Healthy Wealthy & Smart

Latest Episodes:

426: Dr. Peter Fabricant: Pediatric ACL Injuries Apr 04, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Peter Fabricant on the show to discuss pediatric ACL injuries. Dr. Peter Fabricant is an orthopedic surgeon specializing in pediatric and adolescent orthopedic surgery. His clinical expertise is in sports medicine and trauma surgery of the knee, hip, shoulder, elbow, and ankle. In this episode, we discuss: -How to determine if a patient should have non-surgical treatment or surgical treatment following ACL injury -Rehabilitation considerations following Physeal-Sparing ACL Reconstruction Surgery -Setting realistic expectations for return to sport with the pediatric population -And so much more! Resources: HSS Peter Fabricant For more information on Dr. Fabricant: Dr. Peter Fabricant is an orthopedic surgeon specializing in pediatric and adolescent orthopedic surgery. His clinical expertise is in sports medicine and trauma surgery of the knee, hip, shoulder, elbow, and ankle. Dr. Fabricant completed his undergraduate studies at the University of Rochester, graduating with honors. He then attended Yale University School of Medicine. During his orthopedic surgery residency training at Hospital for Special Surgery, Dr. Fabricant earned a Master of Public Health Degree from Columbia University, and won several awards for excellence in patient care and innovation in patient safety. Following residency, Dr. Fabricant completed two fellowships: first in pediatric orthopedic surgery at The Children's Hospital of Philadelphia and the second in sports medicine at Boston Children's Hospital. This afforded him the unique opportunity to study with renowned mentors at both institutions, including Dr. Lyle Micheli, Dr. Mininder Kocher, and Dr. Theodore Ganley, in order to compile additional subspecialty training uniquely focused on the care of children and adolescents with sports-related injuries. He has cared for athletes and performers at all levels, including the Boston Ballet, Babson College, the International Skating Union World Figure Skating Championships, and the Boston Marathon. Dr. Fabricant is an accomplished researcher, with over 100 peer-reviewed publications and 15 book chapters in circulation. He has received multiple institutional, national, and international awards for clinical research, including the Herodicus Award (AOSSM), the Excellence in Research Award (AOSSM), and the Promising Career Award (PRiSM Society), among others. Dr. Fabricant currently serves on several research and education committees in two international professional societies (POSNA and PRiSM). He is a member of several pediatric orthopedic and sports medicine research consortiums, through which he participates in cutting-edge multicenter clinical research studies with many of the most prolific researchers in pediatric and adolescent sports medicine. He also serves on the editorial boards of Clinical Orthopaedics and Related Research (CORR) and the Journal of ISAKOS, on the Peer Review Committee for the Orthopaedic Research and education Foundation (OREF), and as a reviewer for several academic orthopaedic journals including the Journal of Bone and Joint Surgery (JBJS), the American Journal of Sports Medicine (AJSM), and the Bone & Joint Journal (BJJ). Dr. Fabricant understands the physical and emotional complexities of injuries in youth and adolescent athletes. Sports and recreational activities provide social, emotional, and physical development, leadership skills, and encouragement for children to work as a part of a team with their peers. Dr. Fabricant has dedicated himself to addressing sports injuries in the context of all of these important issues and strives to return his patients back to their sports and activities as quickly and as safely possible, while minimizing the risk of future injury and prioritizing their long-term health and well-being. Read the full transcript below: Karen Litzy: 00:00 Hi Dr. Fabricant Welcome to the Healthy Wealthy and Smart Podcast. I am so excited to have you on today to talk about pediatric ACL injuries. Karen Litzy: 00:13 So we're just going to kind of jump right into it because I know our time is limited here so the reason that I wanted to do this is because I have a patient now with an ACL tear who had surgery and there seemed to be a lot of questions in the rehab world around this population. So after a confirmed ACL tear in a pediatric patient can you take us through your decision making process as to whether or not that patient will have non-surgical treatment which would mean high quality rehab or ACL reconstruction plus rehab. Dr. Fabricant: 00:53 Yeah that's a really great question. So historically kids who still had you know growth remaining who had open growth plates would kind of be held off until they were fully grown and then have an ACL reconstruction then. But we know that that's not the ideal thing to do just because they have an unstable knee they can develop cartilage and meniscus injuries that might not be repairable once they reach the maturity but there are a subset of patients who tend to do pretty well without surgery and with high quality rehab alone. And so typically when I'm evaluating a patient the ones that tend to do well with high quality rehab alone would be typically younger patients. So kids who are like under 14 years old and kids who have non full thickness ACL tear. So like a partial ACL tear like a 50 percent tear. Dr. Fabricant: 01:49 And so kids who are young and who have you know a 50 percent partial tear their ACL who have rotational stability of their knee so their knee doesn't kind of rotate during things like a pivot shift examination. Those are kids who tend to do pretty well without surgery with a period of protected weight bearing bracing and high quality rehab. When I'm seeing kids who are either older and or have a full thickness ACL tear with a really unstable knee those tend to be the kids who we recommend surgery for especially if they're involved in cutting or pivoting sports jumping or landing sports things like that. So that's basically how I approach it in general. Karen Litzy: 02:34 And so let's talk about the surgical procedures because there are several surgical procedures one can do on a pediatric ACL patient taking into account the growth plate damage. How do you decide which surgical procedure to do with this population? Dr. Fabricant: 02:57 I think that's a great question too. So I kind of think about these kids in three groups. Dr. Fabricant: 03:04 Let's go from kind of oldest to youngest so the oldest type of kid is the kid who either has growth plates that are closed or near closed or they have very little growth remaining let's say like less than six months of growth remaining. Those are kids that I kind of think about a little more like adults. But then within that within kind of specific to your question the kids who have open growth plates. The question I ask myself are kind of are these kind of the youngest kids like prepubescent kids. So those are kids with greater than 2 years of growth remaining. In girls, those who haven't had started having their periods yet. In boys and girls kids who really haven't had a growth spurt or who are kind of prepubescent. Dr. Fabricant: 03:53 There's kind of that group and then there's the pubescent kids who are between let's say two years of growth remaining and six months of growth remaining you know in girls let's say they've had their periods for a year, in boys they may have already showed some signs of puberty or of their growth spurt. So those are kind of the pubescent kids even though they have growth remaining and so in thinking about a reconstruction technique I try to figure out are they in the prepubescent group or the pubescent group. And then there are a couple of different described surgical procedures in each but in broad generalities the prepubescent group you need to really avoid the growth plate completely and so that can be done either with techniques where you do drill tunnels in the bone but you confine it to the epiphysis of the bone or the area that's kind of away from the growth plate or you can do a procedure where you're not drilling any tunnels which would be like the IT Band ACL procedure and that those both can protect the growth plate and they're both been well described and then in the kids who are pubescent who have growth remaining but maybe not so much growth remaining those kids you typically can drill tunnels in the bone but you just need to use a graft that's made of soft tissue because if you take let's say a bone plug from a graft and fix it across the growth plate that can inhibit their growth and cause a limb length deformity limb length discrepancy or like an angular deformity of the limb. Dr. Fabricant: 05:31 So that's kind of how I think about the two groups that still have growth remaining and taking surgical procedures. Karen Litzy: And does the activity of the child come into play when deciding on which procedure to do or is it really just their kind of bony anatomy and age. Dr. Fabricant: Yeah it's mostly their age and skeletal maturity and their developmental maturity. The sports sometimes come into play when you're deciding whether or not to do a reconstruction but once you kind of made the decision to do a reconstruction you know which technique you choose is typically chosen based on their skeletal maturity. Karen Litzy: 06:11 Got it got it. And then you sort of alluded to this a little bit earlier talking about the meniscus but why is the health of the meniscus so important in the pediatric ACL patients. Karen Litzy: 06:22 So from what I've read it seems like if there is a bucket handle tear or other repairable meniscus injury surgery is really warranted. Why is that? Dr. Fabricant: 06:42 So if there's the meniscus is pretty precious tissue and it's really the shock absorber of the knee but it also provides secondary stability to the knee, nourishment of the joint. It provides congruence between the femur and the tibia and so it's really important to try to save as much meniscal tissue as possible and then these kids obviously have quite a long life ahead of them and many have a long athletic career ahead of them. So you definitely want to save as much meniscus as possible so if there is a large unstable meniscus tear and the knee remains unstable it's likely to continue to degenerate whereas if you go and stabilize the knee and fix the meniscus you have the best chance at preserving that tissue and getting it to heal. Karen Litzy: 07:20 Yeah that makes sense. And now for a lot of my listeners who are physical therapists this is sort of the money question right. Karen Litzy: 07:27 What are the most important considerations for rehab after these physeal-sparing ACL reconstruction surgeries? Dr. Fabricant: 07:36 So it's interesting there's not like a really strong evidence base about like specific things with rehab but I would tell you that kind of the way that I approach it and kind in in broad generalities typically the first six weeks are where there's the biggest difference depending on how the procedure goes. So if if it's let's say a procedure where you're drilling tunnels and fixing it with implants you know those kids can tend to weightbear relatively soon the implants tend to confer a lot of stability to the graft and allow the body to heal the graft. If there's a meniscus repair at the time of surgery, I tend to protect the weight bearing for a total of six weeks just to let the meniscus heal and in the kids who end up getting the IT Band ACL because there are no tunnels drilled in the bone and therefore there's no like screws holding the graft in place and the graft tends to be fixed to the periosteum of the bone or the skin around the bone with heavy duty suture. Dr. Fabricant: 08:39 Those kids I tend to protect for six weeks regardless of if they've had a meniscus tear repaired just because I want to make sure they've started to have some biologic healing of the graft before I let them really bear full weight. So for me the first six weeks are kind of the most critical portion where if I've done a IT Band ACL and I'm kind of relying on suture for fixation I tend to protect their weight bearing a little longer but once they hit about six weeks for me at least the rehab tends to progress the same whereas essentially all kids are kind of started to wean off crutches by six weeks starting to work on strengthening and then for me I tend to let kids start to jog around 12 weeks and from there on it's pretty similar rehab to the adult rehab. Karen Litzy: 09:24 So why with the ACL reconstruction using the IT band, why is no lunging a precaution with this population. Dr. Fabricant: 09:37 When I was in training I had some of my mentors would say that they found that kids who load the knee from a flexed position after any ACL reconstruction tend to kind of flare the knee up especially in the early phase and so I tend to tell kids to avoid you know deep lunges and squats early on. So that's just something that I do I don't know that there's a lot of great evidence for that but it seems to have worked for some of my mentors and so I've kind of adopted it into my practice as well. Karen Litzy: 10:13 Got it. Got it yeah. Because I read that out of Boston right. And OK so that makes a lot of sense because I often wondered. Karen Litzy: 10:24 Well they can jog and run but they can't squat or they can't lunge. And is that obviously to protect the knee and is that also to maybe protect secondary problems like patellar tendinopathy or something like that. Dr. Fabricant: 10:38 You know right after surgery there is a bit of inflammation going on in the knee and so certainly doing like deep squats and lunges can increase the risk of further inflammation. Dr. Fabricant: 10:50 But I really do like squats like leg presses that go down to about 90 degrees of knee flexion. I really find it helps strengthen the knee without inflaming it too much. But you know the physical therapist that we work with tend to do that and the patients do pretty well and they end up building it pretty quickly. Karen Litzy: 11:12 That makes sense. And now let's talk to a lot of these kids want to return to sport. I mean you're working with kids all the time as you know their attention spans are a little short and they're all really excited to get back to sport A.S.A.P. but according to the IOC consensus on pediatric ACL they recommend waiting twelve months to return to sport. So what is your thought on that? Dr. Fabricant: 11:43 Yeah I would say the short answer is I agree with that completely. I typically mentally prepare kids for a year to return to play. Dr. Fabricant: 11:53 I think that you know there's really three things you need in order to successfully return back to sports safely. So one is the anatomy which is really the job of the surgeon and reconstructing the anatomy. The other is you know strength and balance and coordination which is a team effort between the physical therapist and the patient and the surgeon as well. And then the third thing is just time. So it just takes about a year for the graft to incorporate and mature and remodel and kind of be biologically ready. And I think that's the hardest part about this surgery is really kind of keeping the kids engaged for a full year. I think kids sometimes hear about some professional athletes who get back to sports sooner than a year and so they feel like they want to get back sooner than a year. Dr. Fabricant: 12:39 But I typically tell families you know a couple of things. First off the average time to return to sport, even in professi…

Full show notes at the publisher

425: Nikki Kimball PT: Ultra Running, Physical Therapy & Gender Differences Mar 30, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Shannon Sepulveda guest hosts and interviews Nikki Kimball on her experiences as a female distance runner. Nikki Kimball is an American distance runner specializing in the Ultramarathon. She is also a physical therapist in Bozeman, Montana. In this episode, we discuss: -Nikki's journey to becoming a long-distance running athlete -The societal health and wellness ramifications of running -How Nikki's experience as a physical therapist has shaped her running journey -Gender differences, both physical and financial, in competitive running -And so much more! Resources: Shannon Sepulveda Website Shannon Sepulveda Facebook Oiselle Trail Sisters Nikki Kimball Instagram Email: nikkikimball@yahoo.com For more information on Nikki: Nikki Kimball (born May 23, 1971) is an American distance runner specializing in the Ultramarathon. She ran her first 100-mile race at the Western States 100 Mile Endurance Run in 2004, and was the female winner. She was the winning female at Western States again in 2006 and 2007, becoming only the third woman to win Western States three times. In 2014, she won the Marathon Des Sables multi-stage endurance race on her first attempt. Prior to running, her main sport was cross-country skiing. She was crewed at the 2007 Western States by U.S. Senator Max Baucus of Montana, where Kimball lives. She lives in Bozeman, Montana. For more information on Shannon: Shannon Sepulveda, DPT, M.Ed., CSCS, WCS is the owner and Physical Therapist at Shannon Sepulveda, DPT, PLLC. She is an Orthopedic and Women's Health Physical Therapist and is currently the only Board-Certified Women's Health Physical Therapist (WCS) in Montana. Shannon received her undergraduate degree from Dartmouth College, Masters in Education from Harvard University (M.Ed.) and Doctorate of Physical Therapy (DPT) from the University of Montana. She is also a Certified Strength and Conditioning Specialist (CSCS). She has been a practicing Physical Therapist in Bozeman, Montana for over 6 years. In her free time, she enjoys running, biking, skiing, hunting and spending time with her husband, son and daughter. Read the full transcript below: Shannon Sepulveda: 00:00:00 Hello and welcome to the Healthy, Wealthy and Smart Podcast. I am your guest host, Shannon Sepulveda, and I am here with Nikki Kimball. Hi Nikki. So Nikki, can you tell us a bit about you and what you do? Nikki Kimball: What I do? My favorite subject, I am a physical therapist here in Bozeman and I also coach running, ultra marathon running. And I got into that because I've been an ultra marathon race or professional racer for almost two decades. And that's kind of what I do. Shannon Sepulveda: So in the ultra marathon running world, when you say Nikki Kimball, people are like, oh, Nikki Kimball. And I feel like, so Nikki is a very accomplished ultra marathoner for those of you who don't know who Nikki is. So we are very, very fortunate to have her here on the podcast. So how did you get into ultra running? Because back then it seemed like it's not as popular as it is now. Nikki Kimball: 00:01:01 No, I don't think it is, but there were still, you know, a boatload of us. I mean there are thousands of us who absolutely loved this sport and we, you know, there wasn't much money at it or anything like that. It wasn't very popular. But I think a lot of cross country skiers come into it sort of organically because of the training we do for cross country skiing is essentially ultra marathon training, which is kind of funny because the women don't get to race very far. The longest they can do is 30K at the Olympics. It's pretty pathetic. But regardless, we always trained with the guys anyway. So we would do these four or five hour run hike things in the woods. And so it was kind of doing it anyway. Nikki Kimball: 00:01:50 And in graduate school I raced a lot of 5K's, 10K's, half marathons, marathons, just kind of wherever. Cause I had a store team that sponsored me and they'd pay all my race entry fees. And so I just go do fun things. And it just like sort of saved me through Grad school because it had gave me this other thing besides studying all the time. And it made me sort of mentally clearer. I just loved it and I'm just like running makes me happy. It just makes sense to go out and run and run and run. And so yeah, at the time it wasn't super, it wasn't mainstream popular, but those of us who did it loved it. Did it all the time. Shannon Sepulveda: So you grew up Nordic skiing? Nikki Kimball: 00:02:41 Yes, in high school. I grew up in a town called Chittenden in Vermont, so south central Vermont town and I grew up skiing. My brother was four years older, so he was skier and the Bill Koch Youth Ski League is this big, big thing then. I don't know if it still is, but there would be these races for kids and because I mean the kids who would be racing, you know, from eight years old on, they kind of knew what they were doing, but they had to do something for like the little brothers and sisters. So they'd have these races, they called Lollipop races because you get a lollipop at the end and you might go 100 meters maybe holding your parent's hand. But I believe I was three when I first did this. I basically learned how to ski and walk at the same time, I'm sure. Nikki Kimball: 00:03:31 And so yeah, I mean I just don't remember life without competition, without endurance sports. Shannon Sepulveda: And then did you race in college? Nikki Kimball: And I raced at Williams College, so all four years, so division one racing. Then, partway through college I decided to switch to biathlon. So my senior year I had to keep my rifle at a professor's house cause they weren't too keen on having rifles on campus. And so I raced a couple of years in biathlon hoping for the '98 Olympics and I raced through '94. Shannon Sepulveda: Oh Wow. So how is biathlon different from cross country skiing, like endurance wise. What do you think? Nikki Kimball: Similar, really similar. I mean, it's just adding this sort of cognitive piece to it. I mean to go from skiing as hard as you can to shooting clean for five rounds is, it just requires a whole different skillset. Nikki Kimball: 00:04:37 Of patience and humility and cognition. I mean, looking at where the wind is and deciding you know, how to change your sites on your rifle, by this, you know, it's just an extra layer. And I loved that. Shannon Sepulveda: Do you feel like that has influenced your ultra racing at all? Like part of it? Nikki Kimball: Probably not a ton. I mean, I think the calmness needed to do well in biathlon in the humility is super helpful. So those two things are good because if you're racing a hundred miles, something is going to go wrong and running. You don't have perfect races when you're beyond 20 hours, you just don't. And so having, you know, biathlon does teach a bit of that, sort of humility but also ability to change with the changing situation. You might come into the range and the wind's coming from a completely different direction than it was when you, when you cited your rifle in and you have to deal with that. Nikki Kimball: 00:05:48 And similarly, an ultra marathon is very common that you come into an aid station and the bag of stuff that you wanted there isn't, or your crew isn't there or something that you expect isn't there. And so that ability to think during the race and make changes to your plan during the race is definitely something is common between the ultra running and biathlon. Shannon Sepulveda: Cool. So then when you say graduate school, do you mean physical therapy? And so how did you get into running, cause it sounds like that's where the transition went into ultra running, is that right? Or where the transition to competitive running? Nikki Kimball: Yeah, absolutely. Because I threw 94, I was ski racer, which is sort of a different body type also, more muscular and a lot more upper body mass. So, you know, through 94, ski racing was the only thing I really wanted to do. And I also was kind of I hadn't raced anything long in running, so I wasn't very, and I wasn't good. Nikki Kimball: 00:06:57 I was fantastic for the middle of the back. I hadn't really realized that I had any ability in running because my abilities not in running, it's in enduring. I always qualified for nationals in D1 skiing. And there was definitely something I wasn't good at. Actually in 94, after a really successful year of biathlon doing well at Olympic trials, I wasn't expecting to make the team because I can shoot very well. Did very well at nationals. And then I ended up getting very sick with depression, losing about 20 pounds and I couldn't even run three miles. Like I couldn't, I couldn't do anything. Nikki Kimball: 00:07:55 I was just sleeping. All I did. And when I went to Grad School, I came in with a completely different body. I mean I lost all my muscle, and really I was in Philadelphia, so I'm like, well, what can I do? So running was the thing I could do and this was way before most psychiatrists and counselors were thinking that exercise was important for running. But I sort of knew it, you know, I just knew that I could think better, I could function better, all of those things, everything better when I'm exercising. And so it was sort of natural for me to just my daily dose of endorphins that is just critical to me. Even having normal brain function. It would be like I'd have to run an hour a day just to stay sane. Nikki Kimball: 00:08:49 So then I went to graduate school and I'm in Philadelphia and I go and do this 5K race and I win it, and I'm like, what the heck? I am not a runner. This is crazy. And then the store team picks me up and then we just started running longer and longer and more and more trails and you know, so it wasn't something I never set out to be a good ultra marathon runner. It just sort of, it just was what I did anyway. And then I realized it was a support. Shannon Sepulveda: Yeah. That's really cool story. Awesome. So what was ultra running like when you started and how is it different now? Cause I mean, how long ago was that when you started? Nikki Kimball: 00:09:38 I started in '99, 20 years ago. It was still very, very competitive at the top. But the fields were not as deep. And there wasn't, you know, it was never talked about in runner's world, I don't think runner's world even knew what ultra running really was. And it didn't really need to create a magazine, but it was like runner's world is for sort of mainstream runners and getting people into running and it's fantastic for that. But ultra running was never something that would even be considered in, you know, for their audience. And I think that's really telling now. They know now they talk about ultra running and that kind of stuff. And ultra running is now becoming appealing to your general public. It's just not something that's freaky anymore because it's in the running media. Nikki Kimball: 00:10:32 Part of me wants to go back to the old ways where you raced and you had only water at the aid station. The aid stations might be two hours apart and you want a belt buckle after you set a world record you know, it was great. Not that I ever set any world records, but, that's the trail runner part of me. But that was kind of Nice. It wasn't very commercial. And now it is more so, but I'm also part of that. I mean I was in films about running several films about running. I was promoting, you know, Nike northface Hoko, which ever sponsor I had at the time. And you know, kind of using my running to promote basic health and fitness things. And you know, I mean it just, I mean I definitely was heavily involved in media surrounding running, so the increase of popularity of running, I'm not innocent in that. Shannon Sepulveda: I think it's awesome. I think it's really great because not everybody's going to be fast at a 5K and some people are really good. It's completely different. Being fast at a 5K is completely different than running a hundred miles. Yeah, it's totally different. And some people are really good at it and some people are not. And some people, the accomplishment of running just running 50 miles or 18 miles or whatever, will get them through, get them on a high for a whole year. I mean, the fact that they can do that. So I think that's amazing. Nikki Kimball: 00:11:54 And it'll get them training for a whole year. Will get them healthier in an age in which sedentary lifestyles our biggest killer, or contributes to it anyway. We really need to make sports mainstream and running is so easy and it's something we don't need special equipment for, you can do it on any budget. And then you can still compete in it. Shannon Sepulveda: But I mean, it's like if you were a baseball player, you can't just go play baseball games a lot of the time. But if you're a runner, you can always say, I'm going to sign up for x race and train for x race. Nikki Kimball: 00:12:49 Yes. And so it's the perfect lifestyle, lifetime sport and you can do it if you're running, you know, if you're running team, if you, let's say you want to do stuff with people, you're running team doesn't show up for a workout. You can do that work out on your own. You know, it can be as social or isolated as you want to be. And I think runners know that, you know, sometimes, you know, you and I are both physical therapists. Sometimes we have a whole day of patients. We want to go out and run the five, 10 whatever miles by ourselves because we're just, we need that break and not talk. And then other times, you know, you want to go out with a group of 10 people and just, you know, just chat the whole way. Nikki Kimball: 00:13:40 And I swear that if political leaders could do all of their work while running, things would actually work. I mean, cause I swear every, you know, every long run you go on, somebody comes up with an idea that just seems brilliant. Shannon Sepulveda: Yeah. And you get to talk to people who believe different things and have actual conversations with people because there's nothing else to do, right. You're out in the woods for four hours and that's who you're with and you can talk about stuff and you're not checking your phone. And now I think it's great. Nikki Kimball: Yeah. And it's something that's so foreign to us in modern times. You know, we're always sort of plugged in and we're always hanging out with only others like us and running sort of takes all that away. Yeah, I really liked that. Shannon Sepulveda: And I think, you know, even, you know when I get postpartum women in here and they want to run a 5K after they've had a baby and they're like, well I'm not really a competitive runner. Nikki Kimball: 00:14:37 I just, I really want to run this 5K. And I'm like, that is awesome. I really want to run it in under 30 minutes. Well that's such a great goal. Like let's do that and it's attainable and it's great. It gives people a goal of something to do. It doesn't have to be 100 miles, you know, like it doesn't, that's the beautiful thing about running. Nikki Kimball: And I love about ultra and running in general is that different variations on running are becoming popular. Whether it's spartan racing or color runs or you know, like none of those events is going to attract every person, but it's going to attract s…

Full show notes at the publisher

424: Drs. Kory Zimney & Jessie Podolak: Why the Language you use with Patients Matters Mar 26, 2019

Show notes

LIVE from the Align Conference in Denver, Colorado, I welcome Kory Zimney and Jessie Podolak on the show to discuss why language matters to patient care. Dr. Zimney is an Assistant Professor within the Department of Physical Therapy at the University of South Dakota, Senior Faculty with International Spine and Pain Institute (ISPI), and researcher with Therapeutic Neuroscience Research Group and USD Center for Brain and Behavior Research. Jessie currently owns and operates her community's first direct-pay physical therapy practice, seeing a variety of patients with acute and chronic pain conditions. She has been teaching pain science and manual therapy techniques at continuing education courses since 2013. In this episode, we discuss: -How language affects your actions -Looking at language through the patient perspective -What is negative effective priming -Ways that you can enhance your communication style -And so much more! Resources: Align Conference Kory Zimney Twitter How to make stress your friend Ted talk For more information on Kory: Kory Zimney, PT, DPT has been practicing physical therapy since 1994 following his graduation from the University of North Dakota with his Masters in Physical Therapy. He completed his transitional DPT graduate from the Post Professional Doctorate of Physical Therapy Program at Des Moines University, Class of 2010. At this time, he is in the candidacy phase in the PhD PT program at Nova Southeastern University. Currently Dr. Zimney is an Assistant Professor within the Department of Physical Therapy at the University of South Dakota, Senior Faculty with International Spine and Pain Institute (ISPI), and researcher with Therapeutic Neuroscience Research Group and USD Center for Brain and Behavior Research. His primary teaching, research, and treatment focus is with pain neuroscience, therapeutic alliance, and evidence-based practice for orthopedic injuries of spine and extremities. He has published multiple peer reviewed research articles in these areas. Past work experiences have been with various community-based hospitals working in multiple patient care areas of inpatient, skilled rehab, home health, acute rehab, work conditioning/hardening and outpatient. He has completed the Advanced Credentialed Clinical Instructor program through the American Physical Therapy Association and is a Certified Spinal Manual Therapist (CSMT) and assisted in the development of the Therapeutic Pain Specialist (TPS) through the ISPI certification program; and has a Certification in Applied Functional Science (CAFS) through the Gray Institute. For more information on Jessie: Jessie received her Master's Degree in Physical Therapy from the College of St. Catherine, Minneapolis, in 1998. She completed her transitional DPT from Regis University, Denver, in 2011. She has been teaching pain science and manual therapy techniques at continuing education courses since 2013. Jessie currently owns and operates her community's first direct-pay physical therapy practice, seeing a variety of patients with acute and chronic pain conditions. She has special interests in manual therapy, Pilates, spine and running injuries. She is a certified clinical instructor through the APTA and has completed her Therapeutic Pain Specialist certification through ISPI. Read the full transcript below: Karen Litzy: 00:00 Hey everybody, welcome back to the podcast. I'm your host, Karen Litzy coming to you live from the align conference in Denver, Colorado. And I am fortunate enough to be sitting here with Kory Zimney and Jessie Podolak and we're going to talk about the workshop that they did yesterday and will probably do again tomorrow on moving our language and why language matters around people with persistent pain. So my first question is why does it matter? Jessie Podolak: Well, words are powerful. We started off by just doing some cool quotes that words change worlds, right? And words can pierce like a sword. The tongue of the wise brings healing. And that's just ancient wisdom, right? We've known that words just have so much power. They shape our perceptions, they shape our action. We know even from the research, just how we look at something. So for example, one of the studies we cited was if crime is presented as a beast, okay, crime is a beast versus crime as a virus. Jessie Podolak: 01:12 When crime is presented that way with just those two words. And we survey people and we say, what should we do about crime? Those who hear crime is a beast, 71% say we should increase law enforcement. 51% of those who hear crime has a virus say we should increase law enforcement. So the word evokes more of an action response when we hear the beast versus virus. And other one was the economy, is the economy stalled or is it ailing? If the economy is stalled, we jump start it, right, stimulus package. If it's ailing, maybe we take measures that are really going to do long term change. We look at education levels or socioeconomic things and what can we do with this economy? So words shape so many things in general and in healthcare, the word surrounding pain, can evoke a lot of fear. Jessie Podolak: 02:08 They can evoke a lot of a knee jerk reactions of what needs to get done. It can kind of force us to look at these more short term solutions. And I think that's been a theme emerging throughout this conference is that there's so many things that we do that are helpful in the short term but can actually be harmful in the long term. So the words that we have surrounding pain, probably lend themselves many times to short term solutions. And if we want to look at really a sea change in how we approach pain, we've got to think and consider our language. Kory Zimney: 02:45 When we look at what we're just talking about, you know, a lot of people, I think they look at it and they go, well that's just a little change. You know, it was only 20% different. What's the big deal? And to me, you know, and it's all about nudges, that a lot of times it's just these little changes that can make huge difference for some people. And I get for a lot of people it probably wouldn't make a big difference, but if it did make a difference for a person, why wouldn't I want to try to maximize every little opportunity that I could get? And I know some people look at it like, well, I don't think language is that be all, a lot of people I can tell arthritis and they don't have a problem because I used that word and I get that. But what about that one person that it did make a difference for? How do you know it didn't make a difference for somebody? And if we have good evidence that shows that these little changes can make a difference, why wouldn't we try to maximize every little bit of that? Karen Litzy: 03:33 Yeah. And I think that harks back to Kory to what you said this morning about everyone in the room has probably treated one person in pain and that's great. You treated one person, but you can't extrapolate what works for one person to a population. And so I agree that I think in as much as saying, do no harm, changing words around that might connect with someone I don't think is going to be incredibly harmful. By reframing words that maybe we know might be a little harmful. Like arthritis or what are some other ones from yesterday? Jessie Podolak: One for me was wear and tear. How often do we say wear and tear. And what's the first thing that pops into your mind when you hear wear and tear? What's an object? Yeah, the tire. And what's that gonna do? It's gonna blow. Jessie Podolak: 04:24 Right? So if I say you have wear and tear, what is kind of even a subconscious thing? They're just waiting for it to blow. And how does that influence your movement? How does that influence the adventure you have in life? How does that influence your whole being? Just knowing I have wear and tear for some people they might say, well I don't care. I'm going to wear it out. I'm going to grind that thing to the ground. But for others they might say, oh my gosh, these tires have to last me another 20 years. I better take really, really good care and back way off. So wear and tear is a hot button one for me. Kory Zimney: 05:03 But yeah, so it's just those little phrases that are so easy for us to throw around. But we have to recognize that the lens that the patient looks through is probably different than the lens that me as the therapist with all my education and training on how I look through it. And I think that's just, again, taking that patient perspective is something that we all can hopefully try to do a little better sometimes. Karen Litzy: 05:28 Yeah. And one thing from yesterday's class that I had never heard of before was negative effective priming. So can you explain what that is and then how we use it maybe not even knowing we're using it as therapists. Kory Zimney: 05:43 Yeah. It's really kind of what you talk about is kind of what you start thinking about. And so if I'm telling you how you're going to lose, if you don't do your exercises, you won't be able to do these things. And just create more of a negative type of attitude to everything, in everything the patient sees then will be directed more towards the negative. Where if you can flip it to more of a positive type outlook as far as when you do this, you'll be able to do these things and you can do that. And again, always flipping it to more of a positive direction. So again your just priming them, nudging them, turning them towards things that they can do as compared to, you lost this, you won't be able to do that. So, it's those little shifts and changes to focus on those positives. As a clinician, you know, you struggle like our patient's so negative. And then we come up with these negative phrases sometimes and it's like, well, how are we helping prime them the right direction? Karen Litzy: 06:34 Right, and what are some examples of maybe common negative priming that we may do as therapists? Kory Zimney: 06:41 If you don't do your exercises, you know, that shoulder's gonna only get worse. You know, if you're overweight, you know, this puts lots of extra pressure on your knees, they're more likely to wear out. It's just those little negative type of things. It's so easy. We can look at, we were talking about what they lose, you know, the kind of the gain aspect or the loss aspect. And oftentimes we tend to talk about the losses and patients will get focused on that, on the negatives. That's just human nature that we focus on negatives. As a clinician, if we're adding to that, it's only going to multiply more. Back in younger days as a clinician, I'd always get so proud of, you know, if I could get their problem list to 10, I thought, how cool am I am double digits. Kory Zimney: 07:24 You know what I mean? Just get that problem list as long as possible, you know, but really looking at the optimism list, what things can they do? You know, what things can they do better? And you know, isn't that, how cool is that? That you can do that? In focusing on those things and what they can do better, what things they can do instead of on what things they've lost, what things they couldn't. So that's that kind of priming a kind of nudging more into a positive direction compared to our traditional, you got dysfunction, you can't do this, you're broken. Jessie Podolak: 07:50 Yeah. And even the way we asked that question, Lindsay had just a really nice thing this morning that she talked about with goals instead of, you always think of, you know, what are your goals? And that's kind of an obscure thing, but I think she asked it in a way that was something like, tell me something that you'd like to do more of, be better at, or return to doing that you currently can't. It flipped it because it started, you know, there's this great quote from a Ted talk that I love by Kelly McGonigal called making stress your friend. It's awesome. She has this quote in there near the end where she said, you know, it's so easier to run towards something than away from something. And if you look at your patients, what are they right in their goals? Jessie Podolak: 08:29 I want to get rid of this pain. I want this away from me. I want to avoid it. It's so overtaking their life that they're running from it. But if we can just direct people towards what is to come and even get them to maybe cast a little vision, which I know is scary. Right? And you don't want to have false hope. We talked a lot about that, about how to balance reality and honesty. And sometimes to say, I'm not sure how this is going to turn out, but I'm with you in it. Right? But I think, you know, this is the worst I've ever seen, or man, this is the biggest trigger point I've ever felt, no wonder you hurt. Those things come from a place of pity or sympathy which it's well intended, but it's not as far on the empathy and compassion scale that we want. Jessie Podolak: 09:26 We want that empathy and compassion of, I see where you're at and where you've been, but I'm with you as we go forward, I guess how I look at it. Karen Litzy: Absolutely. And I think that sentiment of yes, I'm with you, but being honest, so doesn't mean everything's pie in the sky. And I think that's where people, when they hear about this, explain pain, quote unquote or PNE, they think, oh, you're just talking away the pain and you're not being honest. You're not being realistic. But that's not what we're saying when you're talking about language and talking about communicating with someone who has persistent pain. So one of the examples we used yesterday was like hippo A and we said, you know, yes, you're, you may have pain and we're going to work on strengthening. There is a chance you might need surgery, but if you do, you'll be stronger going in. So you have to be honest, you can't say to someone with severe hip OA, you'll be fine. Just do a couple exercises. It's just not realistic. And then when the person isn't fine, that's a steep fall. Jessie Podolak: 10:18 Yes. And it goes back to this, not swinging too far on the pendulum away from the bio, it's still bio-psychosocial. And how do you explain something that there are biomechanical issues in a way that's not scary that still honors the bio, but that kind of de-catastrophizes or softens, it's really just about softening and responding. Like watching the patient's nonverbals. You can tell when you're starting to freak somebody out. And so then you make the adjustment and you just be very, very present. Jessie Podolak: 11:12 So it's certainly our language, but like, as you know, Kory talked about is communication. And I really like what Jonie said about pain neuroscience communication versus just education, I the smart therapist I'm going to teach you, silly patient about how this works. No, this is about communication and dialogue and how do we do that? Karen Litzy: Yeah. And Kory, I think you said this yesterday, but correct me if I'm wrong, I think you said that the body is not fixed rather a robust ecosystem that has the ability to change and grow. Kory Zimney: 11:54 Yeah. And that was actually a TPS grad that we have that talked about that. The beauty of the amazing plasticity and I mean I go back to when I used to, you know, work somewhere in our rehab unit and when a patient came in with a stroke, you knew there was brain damage and you could see the MRI report. But the beauty is you had no idea what t…

Full show notes at the publisher

423: Dr. Duane Scotti: Using Social Media to Reach Your Ideal Client Mar 21, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Duane Scotti on social media marketing. Dr. Duane Scotti is a physical therapist, educator, researcher and founder of Spark Physical Therapy. He is considered a leader in the fields of rehab, sports medicine, performing arts medicine, and human performance optimization. With years of experience as a physical therapist, runner, and dance instructor in combination with his strength and conditioning background, Duane has been working with many patients to improve all aspects of human performance. In this episode, we discuss: -How to decide which social media platform is right for your marketing strategy -What social media content will best build loyal customers -The benefits of scheduling out social media content in advance -And so much more! Resources: Duane Scotti Twitter Duane Scotti Instagram Spark Physical Therapy Facebook Spark Physical Therapy Website The Clinical Outcomes Summit For more information on Duane: Dr. Duane Scotti is a physical therapist, educator, researcher and founder of Spark Physical Therapy. He is considered a leader in the fields of rehab, sports medicine, performing arts medicine, and human performance optimization. With years of experience as a physical therapist, runner, and dance instructor in combination with his strength and conditioning background, Duane has been working with many patients to improve all aspects of human performance. Duane is currently the founder of Spark Physical Therapy, providing prehab, rehab, and performance optimization services either onsite or in the comfort of your home within the Cheshire/Wallingford CT region. He also is a clinical assistant professor in the Department of Physical Therapy at Quinnipiac University responsible for coordinating and teaching musculoskeletal examination, intervention, and advanced manual therapy within the orthopedic curriculum. Duane received his Bachelor of Health Science degree and Master of Physical Therapy degree from Quinnipiac University in 2001 and 2003. He then went on to receive a clinical Doctor of Physical Therapy and a Ph.D. in Physical Therapy from Nova Southeastern University in 2017. Duane is a board-certified Orthopaedic Clinical Specialist, Certified Mulligan Practitioner, certified in dry needling and has advanced training in spinal manipulation, dance medicine, gymnastics medicine, and rehabilitation for runners. Duane has been in clinical practice working with orthopedic, sports, and performing arts populations since 2003. He has strong clinical and research agendas in screening, injury prevention, and rehabilitation for runners, dancers, and gymnasts. Duane uses an integrative model of manual therapy including manipulation, mobilization, and soft tissue treatment including dry needling and the Graston technique for the management of musculoskeletal dysfunction. Duane is a physical therapy advocate and is actively engaged with the American Physical Therapy Association and serves as Vice President of the Connecticut Physical Therapy Association. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Janet Kantor with Duane Scotti, a physical therapist from Connecticut who is joining me today on healthy, wealthy and smart. And today we're talking about doing a specific niche on social media and really just nailing it. You are nailing it, Duane. So first of all, thank you so much for coming on. Duane Scotti: 00:19 Thank you for having me. This is awesome. I'm very happy to be able to talk to you about this topic today. Jenna Kantor: 00:26 Yes. So I would love to know first, how did you choose what social media platform you were going to put most energy on or also I've seen you on Instagram, but you may also be on other platforms and I would just love for you to expand on that. Duane Scotti: 00:41 Great question. When I was looking into kind of getting into social media and using it as a platform, I thought about what is my audience, right? So most of the patients that I treat are adolescents, so I basically treat gymnast runners and dancers and a lot of them are on Instagram. So I started the Instagram account and started learning everything I could learn about Instagram, but their parents are on Facebook. So a lot of, you know, their parents are on Facebook and there's different groups on Facebook. So that's been beneficial from that standpoint. So those are really the two platforms that I utilize. I do have a Twitter but I haven't used it. Primarily because that's more for professional and other PT's and that's not really my target audience. Jenna Kantor: 01:27 Right, right. Absolutely. I like how you hit the nail on the head regarding Twitter specifically, I'm not as active myself. I have something set up where it automatically posts, but my heart isn't there because that's like you said, not where my target audience is. And I like how you bring that up. So how does your content differ from Facebook where the parents are, to Instagram, where the kids are? Duane Scotti: 01:52 There's not too much differences in terms of I do post the same content basically to both platforms. The messaging is a little different if I'm sharing it to a group. So specifically at our local dance studio, we have a closed group so my messaging is going to be a little bit different, kind of targeting the parents and looking out for their dancer, as well as the stories on Instagram. So the stories are on Instagram are a little different, but the content posts that I do on a daily basis, they are going to be the same post that just instantly goes over to Facebook and I'll shoot it over there from Instagram. Jenna Kantor: 02:27 And you just mentioned a little bit about you have kids who are going to these dance schools. There's a relationship you already have with these parents that's helping you build these groups. Would you mind elaborating a little bit more on how that came about? Duane Scotti: 02:44 Yeah, so, well I guess first off, I do have two daughters. One is a dancer and one is a gymnast Jenna Kantor: 02:49 Shout out to your kids. Duane Scotti: 02:51 So they are at the local gym, the local dance studio that I've been affiliated with awhile. I also taught at the local studio, I was a dance instructor there. And you know, obviously those relationships, the families, they kind of have known me and trusted me for years and I've helped out their dancers before. So those are kind of how those relationships have been built. It's really more of me just being present and being there for, you know, picture day and you know, I'm there doing, you know, kind of complimentary screenings and things of that sort. So you kind of develop that rapport and relationship with the families where you kind of earn their trust, that you're going to be kind of looking out for their dancer. Jenna Kantor: 03:34 You know, you hit upon something that I think is so valuable. I actually interviewed Karen Litzy the other day for her own podcast, this podcast in which we are interviewing for right now. And she was talking about these relationships and how she just lives her life and through the things that she's already passionate about. She's made these relationships and help those relationships grow. And it sounds like that's what you have hit upon, which you agree. Duane Scotti: 04:01 Absolutely. Absolutely. Relationships are everything and from a practitioner standpoint, your relationship with your patient and their families are important. But then expanding beyond that and you know, things are a lot different than the healthcare world. And when I first graduated, you know, it was prior to direct access time and everything was about trying to foster that relationship with your referring physician. Now it's a completely different animal. You know, my relationships I'm fostering with are the communities in which I serve. So looking at the gymnastics community or it's the relationship with the coaches, right? And having, you know, I'm just thinking about the first facility that I started in, it was talks with coaches, not just one saying, Oh yeah, I'm a physical therapist, let me treat your gymnast. But it was many talks, many conversations you developed that rapport, that relationship, and then that turns into, hey, can you help this gymnast out? Duane Scotti: 04:56 Oh we have another one. Can you help this one out? And then you kind of foster that relationship over time and then you wind up seeing, you know, your practice or your business kind of growing from that standpoint. And it's really kind of getting into our communities and for me at least that has been successful is having those relationships with, you know, the dance studio owners, the gym owners, now we're treating out of an aerial silk studio. So really you develop that relationship and then they recommend your services to people that are in their circle, right. And their business because they trust you. So I think those relationships are definitely, definitely important for kind of long term success. Jenna Kantor: 05:38 Yeah. And it just makes it more enjoyable because you honestly enjoy each other and so I think that's great. So let's go back to the social media stuff. Your content itself, I mean, I've seen the video of you dancing with your daughter, which was great. What was it? The diggy? Duane Scotti: 05:53 That was the Kiki challenge. Jenna Kantor: 05:56 I think that video pretty much went viral. Am I correct? Duane Scotti: 06:00 Yeah. That one was definitely my best performing video. So yeah, it was fun. That was something that, you know, a lot of people were doing that. And I think you saw on the news like a dentist had done it. I was like, you know what, we should do this as a physical therapist and just showcase what physical therapists do. So, you know, my daughter's a dancer and she was interested. I said, Gabby, let's do it and let's do a little dance. So we just kind of put it together real quick and that was fun. And that's the thing I do like about social media. It's really nice. You can have fun with it. We are professionals and we always have professional interactions with our patients, but we also have fun with them. Duane Scotti: 06:37 Right. And we're human, we're people. So just kind of showing some of that human side I think has been definitely beneficial. And you know, if you look at your insights on, you know, Facebook or Instagram, the posts that do the best are the ones where I am not trying to be super serious and I'm not showing the best technique and the best tool in my toolbox that I know it's more of me just being genuine and it's more of you know, doing a silly dance or you know a picture with the family or you know, something that's kind of outside the box. Jenna Kantor: 07:14 It lets people feel more connected to you. So let's go into more on Instagram because Instagram unlike Facebook, Facebook you can schedule posts for free, Instagram you can't right? So are you using one of those paid for platforms to post or do you just post daily and what is your schedule that you abide by to be consistent? Duane Scotti: 07:40 Well, you hit a really important point is that consistency is key with Instagram and Facebook. It is one of those things and it's just like anything we do in life habit, right? Exercise goals, running goals, wherever it is. Getting to the gym, you gotta be consistent and I don't know, people for different things what like two or three weeks to form a habit and then it becomes a habit. And for me that's been helpful where now it's just part of my daily routine and scheduling it in advance and doing batching and kind of putting videos together, putting, you know, writing, you know, batching all your posts together. It's definitely helpful. It makes it easier. But unfortunately Instagram does not have, like you said, where you can schedule out your posts, so you do need to post it. Then I have heard of other platforms that you can utilize to put your posts in, but it still will send you a reminder to your phone saying this post is ready to go. And then you'd have to open Instagram and actually post it. So that is the limitation in terms of time management. So it is "work" where you need to think about it. Hey, I have to post on this day. I've thought about and you know, and maybe in the future trying to delegate a bit of that out, just to ease a little of the burden of having to do that. And I actually trialed that shout out to Nikki when I was on vacation. Jenna Kantor: 09:04 Hi Nikki. I don't know who you are, but thank you. Duane Scotti: 09:07 She did an awesome job and I wrote all the posts in advance and she did the posting for me when I was out of the country and I couldn't post. So I think it's a doable model, but you still needed to write the post. And because I think, again, going back to being human and genuine, right? So a lot of these bigger businesses, you know, they have marketing people who are doing their posts, but you can tell it's more from a marketing angle and standpoint. It's not that person being genuine and who they are. Jenna Kantor: 09:34 That was so eloquently said. I don't know if we'd go out for coffee, but good, good job. Duane Scotti: 09:41 Right, right. So that is, you know, on Facebook they do have the scheduling, but if you're going to wind up forcing an Instagram, again, like I said, you can just shoot it over to Facebook then. So yeah, I unfortunately don't have a scheduling system that will just like send them all out. Which would be nice. Jenna Kantor: 09:58 And then for the content preparation, do you pretty much do like on Sunday you prepare for the week or do you kind of do daily? Do you have a system for that yet or how do you do that? Duane Scotti: 10:10 Sure. I don't do that specifically on Sundays, but on Sundays I do iron all my outfits for the week. Jenna Kantor: 10:15 You buy clothes that you need to iron? That's lesson number one. You're supposed to buy shirts that are iron free, like you don't need an iron. So let's start there. Now move onto the creating of content. Duane Scotti: 10:33 Yeah. So it's really whenever I have free time, so there's no specific day where I'm like, okay, Sunday is the day that I'm going to do all that. It's whenever I have a chunk of time, then I have a calendar. I have a plan for what's going to be com…

Full show notes at the publisher

422: Dr. Justin Moore: The Future of the APTA Mar 18, 2019

Show notes

LIVE from Graham Sessions in Austin, Texas, I welcome Justin Moore on the show to discuss the American Physical Therapy Association. Dr. Justin Moore, PT, DPT, a physical therapist and veteran of both the profession and the association with more than 20 years' experience, leads the American Physical Therapy Association in the role of CEO. He has been with APTA for 18 years and has held numerous positions, including executive vice president of public affairs, leading the public policy agenda and payment and communications departments, leading its federal and state affairs advocacy departments and serving as the association's lead lobbyist on Capitol Hill. In this episode, we discuss: -How the APTA strives to provide an inclusive experience as a macro organization -What Justin would change about the APTA -APTA's role in the World Confederation for Physical Therapy -Justin's biggest takeaway from the Graham Sessions -And so much more! Resources: Email: justinmoore@apta.org Justin Moore Twitter Justin Moore LinkedIn World Confederation for Physical Therapy Congress 2019 The Healing of America by T.R. Reid Book For more information on Justin: Justin Moore, PT, DPT, a physical therapist and veteran of both the profession and the association with more than 20 years' experience, leads the American Physical Therapy Association in the role of CEO. He has been with APTA for 18 years and has held numerous positions, including executive vice president of public affairs, leading the public policy agenda and payment and communications departments, leading its federal and state affairs advocacy departments and serving as the association's lead lobbyist on Capitol Hill. Moore also previously oversaw APTA's practice and research departments. He has been honored for his contributions to physical therapy and public policy by receiving the R. Charles Harker Policymaker Award from APTA's Health Policy and Administration Section and the Distinguished Service Award from APTA's Academy of Pediatric Physical Therapy. In addition, Moore has written, presented, and lectured on health policy, payment, and government affairs issues to a variety of health care and business groups across the country. Moore received his doctor of physical therapy degree from Simmons College in Boston, Massachusetts, in 2005, his master of physical therapy degree from University of Iowa in 1996, and his bachelor of science degree in dietetics from Iowa State University in 1993. He was honored by Iowa State University's College of Human Sciences with the Helen LaBaron Hilton Award in 2014 and the university's Department of Food Science and Human Nutrition's Alumni Impact Award in 2011, and he was the Family and Consumer Sciences' Young Alumnus of the Year in 2003. He also recently completed a 3-year term on Iowa State University's College of Human Sciences Board of Advisors. Moore was part of the inaugural Leadership Alexandria class in 2004 and served on the Northern Virginia Health Policy Forum Board of Directors. Read the full transcript below: Karen Litzy: 00:01 Hey Justin, welcome back to the podcast. I'm so happy to have you back. So we have a couple of questions to get through today and we also want to talk about the first half of Graham Sessions. So we are recording live at Graham sessions in Austin, Texas. And I've got a couple of questions for you and then we'll talk about your big takeaways from the morning session here at Graham sessions. So first thing is, and this will probably be addressed at Graham sessions tomorrow, but what is the APTA doing the American Physical Therapy Association doing to address the current needs of physical therapists, physical therapist assistants and students to ensure their membership is quote unquote worth it? Justin Moore: 00:44 Yeah, it's a great question. It's a question I get often and unfortunately don't have always a great answer because it is such a personal and passionate issue of how do you find value inside this community of APTA. And as you know, value has two meanings, an economic meaning, do you get a return in your investment? And so we look at the physical therapist and the physical therapist assistant of investing in APTA and do they get a return, so there's an economic part of this question, but there's also a principal part. Do you value APTA? And we'd like to focus on that. And then how can we really engage the physical therapist and the physical therapist assistant and really showing value to APTA and getting value from APTA. And I sort of look at it in Adam Grant's philosophy of give and take, you know, the transactional or economic value is what do you get from APTA? Justin Moore: 01:38 And then the give is what do you give to APTA? We're really blessed by our members giving to us and increasing the value for all. And I think the value at the end of the day, the take home value that PTs get from APTA is we're an unabashedly, aggressive about increasing the opportunities for physical therapists. So if you believe in that mission and that value, how do we continue to connect you to your colleagues? How do we continue to build a community that's going to make this career you've chosen make a difference in people's lives, but also return a fulfilling career to you. And so get that return on investment and that value. So, another thing I'll just tie is our board of directors has been really aggressively looking at how do we continue to be relevant to the next generation of clinicians. And we know healthcare is changing. We know business is changing and we have to be getting better at being relevant at the point of care. We have to get better at promoting the value of our profession and we have to get better at connecting our experts. And right now, I think that's what our strategic planning process is about, is how do we become more relevant to those individual clinicians and professionals. Karen Litzy: 02:50 And I think that's different from a couple of standpoints. One and we'll probably talk a little bit about this tomorrow, is that APTA is obviously a macro organization. There's 101,000 members. So how do you incentivize members from one not dropping off, So a retention issue, right? And two, how do you attract them in to have that feel of more of a micro organization? Right? Cause it's all about the details and it's all about incentives. So how can the APTA, which is a very large organization and it needs to be that way. It can't be small. So how do you give a macro organization a micro feel? Justin Moore: 03:35 Yeah, absolutely. It's our greatest challenge. And I think, you know, one of the things that is very good about APTA is we interact with probably 95% of potential members in a five year period. So we have 80% market share of students, 30% market share of practicing professionals. It's a little less than 10% of physical therapist assistants. So we do engage with almost our entire community over a five year period. But we have to return value in the short term to keep them a member. And the greatest challenges that is, how do you let this very diverse clinical community, how do you build a spirit and harness the power of inclusion? So people can find their people so they can find their community inside this large network of professionals. And sometimes APTA has been too complex, too fragmented, and too divisive to achieve that objective. Justin Moore: 04:29 And so we have to look at those themes on a pretty regular basis is how do we become more inclusive? And so how do we help people find their people, their network of individuals, because they're going to get great value in that if they're going to be a better private practitioner, if there going to be a better pro Bono clinic operator? If they can connect to their people that's going to return value, how do we reduce the fragmentation? We all are committed to promoting the value of PT Well, if we're talking about the value of a certain part of PT, we're constantly competing inside the PT world. It really dilutes our impact. And we know that from data is we're a pretty fragmented community. And so we've got to reduce that fragmentation and build unity. And have to be better working together. Justin Moore: 05:17 We're not unified. The bigger you get, the harder it is to feel the intimacy. We had a consultant work with APTA's board one time and he put up a matrix. He said, you can be three of the four things in the quadrant, but you can't be the two things that are across from each other. And the two things that cross each other in that matrix were intimacy and strategic. And so to be a strategic organization, can you still be intimate in an association of one where you address every need, every one, and we have to figure out, we're going to be a complex organization, but we have to figure out how to give an intimate experience, but be strategic in that intimate experience. Karen Litzy: And it's a challenge. It's a challenge for a large organization, but it's good to hear that that's on the minds of the people at APTA. Justin Moore: 06:06 Yeah. I think we've realized that we have fallen short at times of really being able to connect people, really giving people a sense of inclusion. Even though we've tried to be inclusive. If it is not conveying that to the end user or member and they don't feel included then we're missing the mark. Karen Litzy: One thing it's not about is the money. Justin Moore: We can give you in economics, I always tell the story is, you know, it is a federated model, has a complex new structure, but APTA dues are 295 in the realm of that, it's a pretty low price point inside of professional associations. If you compare us to other medical associations, other nursing professions, it's a pretty low price points. We probably return economic value for transactional value to the member, and show that value pretty well. But if they don't value their experience, it doesn't matter what the price point is. And so that's what we really have to work to achieve. Karen Litzy: 06:59 Yeah. Not Easy. I look forward to seeing what comes out in the next couple of years there. Okay. Moving on. If you can end with, maybe we already said this a little bit, but if you can change one thing about the APTA organization, what would it be and why? Justin Moore: 07:13 I think it would be to harness the power of inclusion. We've really been focused on that and how do we create a community that at times has been competitive or fragmented and how do we bring them together for commonality and unification around promoting the value of PT, promoting the brand of PT and we're going through a process right now at APTA of rebranding and we're going to be launching that in the next 12 months. And what we found is we went through the research on doing that is we're conveyed way too many opportunities to put your own perspective of what the value of PT is. And we need to really get unified and more inclusive in that march toward promoting our value. Karen Litzy: 07:57 Simplify the message a little bit more. It is hard because within physical therapy you have so many options of workplaces and how you work and who you work with and states and personalities. And I mean the list can go on and on. I would imagine having that sense of inclusivity among 101,000 members, but 300,000 PTs across the country is not easy when everyone is so diverse, diverse in race, religion, gender and diverse in practice settings. So it's like you have to not be, I'm trying to do everything but a master of none. Justin Moore: 08:43 If you're trying to do everything, you're actually doing nothing. That's sort of been a challenge for APTA. They're trying to be all things to all people and was at times maybe a little bit mediocre at everything. So we really have to do that. And I think the common theme is we've done some analysis both on the data side and then actually a social listing. And two themes come out about the PT community is we're pretty divisive. So when you guys see this is people like to tear other people down or can say that they're better at a certain thing than others. So if we could get away from that divisiveness and correct that, that would be great. If an outsider was looking at our dialogues, it would not be a positive experience. Karen Litzy: 09:36 I've had a patient tell me like what you guys really don't get along. I've seen some conversations on social media. And I was first of all shocked that a patient would actually bring that up so people are looking and they are reading. Justin Moore: 09:44 We've had outside consultants that have look at this and they said they can't believe two things. How some of our acting members tear us down. And so these are people who have already made a decision to join us but yet like to tear down the organization. And then what we found is when we were out looking at the research on our next strategic plan and looking at net promoter scores our highest distractor group, was some of our longest serving members, and essentially we figured out we're not engaging their expertise well enough. And so that was sort of a wake up call for us instead of saying, oh, why are former leaders tearing us down? We said, wait a minute, they're feeling lost. They're feeling not included. They have given a lot of time to this association and now they feel like they've been dropped off a cliff. And so how do we give them a parachute, how do we give them a glider? What can we do to keep them in the spirit of inclusion? Karen Litzy: 10:36 I think that's great because you know, in some conversations I had yesterday, someone brought up to me that it was really great and it was that the APTA has 101,000 quote unquote experts. So the organization is not the expert. They're the facilitators of all these experts that they have at their fingertips. And just think how much the organization can do by being a stellar facilitator of all those experts. Justin Moore: 11:05 APTA is a vehicle. We don't practice, we don't do research, right? We don't do, we do a little bit of education. We do a little bit for professional development, but we can be a vehicle where our educators can educate, our researchers can publish, our researchers can have access to funding and our practitioners can get that. So we have to really leverage our role as convener. Our role as networker. As a funder. The very basic principle of association is people come together for collective success. So they give us dues you use to put into a collective operation for PR, for advocacy, for all those things. And we've got to get better at that. Include that spirit of inclusion. Karen Litzy: 11:46 Perfect. Alright, next question. So the World Confederation of PT Conference is coming up in a few months in Geneva in May. So how is the APTA improving its outreach and involvement in the international world of physical therapy? Are you going to be in Geneva? Justin Moore: 11:54 Yeah, it's a big priority for APTA to be an international partner and contributor to global PT. And so WCPT is one part of that. It's not our inclusive effort. But APTA has a long history of involvement with WCPT including being one of the founding countries and including having at least a couple of presidents I believe. So, most recently, Marilyn Moffat was president of the WCPT. So we have a longstanding commitment and contribution to WCPT and the conference in Geneva will be a great community of international leaders where we can go and be in a posture…

Full show notes at the publisher

421: Dr. James M. Dunleavy: The APTA House of Delegates Mar 14, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Jim Dunleavy on the New York House of Delegates. Jim Dunleavy is Chief Delegate of the New York Physical Therapy Association Chapter. James Dunleavy graduated Cum Laude with a Bachelor of Science in Health Education from Manhattan College in 1976. He received a P.T. Certification in 1977, followed by his MS. P.T. in 1983 from Columbia University. James was a Co-founder and acted as its first President of the Acute Care Section from 1992-1997. He served as an APTA Director from 1998-2004 and received the APTA's Lucy Blair Service Award in 2005. Currently, James is the President of the New York Physical Therapy Association, an office he took in 2006. In this episode, we discuss: -What is a motion? -An overview of how the delegate assembly functions -Jim's advice for new graduates who are looking to get involved in professional organizations -And so much more! Resources: Jim Dunleavy Twitter New York Physical Therapy Association For more information on Jim: APTA spokesman James M. Dunleavy is administrative director of Rehabilitation Services at Trinitas Regional Medical Center in Elizabeth, New Jersey. He also serves as adjunct faculty in the Transitional Doctor of Physical Therapy Program at Rutgers University. As an active member of APTA, he founded the association's Academy of Acute Care Physical Therapy and served as its president for 5 years. He has held various volunteer positions within the association, including serving as a director on the APTA Board of Directors. Dunleavy also has held many volunteer leadership positions on APTA's New York Chapter Board of Directors, including treasurer, district chair, district director, and president. In 2005 he received APTA's Lucy Blair Service Award. He was the first recipient of APTA's Acute Care Section Leadership Award, now named after him. He received a bachelor's degree in education from Manhattan College, a master's degree in physical therapy from Columbia University, and a doctor of physical therapy degree from Massachusetts General Hospital Institute of Health Professions. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor with Jim Dunleavy who is the NYPTA chief delegate. And I am very excited to be interviewing this morning. So first of all, thank you so much for agreeing to be interviewed on the wonderful, healthy, wealthy and smart. So delegate, chief delegate. Would you mind explaining what that is for anyone who does not know and what that is related to within the New York Physical Therapy Association? Jim Dunleavy: 00:30 Well, the chief delegate actually leads the delegation from New York to the national house of delegates each year. I'm basically the organizer. I do the assignments of motions. I hold webinars and phone calls with the delegates during the course of the year to get them up to speed with the issues that are facing us that are brought before the house of delegates each June. Jenna Kantor: 00:58 Yeah, it's excellent. And I'm on that email list and so I'm always just going reading, having different physical therapists help transcribe it for me. So thank you, you just are so good at keeping us up to date with that. So for you, I'm just wondering on a weekly basis, how much time do you need to put into your job? Jim Dunleavy: 01:17 I would say it varies. It gets more as we get closer to the house of delegates each June. The APTA has gone through kind of a metamorphosis and has created almost a year round type of governance process. So, the motions are starting to be brought out in concept form, usually early in the fall. In the past it's just been we get it in March, we read it, we go to the house, that's it. But now we have to really look at it almost as a year round job to keep people on top of it. Make sure we see what issues are coming possibly before the house. And giving our input from New York as to how we feel about these motion concepts and then the full blown motion will affect us in New York. Jenna Kantor: 02:15 So when you're saying motion, what do you mean by motion? Is that a new law? What is that? Jim Dunleavy: 02:20 We run a house of delegates. It's similar to a mini Congress or a mini house of Representatives. And so the issues that come before that house have to be in the form of a motion, which is a clearly defined statement, whether it be a policy, whether it be charging the APTA to do something, whether it be a philosophical or sociological position. And the group will review it, they will discuss it, they will argue about it and then they will vote on that motion. Jenna Kantor: 02:54 Oh, so it's like when it goes to the Senate or Congress. So if I was to think of the school house rock video where they're singing, I'm just a bill. Do you like that reference? Yes, but honestly, that's where my brain needs to go cause I'm massive beginner with this. So I right now I'm an alternate, which I'm very just honored to even be an alternate for the possibility of going. So I was wondering what is it like, let's say day one at the delegate assembly? Is it just people just kind of, you know, is it, how are things brought in order? Is there an introduction? Are there, is there a ceremony with candles and, and you know, it was some sort of like traditional dance. What happens on day one at the delegate assembly? Jim Dunleavy: 03:49 The candles and the dancing, that's a good idea. Maybe we'll get them going a little bit more. First two things. One, you mentioned the term delegate assembly. The delegate assembly is actually New York's own little congress, little house of Representatives. What I'm chief delegate of is the delegation of New York that goes to the national house of delegates. So in New York, we're a little different than other states. We have 10 districts. We have representatives from each of those districts come to our delegate assembly, usually in April or May, where we review all the things that are going to come before the house of delegates plus vote on any bylaw changes or other issues that are going on in New York state alone. In terms of how it's structured, you have delegates are voted upon to go to the house of delegates by our delegate assembly. Jim Dunleavy: 04:51 So that's one set. Then in addition, each district has the ability to designate one person. So there's 10 and then whatever is left in the order of the voting in the delegate assembly, those people are on our alternate list. So, believe me, it happens every year. We have people who drop out for various reasons. In fact, I have one right now that I have to replace, so I don't know where you were on the list, but you might be getting a call from me later. I have to keep track of that and I have to constantly update the APTA delegate list and the chapter deligate list. So they get all the information that they need either as now an active delegate and not an alternate. Jenna Kantor: 05:44 If somebody was an alternate, like my situation and then I'm down at the end of the list. But I'm also, honestly, I really am grateful to be on the list especially as a new Grad. So I'll take it, so if I was able and fortunate enough to, you know, be able to fill in for someone, does that make me for the next year as a regular delegate or am I still considered an alternate? Jim Dunleavy: 06:10 The delegation is a one year service time. So we will vote this coming April I think is the delegate assembly. We will vote for the delegates going to the 2020 house of delegates. This group of delegates that are going to Chicago in June of 2019, they were voted upon last delegate assembly. So it's a one year cycle. We've actually talked about changing that to maybe get a little bit more experience in four people. So we're talking about maybe changing the bylaws to two years of service. I'm not sure yet, but it is a one year service time. Jenna Kantor: 06:58 Okay. Very good to know. Alright, so let's go back to day one. So we're at the house of delegates day one. So apparently there was no dancing ritual. So what is the order usually on day one at the House of delegates? Jim Dunleavy: 07:24 For the New York chapter, what we usually do is our delegation comes in usually the day before the house opens. And I usually try and hold a, what we call a caucus meeting to just orient everybody, go over any changes that I'm aware of and in any of the motions, prepare the delegates for the next morning, which are the interviews for people running for national office because the house of delegates is the voting body that votes for president, vice president and so on. We have interviews of those candidates all morning and we have I think four rooms or five rooms that we have delegates in who asks these candidates questions, we will then come back as a delegation together. We will talk about the candidates, make our selection and then start to work on the motions. Then after that, usually in the late afternoon, early evening, the house of delegates starts and it's a pretty impressive place if you've never been there because you have over 400 plus of your colleagues from around the country sitting in front of a large dais with the speaker and other officers there. And we run a parliamentary rule meeting with the idea of making the best decisions for the profession in the United States. Jenna Kantor: 08:53 This is honestly very exciting to me as much as I'm calm as I'm saying this, like it's just, it's getting my heart beating and I'm like, I want to be there one day. This is just a random, silly question, but Lord knows anyone who knows me, I love random silly questions. So if I was to be interviewing for any of these amazing higher positions, that can make a great difference. If I did the splits or broke into a song and dance, would that help my position or possibly pull things back or maybe would you cast me in a Broadway show instead? Jim Dunleavy: 09:24 I'd probably go with the Broadway show. Probably doing the song and dancing in an interview here, I don't think the culture would really take to that very well. I think though that the culture in the interviews is changing with the age of the delegates. We talk a lot about millennials. We talked a lot about all of them, gen x'ers and everything else. And how we have to change our communication style in order to reach out to our newest members and future leaders. I've seen a change in culture and that it's a little bit lighter, but I don't think we're doing the song and dance just yet in the interview process. Jenna Kantor: 10:18 So no Hamilton rap? No, no, no. Okay. Okay, good. Just good to clarify it. In the hallway, right to take care of those nerves. So when going in the rooms, this honestly reminds me cause I have the musical theater background of auditions. It really does. So for you guys on your end, as you are interviewing these people, I mean aside from the buckets of coffee that you're probably having to just stay really focused. You really need to see that people are right for these positions. Do you try to make it a friendly environment or like what kind of environment are you trying to create to help that person who is being interviewed? Jim Dunleavy: 10:59 Well, I think we're trying to make it a level playing field because what we have done is we have agreed to do a set questions in every room so that the delegates that are in each room gets to hear each candidate's answer to the same question. Then each room does have an opportunity to ask some of their own questions. So when I ran for APTA board and I had to do these interviews myself, that was not the case. I had no idea what was going to be thrown at me in terms of questions. You could be asked anything. I think now it's at least fairer, it's a level playing field for the candidates. They know they're not going to get any serious kind of Gotcha questions cause we went through a period of time where people thought that was fun. So I think it's a much easier experience for the candidate then perhaps maybe it was when I ran. I think people still get insights into these people. Jenna Kantor: 12:16 Absolutely. And for working with your team when you are discussing, cause you're saying people are in different rooms, you know, you have the different rooms and are you guys all, is it say Melanie goes in, she gets interviewed in one room. Does she get sent to the next room and the next room? So all three groups interview? Jim Dunleavy: 12:37 Yes. The candidate will get a schedule for the morning, what rooms they have to be in. So usually very close to each other Jenna Kantor: 12:48 And muscle relaxers. Anything for the nerves, right? Jim Dunleavy: 12:51 Absolutely. Yeah, there is. And there is a candidate's lounge where they set up food and coffee and everything else. So you have a place to go and cry when you mess up in the interview. It really is a very well oiled machine how they do it. So what I'm going to have to do as chief delegate, I'm going to have to basically divide up our delegates equally for each room. And then I'm in one room with what we call the Northeast Caucus, which is all the states, pretty much in the northeast. But they'll be New York delegates probably somewhere in the neighborhood of six or seven, maybe eight in each room. So they can hear the differences in the different questions and then I will bring them all back together after the interview session and go through that and make sure that everybody hears what was said in every room by each one of the candidates. Jenna Kantor: 13:48 Oh, that's so smart. Yeah. I really like how you guys have a system because that's not easy to even develop that system that works for everyone. So I think that's really, really cool how you guys have that organized. So you're done with all these interviews, you have to decide that night for that or was that during the whole weekend that that's part of the house of delegates? Jim Dunleavy: 14:09 It used to be much more laborious until we went to electronic voting. So after the day of our interviews that evening, the house will open and one of the first orders of business is that we will all vote on the candidates. And then at the close of that session, which is usually around eight o'clock that night, the results are posted both outside the house of delegates room. And on these huge screens that…

Full show notes at the publisher

420: Dr. Karen Litzy, PT, DPT: It's All About Relationships Mar 11, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Karen Litzy on her journey to become a leader of the physical therapy profession. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit. In this episode, we discuss: -How Karen started her career in New York City -The importance of relationship building to grow your practice -Why you should say yes to things that align with your values -A sneak peek at the Strictly Business Mastermind -And so much more! Resources: Karen Litzy Twitter Karen Litzy Instagram Karen Litzy Facebook FOTO Outcomes Summit, use the discount code LITZY For more information on Karen: Dr. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit. Through her work as a physical therapist she has helped thousands of people overcome painful conditions, recover from surgery and return to their lives with family and friends. She has been a featured speaker at national and international events including the International Olympic Committee Injury Prevention Conference in Monaco, the Sri Lanka Sports and Exercise Medicine Conference, and various American Physical Therapy Association conferences. Karen has been featured in magazines and websites like Redbook, Women's Running, Martha Stewart Living, Family Circle, Health.com and CafeMom. She has been a guest on several podcasts including Entrepreneur On Fire, Hack the Entrepreneur, and The Healing Pain Podcast. She lives in New York City. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor interviewing for Healthy, Wealthy and Smart. And I am here with the founder, the original Mama Jamma, Healthy, Wealthy and Smart Karen. And I am going to be a major fan girl. No apologies for this at all because I've been wanting to interview Karen for a long time because she is just one of the most inspirational people in physical therapy. And I would say honestly amongst women and physical therapy, the leadership that you take is absolutely incredible and I appreciate you agreeing to coming on. So thank you. Karen Litzy: Well thank you. And I think this is the first time I've been interviewed on my own podcast. I think so unless you count the time Bronnie Thompson was asking me questions and made me cry. But for the most part, this is definitely the first time. Jenna Kantor: 00:51 Not a meltdown in this one. Well what I'm really excited about as so anybody who is a fan of Karen lets you see all that she does. This is to really learn about her backstory and also how possible it is to get to where she is at now. So one thing we were talking about the other day, Karen, as you were saying, how you moved to New York and you knew no one, I would love for you to expand upon that and how you took those steps to knowing everyone. Karen Litzy: Well, so when I first moved to New York, I knew my roommate because we had gone to high school together and maybe two other people that we went to high school with. And what I decided to do when I first moved to New York is I couldn't find a physical therapy job that I felt like it was a good fit. Karen Litzy: 01:43 And so I ended up working at what was then called Reebok Sports Club. It's now an Equinox, but it was this sort of a country club in the city. So it was a very high end, very expensive gym. So I started working there as a personal trainer. And because of that environment, there were so many personal trainers, Pilates instructors, nutritionists, not to mention all of the people who go in and out of the gym and all the clients I was lucky enough to work with. And because of that I was able to meet hundreds and hundreds of people. And to this day, those trainers, the people who work, like a computer program there for children, there are nutritionists, pilates instructors. To this day they still refer patients to me. And that was wow, 18 years ago. So, you know, we talk about building relationships and how important that is. Karen Litzy: 02:41 And I think having that as my first job in the city and being exposed to so many different people, I felt like it really helped me build relationships and friendships at this point that have continued to blossom and grow. And I mean, I just had a patient that was looking for a strength and conditioning coach. And so I said, well, I work with one, a person who is amazing. And he was one of the first people I met at my new job 18 years ago. So it was a bit of like an unconventional path for a physical therapist and it's just cause I couldn't find my fit. I couldn't find that niche that I really wanted and maybe the clinic that I really wanted to work at and now that being said, I knew ahead of before I moved to New York that this gym existed and that it was a high end gym and that I would be exposed to a different kind of clientele. Karen Litzy: 03:36 I don't know why I looked that up to begin with, but it was because of that, that gave me the idea to go out on my own and to start seeing patients in their homes and home gyms and homes and offices because all of the personal trainers at this gym, we're seeing people outside of the gym. If they're doing that, then why can't I do that? Why can't a physical therapist do that? Why do they only have to come to a clinic in a more traditional sense of the word? So it was because of that first job that I met so many people and those relationships continue to grow other relationships and that I got the idea to do my business. Jenna Kantor: 04:28 That's incredible. So for you, now that your network has expanded over time, clearly it's like full bloom. Hello, I look at you almost like the Oprah of physical therapy here. So how do you keep in touch or maintain these relationships with all these people? Like what is your skill for that? Karen Litzy: So as far as maintaining them within New York City, it's pretty easy because we'll get together or you send a quick text. Cause most of these people are my friends and I credit working at that gym and also playing softball in central park that I was able to meet so many people. Jenna Kantor: You play softball. Hold on, pause, elaborate. Karen Litzy: So one day I was running in central park and I was like, Ooh, softball. So I went down and I was like, Hey, do you guys allow girls to play? And they were like, no. And I was like, oh, um, okay. And they said, well, what do you do? Karen Litzy: 05:16 And I said, well, I'm a pitcher. And then they asked if I was good. And I peeked my head around and looked at their pitcher. I'm like, I'm better than the one you have. And so the next week I went for my tryout and then I became their pitcher. And then the following, summer I was recruited to play in a fast pitch like windmill fastpitch league. So I played there for several years and all the guys that I played with on that softball team, are lawyers, and they have referred patients to me. And you know, you just keep in touch. And so I met my two best friends that way in the city and they refer people to me from a business standpoint, but they're also my friends, you know, and they're part of my lifeblood of being in the city. And so my best advice if you're moving to someplace where you don't know anyone is to get involved in things you like to do. Karen Litzy: 06:07 So I love playing softball. So that's what I did, you know, and I loved working out. So I decided to work in a gym as my first job. So instead of kind of pigeon holing yourself into what just physical therapy or just this, just that, like really kind of open yourself up because you never know who you're gonna meet. So in this city it's easy to keep in touch, well, I shouldn't say it's easy. It's not easy, but if it's a priority for you and your life, you make it and you make it a priority and you put in the effort. And so for me, and as you know, Jenna, you keep in touch with a lot of people. You spend your time on networking and on making those relationships. And the best way to do it is to make it a priority. Karen Litzy: 06:47 And so I may have, you know, my week is sort of chunked out so I have patient care, but then there's times where I'm like, okay, all I'm going to do is write emails and send messages to people and it's in my calendar, it's write emails and send messages to people just so that you're still in there hemisphere. Jenna Kantor: You know, it's keeping those relationships. Otherwise it becomes that long lost relationship. Even if when you hang out with them again you could just act like no time has passed. It's still something that needs to be rekindled. So it avoids that. Karen Litzy: And it's putting in the effort. Like a good friend of mine, his name is Dr. Jordan Metzl who's a physician in New York and he does free workout classes every month. And so I try and make it a point, okay, I'm going to go to one of his classes even though I can't walk for two or three days because my legs are so sore afterwards. But I make it a point because he's my friend and I want to support him and I think what he's doing is important. Jenna Kantor: 07:37 I love that. I'm sure I've probably seen pictures of you after the workout going, just finished the workout with Metzl right now. I love that. And you actually are tapping upon something that I know we are 100% agree upon is really supporting what other people are doing. Showing up for what they do is a real big part of the networking and how your life and your career has truly grown. Karen Litzy: Yeah. It's just being supportive of people that you believe in. So going to something like the CSM where there's 16-17,000 people here, like there are people that I want to make it a point that I at least say hello and that I have a conversation with, even if it's just five minutes, you know, because it's important to me and I hope it's important to them, but I know that it's important to me because I want to show up for them and I want to support them. Karen Litzy: 08:31 And so that's just what you do if you want to keep your relationships going. And as far as keeping relations with international colleagues, it could just be a quick, a quick note on Twitter or a quick email or hey, I thought about you the other day because I really want to introduce you to this person because I think you guys should at least know each other cause you're doing the same research or you know, I met a colleague in the Netherlands and he has since referred patients to me in New York and he's a physio in London, but you just keep in touch with people and you do good work. And I think that's the best way to keep your relationships going. And it doesn't have to be every day, right? It could be consistent. Karen Litzy: 09:24 It takes five minutes. A lot of times I do this when I'm on the bus cause I'm going from patient to patient. So what else am I supposed to do on the bus? You know, so that's sometime when I'd be like, okay, I'm going to make sure that I reach out to so and so in Australia or to this person in Pennsylvania or to this and that's a good time. So I'm lucky in that sense that I have like random downtime. Chunks during my week and you just, if you think about someone, just let them know. Jenna Kantor: Yeah, it takes seconds. It takes seconds. Okay. So you have your hands on many things which I love about you. So you have this podcast, which is amazing and soaring and now you also have a team working for you with this podcast. Jenna Kantor: 10:07 You have your own practice, you have the speaking course. What am I missing? You have a course coming up that's going to be helping practitioners, which is amazing. You're the nominating committee for the private practice section? Am I missing anything? I want to make sure we tap and tap everything. Okay. So you're doing all these things now, did they all come about all at once for you to achieve it? Or did some of them overlap as you were developing them? Oh, and you're working to become a paid speaker. I mean these are a lot of fantastic things, all a hundred percent possible to achieve in a life, but for you achieving each and every one, have some of them overlapped in the process of growing? I would love to hear that journey. Karen Litzy: 10:56 Yes. And I also think that one allows for the next and allows for the next. So one event allows for the next event and for the next and for the next or one experience allows for the next. So for instance, starting the podcast many years ago, I took a couple of years off to go back to get my DPT, but starting the podcast had led to credibility and has led to visibility and in maybe some vulnerability on my part. So when people can see that you're being credible and you're being authentic and you're putting yourself out there, they're drawn to that. And so from that, I was invited to be on a proposal to CSM and then that got me public speaking a little bit. And then maybe from that someone sees you, it's like, hey, you know something, I really like this. We should try this. Karen Litzy: 11:50 And so I kept saying yes, yes, yes, yes. And to say as a piece of advice, say yes to everything until you can say no, terrible advice. I don't know. It was terrible advice. Awful. So what I started to do, cause I was saying yes, everything and it is overwhelming and you get burnt out and you start to cry and then you don't feel like you have a personal life. And I want a personal life as well. So now what I've started to do is say yes to things that align with your values. Say Yes to things that in your gut it's a hell yes. Because when you start saying yes to things that are like, I guess I should do it, it's a no, like if you're saying I guess I should do it, you don't want to be shoulding things. Karen Litzy: 12:30 It's like, yes, I want to do this. Not, yeah, I guess I should do it. And so I think having that in my mind has been able to narrow my focus a little bit more. So it sounds like I'm doing a lot, but it's all inter related. Jenna Kantor: It's connected. And I even left out that you have the annual women in PT Summit. Karen Litzy: But again, that's all connected…

Full show notes at the publisher

419: Dr. Sue Griffin: The Speaker of the APTA House of Delegates Mar 04, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Sue Griffin on how to be the speaker for the APTA's House of Delegates. Dr. Sue Griffin is the Speaker of the House of Delegates for the American Physical Therapy Association. In this episode, we discuss: -What are Robert's rules of order -The responsibilities of the Speaker of the House of Delegates -What roles you should seek in order to prepare for Speaker responsibilities -Why Sue loves the APTA -And so much more! Resources: National Association for Parliamentarians Use the discount Code: LITZY For more information on Sue: Dr. Griffin has been a physical therapist for more than 30 years. She has practiced in a wide variety of clinical settings throughout that time, and continues to practice in acute- and long-term care. Dr. Griffin has taught ethical coursework for entry-level and post-professional PTs and PTAs at the state and national level. Examples of Dr. Griffin's accomplishments include: Elected Speaker of the House of Delegates for the American Physical Therapy Association in 2014. Full-time professor for the Physical Therapist Assistant Program at Blackhawk Technical College in Janesville, WI for more than 20 years. Served on the Ethics Committee for the Wisconsin Physical Therapy Association from 2007-2013. Chaired the Wisconsin Physical Therapy Association Task Force in 2004, when the Wisconsin PT practice act was updated. Lead instructor in a PTA program, delivering content in a wide variety of clinical areas. Long-term and indepth involvement in clinical education. Licensed doctor of physical therapy with a broad background in many areas, including longterm care, acute and rehab spinal cord, acute head injury, inpatient and outpatient orthopedics and neurology, and amputation. Board certified in geriatrics. Very active member of WPTA and APTA. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor with Healthy, Wealthy and Smart. And I'm here with Sue Griffin, which is absolutely incredible. I am just a fan of anyone who is involved with the APTA and really making a change. So would you mind sharing, your the speaker of the House of delegates, would you mind explaining what is that position? I would love to learn. Sue Griffin: 00:20 Sure. So speaker of the house runs the house of delegates. So the house of delegates is pretty analogous to like a representative body like you'd have in your state legislature, like the assembly. So, every state chapter gets to elect physical therapists as representatives. And it's the number is based on the number of members they have in their chapter. So we have about 400 every year that together and they kind of look like, you know, if you've seen those old convention things like the long tables and the state signs, I mean, that's kind of what it looks like. It's in these huge ballroom. There is a day is, and so up on the day is, that's where I preside from. And so the speaker stands on the day is and runs the meeting and it's incredibly formal because you can't have 400 people like talking over one another. Sue Griffin: 01:09 It sound like, you know, English parliament or something, which we don't want. So that's the state chapter part. And then we also have all of the sections have a representative, the student assembly sends two representatives, the board of directors are there and the PT Caucus. So they all have representatives. They don't have a vote, but they are able to speak and debate and offer motions and things like that. So that's how our association creates positions and policies. Jenna Kantor: 01:44 So with all these people together, you are leading the meeting? Robert's rules and all. Sue Griffin: 01:51 Yes, very, very formal. And so we stick to Robert's rules really strictly because otherwise again, like it would be chaos. Jenna Kantor: 02:00 Oh yeah, absolutely. And would you mind explaining what are Robert's rules for those who do not know? Sue Griffin: 02:06 Everyone knows what. No, I'm kidding. I'm kidding. No. Sue Griffin: 02:09 So Robert's rules of order is a specific kind of school of parliamentary process. So there are a couple of different schools, but this is probably the most famous. And so there's literally a book that kind of like a thick little mini Bible and it helps you run a meeting. So it has rules about procedure, like who can speak when and if someone brings a motion, in other words, if they want to take action, they present in a very carefully worded format and then there are processes for how people can change or amend that motion so that you can, it's a way for a group to make decisions. Jenna Kantor: 02:47 And it makes it easier for everyone else to follow. Sue Griffin: 02:50 Right. And the basis is really to protect the voice of the minority and yet still let the majority accomplish their will. Jenna Kantor: 03:00 I love that kind of the whole purpose of it. And what is the time commitment for your position? Sue Griffin: 03:05 It varies a little bit, but there's kind of a low level steady level of commitment that's probably five to 10 hours a week because I also serve on the board of directors, so I have to participate on all the board activities as well as manage the house activities. And then like times like this, like pretty much from January through June. So the house of delegates right now is always in June, so pretty much from January to June, or at least CSM to June is when people are really working hard on their motions and we're trying to help them craft them. And so I would say the time commitment is, you know, probably 15 to 20 hours a week. Jenna Kantor: 03:45 That's great. That's great. Well, you're making a big difference, so that makes sense. And then of course as it gets closer, I'm sure it increases. Sue Griffin: 03:52 It does. I don't know that I'm making a big difference. I think I'm helping everybody make a big difference. Now, I'm going to think I'm trying to just, you know, I'm the facilitator. I'm not the, I'm not the maker. Jenna Kantor: Yeah, yeah, absolutely. So as the facilitator, why do you like this job? Sue Griffin: Oh, it's just great. I mean, first of all, it's just so many passionate and really smart people, you know, coming together and they all have such great intent. I suppose every process like this is political to some extent, but you know, we don't have, everybody is really trying to move and accomplish what they really believe is best for the profession. And I feel like we really have a group that shares common values at a really deep level. And it's just so exciting to see those people come together and be able to accomplish things because physical therapy is the best profession. Right? And so for us to be able to do things that can help us elevate our level of practice, get people to access us better. I mean that's the kinds of things that you know our association is trying to drive to do. And this is, this is a big part of that. This is the driving body in many ways. Jenna Kantor: 04:59 Oh absolutely. That's honestly why I love the APTA personally. So for you, what past experiences greatly contributed for you being able to handle and take on this position? I would love to hear your journey. Sue Griffin: 05:12 I think a really formative part was when I served as the secretary of our state chapter in Wisconsin and I did that role for four years and you know, secretaries have to take minutes. And so, you know, you're in a meeting with maybe 12 or 15 people and that meeting is not run very strictly on Robert's rules of order. So, you know, there's a lot of discussion, which is really perfectly appropriate. But at some point, you know, I would find myself kind of listening and then I'd say is so is this what you're trying to say? No, I'd take notes and I help people craft motions and they're like, yeah, yeah, that's, that's what I want to say. That's good. So it really helped me learn how to listen to a lot of conversations and try to distill the essence of what people were trying to accomplish. Sue Griffin: 05:55 And that has served me very well because part of the speaker's role is to serve on a committee called the reference committee, which is a group that helps people guide and craft their emotions in a way that's specific. And so it's really helpful for that, but it's helpful when you're trying to facilitate a group of 400. You have to be able to listen and kind of hear and try to sense where people are going. Cause they kind of know where they want to go. They don't always know how to get there. So I think that really helped. But then, you know, early on I became a member of the National Association of Parliamentarians, which has a lot of great educational resources. So that's how I learned a lot about, more about the intricacies of Robert's rules. And I was really lucky that I got to serve for seven years. Sue Griffin: 06:39 So I'm from Wisconsin, and Illinois runs a state assembly like New York does. So I served as their parliamentarian for several years. And so, you know, again, I wasn't running the meeting, but I had to understand it. I had to prepare it, it had to help me learn how to anticipate when amendments might be coming, how would you handle them. And so it really taught me a lot about how to prepare for the meeting in a way because you never want to be surprised if you can avoid it. So I would say those are really the main things that helped me prepare for the speaker role in particular. Jenna Kantor: 07:15 I love that because there's not one way. What are other jobs, as obviously from what you got to be part of was helpful, What are other jobs that you would recommend people try to be appropriate for your position? Sue Griffin: 07:34 I think anytime you can be in a position where you are responsible for facilitating, so certainly, you know, being a chapter president, but even, you know, running a committee meeting. So, I think those are good roles. There's a position on the board of directors called the Vice Speaker of the house. So that person becomes obviously intimately involved. Jenna Kantor: 08:00 So going back to that question, so what jobs, aside from the ones that you just mentioned, would you recommend people could take on in order to be appropriate for your position if they were looking and going, oh, one day I'll be Sue Griffin. Sue Griffin: 08:19 Well probably one thing I should've mentioned that I didn't and it's you really need to be a delegate to the house of delegates, right? I mean, I did that for 15 years at least. So they need to be a delegate and that really helps them, I think link into other, I mean, at least to help me link into other opportunities, either at the chapter or section level so that they can kind of figure out their path. But again, being a secretary I think is a really good role. Anything where they have to run a meeting so they could be like even a SIG chair or a, you know, a committee chair. It doesn't have to be president, but certainly being chapter president could help because you obviously have to run meetings. Being on the reference committee is phenomenal. I mean it gives you a great role. And then we also have another position on the board called the Vice Speaker of the house of delegates. And sometimes people who've been in the vice speaker wanted to go to speaker and sometimes they haven't. So I mean it's not obligatory of course. And it's not required to be vice speaker, but those are some other ideas or options I would say. Jenna Kantor: 09:20 Awesome. I love that. And what motivated you to work specifically towards this position? Cause there's a lot of positions that make a great difference in the APTA. So what made you go this is the fit for me. Sue Griffin: 09:33 Yeah, that's actually the only one I've ever really wanted. And you know, my very first probably hour as delegate, you know, back in 1995, I just was captivated by the formality of the proceedings. I was captivated by how he managed everything and how he really helped people accomplish their work. And that was very appealing to me to be able to help people move forward and accomplish what they wanted to do. Jenna Kantor: 10:01 What is something you have accomplished in this position that makes you so proud? There may be many. I can see your brain going tick, tick, tick. Oh Gosh, there's a lot. But I would love to hear one or maybe a few that pop in your head. Sue Griffin: 10:14 Well, it's funny cause you know, I'm a Midwesterner so I can't be proud of myself for anything. You know, I can be proud of other people. Jenna Kantor: 10:21 That counts, that counts. We're all in this together, so I would love to hear that. Sue Griffin: 10:25 I mean I'm really proud of how the delegates work really hard. Well first of all I guess I've been really honored because they really have put a lot of trust in me and so they have allowed me to help them enact procedures and activities that make the house more efficient. And so I'm really proud of how people who've been really entrenched in something that's really formal and very traditional laden had been really willing to change and to take on change and to try different things and procedures to see if we can improve. I feel like the association on the whole is like on the cusp of really bold things and so I'm really proud of being able to help the house as a major decision making body try to also change in ways that are kind of in lock step with that boldness. I'm really proud of all the work the house created for the first time in my knowledge, a special committee to do a complete revision of every single policy position, standard document guideline in our whole association, like 350 documents and they've done this over the course of two years. So I'm really proud of their work and again, how they've really elevated the level of work and function of the house. So that's pretty cool. Jenna Kantor: 11:40 That is. That is, and you've been around for all of it to happen. I love that. What goals are you working towards now or goal that you are working on in your position to just up the ante. Make it even better. Sue Griffin: 11:52 I think it's just kind of that same thing right? Like trying to continue to move on with that progression, stay in wi…

Full show notes at the publisher

418: Phil Tygiel, PT: Changing Bylaws to Change Practice Feb 25, 2019

Show notes

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Phil Tygiel on bylaws within the APTA Private Practice Section. Phil Tygiel, PT, MTC, is the PPS Bylaws Committee Chair. The Bylaws Committee reviews, maintains, and updates the Section bylaws to meet the needs of the membership and the requirements specified in the guidelines set forth by APTA. In this episode, we discuss: -What information is contained within the bylaws -The process for changing a bylaw -The multiple avenues you can enact change within your professional associations -And so much more! Resources: PPS Member Bylaws Email: tygielpt@aol.com FOTO/NetHealth Outcomes Conference (use the code LITZY) For more information on Phil: Phil Tygiel, PT, MTC, is the PPS Bylaws Committee Chair. The Bylaws Committee reviews, maintains, and updates the Section bylaws to meet the needs of the membership and the requirements specified in the guidelines set forth by APTA. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor. I am here with Phil Tygiel who is the head of the bylaws committee for the APTA private practice section. So first of all, thank you so much for coming on to healthy, wealthy and smart to be interviewed. So I just wanted to do this podcast for people to get a better understanding of bylaws and their value and why it can be a long process for some, for change. You were actually, before we even started, you started to talk about how there is this rule where it's like this five year rule and I would love for you to go into that. Why there's a five year rule for change. Phil Tygiel: We're actually, that's for APTA, not for the private practice section. Jenna Kantor: Oh, okay. Okay. Oh, thank you. So there we go. It's something you already clarified. Thank you. So for the private practice section, is there some sort of rule like that? Phil Tygiel: 00:51 No, you can bring up bylaw changes anytime you want to. I always discourage it. I always say my job as chair of the bylaws committee is to put the bylaws in an envelope, seal the envelope and keep it sealed for the duration of the president's term. Bylaws are great. They outline rights, privileges and responsibilities, and they are not to be taken lightly or changed lightly. And very often people will come to me and say, we need this change in the bylaw. And when I look at what they want to do, they don't have to change the bylaws to do that. Bylaws, as you mentioned, are somewhat rigid and they're supposed to be, they're not easy to change. It requires prior notice to all of the members that you intend to change the bylaws. And the reason for that is you're changing their rights and privileges. Phil Tygiel: 01:41 They have a right to know that you're changing the rights and privileges. You have to have prior notice of at least 30 days prior to the meeting. And then there's debate and it takes a two thirds majority to change any bylaw. As I said many times, the board will come to me and say, I want to change this bylaw. And I usually try to discourage it and figure if there's ways to do what they want to do without changing them is all too often people run to the bylaws and we have to change this when actually the bylaws are pretty good. They don't need change. For instance, there was one year the board, I think it was the membership committee wanted to have lowered starter dues for new members and they wanted to change the bylaws. Biggest dues are outlined. The dues structure is outlined in the bylaws. But I looked at the bylaws though the board had the right to lower the fee but not raise it. So they didn't need a bylaw change to get that starter dues change in that case and discouraged it. And we didn't go in there and change the bylaws. Jenna Kantor: 02:47 So you were saying that you guy's meet and they have to submit it 30 days prior. So I'm wondering for the 30 days prior, like how often do you guys meet in general, so how many times would there be that opportunity for it to be heard and voted upon if it would get that far? Phil Tygiel: 03:07 Technically we have two meetings a year, one at the private practice section annual conference and I think they have one at CSM this year. I'm not even sure about that. So those are the only two times that you can change the bylaws. You do need a quorum at a meeting, which was a certain number of people have to be there. And usually the CSM of business meeting you don't have one. So pretty much the only time we tried to change the bylaws if needed is at the annual conference. As I said, the 30 days notice goes out and all of the discussion occurs at the business meeting when we vote yes. Jenna Kantor: 03:46 How long have you been in this position, first of all. And then from your experience and all the years that you've been in this position, how many bylaws have you actually changed? Phil Tygiel: 04:00 Yeah, I think I've been doing it about 20 years now. Nobody else wants it. So I keep on getting recycled and in those years I think we've probably changed, made minor changes to the bylaws about five times. Don't ask me what those changes were. I put the envelope away. Jenna Kantor: 04:23 So for you it doesn't sound like it makes much of a difference when these bylaws are changed that much because it really is set up pretty well already. Phil Tygiel: 04:33 I think they're pretty good. I mean they let members know what they're entitled to do, what the dues are going to be. If they have concerns how to raise those concerns. It tells them how often we have meetings. What prior notice we have for those meetings. It lays out the fiscal responsibilities of the board and all the board positions. So most of that doesn't have to be changed. It can stay where it is. Sometimes I've been in situations where one of the positions on the board has certain responsibilities that are assigned, like they're in charge of three committees and sometimes people want to put that in the bylaws that the vice president will be in charge of these committees. And that's usually a mistake because you'll change committee liaisonships based on the new personnel you have, you know, you're going to let new people every three years and you might have one person who's vice president who was very good on programming. So they will be liaison to the program committee. The next vice president might be much better off from communication. So they'd be the liaison to publications committee though, that type of thing. So you don't want certain things you don't want etched in stone and the bylaws, remember, if you make a mistake with the bylaws, it also takes a two thirds majority to correct that mistake. So sometimes bylaws mistakes stay in place for years and years. So again, you want to tread very lightly on changing them. Jenna Kantor: 06:11 Well, I mean you were already saying that you're only meeting two times a year, so that already is a limitation on getting that two thirds majority vote. So I can definitely see how that could be impeding on change. No, I definitely have to be honest. From my perspective, this seems like a definite area where there might be room for change and my mindset, because I'm a new Grad, so I'm thinking, oh my gosh, this sounds so stagnant. Like there is not a set way to really make big, big changes. I would love for you to speak on where my brain is going and educate me. Phil Tygiel: 06:47 Oh, actually there's a way, there's lots of ways to make big, big changes that don't require bylaws changes. For instance, let's say there was direction that you wanted the private practice section to take, you wanted them to lobby congress to do something and you wanted to make that a priority. That's not a bylaws issue. You would show up at a business meeting and say, I move that the private practice section endorse this position. Okay. Now, first of all, it does not require prior notice. It only requires a majority vote, not a two thirds vote. And those are the more important things that most of us are concerned about. Which way we're going, what do we want to accomplish? Those things are not in the bylaws. What is in the bylaws is how you can do those things. The fact that you have to have these meetings, that you have the right to speak, that you have the right to vote, that you have the right to make motions. So that's a very, very fluid process. Also remember sometimes if you have a really good idea that nobody else thought about, you can go to the board and say to the board, hey, why doesn't the section do this? Same with your state association and all that. So you can just say, let's make this happen. And that can be done with the snap of a finger. So not being able to change the bylaws does not restrict what you want to accomplish. Does that make sense to you? Jenna Kantor: 08:10 And then what you do as somebody is saying it's not in the bylaws, it doesn't allow it in the bylaws and then you can't find that it's in the bylaws. What is the professional way to handle that kind of communication with that individual that you're trying to work with? Phil Tygiel: 08:28 The first thing I usually do is ask what is it you are trying to accomplish? And I want to see if there's a way they can accomplish that without having to change the bylaws. If we find that they do need to change the bylaw to accomplish what they want to accomplish. Let's say they want to add two new people to the board of directors, that would require a bylaws change. We would then draft a motion and to change the bylaws by changing this section on the board of directors by adding two positions. The executive board would look at it and see if they approved it, which they don't have to do. Membership has priority over leadership. We should always keep in mind that the pyramid is inverted. Membership is on top president is way at the bottom. Phil Tygiel: 09:22 So the membership has the right to do what they want to. So anyway, then we would draft the bylaw in the case of APTA sections, chapters, any bylaws change that the section has, has to be in keeping with the bylaws of APTA. So we'd run it by APTA to make sure it's not in violation of anything that APTA wants to do or says you have to do. For instance, let's say we wanted a bylaw change that would prevent life members from being members of the section. I don't know why anybody would want to do that, but the APTA would look at that and say, you can't do that. That's a violation of the APTA bylaws. So we do have that higher authority anyway. If the bylaws are keeping with what the APTA will allow we would publish it to the membership and probably in Impact or maybe online saying we will be voting on this bylaw at the next meeting. Phil Tygiel: 10:31 Next meeting comes and the bylaw is moved. And someone has to say it and then there's debate and then they call for a vote. Since you need a two thirds majority with a standing vote, it's carried if it's not clear with standing vote, but it could be close, you do a roll call vote where everybody stands up and counts off. And if you don't get your two thirds, you don't get the bylaws. And it's important to remember what I said originally. The bylaw protects your rights and privileges as do Robert's rules of order. So even if there's a fairly hefty majority that feels that their rights and privileges of being violated, they have a right to say we're not going to let you pass this. Jenna Kantor: 11:21 I like how you connected it back to the APTA because they are the Higher umbrella organization if you will, of the private practice section. And this actually can segway into what I was mixing up at the beginning of this interview. So if you wanted to make a change but it didn't go in accordance with the APTA bylaws, now this is where they have the time limit on how often? Phil Tygiel: 11:47 Yes. It got to be a nuisance of people would come in with requiring bylaws changes every year and many of them were really not necessary, but they are very time consuming to debate. So many years ago, and don't ask me how long ago it was moved and seconded and passed that it's in the bylaws that you can only have bylaws amendments every five years I think it is with the APTA and that goes through the house of delegates which is a completely different process membership doesn't vote, your delegates do. That can be bypassed. It requires a two thirds vote just to hear the bylaws if you want to do it in an off bylaw year. So it got rid of some of that cumbersome activity that really wasn't necessary. Jenna Kantor: 12:38 No, it's good. It's really good to hear your perspective and just gain a better understanding of how well put together everything already is and why it may not be the fastest for the change, but there's a big reason for that. So thank you so much Phil, for coming on to just share your knowledge. So people who are looking for change, they may not necessarily, well now they know they may not necessarily need to go to you to find out about how to change the bylaws. They are actually still a lot of opportunities to get it done elsewhere. So thank you so much. Phil Tygiel: 13:10 My pleasure. I think the main messages that the association, whether it's private practice section, or any other section, belongs to the membership and they have rights and privileges. They can make change and sometimes the change comes from a single person with a new idea and sometimes that new ideas violently objected to by people in leadership, people who have been there forever. But there is a mechanism to be heard. There is a mechanism to make change and advance and we do very well with it. Sometimes, a good idea, it takes three or four years to pass. But that's not because of the system. It's just cause it took you that long to get people to understand what you were trying to do. That's not necessarily bad. Jenna Kantor: 13:50 That's good. And I love that. I like how it really does revolve around membership because we are all in this together. And for us to just come forward with an idea, thinking, oh, I'm right, I'm right, I'm right. That's not how it works in a community at all. So thank you. Thank you so much. Phil Tygiel: 14:04 Thank you. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook…

Full show notes at the publisher

417: Dr. Mike Pascoe: Innovation in PT Education Feb 18, 2019

Show notes

LIVE from the Combined Sections Meeting in Washington DC, I welcome Dr. Mike Pascoe on the show to discuss the use of social media to disseminate physical therapy educational resources. Mike Pascoe, PhD, is a neurophysiologist and assistant professor in the physical therapy program at University of Colorado. His scholarly efforts center around the investigation of constructivist approaches in technology-enabled learning environments (e.g., wiki usage, interactive modules, cadaver skin examination, etc..) to improve learning outcomes and student satisfaction in anatomy courses. In this episode, we discuss: -Research highlights in the field of cadaver anatomy -How Mike utilizes social media and live blogging during his anatomy courses -How the Anatomical Board serves anatomy educational goals in Colorado -Cognitive principles of learning for success in PT school -And so much more! Resources: #APTACSM Twitter Mike Pascoe Twitter Mike Pascoe Website Mike Pascoe Snapchat TedxBoulder - Mike Pascoe - The Ultimate Gift - Donating your Body to Science Learning Scientists Website My wife Stephanie's website - https://spascoedpt.com/training/ University webprofile - https://som.ucdenver.edu/Profiles/Faculty/Profile/15328 Research Gate profile - https://www.researchgate.net/profile/Michael_Pascoe2 Academic website - http://mikepascoe.strikingly.com Light field photography - article Student created wiki - article Live blogging - article State Anatomical Board, body donation - TEDx Talk Writings on medium.com - https://medium.com/@mpascoe AnatomySnap information - https://www.snapdex.com/anatomysnap YouTube channel - https://www.youtube.com/user/redbnr22/videos Vimeo channel - https://vimeo.com/pascoe Add me on SnapChat - https://www.snapchat.com/add/anatomysnap Publons peer review profile - https://publons.com/researcher/1374925/michael-a-pascoe/ For more information on Mike: Mike received his PhD in neurophysiology from the University of Colorado (Boulder) in Dec 2010. He then joined the faculty of the Physical Therapy Program in the School of Medicine at the University of Colorado, Anschutz Medical Campus. He teaches clinical anatomy and in his spare time loves hanging out with his wife Stephanie and their dog Maia. Read the full transcript below: Karen Litzy: 00:01 Hey everybody, this is your host, Karen Litzy and we are coming to you live from the combined sections meeting in Washington DC. And I have the pleasure of once again seeing assistant professor Mike Pascoe. I saw him late last year in Denver. So Mike, Welcome to the podcast. Thank you for coming on. Mike Pascoe: 00:18 It's my pleasure. Thanks for having me. Karen Litzy: 00:20 All right, so we read your bio, but what I would love to hear from you is a little bit more about yourself so the listeners kind of know where you're coming from and what we have in store for our talk today. Mike Pascoe: 00:32 Yeah, let me give you some things about myself that I really just drive who I am and what I do. So I am a Colorado native, so there's just a lot of fun things to do in Colorado and I've managed to stay in a really awesome place. And so there's a lot of fun to have there and a lot of that fun I have with my family. So I'm married to Stephanie Pascoe, she's a PT, so she's the clinical half of the marriage. And so we liked doing a lot of things together and we like keeping our two daughters busy as well. So very family driven and we've got a lot of fun with a five year old and a three year old girls. So I like to bill myself as a minority in a sorority. That's what things look like around my house. Lots of pink and yeah, so I basically am here at CSM with Stephanie and we both get to go do our own things and check out the various different talks, different posters, different presentations. And I've been able to come to CSM since I started at CU in 2011 so yeah, it's been a great conference. Great to catch up with old friends and make some new ones. Karen Litzy: 01:36 And so today we're only on day one of the conference, but have you gone to any lectures or any poster presentations that really stand out in your mind? Mike Pascoe: 01:45 Yeah, I really wanted to see what Chad Cook and others had to say about predatory publishing. So that was very informative. I'm aware of the concept and fortunately have not fallen prey myself, but it was good to just see the numbers and how big of a problem in this, you could, you could call it an epidemic. So Karen Litzy: 02:03 Yeah, package that really well. Predatory journals, predatory conferences, things like that. I mean it's a thing and people fall for it. Mike Pascoe: 02:11 Yeah, they said that the analogy is everyone's got a rich relative in Africa that just died and wants to offer you $1 billion. So it's a new spin on that old email tactic. Karen Litzy: 02:23 Exactly, exactly. And it's unfortunate. It's unfortunate, but hopefully they're chorus kind of gave you a little bit of insight on what to watch out. Mike Pascoe: 02:33 Yeah. If you go onto Twitter, which if you're not on Twitter, then I don't know what's going on. It's the best way to find out what's going on, at the conference. Great #APTACSM. And that's where a lot of us are sharing the real pearls from the session. So there's a lot to catch up on there. But then following that was a real exciting meeting of special interest group with the Academy of physical therapy education. Then that's the anatomy educators special interest group. So that grew last year was the first year there were maybe 50 of us and now there's 133 so we're really growing a nice base and we're really starting to cut our teeth on what we wanted to find and how we want to really enhance PT education specifically in the anatomy domain. Karen Litzy: 03:16 Great. So now let's talk about that. So let's talk about your teaching background and what you're doing over there at the University of Colorado medical campus. Mike Pascoe: 03:27 Yeah, so about 80% of my time on campus in my role is as a teacher. So I'm really striving for excellence there. And basically I started in 2011 they hired me with very little teaching experience at the professional level, but I really had a passion for teaching undergraduate students when I was a graduate ta. So that's where I first fell in love with teaching anatomy. And then I got on board with CUPT and I teach PT anatomy. That's my main role. About 50% of my job is designing and delivering the content for the PT students. But I've also been able to extend into the physician assistant and a medical student anatomy courses. So that keeps me pretty busy. It's a lot of gross anatomy. It's a lecture in the morning and then going into the lab in the afternoon and looking at the cadaver donors. Karen Litzy: 04:17 I remember those days. Mike Pascoe: 04:20 I'm telling Ya, it's the most memorable and favorite course of all PT students Karen Litzy: 04:26 It actually was my favorite course and I firmly believe every human being should take gross anatomy because you should know what's going on in your body. Mike Pascoe: 04:35 You should know how the equipment operates. And there's some real good research out there and you know, a lot of people can identify where the heart is, but you ask them where the liver is and that's where we need a little bit of improvement. Karen Litzy: 04:46 Absolutely. So now outside of teaching, what other things are you working on? Any kind of research? Mike Pascoe: 04:53 Absolutely. And you know what I've learned from all the excellent mentoring I've had in my role is that you should really cover your basis. It should really be optimized in what you're doing with your research as an educator. So what you do is you do education scholarships. So I walked away from bench research and neurophysiology and now my laboratory is the classroom. So I do educational research. It's every bit as rigorous as looking through a microscope and you know, modifying genes in a lab. But basically the students are my subjects and I will take an idea that I think is going to be a way to improve my anatomy, teaching, design a protocol, get my IRB approval, collect the data, get some graduate students under my mentorship to help run through the project. Sometimes we find a positive result and sometimes we don't, but we send those results out anyway and I've been able to get some projects out the door. Mike Pascoe: 05:46 Just a couple of highlights. There's a type of photography called light field photography, so that's been really interesting to see how you could change the focal point of a cadaver photo after the photo's been taken. Lot of anatomy clustered together, so it's often hard to get everything in focus so that gets around that. But also publishing on students using a Wiki to organize their study materials and why blogging. Actually I got to do a lot of live blogging, have a PT conference and we surveyed the people using a viewing the coverage and they really had positive rankings and satisfaction with the coverage. So I'm really promoting that and hoping that more PT conference organizers jump on top of that. It's a compliment to Twitter. Karen Litzy: 06:31 So how were you live blogging and how is that different? I was going to ask is that, what kind of platform is that? Mike Pascoe: 06:37 Yeah, we use a platform called cover it live. They're still out there. No conflict of interest, no disclosure, no relation, but basically what you do with live blogging as you can really issue more of a transcript of what's going on there. No character limits. Like Twitter, Twitter is usually more about the bite size pieces, but a live blogging is much more of a script and you can really capture a lot. You can integrate photos. And what's been really fun is to capture the question and answer session part of the session. People really rated that as a really good feature of live blogging. Karen Litzy: 07:11 So you pretty much have to know how to type well to do that. Mike Pascoe: 07:14 Right. Karen Litzy: 07:16 Because for someone like me who has to look at the keys at the same time, cause I never learned how to type. Yeah, that would be my problem. Mike Pascoe: 07:23 Hunting and pecking is hard, but the bigger skill is contextualization and knowing your audience. And it was real good for me to learn about how to interpret what a physical therapist was saying about a whiplash and the anatomy of neck muscles and how that can be put together so that way a PT audience would benefit the most. So yeah, that's a big skill as well. Karen Litzy: 07:47 That's awesome. I've never heard of that. I mean I don't think I can do it because like I said, I can't really type, but I love the fact that it's long form. And so if I wanted to, if, if I wanted to watch you do this, how do you, how do you do that Mike as not for you as a person blogging but as the consumer. Mike Pascoe: 08:09 So we have to get a marketing campaign out there. And what we ended up doing was just promoting the link to the webpage through social media. So fortunately people are very aware of that conference has come with their own hashtags and people are having conversations around the conference leading up to the conference. So we took advantage of that. Now we would just publish in advance, these are the sessions Mike is going to be covering. So come back this day at this time for the live coverage. The real beauty of this platform too, as you can play them back, well you don't play them back, you, you scroll through a timeline and you get to look at the content that way. So it was really rewarding to know that you're helping people real time, but for the busy clinician that can't step of treating patients at 2:00 PM that could come in and look at it later. That's really good. Karen Litzy: 08:59 Sounds great. So aside from being a little more innovative in your teaching and in academia, in education, which obviously, is a must these days. What else are you doing as your role at CU or your role as an educator? Mike Pascoe: 09:19 So another real cool role that I took over about a year ago was, it's an administrative role, but it's for the state, Anatomical Board of Colorado. I serve as the secretary treasurer. And so I oversee the day to day operations at the anatomical board. And basically this is still educational because what we do with the anatomical board, our big mission is to serve the educational goals of anatomy education in the state of Colorado. So think of every health care profession program, PT, OT, MD, dental graduate programs. Whenever a program would like to use a donor for an educational resource, they approach us, they make a request, we take a look at how many donors we have available. And we're very fortunate in Colorado that we have a very large donor pool, a large donor base, and I help assign the donors. And so indirectly I'm able to impact thousands of students a year with anatomy education simply by facilitating the use of cadaver dissection. Karen Litzy: 10:21 That's awesome. Very cool. I often wondered how that worked now, well at least now I know how it works in Colorado. So you had mentioned earlier the use of social media. So if people are listening to this and they're not familiar with you, I obviously suggest following you on social media, but how has your use of social media impacted the way that you teach and the way that you sort of view education in physical therapy? Mike Pascoe: 10:51 Yeah, so I incorporate social media into my teaching directly and indirectly. So directly I have recognized that there's a real power behind this, this cognitive psychological principle called retrieval practice. So any way you can get your students to practice retrieving information without the learning materials in front of them, they're going to benefit. Studies have shown that for decades. So how am I going to, aside from doing like the polling audience response system, how can I really get their attention? And I found what's really successful is to use social media and people are doing Twitter, people are doing Instagram, but students really pay the most attention to content on snapchat. And if you're not familiar with snapchat, the thing that makes it different, what sets it apart is that the content disappears after 24 hours. So when you're doing retrieval practice, you don't need it necessarily for the student to preserve the questions and answers. Mike Pascoe: 11:49 They just need practice interacting with the content that goes away. And they know this. So there's something about the way the brain is wired and the brain pays more attention to ephemeral content so they know it's going to go away. And so I, I push out questions during the semester and they get the question, they get the answer later. So it's great for the students, but it's great for me, the educator I found with Twitter and Instagram, it really took so much time, to perfectly create the right content. But everybody on snapchat understands that it's raw, it's unedited and it's uncurated. So as long as I put the correct information out there, it's quality enough. So it's very quick. It's very rapid. And every time the students find out that I run in anatomy related snapchat account, they can't believe it. At first they're in disbelief like what's going on. Mike Pascoe: 12:38 But once I convinced them that this is educationally based on sound pedagogy, they're onboard. And then I'll have a break from it and they'll bug me. We need more…

Full show notes at the publisher

Our TOPPODCAST Picks

Follow Us

Stay Connected

Related Podcasts

Links

Stay Connected