Are You Doing Me a Favor? - With Dr. Lance Mabry

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[00:01:19] Welcome back to Untold Physio Stories Podcast and when you host Doctor E with Modern Manual

[00:01:22] Therapy Edge Mobility System and our four month online mentoring program Modern Rehab

[00:01:26] Mastery, Dr. Andrew Rothschild is not with me today but I have a very special

[00:01:30] guest.

[00:01:31] I've been trying to get him on forever.

[00:01:32] It's Dr. Lance Maybury.

[00:01:34] How's it going today, Lance?

[00:01:35] It's doing well.

[00:01:36] It's so good to be here and I'm so glad to finally be doing the show.

[00:01:39] Yeah, finally.

[00:01:40] So Lance posted a lot of amazing content on LinkedIn and I'll leave his profile in

[00:01:46] the show notes but he posted something that really resonated with me and we can talk

[00:01:52] a little bit afterward but if you're post about first earning the title Doctor.

[00:01:57] So why don't you give a quick intro and then tell that story?

[00:02:01] Sure.

[00:02:01] Yeah, so Lance Maybury.

[00:02:03] I work at High Point University as an assistant professor where I teach diagnostic

[00:02:08] imaging, primary care differential diagnosis and some of the APTA related content.

[00:02:14] I teach diagnostic imaging to new education through redefined health education and we

[00:02:20] recently came out with a study in the Journal of Manual and Manipulative Therapy on which

[00:02:24] physical therapists are using the title Doctor which ultimately spurred me to share

[00:02:29] my story on LinkedIn that you saw.

[00:02:31] Alright, so yeah, why don't you go tell the story?

[00:02:34] Yeah, so I think, you know, so I graduated my DPT in 2007.

[00:02:40] So in 2007 it wasn't the mandated degree yet.

[00:02:44] The mandated degree at the time was still a master's degree.

[00:02:48] The doctor didn't become mandate until 2017.

[00:02:52] So, you know, at the time a lot of the DPT programs were still being taught by a lot of

[00:02:59] physical therapists that had earned their master's or their bachelor's previously and

[00:03:03] there was this, you know, there very much a culture of don't call yourself Doctor.

[00:03:08] You know, you are worse than the master's before you.

[00:03:11] You are worse than the bachelor's before you and you know, this don't use the

[00:03:16] Doctor.

[00:03:16] It was like a stigma, right?

[00:03:18] And there was this big conversation around building therapeutic alliance by going by

[00:03:25] your first name and I think that's one of those conversations that we still hear echo

[00:03:30] in the profession today.

[00:03:31] So when I first hit the clinic as a junior clinician, I very much had those same decisions

[00:03:38] to make.

[00:03:38] Do I call myself Lance?

[00:03:40] Do I call myself Doctor?

[00:03:41] You know, what is, you know, Doctor Maverick, Doctor Lance?

[00:03:44] What do I do?

[00:03:45] And, you know, I ultimately decided I'm going to go for therapeutic alliance.

[00:03:50] I'm going to go with my first name and frankly it was probably more of an area of

[00:03:56] comfort, you know, Doctor Maverick was never my name for whatever it was 25, 27

[00:04:01] years but Lance had always been my name and that felt comfortable to me.

[00:04:06] So early in my career, I was introducing myself as Lance until I saw a patient

[00:04:13] and, you know, during our interactions I said just call me Lance.

[00:04:18] And he got reasonably irate and he kind of berated me for an extended period which I'm

[00:04:24] not going to go into, you know, during the podcast but, you know, oh, are you doing

[00:04:28] me a favor for calling, you know, by me calling you Lance and, you know, how is this a

[00:04:32] favor and who am I, who are you really doing a favor for and really kind of dug

[00:04:36] into me and I think we've all had challenging patients and I think that, you know,

[00:04:41] as we become more seasoned, we're able to better understand some of the challenges

[00:04:45] that patients are facing when they come see us but early in my career that was a

[00:04:50] new experience for me.

[00:04:51] So I really, you know, that really resonated with me, that experience and I

[00:04:55] really leaned into it and I started understanding that well, I might not be

[00:05:00] calling myself Lance for the patients.

[00:05:02] I might be calling myself Lance because of my personal comfort and so I

[00:05:08] started calling myself Dr. Maverick, you know, hello, I'm Dr. Maverick, I'm your

[00:05:13] physical therapist and what I found was it was just a dramatic impact with the

[00:05:21] patient so no longer was I, excuse me, evaluations became a lot less

[00:05:29] effortful so patients were being more compliant to they were doing their

[00:05:33] exercises, they were doing their exercises without me having to work very

[00:05:36] hard for them to do them.

[00:05:39] They were better willing to take my advice.

[00:05:43] There was less of that, you know, I'm just here seeing you until I go back to see

[00:05:47] my doctor for imaging or whatever else.

[00:05:49] It was the patients really started to listen and respond to what I was saying

[00:05:55] and for me it was a transformational moment.

[00:05:58] It was like, oh, like okay so, you know, this isn't about me feeling

[00:06:03] comfortable saying Lance, this is about the patient experience.

[00:06:06] This is about getting the patients where they need to be and I think that this

[00:06:11] thread surrounding provider alliance being better with first names, I think it's

[00:06:18] not an illusory anywhere, it's unfounded and frankly from personal experience

[00:06:22] I would say the exact opposite is true that using our earned title leads to

[00:06:28] more therapeutic alliance and only just add one more story.

[00:06:33] So I had a colleague when I was working at Eglin Air Force Base, Jack Reardon,

[00:06:38] great guy, psychologist and went into his office one time and he had all of his

[00:06:44] degrees on the wall and his bookshelf looked like they had encyclopedia

[00:06:50] Britannica, all the different volumes of all same like color and shape books and

[00:06:54] you know it was really just an excellently done office and so I commented to him like,

[00:06:59] wow your office is really impressive and he told me he said, you know, there's evidence to suggest

[00:07:03] that when patients see signs of achievement and excellence on the wall that their outcomes

[00:07:10] are better and I was always one that had my diplomas in the closet.

[00:07:14] I never hung them up and it never seemed important to me, it wasn't part of my ethos

[00:07:18] but I figured okay I'll try it.

[00:07:20] So hung my diplomas on the wall and the patient response was amazing.

[00:07:25] I would step out to get their exercise print off and I'd come back and you know they'd be

[00:07:30] talking about oh you have your doctorate degree, I see your diploma, you want the baler?

[00:07:34] Oh you know, oh you're a board certified orthopedic specialist and it was amazing to me how impactful

[00:07:41] just hanging those things on the wall were for patients.

[00:07:44] So now that is Dr. Mabry is who I am and hanging those diplomas on the wall is who I am and

[00:07:51] it's not based in conceit, it's based in getting my patients better and getting them where they need

[00:07:57] to be. Awesome, awesome. Wow I have so many comments. I mean as a novice clinician when I

[00:08:03] used to actually wear a shirt and tie and I was so young and probably so young looking I always

[00:08:08] used to say my name is Dr. Rilio so but you can call me Erson but I always made sure that they knew

[00:08:15] I was Dr. Rilio so first. Yeah and I didn't have that reverse kind of like odd humility that

[00:08:21] they teach PTs to have because I always wonder one, one of my points is what other doctoring

[00:08:26] profession has that? You know I don't know if pharmacists or OTs or any of the newer

[00:08:31] doctoral professions like us also have that but it's certainly not chiropractors or MDs.

[00:08:37] I remember my, I would also have all my certification of my menotherapy certificate and my fellowship,

[00:08:44] my doctoral degree was like it is super ornate, like gold trimmed frame. The frame was super

[00:08:52] expensive and I remember the same thing would happen I would go to the restroom or something

[00:08:56] or leave them and they'd be like wow hey I didn't know you were a doctor and I'd

[00:08:59] yeah that would it would actually irritate me you know it would irritate me because

[00:09:03] like well you don't remember me that it's my fault really for saying call me Erson because I

[00:09:09] but me mom in a certain time now that I'm like almost 50 no one questions that anymore and I just

[00:09:15] wear like a cap and like workout clothes you know my wife always doesn't do casual but you know I

[00:09:20] don't want to, I had a student once split his pants showing the patient how to do a squat

[00:09:25] so I'm just like beyond that you know I'm moving and everything but I wonder you know

[00:09:30] I know you will only, I actually will have your research partner on a podcast later next week

[00:09:36] but I wonder what other professions also have that as an issue you know.

[00:09:40] Yeah well I think it's a great question our one of our colleagues on the on the paper James

[00:09:46] Smolliga, Jamie Smolliga he his background is as a veterinarian he's been teaching in

[00:09:51] DPT programs for years in pathophys and cardiopulmonary pathologies but I was talking to him

[00:09:59] the other day and he said that veterinarians were the quote original not real doctors that they went

[00:10:06] through a very similar phase and vets where you know should they call themselves doctors should

[00:10:10] they not and to me it was an eye-opening moment that oh okay so this is a normal progression

[00:10:16] that professions go through when they advance to a doctorate degree so so I think that this

[00:10:22] this is normal growing pains I mean I think you know once we you know it's like anything you

[00:10:30] know once you have the early innovators and the early adapters take this on at some point the

[00:10:35] the tide's gonna turn and it's gonna flip and we're all gonna be you know Dr. Rohilio so or Dr.

[00:10:40] Mayberry it's coming right and I think we're at that flash point where it's about to flip

[00:10:45] and that's going to be where where we are as profession. You know when I started my career

[00:10:49] I started blogging I started my practice I just left this like this clinic that I managed and I

[00:10:54] just went on my own. I had to make ends meet so I became a clinical peer reviewer and the

[00:11:00] the company that I worked for was originally all chiropractors and they decided to take on some

[00:11:05] PT contracts so they needed some clinicians and it's funny because probably because chiropractors

[00:11:11] have already been through that but also because they they were on you know they were on defense

[00:11:17] and always being attacked early on by the medical profession and everything so

[00:11:21] they were probably very stringent. They probably even never said you're not a doctor. Yeah they probably

[00:11:27] said like you are a doctor you're equal to doctors but it wasn't until I worked in an office full

[00:11:32] of chiropractors that everyone referred to me as doctor because they're like wow you have your

[00:11:36] doctor that is amazing as opposed to what you said earlier because I you know I I graduated

[00:11:42] with my dual BS MS during a time when the when the terminal degree was BS right so every time I went

[00:11:49] to an APTA conference or something and we're like oh well just because you do a thesis doesn't mean

[00:11:53] you have a better degree to me. There's some like yeah I mean it's a thesis right like don't call

[00:11:58] your capstone project a thesis because it's not a thesis a thesis is a thesis whatever why are

[00:12:05] you attacking me for this like what and then you know I went two days I graduated my BS MS

[00:12:12] I went a weekend and I immediately started a Stanley Paris's DPP program before transitional was

[00:12:18] even a word and I got the same thing every time I attended these courses I used to have a little

[00:12:24] DPP badge and some half the PTs were like wow that's great that's amazing you and the other

[00:12:29] half were like what's so great about that I already have my masters and I'm like well I'm

[00:12:34] I just got the flag from the bachelor's PTs now I'm getting the same flag from the master's PTs

[00:12:40] why is this what in a profession does I mean because no other profession had the transition

[00:12:45] you know what I mean yeah like I don't think chiropractors or vets or MDs I don't know what

[00:12:50] I don't know if they ever had a terminal of a bachelor's you know oh yeah I don't think

[00:12:55] they had that maybe PA's or something I was just so upset I would just like

[00:13:02] what is it to you you know yeah no it's interesting the so I have never heard a DPP a doctor of

[00:13:11] physical therapy I've never heard any DPP anywhere ever say anything negative about

[00:13:16] you know master's PTs or bachelor's PTs is I've never heard it's always the other way but it's

[00:13:20] always the other way and frankly you know you mentioned I'm on LinkedIn earlier there was one

[00:13:26] one I think bachelor's trained PT that was just particularly aggressive

[00:13:31] going after DPTs on my thread and frankly he inspired me I was finally like you know what like

[00:13:37] it's been whatever it's been it's been 15 years of hearing this stuff from bachelor's and master's

[00:13:42] all right let's put our money is where our mouth is and let's start doing some research into

[00:13:46] this and and frankly that that bachelor's PT inspired me to start digging in and my last

[00:13:52] couple of papers have really shown you know where where DPTs are you know DPTs are more likely to

[00:13:58] see direct access in one of my papers DPTs are more likely to you know practice diagnostic imaging

[00:14:03] and integrate diagnostic imaging into their practice you know there's there's other studies that

[00:14:08] show that child's at all Ross at all so you know I think that the you know the tide is turning

[00:14:15] like enough enough of this enough of the guys have just got to retire yes you know it's supposed

[00:14:24] to be vision 2020 everyone at the DPT or be grandfathered in like either let's just do one

[00:14:30] or the other I mean grandfather them in so they can stop their complaining you know I think

[00:14:35] there well I think California is looking at that but I think the reality is you know we should all

[00:14:39] hope that the profession gets better I mean right now you know when I graduated in 2007

[00:14:45] you know residency wasn't really a thing you know residencies and fellowships were about equal

[00:14:51] back then now residency roughly 10% of graduates go into a residency after after the DPT so I am

[00:15:00] not residency trained but there will come a time sometime down the road that every PT goes on to

[00:15:06] residency before they practice just like MDs and frankly I hope that they are better than me

[00:15:12] like I I and the evidence would suggest that they are better than non-residency trained PTs I hope

[00:15:18] they're better than me I want them to get hopes though right otherwise why are we doing it right

[00:15:22] yeah so so I mean I have the humility to say like you know that I'm laying the groundwork for

[00:15:29] and then hopefully they pick up the mantle and go from there just like I picked up the mantle

[00:15:32] from those before me I'm you know I tell people I'm standing on the shoulders of giants you know that

[00:15:38] the masters and the bachelor's PTs that had this vision for vision 2020 they weren't DPTs

[00:15:43] you know and they they laid out this vision frankly it would be it would be a

[00:15:51] it would be an insult to the profession to not carry on the vision that they laid out so

[00:15:57] so let's keep running with it yeah awesome hey so where can people find you and mention your courses

[00:16:04] again sure so I teach diagnostic imaging through redefined health education so I will give a link

[00:16:12] that you can share with your listeners in fact maybe I'll even talk to Katie and we'll get

[00:16:17] your listeners a discount so if we get a discount I'll but I'll give you the discount code to

[00:16:22] put in the in the chat I'm also linked in but nobody should follow me on social media I hate social

[00:16:28] media but you are an all-star on linkedin why I hate it I mean I also hate social media

[00:16:37] but it is necessary it's a necessary evil for my job it is it is I every day I wake up and think

[00:16:45] I should just delete this account I should just delete this account and I haven't done it yet

[00:16:48] but one one day it'll happen one day it'll be deleted oh yeah for sure I can tell you guys

[00:16:53] listeners or viewers or whatever don't be surprised and I just disappear someday and

[00:16:59] when people wonder what happened to me it's that I just bought like a hundred acres of land and

[00:17:05] decided to just be a farmer that's my dream right there I do I would not want to do this

[00:17:11] I love the physical therapy profession but man I hate social media I'm with you there brother

[00:17:16] all right hey if you enjoyed this story if it really resonated with you

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[00:17:29] leave us a five star review I will do it and yeah awesome awesome thanks and as always you guys

[00:17:34] have a great day