believing that something they can go get for free, any night of the week, is actually going to assist them in terms of treatment for their mental health and substance abuse issues.

14:00 AUSTIN: Yeah, I feel like this has got to be a hotbed question and maybe a circumstance for a lot of different rehabs in this space. And I imagine there’s some people that are really into the 12-step programs. And live and die by it.

And then there’s those that are trying to change the game. What’s kind of the adversity that you face in the space currently with maybe other rehabs? Or kind of the changing landscape that maybe will keep something like what you’re doing from growing at a rapid rate? Or becoming more of the mainstream?

14:26 MATT: If I may I think that over the last five years, you’ve seen the catapulting of the psychological and the medication assisted treatment model actually quickly outpacing any sort of 12-step ideology. And I anticipate in the next 5 or 10 years, the 12-step is–I don’t want to say a dinosaur, because I don’t want to classify it as something that doesn’t have value because I think it is–but I think it will quickly kind of go back to being supported as almost like a like a faith-based sort of support group, which is exactly what it should be. And that hopefully with good science, good evidence-based practice, good research methods will continue to improve and work at what works. And that those methods will then be established as being true treatment models that have proven methodology. And I think that’s the direction the treatment community needs to continue to go.

One of the biggest barriers, I’d say, is the criminal justice system. A lot of judges are not educated… Although that’s changing… About true treatment versus what I would call “pseudo-treatment” and that’s because most of the lower end facilities–places that are either state-run or funded completely in a non-profit setting–a lot of times those programs are still tied to 12-step treatment.

They’re cheap. You don’t have to have doctors, you don’t have to have professionals, you just have to have someone that’s also been addicted at some point in time. That’s–in my eyes–a very faulty means of trying to create change. But it is what it is.

And so, I think as soon as the requirement for all programs–whether they’re state-run, medical accepted, private pay high end programs–if there’s an expectation that people document their work. Do research on their work. Prove efficacy in their work.

And also use treatment methods and pay the people that are licensed to do such. I think you’re gonna see a much larger turnaround in terms of the treatment space.

16:29 JOE: Yeah, it’s more so kind of like how the 12-step program will not necessarily take a backseat to the new proposed programs but it’s more so that will be supportive of the evidence-based treatment kind of similar to how when people go to church and that helps them with their faith and faith-based things. That that just is a supplemental kind of program in addition to what you would be offering. Just to kind of tack on top of it.

But you’re having the evidence-based treatment, and this would just be something in addition to kind of help support that.

17:00 MATT: Right adjunctive. And in my eyes, I think that’s exactly what the 12-step movement and that’s what it should be about. Again, I know a lot of people that have received a lot of help, companionship and support through 12-step.

But I’ve also had a ton of patients that have had a lot of negative implications. And I think those issues more stem from the falsehood that 12-step is a treatment program. And that you somehow can start there and then end well. I think that 12-step is something that can be like I said adjunctively added in, and it might provide you that support moving forward. But you still have to go through good treatment. You can’t break a leg and then go to church and say “we’re gonna go to a prayer group, and then we’re gonna go to prayer group every week. And that’s gonna help your leg.”

Sure, there might be some things that are positive about that. But you still have to go get your leg set. You still have to get a cast on it. And then maybe as part of the rehabilitation process you can have these other pieces that are positive.

So that’s… I’m not here–like I said–to dethrone 12-step. I’m not here to hate on it. I just simply am here to put it in perspective of where it needs to be in order to help the epidemic that’s going on in our country.

18:17 JOE: Exactly. And I would say even now more than ever given the opioid epidemic right now. Like you’re saying… It’s good… Those problems and those addiction problems are just as serious if not more serious and bad as if you were to get injured and you need to go to a hospital and get medical, evidence based, science-based treatment to get those things taken care of. But if you have something in addition to that like you’re saying like a prayer group, or you at a church, or the 12-step program, that’s something to kind of keep your moral compass going.

But you still need to get the root of the problem taken care of, and then for your ongoing treatment or whatever it may be those supporting programs are there to kind of help guide you along the way as you like continue down your path of sobriety or just getting better getting clean, things like that.

Whereas you need to have that upfront treatment. To address the problems head-on and then using this as… That would be basically a step one. And then step two is kind of like on your own time, on your own… However, you see fit to go to these types of programs throughout the rest of your life. However long you need to.

19:18 MATT: Absolutely. Well said.

19:19 AUSTIN: Yeah and I think the truth lies in the fact that it seems as though addiction is growing right? And the epidemic that we’re currently in with opioids is… Clearly something’s not working right? And we need to be progressing and coming up with a new plan, to make sure that we can actually start cutting down. And cutting back.

And I’m curious about your take kind of on the opioid epidemic and what you think would help or maybe what you’re currently doing in that space.

19:46 MATT: So, I think that the opioid epidemic is complex, but also quite simple. So, I’m kind of stretching everything out there. The complex part of it is how much neurologically and in terms of neural pathways, how it affects the brain in terms of development. As well as motivation. There’s a there’s a lot of complex issues that I see that stem from opioid addiction. And so, I think that that we’re going to just now be starting to understand that we have all these individuals that have been addicted to opiates. I think that this is gonna be a longer-term problem. The relapse rate is high. And so, I think those are kind of complex issues.

In terms of causation–again this is purely my opinion–but I think that we have seen a disintegration in the family system, right? I think most people come from… A lot of people come from split homes. I think that we have seen more pressure put on public education to be the parent versus the household. And I think that both through media and Hollywood glorification of a lot of substance abuse–I mean, I remember “Pulp Fiction.” I mean, my god, heroin use never looked so sexy right?

And so, I think those types of things in conjunction have led to this kind of social phenomenon where opiate use is just acceptable. And the consequences of that from my knowledge base in clinical standpoint is terrifying. I mean, you literally have people thinking it’s okay to recreation… Or attempt to recreationally use a substance that can put you down on the spot use number one. And that’s concerning.

21:38 AUSTIN: Yeah absolutely is.

21:39 JOE: It’s kind of crazy too… And I have a slight background in and knowledge I work with a fair kind of variety of rehab clients so I’m kind of in the mix and talking with them all the time. Always asking them questions and what they’re seeing in trends like that.

And a big thing that is kind of crazy with the new epidemic is your typical patient that you would see before for treating these types of problems has now seen a big shift. Where it’s not a lot of broken households. It might be the parent comes from not a bad place but they get an injury, or they have a surgery and the next thing you know they’re getting prescribed a drug. And the next thing you know they’re addicted to that drug.

And then they can’t get access to it anymore, and now they’re turning to heroin and things of the like. And it’s harder for these types of patients to kind of accept that reality of what’s going on to them, so they’re a little bit more hesitant to get that help when the time comes.

And so, I’m kind of curious. Is that something that you’re seeing as well, in terms of that shift where your typical–I guess rehab patient–is kind of shifting in that way where it’s not necessarily someone coming from that broken home or bad place and can basically come from anywhere now?

22:44 MATT: Well, I would absolutely agree with that. I guess, I want to rephrase “broken home.” I think maybe the picture is kind of someone that’s in a state of poverty or possibly in a bad place in society.

That’s actually not the case. Most research shows that opiate addicts are actually coming from–like you said–actually, sometimes even better than middle class upbringing.

Yes, so that’s absolutely the case. I think the big thing I want to pick up on is just what you said about the over prescribing of opiates. I mean, this has been an issue when I was doing some of my doctoral work. I was really focused on oxycontin. And oxycontin epidemic really helped propel and push what we’re seeing now with the heroin use.

And I knew this was going to happen long before. Because once the government kind of retro-actively took hold of the prescribing–sometimes too much so, for some of my physician friends–we basically had a lot of people that were only left with black-market options. And so, I think that’s we’ve seen.

But it’s bigger than just doctors prescribing pills. I think it’s just again–I hate to go back to my social paradigm–but in our society we are increasingly becoming more concerned about quick results. Not feeling pain. Not doing any sort of work to work through things. And assuming that we have to be comfortable at all points of time.

24:06 JOE: That’s a really good point

24:07 MATT: Yeah.one of my favorite books “the road less traveled” the first line is “life is difficult.” and life is difficult and it’s intended to be. And a lot of good and happiness can come from it, but it usually comes from the struggle. They’ve done a lot of research on that. The best moments of life come out of the struggle. Not the warm enveloping case that kind of would help pillow us from any type of issue.

And so, I think those things have also added and fueled the opiate epidemic. This individual desire to demand to be out of pain. To have doctors give you any pill that works immediately. And then using those to kind of cope or fuel treatment of things that they’re not necessarily supposed to do.

So, I think again in terms of like the complexity of the opioid epidemic, I think there’s things that we can be working on in addition to the treatment. And the good treatment of addiction. I think we also have to really do a societal, sociological sort of check about where we’re going wrong in terms of the family. In terms of medical treatment, education. Because I think those things are going to be more meaningful long-term than just treating a symptom.

25:17 JOE: Yeah, that’s a very interesting point. Because it’s a very indirect kind of that’s a causation type of thing where it’s like if you were just able to take care of this first and this kind of stigma of the instant gratification. Just not… I don’t want to say “coddling” because that’s kind of extreme… But just being able to understand that you are going to face struggles. There is gonna be hardship. So, you might as well face them now or kind of early on. So, you know when the bad ones actually come how you’re gonna handle it. How you’re gonna bounce back from it.

Because it’s just the wiring of your brain. And the way and things that you learn from it could end up leading you down a much better path than the way that you could go: i.e. ending up addicted to drugs, or anything. Like anything bad. Like any type of vice.

So, it’s a very kind of interesting point to make there that I wasn’t even thinking on the forefront of this.

26:07 AUSTIN: Yeah, we got we got joe’s cogs turning over there. He’s a very inquisitive individual right now. Sometimes he doesn’t talk so much, but he’s into it.

26:16 JOE: I do have a question for you. And I think this kind of stems from this–from what we were originally going to discuss and it kind of started mulling in my brain–was there’s been a lot of studies coming out recently about how some psychologists or psychiatrists are using drugs like MDMA or mushrooms to treat people with PTSD. And using those in kind of a clinical setting.

Do you have any thoughts on that? Or kind of see where that’s going? The benefits, things like that?

26:43 MATT: So, I just actually read a research about psilocybin, which is the substance that’s found in mushrooms. And so, yeah, they are doing some experimentation on this. I think they’ve done some of these things before. I’m gonna go back to Timothy Leary and acid and what not. But I think that there is value in a lot of things that aren’t really well explored. I mean we have had a little bit of a puritanical view in our country, in my opinion, particularly when it comes to these substances that might be of some help.

And so, there’s a drug called ibogaine–it’s a plant actually–and it’s been shown to have some efficacy in terms of opiate addiction and withdrawal and some of those things. And it’s a hallucinogenic.

So, I think that there is some value. I think you have to look, and again, you have to study it and you have to see. I’m an open-minded guy. And so, I think that we continue need to grow there. But it needs to be done through the lens of again, a possible helper and not the silver bullet.

I rarely find any medication, any substance to be the silver bullet. Addictive issues are biological, psychological and social. Biopsychosocial. And that is the nature of what addiction is all about. It’s not just one thing. And so, while I am supportive of experimentation particularly around PTSD and trauma, because I think trauma has been shown to have a huge correlation and potentially causation with addictive factors.

28:24 AUSTIN: Trauma being psychological…

28:27 MATT: Physical, sexual, mental… PTSD I think everyone envisions… Which I work with a lot of military, work with navy seals and certainly those are kind of the ones that come to mind. But let me tell you, I can only begin to describe the amount of incidences of people that have had substance abuse issues that come in that have sustained enormous physical, sexual abuse. And then a lot of times mental abuse.

People… And I am not a softy so I’m not one that comes in and likes to throw abuse around. “I’ve been mentally abused or verbally abused.”

You hear that a lot. I do believe though that there are times and incidences where people live through things that may not outwardly appear, but the internal scars of them are intense. And that’s where you end up with a lot of symptoms of depression and anxiety. And you have a very difficult time self-soothing. Trusting others to help you out in your situation. And addiction really does provide a solution at least temporarily and at a huge cost–of soothing some of those issues that are left.

So, I think that the whole trauma movement–particularly in substance abuse is of value. I think something we need to look at.

But I also think, like I said, that we need to also look at this holistically. I think there’s a lot of different things. Sometimes in our field and in any field, you become kind of hooked on the buzzword of the day. And right now, trauma is a big thing and I think it deserves its place and we need to look at it.

But there’s other issues that go along with that.

29:58 AUSTIN: Yeah. I feel like the most important thing for someone like yourself and the business you’re in is to keep an open mind. Like you’re saying. Because this is a changing landscape, we’re constantly learning more about the way the brain works. And I imagine addiction’s extremely complex issue neurologically to figure out, right? And the more discovery of the brain occurs we can try to understand that a little bit more. So, I feel like as a doctor and then also therapist, it’s a changing landscape.

I’m curious about switching gears a little bit to the business side of this. And the marketability of a rehab and that changing landscape. To give a little bit of background, I wanted to talk a little bit about Google and kind of the shift that you had to make this year away from Google ads. And maybe they’re coming back. But talk us through kind of why did Google put kind of their foot down on individuals that were advertising on Google and what does it look like to kind of shift your business? To still have visibility on the internet?

30:52 MATT: Well, the first assumption… Wouldn’t even call it an assumption… The first thing you have to make when working with Google, which as you guys know, is procure the largest amount of business traffic that there is. Is that the platform itself is not a stable surface.

Google is extremely socially conscious. Whether you agree with it or not, it is what it is. And because of some things that were going on in particularly my sector of business… And I can touch base on those for a little bit here… I believe that Google–again, whether right or wrong–felt the need to police the space. And so, when Google puts its gavel down as the judge of society, businesses will fall victim very quickly. And so, I think as a business owner–and it doesn’t matter whether it’s in the medical space or anything else–have to be aware that they’re dealing with an organization that is very keen on public perception. And so, if you know that there’s something going on in your market space. Even if you’re not a part of it or that you don’t agree with it or believe in it, you can probably anticipate some retro-action from Google to try to eliminate. Or to build up another side. And so that is just something that I think business owners have got to be aware of.

I mean this year we’ve been seeing an enormous amount of stuff on capitol hill with twitter, with Google, all of this kind of investigation about the methods and the means… Of the judgment of these social media and internet organizations. And so, I think as a business owner you have to be aware of that. Conscious about it. It’s not just as simple as “I’m gonna stick my money in the bank and I know I get 0.9 percent interest.” and it’s kind of this static thing.

I mean it is a work in progress with Google. Things move. And sometimes they move quick. And the bottom can drop out of you. And so, trying to keep a business afloat and open through some of these changes that Google made in terms of their algorithm and in general just what they were trying to do with social consciousness. And also, what they felt was ethical in their nature was very trying.

33:15 AUSTIN: Yes, and to give a little bit of background on what we’re talking about… So, Google has been cracking down on what they consider to be “your money or your life” pages and websites. So those in the medical space that are basically saying “you need our service or your life’s gonna be bad,” right?

And for a rehab you do provide a service of changing someone’s life. The issue is that everyone has access to the internet. Anyone can advertise on Google. Anyone can rank their website on Google. So, Google has to come up with a way to weed out the bad ones, right? And they’re looking at this situation going “this is this is not black and white, but we’ve got to do something,” right? Because it’s maybe for them and what they see it’s out of control.

The problem is for a legitimate business like yourself, if you’re not getting right in that bucket of Google, they’re gonna penalize you right?

34:01 MATT: Correct.

34:02 AUSTIN: Whether that’s you don’t get to run an ad. You don’t get to show up on our search engine, so we’re gonna ensure that you lose all your rank.

34:07 MATT: Blackball you, yes.

34:09 AUSTIN: And they blackball you simply because you didn’t fit a specific criteria. So now we’re jumping through hoops to make sure that we do, right? And then we fit it, and maybe it’s not exactly how we’d like to position ourselves. But we have to do it right? Because otherwise we have zero choice.

So that’s the ever-changing landscape of Google and this space is trying to keep up with them, and knowing that they’re the number one search engine. We have to show up there.

So that side of it is extremely difficult. And I’m kind of curious about your thoughts on kind of the future. And where do you think we’re headed?

34:36 MATT: Well you know what? Looking over this last year I’m actually pleased and I mean this has a little bit to do with my business–but I think that when these types of things happen it makes you kind of get back to the basics. You become a little old-fashioned, right? You get back to making sure that your product is very quality. That your reviews reflect as such. That you’re also doing things that are not just digitally marketing based. You’re shaking hands. You’re out telling people. You’re encouraging people that have had success stories too share with their friends and loved ones.

So, I think it again kind of takes your perspective off of just looking at Google as the one source for everything. And saying “hey, how do we have a holistic…” and we mentioned holistic in human health, but corporations and businesses are very much the same. I’m a systemic therapist. It’s how I was trained. And so, I understand that human beings are systems based. They’re members of a family. There’s a social structure.

And as we know corporations are living, breathing things as well. And if you do not have a holistic approach, and understand that while Google may be a large chunk of the pie, if you over rely and treat them as something that is gonna be a dead center target, you’re gonna come up short sometimes.

So, I think you have to get back to the basics. You have to remember that there’s other avenues to present yourself. And you have to do good, ethical work.

Well I don’t necessarily agree with how Google went about their algorithm changes and how they thought they were going to weed out bad players from good players–I do agree and understand what they were trying to do philosophically. And I think it’s very important to understand that you as a business have an obligation to do things the right way.

I was reading a fantastic piece about the CEO of blackwater–which is the real large investment firm–and he wrote a letter out to CEOs and he was basically just talking about social consciousness. And what that entails is that businesses now going forward are going to be judged in terms of their humanitarian efforts. Is your company inclusive? Is it marginalizing one type of person versus another? And is it doing good work?

And it’s easy for some people to say “well that’s a bunch of gooey, touchy-feely stuff.”

But I think the core of that is something that needs to be considered by all business owners. And that is are you an ethical business? Are you doing the job that you’re saying you’re doing?

And then one thing we know about digital stuff–whether it’s swipe right or swipe left–we can present an image online that doesn’t necessarily match up to who we are in reality. And I corporations were taking advantage of that as well. And so, it’s very crucial for businesses to say “hey, it’s good to look… We have a social presence on the web and to look like that. But is our product or our staff, our employees… Do they all match up with that image?”

And so, I think in my business sector the answer was no. And I think there’s a lot of reasons for that. Some that go back to what I was mentioning particularly about 12-step movement. People being involved in this space that have no business being involved in the space. People that are trying to make a lot of money and not utilizing evidence-based treatment factors. Employing people that are probably dangerous and have many issues. And then trying to cannibalize people that are in a tough problem… A tough period in their life or have problems.

And so, I think that Google was in their socially conscious way trying to create change. And I don’t know… We’ll have to see if that pans out. But what I know for us, is that we had to kind of re-evaluate how we were getting our message out. And again, just bring back our thoughts to “hey, are we doing the kind of work that we need to be doing? And then how do we showcase that work even if Google says we’re getting lumped in with something else?”

38:40 AUSTIN: Right.

38:41 JOE: Yeah, they’re the kings of be comfortable with being uncomfortable. Because it happens five, six times a year. And it’s one of those things that we’re always dealing with. So yeah, we fully get it.

38:52 AUSTIN: Yeah. I’m just glad that we’re an agency that has so many different channels too. So that I can go ask joe in content on what they’re doing with their side of the businesses. And maybe pivot away from SEO, if needed. Or along those lines, because we just can’t rely on Google as much as we want to. And like you said, the number one thing that a business on the internet needs to do is be legit. And that’s where we’re at now.

Which is extremely different than it used to be when Google first started…

39:16 MATT: Absolutely.

39:40 AUSTIN: Even in the early 2000s… Turn of the decade even and that’s the bottom line here. I know we’re working a lot with getting reviews and getting those situated. Because that, from a local standpoint specifically, is becoming one of the biggest ranking factors that Google is relying on.

And the funny thing is like you said–back to basics. It’s a manual process. They actually have hired teams internally to review businesses. To look at reviews and understand what actual people are saying. So not just their algorithmic factors and backlinks and words. It’s humans, the way they feel about a business portrayed online. We cannot stress that enough to whoever, whatever business you’re in listening right now. If you’re not a legitimately good individual with a great business, you’re gonna hurt online as well.

40:00 MATT: That’s right. That’s absolutely right. And I’ll tip my hat to you guys and Power Digital in general, because I think the two things that we had the option to do and did was I knew we needed a better PR movement. That’s something that we’re working on. I mean I’m sitting here doing this right now.

But I think again looking at other abilities to get that voice out and to present your product in a meaningful way is crucial. Versus just having this digital presentation.

And the other thing is you got to have a SEO or a web-based company that is quick on their feet. Because these algorithm changes are going to happen. And you got to diagnose what’s going on quickly. And you’ve got to make those changes. And you have to be willing to do that.

And like you said sometimes it’s unfortunate. I mean from my standpoint, sometimes your homepage doesn’t look as good afterwards when it’s done. But it needs to be done.

But I think that like what you were saying earlier is that you have to be aware of how your customers feel about you. And honestly that’s one of the things that I pride myself about with my business. I don’t care how nitpicky the complaint… If someone has a bad experience, I am dealing with that at that second. And I go back to this and I tell my staff when I do my trainings there, I say… There’s two catchphrases that I really like “the customer’s always right.” I mean that’s a very old-school archaic notion, but it’s absolutely true.

And the gentleman that started the Ritz-Carlton, started on the premise of “ladies and gentlemen serving ladies and gentlemen.” and one thing that I think customer service has gone so awry…particularly sometimes… We don’t want to pigeonhole the younger generation, but certainly there’s a necessity for treating people with respect. Using manners. And that goes from how I treat my staff, but then how I expect my staff to treat our patients. And so, if you have this attitude like people are lucky to be utilizing you as a business. Because you’re number one on Google… Then you’ve got the wrong idea in your head.

41:58 AUSTIN: Absolutely. Well that’s about gonna do it for us. Matt thank you so much for coming on. It’s been a pleasure. It’s been a great year, and we’re really looking forward to 2019 as well.

42:06 MATT: Thank you, gentlemen.

42:14 AUSTIN: Thank you to dr. Matt Bruhin for joining us today on Flip the Switch. I had a great time listening. It was very interesting to learn more about his business. I am the account manager for him here at Power Digital, so it was great to get some additional insight into his business and really understand what he’s going through. And the adversity he’s facing with the current drug epidemic.

42:34 JOE: Yeah, I think this is definitely a topic that needs to be made public a lot more often, and discussed, and kind of progress forward to hopefully find a solution. And kind of get us out of the weeds of what’s going on here. So, it’s always nice to kind of talk to someone who has been able to turn a passion into a business.

42:51 AUSTIN: I think both Joe and I really like making the human connection. The internet can be a place that feels very distant, and not real a lot of times. And something like a drug rehab and working with that can really humanize the situation. And seeing what Matt is up to, and hearing from Matt what he’s doing on a day to day basis makes that a lot more real for us. He’s fighting a great battle trying to help those in a time of desperate need. So, Matt, we really appreciate all the background you gave us and I learned a lot today.

43:21 JOE: Yeah. Me as well.

43:22 AUSTIN: That’s going to do it.

43:24 JOE: Yeah. This has been Patrick Kreidler, Austin Mahaffy, John Saunders and Joe Hollerup signing off.

43:30 AUSTIN: Nailed it.

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