In this episode, Dr. Tim Flynn, renowned clinician and outspoken advocate for reform in healthcare, shares his vision for a system that truly serves patients.
As a leader in orthopedic manual therapy and the voice behind the "Own My Health" movement, Dr. Flynn challenges the traditional "sickness industry" and emphasizes empowering patients to take charge of their health.
Key highlights include the evolving role of manual therapy, the power of mentorship, and how physical therapists can drive patient-centered care in a technology-driven world. Dr. Flynn also shares insights on how clinicians can foster patient autonomy, the importance of providing value as a mentee, and how to navigate the challenges of a system that prioritizes interventions over holistic wellness.
Key Topics Discussed:
The Value of Manual Therapy: Why human connection and hands-on care remain crucial, even in a tech-focused healthcare landscape.
"Own My Health" Philosophy: Dr. Flynn's Substack and vision to transform healthcare by empowering patients to control their own health journeys.
The Sickness Industry: Critiques of today’s healthcare system and the call to shift from excessive interventions to preventative, patient-centered care.
Mentorship in Healthcare: Advice for new clinicians on finding mentors, providing value, and learning by observing master clinicians in action.
The Future of Manual Therapy: The need to practice at the top of the license and integrate holistic approaches to better serve patients.
Whether you're a physical therapist, clinician, or healthcare advocate, this episode offers actionable insights for creating a healthier, more empowering system for patients and practitioners alike.
00:00:02 --> 00:00:03 Well, Tim, welcome to the show.
00:00:03 --> 00:00:06 I'm super excited to talk to you.
00:00:06 --> 00:00:07 I'm over here in North Carolina.
00:00:07 --> 00:00:09 Tim's in Colorado.
00:00:10 --> 00:00:12 And Tim is somebody that
00:00:12 --> 00:00:14 I've had an opportunity to
00:00:14 --> 00:00:17 get to know a long time now, ago.
00:00:18 --> 00:00:20 It feels like it shouldn't
00:00:20 --> 00:00:21 be that long ago now,
00:00:21 --> 00:00:23 but it's exciting to have
00:00:23 --> 00:00:24 him on the show today and
00:00:25 --> 00:00:27 really get to talk about
00:00:28 --> 00:00:28 some things I think that
00:00:28 --> 00:00:29 are really important,
00:00:29 --> 00:00:31 especially with regards to
00:00:31 --> 00:00:33 manual therapy and education
00:00:33 --> 00:00:35 and sort of what manual
00:00:35 --> 00:00:36 therapy education looks
00:00:36 --> 00:00:37 across the educational lifespan.
00:00:38 --> 00:00:39 And I can't imagine anybody
00:00:39 --> 00:00:40 being able to really have
00:00:40 --> 00:00:43 this conversation better than Tim,
00:00:43 --> 00:00:45 because he really has been
00:00:45 --> 00:00:49 on all sides of the education adventure,
00:00:50 --> 00:00:51 being both consumer and as
00:00:52 --> 00:00:53 well as a deliverer of
00:00:54 --> 00:00:55 education and various
00:00:55 --> 00:00:57 pathways and journeys in people's lives.
00:00:57 --> 00:00:59 And so, Tim, welcome to the show.
00:01:00 --> 00:01:01 Well, thanks for having me.
00:01:01 --> 00:01:02 I'm really looking forward
00:01:02 --> 00:01:04 to the conversation today, Derek.
00:01:04 --> 00:01:06 And yes, we go back, I guess,
00:01:06 --> 00:01:07 a long ways now,
00:01:07 --> 00:01:09 which is kind of wild for sure.
00:01:11 --> 00:01:13 I still remember that it was
00:01:13 --> 00:01:15 two thousand and eight when
00:01:15 --> 00:01:17 Evidence in Motion was, you know,
00:01:17 --> 00:01:18 kind of getting off the
00:01:18 --> 00:01:21 ground and you trusted a
00:01:21 --> 00:01:23 few of us lowly schleps to
00:01:24 --> 00:01:26 be a part of a part of the
00:01:26 --> 00:01:27 organization in regards to
00:01:28 --> 00:01:29 fellowship training and such.
00:01:29 --> 00:01:33 And I'll always value that time very well.
00:01:34 --> 00:01:34 Well,
00:01:35 --> 00:01:36 I think that since we are talking
00:01:36 --> 00:01:39 about education, I mean, I look at, I,
00:01:40 --> 00:01:40 like you,
00:01:40 --> 00:01:43 have been super fortunate that I
00:01:43 --> 00:01:45 was put into positions to
00:01:45 --> 00:01:47 teach way before I thought
00:01:47 --> 00:01:48 I was capable of doing it
00:01:49 --> 00:01:53 by people that I were very well respected,
00:01:53 --> 00:01:56 you know, Phil Greenman, John Bedellin,
00:01:56 --> 00:01:57 you know, John Minnell.
00:01:59 --> 00:01:59 You know,
00:01:59 --> 00:02:00 I'm around these people and I'm
00:02:00 --> 00:02:01 way too young.
00:02:02 --> 00:02:03 And, you know,
00:02:03 --> 00:02:04 I guess they call it
00:02:04 --> 00:02:05 imposter syndrome now.
00:02:05 --> 00:02:07 But, you know, you're just saying, wow.
00:02:08 --> 00:02:10 Having said that, you know,
00:02:10 --> 00:02:12 that's really what our role
00:02:12 --> 00:02:16 has always been, I think, is to empower,
00:02:16 --> 00:02:16 you know,
00:02:16 --> 00:02:18 those around us to just do
00:02:18 --> 00:02:20 better and to be better
00:02:20 --> 00:02:21 than we are in terms of
00:02:21 --> 00:02:23 both the practice of what we do, but also,
00:02:24 --> 00:02:27 you know, teaching others going forward.
00:02:28 --> 00:02:30 And I'm glad you brought all that up.
00:02:30 --> 00:02:33 And I think one of the
00:02:33 --> 00:02:33 things that I've always
00:02:35 --> 00:02:37 respected about your
00:02:37 --> 00:02:39 position is that you've
00:02:39 --> 00:02:41 always maintained sort of
00:02:42 --> 00:02:43 the foot in the door of
00:02:44 --> 00:02:46 clinical relevance as well too.
00:02:47 --> 00:02:49 And so I think that that's
00:02:49 --> 00:02:51 always meaningful.
00:02:51 --> 00:02:52 I think we all start in some
00:02:52 --> 00:02:55 way or form with educating PTs
00:02:57 --> 00:02:58 you know, in that clinical setting.
00:02:59 --> 00:03:00 I remember when I first got
00:03:00 --> 00:03:01 my first student,
00:03:01 --> 00:03:02 I think I was only out six
00:03:02 --> 00:03:04 months of PT school.
00:03:04 --> 00:03:05 So talk about imposter syndrome.
00:03:05 --> 00:03:07 I was teaching a student as
00:03:07 --> 00:03:10 a CI from somebody who, you know,
00:03:10 --> 00:03:11 was only going to graduate
00:03:11 --> 00:03:12 six months before me.
00:03:12 --> 00:03:14 And somebody asked me how that went.
00:03:14 --> 00:03:15 And I was like, well,
00:03:16 --> 00:03:16 I don't think I could
00:03:16 --> 00:03:17 really teach them much,
00:03:17 --> 00:03:18 but I could kind of help
00:03:18 --> 00:03:19 guide them a little bit.
00:03:19 --> 00:03:20 But I felt like there's
00:03:20 --> 00:03:22 always been that imposter syndrome,
00:03:23 --> 00:03:25 even for everyone,
00:03:25 --> 00:03:26 I think is kind of refreshing to hear.
00:03:29 --> 00:03:31 Indeed.
00:03:31 --> 00:03:33 So the, I have a,
00:03:35 --> 00:03:37 the topic of our conversation today is,
00:03:38 --> 00:03:38 you know,
00:03:39 --> 00:03:41 and it's about physical therapy
00:03:41 --> 00:03:43 and probably more importantly, I think,
00:03:43 --> 00:03:44 especially for our listeners here,
00:03:45 --> 00:03:47 orthopedic manual physical therapy,
00:03:48 --> 00:03:50 future in education and how
00:03:50 --> 00:03:51 it starts with
00:03:52 --> 00:03:55 the education setting and environments.
00:03:55 --> 00:03:57 And I think we wanted to
00:03:57 --> 00:03:58 talk about it from the
00:04:00 --> 00:04:01 professional side of education.
00:04:01 --> 00:04:03 So entry-level education
00:04:03 --> 00:04:04 going through
00:04:04 --> 00:04:06 post-professional education.
00:04:06 --> 00:04:07 And I might even add,
00:04:08 --> 00:04:08 little bit in there.
00:04:08 --> 00:04:10 This wasn't part of our initial discussion,
00:04:10 --> 00:04:14 but post-professional educational journey,
00:04:14 --> 00:04:16 because I think a lot of us
00:04:16 --> 00:04:17 are now starting to face
00:04:18 --> 00:04:20 that part of our career paths.
00:04:21 --> 00:04:23 And so I guess before we
00:04:23 --> 00:04:24 even get into that,
00:04:26 --> 00:04:27 let our listeners know how
00:04:27 --> 00:04:28 you really kind of became
00:04:29 --> 00:04:31 interested in manual
00:04:31 --> 00:04:33 therapy specifically?
00:04:33 --> 00:04:34 I think we all are familiar
00:04:34 --> 00:04:35 with the work that you've
00:04:35 --> 00:04:36 done and the research that
00:04:36 --> 00:04:38 you've contributed to the field.
00:04:39 --> 00:04:40 But like, where did it all start?
00:04:40 --> 00:04:41 How did you how did you get
00:04:41 --> 00:04:42 interested in this?
00:04:42 --> 00:04:42 How'd you get the bug?
00:04:43 --> 00:04:43 Well,
00:04:44 --> 00:04:46 it's funny because I often joke my
00:04:46 --> 00:04:47 manual therapy training.
00:04:47 --> 00:04:49 I went to Marquette,
00:04:49 --> 00:04:51 graduated in nineteen eighty three,
00:04:51 --> 00:04:54 and we had a four hour
00:04:54 --> 00:04:56 block on manual therapy.
00:04:56 --> 00:04:58 That was the extent.
00:04:59 --> 00:05:00 And not only was that the
00:05:00 --> 00:05:01 extent of the block,
00:05:01 --> 00:05:02 it was on a Friday morning.
00:05:03 --> 00:05:04 and the thursday night
00:05:04 --> 00:05:05 before my wife and I had
00:05:06 --> 00:05:07 gotten engaged she was in
00:05:07 --> 00:05:09 pt school and of course we
00:05:09 --> 00:05:11 were provided with way too
00:05:11 --> 00:05:13 many uh cheap shots so I
00:05:13 --> 00:05:15 just remember that next
00:05:15 --> 00:05:17 morning being super hung
00:05:17 --> 00:05:18 over and that was our only
00:05:19 --> 00:05:20 manual therapy block we got
00:05:20 --> 00:05:22 I mean I was super excited
00:05:22 --> 00:05:25 given my state and uh um so
00:05:25 --> 00:05:27 that was really my initial
00:05:27 --> 00:05:28 entry into manual therapy
00:05:28 --> 00:05:30 but it was just a sliver
00:05:30 --> 00:05:32 How that won you over, I don't know.
00:05:34 --> 00:05:36 But actually, you know, I was in ROTC,
00:05:36 --> 00:05:39 so I went into the Army
00:05:39 --> 00:05:41 right out of PT school and
00:05:41 --> 00:05:43 was stationed down in San
00:05:43 --> 00:05:45 Antonio at Brook Army Medical Center.
00:05:45 --> 00:05:45 And
00:05:46 --> 00:05:48 I was you know life is a lot
00:05:48 --> 00:05:49 you know people say it's
00:05:49 --> 00:05:50 hard work but it's luck as
00:05:50 --> 00:05:51 well I mean I could have
00:05:51 --> 00:05:52 gotten sent somewhere
00:05:52 --> 00:05:54 differently but at the time
00:05:54 --> 00:05:56 it was just kind of a bevy
00:05:56 --> 00:06:00 of super outstanding
00:06:00 --> 00:06:01 physical therapists um
00:06:02 --> 00:06:04 musculoskeletal imaging you
00:06:04 --> 00:06:07 know uh but manual therapy
00:06:07 --> 00:06:08 as well there's a couple
00:06:08 --> 00:06:11 steve stratton was one and that just was
00:06:11 --> 00:06:12 you know,
00:06:12 --> 00:06:13 going to Michigan State
00:06:14 --> 00:06:15 Osteopathic Program at the time, you know,
00:06:15 --> 00:06:17 their continuing education
00:06:18 --> 00:06:19 program and just saying, hey,
00:06:19 --> 00:06:20 this is where you need to be at, you know,
00:06:20 --> 00:06:22 this is where you got to go, et cetera.
00:06:22 --> 00:06:24 But I was just immersed in
00:06:25 --> 00:06:26 this muscle skeletal world
00:06:26 --> 00:06:28 and you just were expected.
00:06:28 --> 00:06:30 you know to to know this
00:06:30 --> 00:06:33 material and to be good
00:06:33 --> 00:06:35 with your hands and um so I
00:06:35 --> 00:06:37 think I was lucky in that
00:06:37 --> 00:06:39 regard but you know my
00:06:39 --> 00:06:42 first exposures uh were you
00:06:42 --> 00:06:44 know teaching you know just
00:06:44 --> 00:06:45 extremity manipulation and
00:06:45 --> 00:06:47 spinal manipulation people
00:06:47 --> 00:06:48 with acute pain uh
00:06:48 --> 00:06:51 syndromes coming in and and
00:06:52 --> 00:06:54 then very quickly I think it was a year
00:06:54 --> 00:06:57 two in I went to michigan
00:06:57 --> 00:06:58 state for a five-day
00:06:59 --> 00:06:59 principles of manual
00:06:59 --> 00:07:01 medicine course and that
00:07:01 --> 00:07:03 was a game changer because
00:07:03 --> 00:07:05 it really first it was a
00:07:05 --> 00:07:07 small group of primarily
00:07:07 --> 00:07:10 dos couple mds and a
00:07:11 --> 00:07:12 handful of physical
00:07:12 --> 00:07:14 therapists but the again
00:07:14 --> 00:07:15 the faculty was you know I
00:07:15 --> 00:07:16 mean it was phil greenman
00:07:17 --> 00:07:18 john minnell john bordillon
00:07:20 --> 00:07:22 I think Carl Steele,
00:07:22 --> 00:07:23 who was a PT but then went
00:07:23 --> 00:07:25 on to become a DO.
00:07:26 --> 00:07:28 It was like a student
00:07:28 --> 00:07:29 faculty ratio about one to
00:07:29 --> 00:07:32 six or six to one.
00:07:33 --> 00:07:36 It was just an immersion.
00:07:36 --> 00:07:38 I realized how little I knew,
00:07:38 --> 00:07:42 but how, how powerful it was.
00:07:42 --> 00:07:44 And that these folks too had,
00:07:44 --> 00:07:45 which been orthopedic
00:07:45 --> 00:07:47 surgeons and had given up
00:07:48 --> 00:07:49 essentially surgery because
00:07:49 --> 00:07:53 they just believed in manual medicine,
00:07:53 --> 00:07:56 non-operative care, you know, back in the,
00:07:56 --> 00:07:57 you know, this is now the mid eighties.
00:07:57 --> 00:07:57 So,
00:07:58 --> 00:07:59 It was very powerful,
00:07:59 --> 00:08:00 both from the technical aspect,
00:08:01 --> 00:08:02 but also from the
00:08:02 --> 00:08:05 professionalization of what
00:08:06 --> 00:08:08 manual medicine really was.
00:08:08 --> 00:08:12 So that really launched my career.
00:08:12 --> 00:08:13 And when I ended up going
00:08:13 --> 00:08:15 back for my master's,
00:08:15 --> 00:08:17 I guess it was in eighty eight to ninety,
00:08:17 --> 00:08:18 I went to Michigan State in
00:08:18 --> 00:08:20 the osteopathic school.
00:08:21 --> 00:08:23 they had a biomechanics department,
00:08:23 --> 00:08:25 which was somewhat
00:08:25 --> 00:08:27 traditional biomechanics in
00:08:27 --> 00:08:28 the fact that we're doing a
00:08:28 --> 00:08:30 lot of tissue mechanics and
00:08:30 --> 00:08:31 stress strain curves and the like.
00:08:32 --> 00:08:33 But Phil Greenman,
00:08:33 --> 00:08:35 Dr. Greenman was a member
00:08:35 --> 00:08:36 of that faculty.
00:08:36 --> 00:08:37 And I knew if I went there,
00:08:38 --> 00:08:38 I could take more of these
00:08:38 --> 00:08:41 courses while I was there.
00:08:41 --> 00:08:43 And I just kept pestering
00:08:43 --> 00:08:45 him until he said, well, Tim,
00:08:45 --> 00:08:46 why don't you just come to
00:08:46 --> 00:08:48 clinic with me a couple of days a week?
00:08:48 --> 00:08:48 I'm like,
00:08:49 --> 00:08:49 Yeah.
00:08:50 --> 00:08:51 And so that was like, you know,
00:08:51 --> 00:08:53 the beginning of the quote
00:08:53 --> 00:08:55 classic kind of mentorship of, you know,
00:08:55 --> 00:08:56 one-on-one in the clinic, you know,
00:08:57 --> 00:08:58 you know, twelve,
00:08:58 --> 00:08:59 sixteen hours a week just
00:08:59 --> 00:09:02 watching a truly master clinician.
00:09:04 --> 00:09:05 And that's when you realize
00:09:06 --> 00:09:08 manual medicine is
00:09:08 --> 00:09:10 described there and manual
00:09:11 --> 00:09:13 therapy or manual physical
00:09:13 --> 00:09:14 therapy as we now know it.
00:09:15 --> 00:09:16 It's holistic.
00:09:16 --> 00:09:18 And, you know, technically, yeah,
00:09:18 --> 00:09:20 he was a skilled manipulator,
00:09:21 --> 00:09:23 but it was all the other stuff.
00:09:23 --> 00:09:27 His patient interaction that
00:09:27 --> 00:09:29 we now call therapeutic
00:09:29 --> 00:09:31 alliance was off the charts.
00:09:31 --> 00:09:34 You just wanted this guy to be your doc.
00:09:34 --> 00:09:34 I mean,
00:09:34 --> 00:09:37 it was just connectivity with
00:09:37 --> 00:09:39 people and could be very firm on,
00:09:39 --> 00:09:40 you know, hey,
00:09:40 --> 00:09:41 you got to do your homework,
00:09:43 --> 00:09:46 but came from a place that, you know,
00:09:46 --> 00:09:47 you just trusted.
00:09:47 --> 00:09:48 And so, yeah,
00:09:48 --> 00:09:52 you look back and those elements just,
00:09:52 --> 00:09:52 you know,
00:09:52 --> 00:09:55 launched my passion and career
00:09:56 --> 00:10:00 and which goes to say how important it is,
00:10:00 --> 00:10:03 I think, that early career therapists,
00:10:03 --> 00:10:04 you know,
00:10:04 --> 00:10:08 Even if it's harder yards
00:10:08 --> 00:10:10 and not getting paid as much,
00:10:10 --> 00:10:12 it does shift your entire
00:10:12 --> 00:10:14 trajectory if you can have
00:10:14 --> 00:10:15 those first couple of years
00:10:15 --> 00:10:17 around people that actually
00:10:17 --> 00:10:19 are doing it the right way.
00:10:20 --> 00:10:21 and are really
00:10:22 --> 00:10:25 patient-focused and understand,
00:10:26 --> 00:10:28 despite the system that's really broken,
00:10:28 --> 00:10:31 that we can still make a difference.
00:10:31 --> 00:10:34 And that will truly launch your trajectory,
00:10:34 --> 00:10:35 I believe.
00:10:36 --> 00:10:38 It's interesting that one of
00:10:38 --> 00:10:39 the things I picked up on
00:10:39 --> 00:10:39 when you said there,
00:10:39 --> 00:10:41 and I've heard this from a
00:10:41 --> 00:10:42 lot of people who have gone
00:10:43 --> 00:10:45 on to be successful in their careers,
00:10:45 --> 00:10:49 is they pester, they beg,
00:10:50 --> 00:10:52 they yearn for the mentorship.
00:10:52 --> 00:10:56 They take charge in their own education.
00:10:56 --> 00:10:56 And I've had a lot of
00:10:56 --> 00:10:58 conversations around that with
00:10:58 --> 00:10:59 dbt students and I'm sure
00:11:00 --> 00:11:00 we'll get into some of that
00:11:00 --> 00:11:02 conversation later about
00:11:02 --> 00:11:04 some of the generational
00:11:04 --> 00:11:05 changes and differences and
00:11:05 --> 00:11:06 things like that but I
00:11:06 --> 00:11:06 still think that there's
00:11:06 --> 00:11:10 value in you know taking
00:11:10 --> 00:11:11 charge of that and
00:11:11 --> 00:11:12 everybody that I've met
00:11:12 --> 00:11:13 that's done something very
00:11:13 --> 00:11:14 well is they're basically
00:11:14 --> 00:11:15 like just they don't stop
00:11:16 --> 00:11:17 knocking on the door and
00:11:17 --> 00:11:18 eventually somebody's going
00:11:18 --> 00:11:19 to open that door and say
00:11:19 --> 00:11:21 okay fine I'll let you in
00:11:21 --> 00:11:22 but if you look across the
00:11:23 --> 00:11:24 board that seems to be one of those
00:11:25 --> 00:11:28 character traits of a, you know,
00:11:28 --> 00:11:29 somebody that has gone on
00:11:29 --> 00:11:32 to become a great clinician and then,
00:11:32 --> 00:11:34 you know, have some level of impact,
00:11:34 --> 00:11:36 wherever that impact might be defined as.
00:11:36 --> 00:11:38 So nice and refreshing to
00:11:38 --> 00:11:39 hear you say that.
00:11:39 --> 00:11:41 And it just occurred to me
00:11:41 --> 00:11:42 as we're talking that
00:11:43 --> 00:11:43 Part of, I think,
00:11:44 --> 00:11:49 that trait is you are vulnerable.
00:11:49 --> 00:11:51 You're going to get told no.
00:11:51 --> 00:11:52 You're going to be putting
00:11:52 --> 00:11:53 yourself out there.
00:11:54 --> 00:11:58 And I think there's an openness in that.
00:11:59 --> 00:12:00 I think maybe it displays a
00:12:00 --> 00:12:02 bit of openness in how you
00:12:02 --> 00:12:06 then view science, how you view learning,
00:12:06 --> 00:12:08 how you view growth.
00:12:09 --> 00:12:10 And so maybe part of that is
00:12:10 --> 00:12:12 just a trait that you kind of need.
00:12:13 --> 00:12:15 That needs to be there in order to grow,
00:12:16 --> 00:12:16 I think, you know?
00:12:18 --> 00:12:18 Yeah,
00:12:18 --> 00:12:18 it's one of the things that I
00:12:18 --> 00:12:20 actually tell even our
00:12:20 --> 00:12:23 students when they're learning things,
00:12:23 --> 00:12:24 either if it's either an
00:12:24 --> 00:12:25 entry-level PT student or
00:12:25 --> 00:12:26 if I'm teaching fellows or
00:12:26 --> 00:12:28 whatever it might be, I always say,
00:12:28 --> 00:12:29 here's two things you got to do.
00:12:29 --> 00:12:31 You have to give feedback
00:12:31 --> 00:12:33 and then you have to crave feedback,
00:12:33 --> 00:12:34 even if it's feedback that
00:12:34 --> 00:12:36 you don't necessarily want to receive,
00:12:36 --> 00:12:37 but you have to beg for
00:12:37 --> 00:12:39 that level of feedback
00:12:39 --> 00:12:40 because ultimately that's
00:12:40 --> 00:12:43 going to help you grow as well too.
00:12:43 --> 00:12:46 So I think that that's a big part of
00:12:47 --> 00:12:51 that educational adventure.
00:12:51 --> 00:12:53 Um, so, you know,
00:12:53 --> 00:12:55 I know your career track
00:12:55 --> 00:12:57 and your trajectory, um, a fair amount,
00:12:57 --> 00:12:58 you know,
00:12:58 --> 00:13:00 and so coming out of the military,
00:13:00 --> 00:13:01 you know, obviously you,
00:13:01 --> 00:13:03 you were a consumer of education,
00:13:04 --> 00:13:05 you were taught.
00:13:06 --> 00:13:07 And then at some point, you know, and you,
00:13:07 --> 00:13:08 and you're always a learner.
00:13:09 --> 00:13:09 Um,
00:13:09 --> 00:13:10 so I'm not going to say that you're not
00:13:10 --> 00:13:11 still learning,
00:13:11 --> 00:13:14 but at some level you then, um, changed.
00:13:14 --> 00:13:16 And I know that you went into sort of
00:13:17 --> 00:13:19 almost a post-professional
00:13:20 --> 00:13:22 focus of education and then
00:13:22 --> 00:13:23 kind of shifted into some
00:13:23 --> 00:13:24 entry level back again.
00:13:24 --> 00:13:27 But talk to us a little bit about,
00:13:27 --> 00:13:28 you know,
00:13:28 --> 00:13:30 what I guess was the next
00:13:30 --> 00:13:31 catalyst if I'm going to
00:13:31 --> 00:13:32 think about phases in
00:13:33 --> 00:13:34 educational journey.
00:13:34 --> 00:13:35 where you started to say, Hey,
00:13:35 --> 00:13:36 you know what we need,
00:13:36 --> 00:13:38 we need to do something bigger.
00:13:38 --> 00:13:40 Maybe we need to educate at
00:13:40 --> 00:13:42 a larger scale or a larger
00:13:42 --> 00:13:43 shift or something like that.
00:13:43 --> 00:13:44 And that was probably the
00:13:44 --> 00:13:45 early two thousands.
00:13:45 --> 00:13:46 I'm sure that that happened,
00:13:46 --> 00:13:48 but talk to us a little bit
00:13:48 --> 00:13:49 about what kind of went into your,
00:13:49 --> 00:13:51 your mindset around all of that.
00:13:54 --> 00:13:55 Well, I mean,
00:13:55 --> 00:13:57 there's a few things there
00:13:57 --> 00:13:58 wrapped in there.
00:13:58 --> 00:14:00 I think it has been,
00:14:01 --> 00:14:03 I think as it relates to AOMT,
00:14:03 --> 00:14:04 I think there is a story
00:14:04 --> 00:14:06 there that we'll get to that.
00:14:06 --> 00:14:08 Because I really think my
00:14:08 --> 00:14:10 passion for manual therapy, I mean,
00:14:11 --> 00:14:12 my PhD was not that.
00:14:12 --> 00:14:13 I learned a lot about a
00:14:13 --> 00:14:15 little which PhDs are.
00:14:15 --> 00:14:17 You learn a method, you learn a lot.
00:14:17 --> 00:14:18 And it was really in bone
00:14:18 --> 00:14:20 stress injuries and things
00:14:20 --> 00:14:22 that were away from manual therapy.
00:14:22 --> 00:14:23 And this is in the nineties.
00:14:24 --> 00:14:25 So I come out in ninety seven,
00:14:26 --> 00:14:28 the ACPAR guidelines are saying, you know,
00:14:28 --> 00:14:29 PTs don't do anything.
00:14:30 --> 00:14:32 for back pain, except, you know,
00:14:32 --> 00:14:33 this manipulation thing
00:14:34 --> 00:14:36 seems to have a little bit of benefit.
00:14:36 --> 00:14:37 And our own professional
00:14:37 --> 00:14:39 association didn't jump on that and say,
00:14:39 --> 00:14:40 well, hell yeah, that's what we do.
00:14:40 --> 00:14:42 So we kind of fought those
00:14:42 --> 00:14:44 guidelines as well as
00:14:44 --> 00:14:45 everybody else that didn't
00:14:45 --> 00:14:47 like what the answer was.
00:14:47 --> 00:14:49 And so I came out during
00:14:49 --> 00:14:51 that time a little like
00:14:51 --> 00:14:53 whoa, I'm, I'm a manual therapist,
00:14:53 --> 00:14:54 even though I've kind of
00:14:54 --> 00:14:55 done this PhD and I was
00:14:56 --> 00:14:58 back in the entry level teaching.
00:14:59 --> 00:15:02 And I felt strongly that, you know,
00:15:02 --> 00:15:04 these skills are basic
00:15:04 --> 00:15:06 skill sets of entry level
00:15:06 --> 00:15:07 professionals that you need
00:15:07 --> 00:15:09 to know how to manipulate the spine.
00:15:09 --> 00:15:10 You need to know how to
00:15:10 --> 00:15:13 manipulate the extremities.
00:15:13 --> 00:15:14 And that's just the basic
00:15:14 --> 00:15:15 skill set to manage.
00:15:15 --> 00:15:17 One of the prime largest
00:15:17 --> 00:15:18 conditions we see is that a
00:15:18 --> 00:15:20 spinal disorder.
00:15:20 --> 00:15:20 So, um,
00:15:21 --> 00:15:25 That, to me, was obvious as I entered.
00:15:25 --> 00:15:27 I was now at Army Baylor,
00:15:27 --> 00:15:28 and so I was teaching there.
00:15:29 --> 00:15:33 But I also became a member of the academy.
00:15:33 --> 00:15:35 And at that time,
00:15:35 --> 00:15:37 I just assumed we were
00:15:37 --> 00:15:39 pushing manipulation and
00:15:39 --> 00:15:41 entry-level practice,
00:15:41 --> 00:15:43 that that was just a basic skill set.
00:15:44 --> 00:15:45 And it was,
00:15:45 --> 00:15:50 I wasn't met with quite the
00:15:50 --> 00:15:52 excitement that across the academy.
00:15:52 --> 00:15:55 And again, I don't, it was well intended,
00:15:55 --> 00:15:57 but a lot of folks felt that this was a,
00:15:57 --> 00:15:57 you know,
00:15:57 --> 00:15:59 a higher level post-professional skill.
00:16:00 --> 00:16:01 And clearly you get better
00:16:02 --> 00:16:03 and better post-professionally,
00:16:03 --> 00:16:05 but there are a skill set
00:16:05 --> 00:16:07 that are really all of us
00:16:07 --> 00:16:08 need to have an entry level.
00:16:09 --> 00:16:09 And we now do that.
00:16:10 --> 00:16:12 But that wasn't at the time
00:16:14 --> 00:16:16 the prevailing wisdom.
00:16:17 --> 00:16:18 And why I was passionate
00:16:18 --> 00:16:22 about it was because the need was there.
00:16:23 --> 00:16:25 And I look back to my
00:16:25 --> 00:16:28 education where my mentors,
00:16:30 --> 00:16:32 osteopathic physicians, one in particular,
00:16:32 --> 00:16:32 Phil Greenman,
00:16:33 --> 00:16:35 caught hell for teaching PT
00:16:35 --> 00:16:36 spinal manipulation because
00:16:36 --> 00:16:39 they felt that a lot of the
00:16:39 --> 00:16:40 osteopaths felt that, no,
00:16:40 --> 00:16:43 that's within their realm, you know,
00:16:43 --> 00:16:44 and that shouldn't be done.
00:16:44 --> 00:16:46 And he was like, well, hey.
00:16:46 --> 00:16:47 who's gonna be doing it
00:16:47 --> 00:16:49 because he was seeing way
00:16:49 --> 00:16:50 back in the eighties that
00:16:51 --> 00:16:52 physician graduates of DO
00:16:52 --> 00:16:54 schools were migrating into
00:16:54 --> 00:16:56 traditional residencies and
00:16:56 --> 00:16:58 really becoming more
00:16:58 --> 00:17:00 traditional silo based
00:17:00 --> 00:17:03 specializations and losing
00:17:03 --> 00:17:04 their manual medicine skills.
00:17:05 --> 00:17:06 And it was very intentional that says,
00:17:07 --> 00:17:09 if we don't continue to teach these skills,
00:17:10 --> 00:17:11 they will be lost and we
00:17:11 --> 00:17:13 will not have this skill
00:17:13 --> 00:17:16 set in US healthcare.
00:17:16 --> 00:17:19 And so that's why I, you know,
00:17:19 --> 00:17:20 in the back was very
00:17:20 --> 00:17:21 passionate about having
00:17:21 --> 00:17:25 that be a skill set of PTs
00:17:25 --> 00:17:25 and entry-level.
00:17:26 --> 00:17:29 But to your question now, then, you know,
00:17:29 --> 00:17:32 scaling up post-professionally, you know,
00:17:32 --> 00:17:34 I was just fortunate, you know, again,
00:17:34 --> 00:17:34 you know,
00:17:34 --> 00:17:36 somebody picks up the phone and
00:17:36 --> 00:17:39 wants to be part of your, wants you,
00:17:40 --> 00:17:41 them on your committee.
00:17:41 --> 00:17:42 And the person on the other
00:17:42 --> 00:17:43 end of the line was a guy
00:17:43 --> 00:17:44 named John Childs.
00:17:45 --> 00:17:48 And, you know, he wanted to do this RCT.
00:17:48 --> 00:17:49 And I'm like, well, yeah,
00:17:50 --> 00:17:51 I'd be happy to be on your committee.
00:17:51 --> 00:17:51 And
00:17:52 --> 00:17:54 And he describes it as being
00:17:54 --> 00:17:56 a very nervous call to someone, you know,
00:17:56 --> 00:17:58 like this expert, you know,
00:17:58 --> 00:17:59 I was looking like, oh, this young,
00:18:00 --> 00:18:02 eager person wants to collaborate.
00:18:02 --> 00:18:03 That's awesome, you know.
00:18:03 --> 00:18:06 And so, but from that, you know,
00:18:06 --> 00:18:08 we did research together
00:18:08 --> 00:18:10 and clearly evidence in
00:18:10 --> 00:18:11 motion begins to formulate.
00:18:11 --> 00:18:13 I was already doing some CD research.
00:18:13 --> 00:18:15 production back in the day, you know,
00:18:15 --> 00:18:17 doing a little digital Mavica, Sony,
00:18:17 --> 00:18:18 fifteen second video clips
00:18:18 --> 00:18:20 and smashing them on a CD.
00:18:20 --> 00:18:21 I don't know if they have
00:18:21 --> 00:18:22 those little discs.
00:18:22 --> 00:18:23 They're called CDs.
00:18:23 --> 00:18:24 They have those things anymore.
00:18:24 --> 00:18:26 But yeah, so that was so weird.
00:18:29 --> 00:18:31 Oh, indeed.
00:18:31 --> 00:18:31 So.
00:18:32 --> 00:18:32 But yeah,
00:18:32 --> 00:18:34 so that quickly we realized the
00:18:34 --> 00:18:36 demand for, you know,
00:18:36 --> 00:18:38 continuing medical
00:18:38 --> 00:18:40 education was continuing to be there.
00:18:40 --> 00:18:42 But ultimately,
00:18:43 --> 00:18:44 the data also was showing
00:18:44 --> 00:18:46 that wasn't changing behaviors, right?
00:18:46 --> 00:18:47 You just didn't change
00:18:47 --> 00:18:52 behaviors with just one-off CEs.
00:18:52 --> 00:18:55 You needed more ongoing
00:18:55 --> 00:18:56 connectivity with people.
00:18:56 --> 00:18:57 And that really...
00:18:57 --> 00:18:59 From that stemmed really
00:18:59 --> 00:19:00 residency and fellowship
00:19:01 --> 00:19:03 training and certifications
00:19:03 --> 00:19:03 and post-professional
00:19:03 --> 00:19:06 training that was more skin in the game,
00:19:06 --> 00:19:07 if you will.
00:19:07 --> 00:19:08 It was longer so that you
00:19:09 --> 00:19:13 had to commit a bit to doing that.
00:19:13 --> 00:19:15 I look back at my career and
00:19:15 --> 00:19:16 even though I wasn't in the
00:19:16 --> 00:19:17 formalized system,
00:19:17 --> 00:19:18 I was going through a
00:19:18 --> 00:19:20 series of courses that
00:19:20 --> 00:19:22 would be certificate-like.
00:19:23 --> 00:19:25 But the people around you
00:19:25 --> 00:19:26 were equally hungry.
00:19:27 --> 00:19:28 And you'd go to class all
00:19:28 --> 00:19:29 day learning these
00:19:29 --> 00:19:30 techniques and then you'd
00:19:31 --> 00:19:32 eat and then you'd grab a
00:19:32 --> 00:19:33 table and then you spend
00:19:33 --> 00:19:35 the next three hours practicing, you know,
00:19:35 --> 00:19:37 with three or four of you,
00:19:37 --> 00:19:39 like making sure you really had it,
00:19:39 --> 00:19:41 you know, before the next day.
00:19:42 --> 00:19:45 And that passion, you know,
00:19:45 --> 00:19:47 I think really makes the expert, you know,
00:19:47 --> 00:19:49 where you got it, you got to get reps,
00:19:49 --> 00:19:51 you know, I mean, you know,
00:19:51 --> 00:19:52 you do it one or two times.
00:19:53 --> 00:19:55 It's now I'm learning to play golf and,
00:19:55 --> 00:19:55 you know, man,
00:19:55 --> 00:19:57 I can tell you that the
00:19:57 --> 00:19:59 amount of reps to just get
00:19:59 --> 00:20:03 minimally competent is a ton.
00:20:03 --> 00:20:03 I mean,
00:20:03 --> 00:20:05 that's just to get minimally competent.
00:20:05 --> 00:20:08 And I think it's like any motor skill.
00:20:08 --> 00:20:09 You know,
00:20:09 --> 00:20:11 you got to be passionate about it.
00:20:11 --> 00:20:13 You got to do the reps.
00:20:13 --> 00:20:14 And so that really led to
00:20:14 --> 00:20:16 more of the certification
00:20:16 --> 00:20:18 residency fellowship kind
00:20:18 --> 00:20:19 of training that we got involved with.
00:20:21 --> 00:20:24 You know, it's so that's a little sidebar,
00:20:24 --> 00:20:26 because you mentioned your PhD.
00:20:26 --> 00:20:28 And so for our listeners out there,
00:20:29 --> 00:20:30 I actually uncovered
00:20:31 --> 00:20:34 unearthed some of your original PhD work,
00:20:34 --> 00:20:35 because I personally had a
00:20:35 --> 00:20:36 bone stress injury.
00:20:36 --> 00:20:37 And I was like,
00:20:37 --> 00:20:38 that can't be that Tim
00:20:38 --> 00:20:40 Flynn on those studies, right?
00:20:40 --> 00:20:41 Yeah.
00:20:42 --> 00:20:43 And it ultimately was.
00:20:43 --> 00:20:44 And I was like, wow, that's pretty cool.
00:20:44 --> 00:20:45 I didn't know that you had
00:20:45 --> 00:20:46 that sort of background
00:20:46 --> 00:20:47 that obviously now I know
00:20:47 --> 00:20:49 how it really just morphed
00:20:49 --> 00:20:51 really quickly back to manual therapy.
00:20:51 --> 00:20:52 But there was a brief
00:20:52 --> 00:20:53 flirtation apparently with
00:20:53 --> 00:20:55 bone distress injuries.
00:20:55 --> 00:20:58 And I'm still quite interested in them.
00:20:58 --> 00:20:59 And had I...
00:21:00 --> 00:21:02 gone a different route,
00:21:02 --> 00:21:03 I probably would have continued on.
00:21:03 --> 00:21:06 But I was in the era of PhD
00:21:06 --> 00:21:08 where you have to do something novel.
00:21:08 --> 00:21:09 And so I was trying to
00:21:10 --> 00:21:10 figure out if this
00:21:11 --> 00:21:12 vibrational characteristics
00:21:12 --> 00:21:15 of tibias would be related
00:21:15 --> 00:21:18 prognostically to bone stress injuries,
00:21:18 --> 00:21:20 which were very common in the military,
00:21:20 --> 00:21:20 the tibia.
00:21:21 --> 00:21:22 And, you know,
00:21:22 --> 00:21:25 we got the instrument to be reliable.
00:21:25 --> 00:21:28 And then once I got back into the Army,
00:21:28 --> 00:21:29 we did some studies at Army Baylor,
00:21:29 --> 00:21:32 and it just didn't pan out.
00:21:32 --> 00:21:34 I mean, there's so many factors involved.
00:21:36 --> 00:21:38 But I was always big, and still am,
00:21:38 --> 00:21:40 that bone quality is a very
00:21:40 --> 00:21:43 different measure than bone density.
00:21:43 --> 00:21:46 Density is a contributor to quality,
00:21:46 --> 00:21:47 but that is just...
00:21:48 --> 00:21:49 one marker, you know,
00:21:51 --> 00:21:52 of health and of quality.
00:21:52 --> 00:21:54 And so, yeah, still interesting.
00:21:54 --> 00:21:56 I read stuff here and there on it.
00:21:56 --> 00:22:00 It was just funny to see out there.
00:22:00 --> 00:22:01 Bone stress injury might
00:22:01 --> 00:22:01 have been a little bit
00:22:01 --> 00:22:02 easier to handle than
00:22:03 --> 00:22:06 something ubiquitous like low back pain.
00:22:06 --> 00:22:07 A little bit easier to
00:22:07 --> 00:22:10 diagnose and have an actual
00:22:10 --> 00:22:13 real patho-anatomical medical explanation,
00:22:14 --> 00:22:15 really, in some regards.
00:22:15 --> 00:22:16 So you chose something a
00:22:16 --> 00:22:17 little bit more difficult and challenging,
00:22:17 --> 00:22:18 which is good.
00:22:18 --> 00:22:19 We're all happy you did.
00:22:20 --> 00:22:21 So, yeah,
00:22:22 --> 00:22:23 I think there's been a lot to
00:22:23 --> 00:22:25 sort of unpack here already a little bit.
00:22:26 --> 00:22:28 I want to take you now to
00:22:28 --> 00:22:32 where you are at currently, you know,
00:22:32 --> 00:22:33 providing entry level
00:22:34 --> 00:22:36 education to manual therapists.
00:22:36 --> 00:22:38 And as you said, you know,
00:22:38 --> 00:22:40 when you went through PT school,
00:22:40 --> 00:22:41 and even when I went through PT school,
00:22:41 --> 00:22:42 even though it was, you know,
00:22:42 --> 00:22:43 some years later,
00:22:45 --> 00:22:46 it wasn't much different, you know,
00:22:46 --> 00:22:47 like we, we didn't learn,
00:22:48 --> 00:22:49 we certainly didn't learn manipulation.
00:22:50 --> 00:22:51 We did not learn,
00:22:52 --> 00:22:53 And then the manual therapy
00:22:53 --> 00:22:55 that we learned was, you know,
00:22:55 --> 00:22:56 obviously based on a lot of
00:22:56 --> 00:22:57 theoretical models that
00:22:57 --> 00:22:58 would just typically
00:22:59 --> 00:23:00 confuse the heck out of
00:23:00 --> 00:23:01 somebody not smart enough
00:23:01 --> 00:23:03 like me to understand those things.
00:23:04 --> 00:23:05 And so, you know,
00:23:05 --> 00:23:07 here we are now in a whole different era.
00:23:08 --> 00:23:08 And you're in a different
00:23:09 --> 00:23:11 era of your educational and
00:23:12 --> 00:23:14 teaching sort of career with that.
00:23:15 --> 00:23:16 You know, what do you...
00:23:17 --> 00:23:19 What do you love, I guess,
00:23:19 --> 00:23:21 about teaching in entry level?
00:23:21 --> 00:23:21 I mean,
00:23:22 --> 00:23:23 I think that's where you're having
00:23:23 --> 00:23:24 a lot of impact.
00:23:24 --> 00:23:25 And I think, you know,
00:23:25 --> 00:23:26 I love the topic of this
00:23:26 --> 00:23:28 because I do think that
00:23:29 --> 00:23:31 it's really important for
00:23:31 --> 00:23:33 our next generation of
00:23:33 --> 00:23:34 manual therapists to
00:23:35 --> 00:23:36 to gain some sort of footing
00:23:37 --> 00:23:38 in entry-level education
00:23:38 --> 00:23:40 and we can do that now,
00:23:40 --> 00:23:41 whereas we couldn't do it before,
00:23:41 --> 00:23:43 yet we still were successful.
00:23:45 --> 00:23:45 I guess, yeah,
00:23:45 --> 00:23:47 what's your passion and what
00:23:47 --> 00:23:48 do you see as sort of the
00:23:48 --> 00:23:50 future of education in
00:23:50 --> 00:23:51 manual therapy and entry-level?
00:23:52 --> 00:23:53 Well, I mean,
00:23:53 --> 00:23:56 I'm extremely passionate about it.
00:23:56 --> 00:23:59 And it is what I, you know,
00:24:00 --> 00:24:02 our health system is so bad.
00:24:02 --> 00:24:03 And it just,
00:24:03 --> 00:24:05 it's just crying for people
00:24:05 --> 00:24:05 that can think,
00:24:06 --> 00:24:08 that can have therapeutic hands,
00:24:09 --> 00:24:10 and that can, you know,
00:24:10 --> 00:24:12 connect with human beings.
00:24:12 --> 00:24:14 Because that's just, to me,
00:24:14 --> 00:24:16 part of the skill set
00:24:16 --> 00:24:17 allows us to actually move
00:24:17 --> 00:24:19 people to optimal health.
00:24:19 --> 00:24:19 And but...
00:24:20 --> 00:24:21 you have to, to me,
00:24:21 --> 00:24:24 it's a window in to that,
00:24:24 --> 00:24:26 despite just the basics of treating, say,
00:24:26 --> 00:24:28 neuromuscular conditions
00:24:28 --> 00:24:29 with hands-on care.
00:24:31 --> 00:24:33 I think the biases,
00:24:33 --> 00:24:35 what I like about intro level, we can,
00:24:35 --> 00:24:36 you know, we're all biased,
00:24:36 --> 00:24:38 but we can at least not
00:24:38 --> 00:24:40 bias them according to even, I mean,
00:24:41 --> 00:24:43 within the century, people, you know,
00:24:44 --> 00:24:44 are saying, you know,
00:24:44 --> 00:24:46 the dangers of manual therapy and
00:24:47 --> 00:24:48 programs not teaching it
00:24:48 --> 00:24:50 because it's dangerous, you know,
00:24:50 --> 00:24:51 and I'm like, you know,
00:24:51 --> 00:24:54 it's just a wild thing that
00:24:54 --> 00:24:56 when you look back the history,
00:24:56 --> 00:24:57 we were doing manipulation
00:24:57 --> 00:24:59 the beginning of, you know,
00:24:59 --> 00:25:01 in the nineteen twenties at
00:25:01 --> 00:25:02 the beginning of our profession, you know,
00:25:02 --> 00:25:03 I mean,
00:25:03 --> 00:25:05 that was the basics of our
00:25:05 --> 00:25:07 profession was hands on
00:25:07 --> 00:25:09 manual manipulative type care.
00:25:09 --> 00:25:12 So it's weird how things got distorted.
00:25:13 --> 00:25:15 But I really don't want to
00:25:15 --> 00:25:17 leave this talk or
00:25:17 --> 00:25:19 discussion without saying
00:25:19 --> 00:25:23 that as the academy in the
00:25:23 --> 00:25:24 manual therapy group,
00:25:24 --> 00:25:27 our role is that of teachers.
00:25:27 --> 00:25:29 And I'm so excited.
00:25:29 --> 00:25:31 There's so many fellows that
00:25:31 --> 00:25:33 are on faculty throughout the country.
00:25:34 --> 00:25:35 And you look and talk to
00:25:35 --> 00:25:39 programs and everybody, you know, says,
00:25:39 --> 00:25:39 you know,
00:25:39 --> 00:25:41 they're excited about their
00:25:42 --> 00:25:44 orthopedic or musculoskeletal faculty,
00:25:45 --> 00:25:45 you know.
00:25:45 --> 00:25:47 Well, there's a couple reasons.
00:25:47 --> 00:25:49 Almost all these are still clinicians.
00:25:49 --> 00:25:50 They're actually still
00:25:51 --> 00:25:53 seeing patients in some capacity,
00:25:53 --> 00:25:55 limited often just due to
00:25:55 --> 00:25:56 the other responsibilities,
00:25:56 --> 00:25:57 but are clinicians.
00:25:57 --> 00:25:59 They have stories about real
00:25:59 --> 00:26:01 patients right now, currently.
00:26:01 --> 00:26:02 Right.
00:26:02 --> 00:26:04 Their passion for what they
00:26:04 --> 00:26:06 do exudes through.
00:26:06 --> 00:26:07 They're not telling stories of,
00:26:07 --> 00:26:08 ''Twenty years ago when I
00:26:08 --> 00:26:09 saw this patient.''
00:26:10 --> 00:26:14 Students react to that.
00:26:15 --> 00:26:16 I'm curious,
00:26:16 --> 00:26:18 the number of fellows that are on faculty,
00:26:18 --> 00:26:19 it has to be quite high.
00:26:21 --> 00:26:23 What's even more exciting to
00:26:23 --> 00:26:25 me is so many programs now
00:26:26 --> 00:26:27 are finally shifting.
00:26:28 --> 00:26:30 whether they're residency or
00:26:30 --> 00:26:32 blended models that, you know, say,
00:26:32 --> 00:26:35 you know,
00:26:35 --> 00:26:36 those that should be teaching
00:26:37 --> 00:26:39 clinical skills should be clinicians.
00:26:40 --> 00:26:40 You know,
00:26:40 --> 00:26:42 they should be expert clinicians.
00:26:42 --> 00:26:42 You know,
00:26:42 --> 00:26:45 I don't want my surgeon taught by
00:26:46 --> 00:26:48 someone that doesn't do surgery.
00:26:48 --> 00:26:49 I just don't feel that's a
00:26:49 --> 00:26:50 good way to do business.
00:26:50 --> 00:26:53 You know, it shouldn't be, you know,
00:26:53 --> 00:26:55 the anatomy professor that's teaching it.
00:26:56 --> 00:26:57 It should actually be the
00:26:57 --> 00:26:59 surgeon that's teaching how
00:26:59 --> 00:27:00 to do surgery.
00:27:01 --> 00:27:03 And I think it's crazy how
00:27:03 --> 00:27:04 distorted our profession
00:27:04 --> 00:27:07 got away from the expertise
00:27:07 --> 00:27:08 of the clinician really
00:27:08 --> 00:27:11 driving the educational system.
00:27:12 --> 00:27:13 And so that's kind of what
00:27:13 --> 00:27:15 I'm most passionate about.
00:27:15 --> 00:27:16 And I think that manual
00:27:16 --> 00:27:19 therapy is really leading that charge.
00:27:19 --> 00:27:21 in that through the
00:27:21 --> 00:27:23 fellowship programs and
00:27:23 --> 00:27:23 that many of those
00:27:23 --> 00:27:26 graduates go on to be
00:27:26 --> 00:27:28 either full-time faculty or
00:27:28 --> 00:27:31 adjunct faculty leading, you know,
00:27:32 --> 00:27:34 various components of the curriculum.
00:27:35 --> 00:27:37 Yeah, you know, it's fascinating.
00:27:37 --> 00:27:37 Like you said,
00:27:38 --> 00:27:39 manual therapy has been a
00:27:39 --> 00:27:40 part of what we do.
00:27:40 --> 00:27:40 And, you know,
00:27:40 --> 00:27:42 it's certainly a part of
00:27:42 --> 00:27:43 orthopedic management.
00:27:44 --> 00:27:45 You know, you're not, you know,
00:27:46 --> 00:27:46 by putting your hands on
00:27:47 --> 00:27:48 somebody and you establish
00:27:48 --> 00:27:50 that relationship as well,
00:27:50 --> 00:27:51 and you learn how to
00:27:51 --> 00:27:53 communicate and have
00:27:53 --> 00:27:54 empathy and all the other
00:27:54 --> 00:27:55 components that are around it.
00:27:56 --> 00:27:59 But it's not even just orthopedic care.
00:27:59 --> 00:28:00 I've actually talked to a
00:28:00 --> 00:28:03 lot of the faculty within our program who,
00:28:04 --> 00:28:05 you know, employ orthopedic
00:28:05 --> 00:28:07 manual interventions across
00:28:07 --> 00:28:09 other types of settings.
00:28:09 --> 00:28:10 And I think, you know,
00:28:10 --> 00:28:13 and one of the things that for me,
00:28:13 --> 00:28:15 when it was time,
00:28:15 --> 00:28:17 when I moved from primarily
00:28:17 --> 00:28:18 teaching post-professional
00:28:18 --> 00:28:19 education to moving into
00:28:20 --> 00:28:22 entry-level education, I think I remember,
00:28:22 --> 00:28:23 I can't remember who it was
00:28:23 --> 00:28:24 that gave me this advice.
00:28:24 --> 00:28:24 They're like,
00:28:24 --> 00:28:25 but you gotta be careful
00:28:25 --> 00:28:27 because you're going to have, you know,
00:28:27 --> 00:28:30 neuro geriatric pediatric
00:28:30 --> 00:28:33 interest from students in these programs.
00:28:33 --> 00:28:35 But I have found that so I
00:28:35 --> 00:28:36 teach an advanced manual
00:28:36 --> 00:28:38 therapy class and about
00:28:38 --> 00:28:39 ninety percent of the
00:28:39 --> 00:28:41 students in our program
00:28:42 --> 00:28:43 take that advanced manual therapy class,
00:28:43 --> 00:28:45 even if they're going into
00:28:45 --> 00:28:48 pediatrics or neuro or some other realm,
00:28:48 --> 00:28:48 because I think even
00:28:49 --> 00:28:49 they're starting to
00:28:49 --> 00:28:51 recognize the importance of
00:28:51 --> 00:28:53 hands on care across all
00:28:53 --> 00:28:53 different kinds of
00:28:53 --> 00:28:55 specializations and areas.
00:28:56 --> 00:28:56 You know,
00:28:57 --> 00:29:02 I'm so hopeful that that is the case.
00:29:02 --> 00:29:05 It's not a musculoskeletal skill.
00:29:05 --> 00:29:05 Yeah,
00:29:06 --> 00:29:08 we use it a lot in musculoskeletal care.
00:29:08 --> 00:29:10 But, you know, I love when I see...
00:29:12 --> 00:29:13 the predominant neurological
00:29:14 --> 00:29:15 diagnosis patient.
00:29:15 --> 00:29:16 I mean, again,
00:29:16 --> 00:29:19 most of these disorders end
00:29:19 --> 00:29:21 up affecting the movement system.
00:29:21 --> 00:29:22 When the movement system
00:29:22 --> 00:29:24 doesn't get to go through its range,
00:29:24 --> 00:29:26 it has impairments that
00:29:26 --> 00:29:29 need some hands-on care to
00:29:29 --> 00:29:33 get them through and to ease movement.
00:29:33 --> 00:29:36 And it makes so much sense.
00:29:36 --> 00:29:37 I mean,
00:29:37 --> 00:29:40 our pediatric team at Colorado Motion,
00:29:40 --> 00:29:40 they
00:29:40 --> 00:29:42 very hands-on focused.
00:29:42 --> 00:29:44 They are manual therapy oriented.
00:29:44 --> 00:29:48 They don't think anything of it.
00:29:48 --> 00:29:50 So much have restricted movement systems.
00:29:50 --> 00:29:51 If you're not doing some
00:29:51 --> 00:29:53 type of manual intervention,
00:29:53 --> 00:29:55 you really are not offering
00:29:55 --> 00:29:57 them top-of-the-line skill set.
00:29:58 --> 00:29:58 And again,
00:29:58 --> 00:30:01 you can move on into Parkinson's,
00:30:01 --> 00:30:04 another example where, again,
00:30:04 --> 00:30:06 loss of full movements
00:30:06 --> 00:30:08 begin to create impairments
00:30:08 --> 00:30:10 at the joint soft tissue
00:30:10 --> 00:30:12 levels that make it even
00:30:13 --> 00:30:15 further difficult to move, right?
00:30:16 --> 00:30:17 Yeah,
00:30:17 --> 00:30:20 I just wish we'd get out of our silos.
00:30:20 --> 00:30:21 I mean, people are,
00:30:21 --> 00:30:22 and I just hope this new
00:30:22 --> 00:30:24 generation just sees it as, you know,
00:30:25 --> 00:30:27 this is just, it's not a silo.
00:30:27 --> 00:30:27 You know,
00:30:27 --> 00:30:30 we treat human bodies and these
00:30:30 --> 00:30:34 skill sets cross all of our quote unquote,
00:30:34 --> 00:30:36 you know, specialties of care.
00:30:37 --> 00:30:37 Yeah,
00:30:37 --> 00:30:37 I think that's something that we're
00:30:37 --> 00:30:38 kind of seeing there.
00:30:39 --> 00:30:39 All right,
00:30:39 --> 00:30:42 so we're moving along in the
00:30:42 --> 00:30:43 journey and talking about
00:30:43 --> 00:30:47 the importance of manual
00:30:47 --> 00:30:48 therapy education as a
00:30:49 --> 00:30:52 professional student level.
00:30:52 --> 00:30:54 Post-professional education
00:30:55 --> 00:30:56 is something that you're
00:30:56 --> 00:30:58 still involved in.
00:30:58 --> 00:30:59 Certainly, when we think about that,
00:30:59 --> 00:31:00 we think about orthopedic
00:31:00 --> 00:31:02 residency or residency, I should say,
00:31:02 --> 00:31:03 and fellowship education.
00:31:03 --> 00:31:06 training and what are your
00:31:07 --> 00:31:10 thoughts on that and how
00:31:10 --> 00:31:14 important that is for our profession?
00:31:15 --> 00:31:18 you know here I'll go up a
00:31:18 --> 00:31:19 level here in big picture I
00:31:20 --> 00:31:21 think you know
00:31:21 --> 00:31:23 post-professional training
00:31:23 --> 00:31:24 ongoing learning is just
00:31:26 --> 00:31:27 it's the nature of being a
00:31:27 --> 00:31:28 professional you know so
00:31:29 --> 00:31:31 whether or not you go to
00:31:31 --> 00:31:33 residency or fellowship uh
00:31:33 --> 00:31:35 hopefully at a minimum some
00:31:35 --> 00:31:36 type of certification
00:31:36 --> 00:31:38 pathway where you you go
00:31:38 --> 00:31:42 deeper into an area of practice I mean
00:31:43 --> 00:31:43 Yeah,
00:31:43 --> 00:31:45 a superficial knowledge of certain
00:31:45 --> 00:31:47 things like, you know, a patient comes in,
00:31:47 --> 00:31:49 they have a diagnosis I've
00:31:49 --> 00:31:50 never heard of.
00:31:50 --> 00:31:50 You know,
00:31:51 --> 00:31:53 I can look up to get a basic
00:31:53 --> 00:31:56 understanding of what this diagnosis is.
00:31:56 --> 00:31:57 But, you know,
00:31:58 --> 00:31:59 and I don't necessarily go
00:31:59 --> 00:32:01 deep down into that.
00:32:02 --> 00:32:03 specialization,
00:32:03 --> 00:32:05 but some specializations
00:32:06 --> 00:32:08 that are core to who I am
00:32:08 --> 00:32:10 as a professional, I need to,
00:32:10 --> 00:32:12 and you pick whatever that is,
00:32:12 --> 00:32:13 but I just feel that depth
00:32:15 --> 00:32:17 versus breadth coming out
00:32:17 --> 00:32:20 of a professional program is necessary.
00:32:20 --> 00:32:22 because you you got to go in
00:32:22 --> 00:32:25 deep and sometimes you know
00:32:25 --> 00:32:26 you go down a rabbit hole
00:32:26 --> 00:32:28 and it you find you're
00:32:28 --> 00:32:29 frustrated that you didn't
00:32:29 --> 00:32:30 get as much out of it as
00:32:30 --> 00:32:32 you wanted but actually you
00:32:32 --> 00:32:34 did because it's the
00:32:34 --> 00:32:36 discipline of driving
00:32:37 --> 00:32:40 deeper into an area of practice
00:32:40 --> 00:32:41 That allows you then to come
00:32:41 --> 00:32:44 back out and be, frankly,
00:32:44 --> 00:32:45 more efficient when you go
00:32:45 --> 00:32:47 down others as well.
00:32:47 --> 00:32:48 So I'm a big believer in
00:32:48 --> 00:32:51 whatever your passion is to
00:32:51 --> 00:32:53 go down a pathway.
00:32:53 --> 00:32:55 And I think programs have
00:32:55 --> 00:32:56 gotten better at that.
00:32:57 --> 00:33:01 of putting into modules ways to do that,
00:33:01 --> 00:33:01 again,
00:33:01 --> 00:33:03 where you could maybe do such a
00:33:03 --> 00:33:05 certification and maybe
00:33:05 --> 00:33:07 that can build on into a residency model,
00:33:08 --> 00:33:09 can build on into a
00:33:09 --> 00:33:10 fellowship type model.
00:33:10 --> 00:33:11 So I think, you know,
00:33:12 --> 00:33:14 various post-professional
00:33:14 --> 00:33:15 training programs,
00:33:15 --> 00:33:16 whether they be at the
00:33:16 --> 00:33:17 university level or
00:33:19 --> 00:33:20 private level are getting
00:33:20 --> 00:33:21 better at doing that.
00:33:22 --> 00:33:24 And I think as a consumer or student,
00:33:25 --> 00:33:25 you know, can,
00:33:26 --> 00:33:27 has more opportunities that
00:33:27 --> 00:33:28 that graduate has more
00:33:28 --> 00:33:30 opportunities to find those.
00:33:31 --> 00:33:34 So that, that's my main, I guess,
00:33:34 --> 00:33:35 takeaway of that.
00:33:36 --> 00:33:39 Yeah, no, and that's, you know,
00:33:40 --> 00:33:40 so good and so great.
00:33:41 --> 00:33:41 I know that, you know,
00:33:41 --> 00:33:43 every student is going to
00:33:43 --> 00:33:43 be a little bit different.
00:33:43 --> 00:33:45 I always talk to them about, you know,
00:33:45 --> 00:33:47 you have to self-reflect,
00:33:47 --> 00:33:49 but at some level,
00:33:49 --> 00:33:51 if you find yourself not
00:33:52 --> 00:33:55 passionate or interested in, you know,
00:33:55 --> 00:33:57 seeking more,
00:33:57 --> 00:33:58 then it's probably a
00:33:58 --> 00:34:00 reflection of other things
00:34:00 --> 00:34:01 going on as well, too,
00:34:01 --> 00:34:03 that you have to kind of think about.
00:34:03 --> 00:34:05 But there is, you know,
00:34:06 --> 00:34:07 I think you even said earlier,
00:34:07 --> 00:34:08 sometimes you have to make
00:34:08 --> 00:34:10 those those investments a
00:34:10 --> 00:34:11 little bit different in a
00:34:11 --> 00:34:13 way that maybe isn't what
00:34:13 --> 00:34:15 they're quite ready and comfortable for.
00:34:15 --> 00:34:16 But then the payout,
00:34:17 --> 00:34:18 whether it's financial
00:34:18 --> 00:34:19 payout or maybe it's just
00:34:19 --> 00:34:21 professional satisfaction,
00:34:21 --> 00:34:23 certainly comes into play
00:34:23 --> 00:34:25 as you go through those those paths.
00:34:25 --> 00:34:26 I don't speak to too many
00:34:26 --> 00:34:28 people who have gone through that.
00:34:28 --> 00:34:30 who have gone into the depths,
00:34:30 --> 00:34:31 like you've said,
00:34:31 --> 00:34:32 who have gone deep into the
00:34:32 --> 00:34:35 caves of things, come back out,
00:34:35 --> 00:34:36 maybe they come away with
00:34:36 --> 00:34:38 some some new letters, certifications,
00:34:38 --> 00:34:39 some fellowship training
00:34:39 --> 00:34:40 and things like that.
00:34:41 --> 00:34:41 They tend to be the ones
00:34:41 --> 00:34:46 that I find to be the the happiest,
00:34:46 --> 00:34:48 the healthiest, in a sense,
00:34:48 --> 00:34:48 even though it seems like
00:34:48 --> 00:34:50 they wouldn't be because of
00:34:50 --> 00:34:51 the amount of like,
00:34:51 --> 00:34:52 effort that it took to get there.
00:34:53 --> 00:34:56 And it relates to, I mean,
00:34:56 --> 00:34:57 we won't go deep into, you know,
00:34:57 --> 00:34:59 the problems of higher education,
00:34:59 --> 00:35:02 the costs, et cetera, but it's well known,
00:35:02 --> 00:35:02 right?
00:35:02 --> 00:35:05 And so part of it is, well, financially,
00:35:05 --> 00:35:06 you know,
00:35:06 --> 00:35:08 it just doesn't make sense to
00:35:08 --> 00:35:10 continue to pour more in.
00:35:11 --> 00:35:13 I clearly see the argument,
00:35:13 --> 00:35:15 and yet sometimes we don't
00:35:16 --> 00:35:18 talk about the fact that if
00:35:18 --> 00:35:21 you leave the profession, you burn out,
00:35:21 --> 00:35:23 and you leave due to dissatisfaction,
00:35:24 --> 00:35:25 which is often because you
00:35:25 --> 00:35:32 feel like you're not –
00:35:27 --> 00:35:29 successful with clients.
00:35:29 --> 00:35:29 You know, you just,
00:35:30 --> 00:35:30 you burn out because you
00:35:30 --> 00:35:34 don't get the hit that you
00:35:34 --> 00:35:37 get when people are successful, right?
00:35:37 --> 00:35:39 When you have success around
00:35:39 --> 00:35:41 you and your patients and clients are,
00:35:42 --> 00:35:42 you know, are
00:35:43 --> 00:35:44 have gratitude and show
00:35:44 --> 00:35:45 gratitude towards you,
00:35:46 --> 00:35:47 you feed off of that.
00:35:47 --> 00:35:48 And, you know,
00:35:49 --> 00:35:51 it now does not become work.
00:35:51 --> 00:35:52 It becomes passion.
00:35:52 --> 00:35:54 It becomes truly your
00:35:54 --> 00:35:55 professional journey.
00:35:56 --> 00:35:59 And I do think that there's
00:35:59 --> 00:36:00 a cost if you don't have that,
00:36:00 --> 00:36:01 because you probably will
00:36:02 --> 00:36:03 leave the profession early, you know,
00:36:03 --> 00:36:05 which is a financial issue.
00:36:05 --> 00:36:06 hit whether you have to
00:36:06 --> 00:36:08 retrain your skill set,
00:36:09 --> 00:36:11 which you will into something else or,
00:36:11 --> 00:36:13 you know, some other type of thing.
00:36:13 --> 00:36:15 And so I think that's,
00:36:15 --> 00:36:18 it is that long game where you, you know,
00:36:18 --> 00:36:20 you have to kind of play
00:36:20 --> 00:36:21 and there's no right answer
00:36:21 --> 00:36:24 for an individual, these big,
00:36:24 --> 00:36:24 broad statements,
00:36:24 --> 00:36:26 but I do think it's worth
00:36:26 --> 00:36:28 looking at it that way.
00:36:28 --> 00:36:29 The people that go in deep,
00:36:30 --> 00:36:33 They generally come out passionate,
00:36:33 --> 00:36:34 understanding,
00:36:35 --> 00:36:37 and have this longer
00:36:37 --> 00:36:39 longevity in the profession
00:36:39 --> 00:36:42 because they just, they, they,
00:36:43 --> 00:36:44 results improve.
00:36:44 --> 00:36:46 And because of that, you know,
00:36:46 --> 00:36:48 feedback from patients improves.
00:36:49 --> 00:36:50 So I want to take us on a
00:36:50 --> 00:36:51 little bit of a different
00:36:51 --> 00:36:53 adventure before we conclude this show,
00:36:53 --> 00:36:54 because I think, you know,
00:36:54 --> 00:36:55 there was an article that
00:36:55 --> 00:36:56 just came out in JOSPT.
00:36:56 --> 00:36:57 It was a really good one.
00:36:57 --> 00:36:59 It was advice to the new grad.
00:36:59 --> 00:36:59 Right.
00:36:59 --> 00:37:01 It was, I think, Jeremy Lewis,
00:37:01 --> 00:37:02 Chad Cook and a few others
00:37:02 --> 00:37:03 were on that paper.
00:37:03 --> 00:37:04 Really nice paper.
00:37:04 --> 00:37:06 um but here's what I want to
00:37:06 --> 00:37:10 ask you because uh I think
00:37:10 --> 00:37:11 a lot of our listeners
00:37:11 --> 00:37:12 especially academy
00:37:12 --> 00:37:15 listeners potentially are
00:37:15 --> 00:37:16 you know a lot of our
00:37:16 --> 00:37:18 membership is fellows um a
00:37:18 --> 00:37:18 lot of our mentor
00:37:19 --> 00:37:20 membership are people who
00:37:20 --> 00:37:21 may be thinking about
00:37:21 --> 00:37:21 fellows of course not
00:37:21 --> 00:37:22 everybody there's also
00:37:22 --> 00:37:24 non-fellow members but they
00:37:24 --> 00:37:26 also have potentially have
00:37:26 --> 00:37:27 gone down a lot of depths and and
00:37:28 --> 00:37:30 holes in their lives as well.
00:37:31 --> 00:37:33 So I want to go into the
00:37:34 --> 00:37:35 post-professional
00:37:36 --> 00:37:38 educational journeys and
00:37:38 --> 00:37:40 get some of your thoughts on that.
00:37:40 --> 00:37:43 So you're the seasoned person.
00:37:43 --> 00:37:45 You have had some successes.
00:37:45 --> 00:37:46 You do feel like you are
00:37:47 --> 00:37:48 effective in a sense,
00:37:49 --> 00:37:52 but you're no longer in that sort of
00:37:52 --> 00:37:55 you know, game of trying to, you know,
00:37:55 --> 00:37:57 build sort of this
00:37:58 --> 00:38:00 repertoire or resume of
00:38:00 --> 00:38:01 certain types of things.
00:38:02 --> 00:38:02 You know, what,
00:38:02 --> 00:38:03 what does that post
00:38:03 --> 00:38:05 post-professional education
00:38:05 --> 00:38:08 look like in your mind, I guess?
00:38:08 --> 00:38:08 Curious.
00:38:09 --> 00:38:10 Yeah, I mean,
00:38:10 --> 00:38:11 I think that's when you enter
00:38:11 --> 00:38:13 the phase that you truly
00:38:13 --> 00:38:15 are a self-directed learner
00:38:15 --> 00:38:18 that you can really continue to grow by.
00:38:19 --> 00:38:21 You seek out new knowledge
00:38:21 --> 00:38:22 and you get more efficient
00:38:22 --> 00:38:24 at seeking out new knowledge.
00:38:24 --> 00:38:27 But I think that person, you know.
00:38:28 --> 00:38:29 It.
00:38:29 --> 00:38:31 I don't look at it as an
00:38:31 --> 00:38:33 obligation to teach,
00:38:34 --> 00:38:36 whether it be being a
00:38:36 --> 00:38:39 clinical instructor for an entry level,
00:38:39 --> 00:38:40 whether it be a mentor for
00:38:40 --> 00:38:42 a resident or fellow.
00:38:44 --> 00:38:46 I think it's very selfish
00:38:46 --> 00:38:48 that you should do it for selfish reasons,
00:38:49 --> 00:38:52 because that to me is that next phase.
00:38:54 --> 00:38:55 And you may have been doing it all along.
00:38:56 --> 00:38:57 but you're doing it with a really,
00:38:58 --> 00:39:00 you know, different intent of, you know,
00:39:00 --> 00:39:01 I want that new learner to
00:39:01 --> 00:39:04 challenge me on what is my
00:39:04 --> 00:39:06 belief structure and what's
00:39:06 --> 00:39:09 going on and this back and forth nature,
00:39:09 --> 00:39:13 which then, you know, keeps me learning,
00:39:13 --> 00:39:15 if you will, going on.
00:39:15 --> 00:39:17 So, I mean, I think that's, you know,
00:39:17 --> 00:39:19 just continuing to be engaged with,
00:39:19 --> 00:39:19 you know,
00:39:20 --> 00:39:21 from a teaching perspective in
00:39:21 --> 00:39:22 whatever form,
00:39:22 --> 00:39:24 whether it be at the university or in the
00:39:24 --> 00:39:25 clinical environment.
00:39:26 --> 00:39:29 The second thing I would say
00:39:29 --> 00:39:32 is going in different directions.
00:39:33 --> 00:39:35 And that I think is key.
00:39:36 --> 00:39:40 I really have broadened, I mean, I've been,
00:39:41 --> 00:39:43 I think, holistic and open to a lot of
00:39:44 --> 00:39:45 New ideas, you know,
00:39:46 --> 00:39:47 as we learn more about the
00:39:47 --> 00:39:49 neuroscience of pain
00:39:49 --> 00:39:50 mechanisms and things in
00:39:50 --> 00:39:53 the last two decades and learning that.
00:39:53 --> 00:39:55 But then that exposes you to the fact that,
00:39:55 --> 00:39:56 oh, my gosh, you know,
00:39:56 --> 00:39:58 look at the gut and the gut
00:39:59 --> 00:40:00 microbiome and how, wow,
00:40:01 --> 00:40:02 how this is affecting you.
00:40:02 --> 00:40:05 you know, all these systems that I've been,
00:40:05 --> 00:40:07 you know, teasing and using my hands with,
00:40:08 --> 00:40:10 and I haven't really been addressing that,
00:40:11 --> 00:40:11 you know,
00:40:12 --> 00:40:14 the same with breath work and breathing.
00:40:14 --> 00:40:15 I haven't been as detailed
00:40:16 --> 00:40:18 and had a deep understanding of that,
00:40:18 --> 00:40:20 how that interplays in what
00:40:20 --> 00:40:23 I'm doing with my manual interventions.
00:40:23 --> 00:40:25 And so taking those elements
00:40:25 --> 00:40:28 that compliment my core, you know,
00:40:28 --> 00:40:31 a clinical acumen and making
00:40:31 --> 00:40:35 sure I'm bringing those into my skill set,
00:40:35 --> 00:40:37 you know, and again,
00:40:37 --> 00:40:38 the same way you got to go
00:40:38 --> 00:40:41 deep sometimes to kind of
00:40:41 --> 00:40:43 end up only pulling one or
00:40:43 --> 00:40:44 two things that, oh yeah, this is my,
00:40:45 --> 00:40:46 I always kind of do this
00:40:46 --> 00:40:48 now with patients, you know, it's,
00:40:48 --> 00:40:49 you know,
00:40:49 --> 00:40:51 and I think our role obviously
00:40:51 --> 00:40:52 is distiller, right?
00:40:52 --> 00:40:52 You know,
00:40:52 --> 00:40:53 we start with a wide range of
00:40:53 --> 00:40:54 information and
00:40:54 --> 00:40:55 which is out there,
00:40:55 --> 00:40:56 but how do we make it
00:40:56 --> 00:40:58 really actionable to my
00:40:58 --> 00:41:00 patients in front of me?
00:41:00 --> 00:41:02 So I think that's the next
00:41:02 --> 00:41:02 phase of the
00:41:03 --> 00:41:05 post-professional phase is
00:41:05 --> 00:41:07 really taking newer ideas
00:41:09 --> 00:41:12 and integrating those into
00:41:12 --> 00:41:14 practice and then
00:41:14 --> 00:41:16 challenging the folks
00:41:16 --> 00:41:18 you're working with and teaching,
00:41:19 --> 00:41:20 what do you think about this?
00:41:20 --> 00:41:21 And this is my
00:41:22 --> 00:41:24 mindset is that out there, this is why,
00:41:24 --> 00:41:26 you know, watch me do this with a patient,
00:41:26 --> 00:41:29 you know, is what do you think of that?
00:41:29 --> 00:41:31 Is that, you know, good, bad, indifferent,
00:41:32 --> 00:41:32 you know, again,
00:41:32 --> 00:41:35 asking for feedback and
00:41:35 --> 00:41:37 hopefully feedback that is not just,
00:41:37 --> 00:41:39 you know, as I say, good job,
00:41:41 --> 00:41:43 something that's actionable
00:41:43 --> 00:41:45 and actually critical that allows you to,
00:41:45 --> 00:41:47 to, to, to improve.
00:41:48 --> 00:41:49 No, I'm glad you did that.
00:41:49 --> 00:41:51 It was actually, I kind of,
00:41:52 --> 00:41:53 you took the bait because I
00:41:53 --> 00:41:55 wanted you to go down that path.
00:41:55 --> 00:41:56 The only reason I wanted you
00:41:56 --> 00:41:56 to go down that path is
00:41:57 --> 00:41:58 it's something I've actually seen,
00:41:58 --> 00:42:00 not just from you, but from other,
00:42:00 --> 00:42:03 you know, folks who I have respected,
00:42:03 --> 00:42:05 where it's not just rinse
00:42:05 --> 00:42:07 and repeat after you've had
00:42:07 --> 00:42:08 your post-professional education,
00:42:08 --> 00:42:08 where you just
00:42:09 --> 00:42:11 I've made it to the mountain
00:42:11 --> 00:42:12 and now I'm just going to
00:42:12 --> 00:42:13 kind of do what I'm going to do.
00:42:13 --> 00:42:14 And I think that that
00:42:14 --> 00:42:16 becomes sort of frustrating
00:42:16 --> 00:42:17 for the post
00:42:17 --> 00:42:19 post-professional phase of
00:42:19 --> 00:42:19 somebody's career.
00:42:19 --> 00:42:20 That's something that I've
00:42:20 --> 00:42:22 always seen that I think
00:42:22 --> 00:42:24 very healthy people start
00:42:24 --> 00:42:25 to look at things very differently.
00:42:25 --> 00:42:27 And you can be sort of,
00:42:27 --> 00:42:29 focused and myopic in some
00:42:29 --> 00:42:30 sense and still go into a
00:42:31 --> 00:42:32 lot of depths or you can
00:42:32 --> 00:42:33 now start to expand your
00:42:33 --> 00:42:35 breadth like you have done and certainly,
00:42:35 --> 00:42:36 you know,
00:42:36 --> 00:42:37 look at things a bit differently.
00:42:37 --> 00:42:39 But I think that that's part
00:42:39 --> 00:42:40 of that excitement for a
00:42:40 --> 00:42:42 lot of folks is that now you can go and
00:42:43 --> 00:42:44 And see how everything
00:42:44 --> 00:42:45 functions and integrates a
00:42:45 --> 00:42:47 little bit differently there as well.
00:42:47 --> 00:42:48 But so I wanted you to
00:42:48 --> 00:42:49 actually say that because
00:42:49 --> 00:42:51 that's something that I've seen you do.
00:42:51 --> 00:42:53 I'm like, oh, what is Tim doing now?
00:42:53 --> 00:42:55 Like this was not Tim from
00:42:55 --> 00:42:56 two thousand two.
00:42:56 --> 00:42:58 This is Tim from twenty twenty four.
00:42:58 --> 00:42:59 And it's and it's got a
00:42:59 --> 00:43:01 little it's got some Tim still,
00:43:01 --> 00:43:02 but then it's got a lot of
00:43:02 --> 00:43:03 other integrated things as
00:43:03 --> 00:43:04 a component to what you do.
00:43:05 --> 00:43:07 And I think that is that
00:43:07 --> 00:43:08 lifeline learning.
00:43:09 --> 00:43:10 I mean, it's thrown around all the time,
00:43:10 --> 00:43:12 but frankly,
00:43:12 --> 00:43:16 I do it for pure selfish reasons.
00:43:17 --> 00:43:20 I mean, from a neurocognitive perspective,
00:43:20 --> 00:43:23 I want to be as bright and
00:43:24 --> 00:43:26 keep my brain as healthy as I can, right?
00:43:26 --> 00:43:29 We know that that's do novel things,
00:43:29 --> 00:43:30 learn new things.
00:43:30 --> 00:43:32 I mean, and why not learn things that,
00:43:33 --> 00:43:33 you know,
00:43:33 --> 00:43:35 you're passionate about and can
00:43:35 --> 00:43:37 actually make a difference, you know,
00:43:37 --> 00:43:40 and I do a lot of these things just,
00:43:40 --> 00:43:42 you know, and chat with people, you know,
00:43:42 --> 00:43:43 at the,
00:43:43 --> 00:43:45 a cocktail party or dinner party about,
00:43:45 --> 00:43:47 Hey, I read about this.
00:43:47 --> 00:43:48 This is pretty cool.
00:43:48 --> 00:43:49 Or I listened to this podcast.
00:43:49 --> 00:43:50 What do you think?
00:43:50 --> 00:43:51 And, you know,
00:43:51 --> 00:43:54 do you integrate this into your life,
00:43:54 --> 00:43:56 you know, and how does that play?
00:43:56 --> 00:43:57 And I think that's just that
00:43:57 --> 00:43:58 natural curiosity.
00:43:59 --> 00:43:59 You gotta,
00:43:59 --> 00:44:01 you have to have in that
00:44:01 --> 00:44:03 post-professional area.
00:44:03 --> 00:44:04 And it's,
00:44:04 --> 00:44:05 I'll say this.
00:44:05 --> 00:44:06 It's interesting.
00:44:06 --> 00:44:07 When I went to Fort Collins
00:44:07 --> 00:44:08 in two thousand three,
00:44:10 --> 00:44:11 there's Colorado has some
00:44:11 --> 00:44:12 excellent clinicians.
00:44:13 --> 00:44:14 I'll say that straight up.
00:44:14 --> 00:44:16 Just really,
00:44:16 --> 00:44:17 it was a very open state for
00:44:18 --> 00:44:19 private practice for, you know,
00:44:19 --> 00:44:21 from the sixties and seventies.
00:44:22 --> 00:44:22 You know,
00:44:22 --> 00:44:24 so it's a very open state in that regard.
00:44:25 --> 00:44:26 You know, lots of people, you know,
00:44:26 --> 00:44:28 hanging shingles and doing things.
00:44:29 --> 00:44:29 And there was a good
00:44:29 --> 00:44:33 practice in town and that was doing,
00:44:33 --> 00:44:33 you know,
00:44:34 --> 00:44:35 was really into the certain
00:44:35 --> 00:44:38 technique set and that
00:44:38 --> 00:44:40 started in the mid nineties.
00:44:40 --> 00:44:42 And now it's already, you know,
00:44:42 --> 00:44:42 now let's say about two
00:44:43 --> 00:44:44 thousand five starting to
00:44:44 --> 00:44:47 see patients coming from that.
00:44:48 --> 00:44:51 area and an excellent clinician,
00:44:52 --> 00:44:53 but a couple of patients would say, well,
00:44:54 --> 00:44:56 yeah, I'd go, I was going to him,
00:44:56 --> 00:44:57 but he's still doing the
00:44:57 --> 00:45:00 same things he was doing back then.
00:45:01 --> 00:45:02 And it stuck with me.
00:45:03 --> 00:45:04 And
00:45:06 --> 00:45:07 Doing it well, and again,
00:45:07 --> 00:45:09 because I don't believe whatever you do,
00:45:09 --> 00:45:10 you do it well,
00:45:10 --> 00:45:12 you're going to get good results.
00:45:12 --> 00:45:13 And I do think there's some
00:45:14 --> 00:45:18 agnostic nature to the technique,
00:45:18 --> 00:45:18 if you will.
00:45:18 --> 00:45:22 But it stuck in my mind like, well,
00:45:22 --> 00:45:23 I don't want to be that.
00:45:23 --> 00:45:25 I don't want to just be
00:45:25 --> 00:45:28 doing the same thing, you know,
00:45:28 --> 00:45:30 ten years from now that I'm doing now,
00:45:30 --> 00:45:31 even five years from now.
00:45:31 --> 00:45:32 you know that I need to
00:45:33 --> 00:45:34 continue to grow because
00:45:34 --> 00:45:35 man the explosion of
00:45:35 --> 00:45:37 knowledge if if I'm doing
00:45:37 --> 00:45:38 the same thing I'm all this
00:45:38 --> 00:45:39 stuff I've read about that
00:45:40 --> 00:45:42 you know that I don't want
00:45:42 --> 00:45:43 to be you know so I do
00:45:43 --> 00:45:44 think there's a lot to be
00:45:44 --> 00:45:46 said for that and we have
00:45:46 --> 00:45:47 to challenge our colleagues
00:45:48 --> 00:45:49 and friends more our friend
00:45:50 --> 00:45:51 friendly colleagues say man
00:45:51 --> 00:45:52 you know don't you gotta
00:45:53 --> 00:45:55 you gotta move on and I always I'm
00:45:56 --> 00:45:57 to the point where sometimes I'll,
00:45:57 --> 00:45:59 I have a really good lecture and I,
00:45:59 --> 00:46:01 I won't repeat it because I'm like, Oh,
00:46:01 --> 00:46:02 if there's one or two
00:46:02 --> 00:46:04 people that have heard it, um, you know,
00:46:04 --> 00:46:06 I don't want to, you know, you know,
00:46:06 --> 00:46:07 I want to bore them.
00:46:07 --> 00:46:07 Right.
00:46:07 --> 00:46:09 You know, and there's,
00:46:09 --> 00:46:09 I think there's a fine
00:46:09 --> 00:46:11 dance because like knowledge,
00:46:11 --> 00:46:14 you have to get some reps at stuff and to,
00:46:15 --> 00:46:17 to embody it both as the giver,
00:46:17 --> 00:46:19 but also as a receiver, you know,
00:46:19 --> 00:46:20 but you just don't want,
00:46:20 --> 00:46:21 I just don't want to be stale.
00:46:21 --> 00:46:21 Yeah.
00:46:23 --> 00:46:24 You don't have those same
00:46:24 --> 00:46:26 stories all the time coming across.
00:46:26 --> 00:46:27 I don't think you're going to be stale.
00:46:28 --> 00:46:28 Well, Tim,
00:46:28 --> 00:46:29 I know that we're getting close
00:46:29 --> 00:46:31 to the end of this,
00:46:32 --> 00:46:33 the time that we had here.
00:46:33 --> 00:46:35 And I just want to, you know,
00:46:35 --> 00:46:36 thank you very much for
00:46:36 --> 00:46:39 spending time with us today
00:46:39 --> 00:46:40 to have this conversation.
00:46:40 --> 00:46:41 I know that we can probably
00:46:41 --> 00:46:42 have a lot of other
00:46:42 --> 00:46:43 conversations about a lot
00:46:43 --> 00:46:46 of other things that I wanted to today.
00:46:46 --> 00:46:48 But my hope is that at least
00:46:48 --> 00:46:50 folks can kind of see, you know,
00:46:50 --> 00:46:51 the importance of, you know,
00:46:51 --> 00:46:52 not just manual therapy education,
00:46:52 --> 00:46:53 but just education in
00:46:53 --> 00:46:56 general and how that, you know,
00:46:56 --> 00:46:59 enhances what we can do.
00:46:59 --> 00:47:00 And I appreciate your
00:47:01 --> 00:47:01 spending time with us today.
00:47:02 --> 00:47:05 Well, it's been a pleasure as always,
00:47:05 --> 00:47:06 Derek.
00:47:06 --> 00:47:07 It's fun to have these conversations.
00:47:07 --> 00:47:10 And I do hope the listeners out there,
00:47:11 --> 00:47:11 you know,
00:47:12 --> 00:47:14 will have these conversations
00:47:14 --> 00:47:15 amongst themselves.
00:47:15 --> 00:47:16 And please reach out to me
00:47:16 --> 00:47:19 if you want to chat because
00:47:19 --> 00:47:21 this area is I'm passionate about.
00:47:21 --> 00:47:22 Awesome.
00:47:22 --> 00:47:23 We will do.
00:47:23 --> 00:47:23 All right.
00:47:23 --> 00:47:24 Well, thank you so much, Tim.
00:47:24 --> 00:47:24 There we go.