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Healthy Wealthy & Smart

The Healthy Wealthy & Smart podcast with Dr. Karen Litzy features top experts in health, wellness and business with a particular focus on physical therapy. We take evidence based medicine and break it down, making it easier to understand and immediately apply to your life. At Healthy Wealthy & Smart our goal is simple: to provide you with the best information so you can live a healthy and pain free life!

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476: Successful Business Partnerships: Drs. Keaton Ray & Scott McAfee

On this episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Keaton Ray and Scott McAfee on how to develop a successful business partnership.  Keaton and Scott are MovementX business partners.  MovementX is on a mission to heal the world through movement.  We believe that if you can move your best, you can live your best.  We are doctor-founded and patient-focused to help bring more convenient, transparent, and personalized physical therapy care to the world. In this episode, we discuss: -What is MovementX and how is it revolutionizing physical therapy practice? -The importance of identifying the strengths and weaknesses of your team -Why you need different channels of communication in a partnership -The key elements of a successful business partnership -And so much more! Resources: Movement X Website Movement X Instagram Keaton Ray Twitter Scott McAfee Twitter Email: info@movement-x.com A big thank you to Net Health for sponsoring this episode!  Check out Optima’s Top Trends For Outpatient Therapy In 2020! For more information on Keaton: I am a passionate physical therapist and wellness/fitness specialist in Portland, OR specializing in reducing pain, increasing strength, restoring mobility and balance, and optimizing performance. I've worked with clients across the lifespan from those who have never exercised a day in their lives, to those who are afraid to exercise because of pain, to advanced athletes looking to take their performance to the next level. For more information on Scott: Dr. Scott believes in a world where anyone can move & live their best. The problem is that with today's healthcare system, finding the best care, avoiding crowded clinics, and dealing with insurance can be frustrating. That's why he chose to do things differently. Dr. Scott's practice is 100% mobile–he provides care in the comfort of your home, gym, or office. He brings a mobile treatment table and helps you decrease pain, increase strength/mobility, prevent injury, restore function, and coordinate your care plan. Wherever & whenever you need care, he can be there. It's convenient, valuable, & personalized to whatever you need. Dr. Scott works with a wide range of people, from youth athletes & avid runners to active grandparents & busy businesspeople. Call or text the number above to get directly in touch with him, and you can have a free phone consultation about what health goals you want to accomplish! 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 here with Healthy, Wealthy and Smart. I'm here with Scott McAfee and Keaton Ray and I am tired. We are at Graham sessions 2020 and I am so lucky to be interviewing the two of you on your partnership with movement X. So first of all, thank you so much for coming on. It's an honor to be speaking with both of you. So first, would you mind explaining what movement X is and then dive into how your partnership began? Keaton Ray: Sure. So movement X is a group of United providers across the country who are providing care in an inspired way. So we refer to it as the 11 star experience. We're going above and beyond the five star experience and providing care where people need it most, when people need it most, whether that's at their home, at their gym, at their workplace, on the track and field at their doctor's office. We're showing up and providing care that makes a difference. So improving lives on both sides of the treatment table for the provider and for the patient. Jenna Kantor (00:58): All right, and now your partnership. Keaton Ray: Sure. So where to begin? So Scott and I first connected on movement X in 2016 or early 2017. Started with a phone call. I knew that Josh D’Angelo and myself couldn't do this on our own, so we called up some trusted partners that we had known closely through the APTA. Scott was one of the very first people we talked to and immediately had a connection over the mission, which is you know, help people move their best so they can live their best. And I'll hand it over to Scott who can explain the transition from that first talk about movement X to him, actually quitting his job, moving across the country, dropping everything to help us with our vision. Scott McAfee (01:50): So it was a very exciting time for me. I was just finishing up my residency program in Southern California. And I loved the people that I was working with. I loved my coworkers. I love my patients. And it was really an amazing residency experience at this hospital. However, I was somewhat displeased with the with the environment of dealing with insurance companies and being somewhat limited in my ability to truly and deeply care for people that I knew I had the potential to as a physical therapist. And after my conversation with Keaton, I got really, really inspired of what the opportunity looked like for physical therapists in this more mobile cash pay model. And it was I think about a week after I had passed my residency when I knew, wow, there's some real opportunity here. Scott McAfee (02:52): And Josh D’Angelo one of the cofounders along with Keaton he had been in the Washington DC area for seven years, was very well connected out there. And at the time right when I was finishing up my residency, I was very comfortable down in Southern California. I had a very strong network. My life was just going straight according to plan per se. And I've never quite learned at any point in my life from a point of comfort and I wanted to flip that on its head. So I decided to move all the way to the East coast to join forces with Josh D’Angelo in Washington DC in addition with Fred Gilbert who moved from Alabama to Washington DC and that's how the partnership began and we began expanding from there and it's just been an absolute wild ride since Jenna Kantor (03:49): I love it. And I love how you two interact with each other. You're both good friends as well as definitely business partners. How the heck did you get to that point? Cause I would love for you to first go into your struggles and then what you did to implement something that would work between the two of you. Keaton Ray (04:08): That is a good question. So all of us, everyone who started the company actually started as friends way before we ever started at business partners. And that is both one of our deepest strengths as well as probably one of our greatest challenges as well. But from day one, it was intentional on our part to learn each other's strengths and be open to each other's weaknesses and communicate if not over communicate about each one of those. So there is times when Scott and I probably are just at each other's necks, including other people. I get frustrated on a daily basis with everyone and they get frustrated with me. And that is okay, that is normal. But what we've done is we've gone through intentional work where we set aside hours at a time, both on the phone and in person to be open about those strengths and be open about those weaknesses. And each and every one of us over the past two, three years has just grown because of that intention that we've put into growing each other. So it is not easy. It definitely changes the relationship, but it's worth the intention. Scott McAfee (05:12): And Keaton and I, we both go back to the student assembly board of directors, although we never served together. I learned so much about how I function on a team in that environment. And I would imagine that you learned the same. And I think once you truly understand yourself and then also once you truly understand and appreciate and realize the mission of what your team is trying to accomplish, that how you get to the end goal of accomplishing that task is irrelevant. You just have to get there. And yes, you are going to agree on certain things you're going to disagree on probably even more things if your team is actually functional. But at the end of the day, as long as you are on a team, it can get to the end goal. That's what matters most. And from there you walk out of the room, no matter what discussion happened inside of that room, all with the same mindset of, Hey, this is our goal. We may have disagreed on how we got here, but now we're all in agreements. Hey this is what matters most. And, you have a clear sight of where you're going. Keaton Ray (06:27): One thing I'll add to that, the other two areas of strength. You said it perfectly, Scott. I think one is putting infrastructure into being able to build a communication pathway. So we have a lot of various company languages that we use that help us recognize when we're falling into several habits that may affect the growth. So one example is the six thinking hats. So six thinking hats. You know, the red hat is the emotional hat, the white hat is the fact hat. The green hat is the innovation hat. The yellow hat is the optimism hat. The black hat is the devil's advocate hat. Josh D'Angelo would be so proud. I just remembered that. And so sometimes when we're in a heated conversation or we don't see things eye to eye, we need to recognize, Hey, I'm wearing my red hat right now and you're wearing your white hat. No wonder we're not seeing each other. And various communication pathways like this have helped us to recognize where we're falling short and where we need to improve. And so without those types of things, it would be a lot harder to grow as a team. Scott McAfee (07:25): I love how you brought that up as an example because not only does that help us make decisions in the board room per se with business it's also helped me make personal decisions, look at problems that I'm facing in my own life from many different angles, right? Hey, if I had a green hat optimist view of this versus a devil's advocate, why would I talk myself out of this? I think I've been able to look at things from somewhat of a stoic and very objective point of view rather than getting to red hat emotional about certain things. And it's also helped in personal relationships as well. So as much as you can grow together in the boardroom, I think you take away so many different things on a personal aspect as well. And yeah, I love that analogy. That was something that Josh D’Angelo initially introduced and has just been so helpful. Keaton Ray (08:19): One more. The last thing I'll say too is if you ever want an ego check, join a group of six. We started with six incredibly innovative, intelligent, outspoken leaders. Sit yourself in a group of six outspoken leaders and have them debate your mission and your vision and your processes and everything in the background there. There is no space for ego when you are working with this large and this capable of a team. So you cannot be a solopreneur and accomplish what we're trying to accomplish. So we've all really worked hard in our egos and it's not always easy, but every single person on this team has done a great job. Jenna Kantor: Would you mind sharing your own personal things you've learned about exploring how you work? I think that'd be interesting for people to hear. You're like, I am actually a person who's like this, I would love for you to share that. So then people could even learn how you are so different. Scott McAfee (09:16): So I might take a second to think about that. And that's something that I have learned about myself is that it often times helps me to take a second and think of getting my thoughts together on how to approach a certain question or an issue or how to solve a problem. Rather than to just speak my mind immediately. But I will say that right off the bat that going into this team, I'm in just awe of everybody who I get to work with on a daily basis. And people often ask me, Hey, why did you move to Washington DC? It wasn't only for this like larger mission and this larger purpose. It was to have conversations late at night with people who inspired me who I just looked up to in so many different ways. And that was a goal of mine when I was actually looking for different colleges to apply to. I was like, who could I surround myself with and have just really deep and insightful talks late at night with and I just feel so fortunate to be able to do that as part of this team and as our youngest member on the exact team that we have, I oftentimes do try to just be a sponge and take in as much information and inspiration from my team as possible. Keaton Ray (10:41): I was laughing through Scott's excellent explanation because sometimes I think we can explain each other's work habits at this point better than we can explain our own. And so I am the opposite of Scott, although it's gotten, I have the team probably operate the most similarly. But you know, there's differences between everyone. So I am very blend and I should take more time to stop and think first. But if something's on my head, it is right out in the open. And so one of the things that we've really worked on as a team between Scott and I, but also between all the team members is managing conflict. So some of us on the team are much more comfortable with conflict. Me being one of them, while others have a little bit more of a reservation around conflict. Now compared to other people, everyone is excellent at managing conflict, but it's a personal comfort as to how you actually deal with that. Keaton Ray (11:31): So I would say while Scott says he's much more, you know, maybe has to think about it in, in the background a little bit. I am much more of that writing your face. Oh, I don't agree with that. Or Oh, I totally love that. You know, kind of person. So a lot more forward facing. But what Scott and I have as an extreme similarity is that we are the doers. We're like, let's do it tomorrow. We have idea. Great. Okay, I'm going to stay up all night. We're going to crank this out. We're going to have a product tomorrow. We're going to launch it, we're going to test it a little bit and we're going to redo it. Whereas Fred and Josh tend to be much more of those visionary. Like, let's stop. Let's look longterm. Let's think of how this affects this. And, it is a wonderful combination because all of us compliment each other so well. You can't have one leadership style without the compliment of the other, but it can lead to frustration. You're moving too fast, you're not moving fast enough. You know, back and forth. So the communication puts us all in alignment and we're stronger because of it. Scott McAfee (12:30): Yeah. Actually one of the core values in our company is passion times purpose. And you can't have one without the other. And the way that I think about that is you cannot have action without strategy as well. And that's one thing that Josh and Fred are so instrumental in teaching us and teaching me and even keep me, is inspired me in so many different ways to behind everything that I do. Always have a strategy and don't skip steps in the action that you want to take. So I think that's very important. Jenna Kantor (13:03): I love that. I love that very much. What made you decide to hire out to figure out how to work better together? How did that, I'm sure alone cause you hadn't figured it had something in play like you do now. How did you get to that agreeing point to go, okay this is who we're going to invest in to improve our communication, to improve our partnership? How'd you get there? Keaton Ray: Yeah. So I think what you're referring to is the consulting work that we did for a team development. So we actually got incredibly lucky. We got chosen by a graduate program working on human resources and team development as their trial team to take a deep dive look into each one of our personalities and our work habits and then do basically a report. So we each had a one-on-one like hour long talk with this consulting firm and they went deep into our work styles. Keaton Ray (13:53): We'll look it up, we'll look it up. And so then they came back at us and basically gave us a very honest report about how our team is functioning and then gave us assignments on how to dive deep and improve the report essentially. So it was a really hard activity and emotionally draining, but it was so bonding and we're so much stronger because of that consulting work we did. You have to recognize your weaknesses. We knew we're not perfect, nobody's perfect. And so we're willing to invest in the team to improve because without this team, the mission of this company doesn't go anywhere. Scott McAfee (14:33): So it was a graduate program at Georgetown university. Jenna Kantor (14:42): Yeah, that's very cool. I love that you guys said that is still looking it up to see if she could get more information. And I want to find this information for the listeners in case there is somebody starting a business who might want to look this up and see if this program might help them as well. Because seeing how you two interact, like I said, there really is some magic, dare I say Disney magic happening between the partnership and I think that is absolutely spectacular. Did you find the name? Keaton Ray: So it was Georgetown's graduate program. Robin Goodstein graduated from that program and started her consulting firm called Balcony consulting. So anyone looking for team-based collaboration and consulting, she's incredible. Jenna Kantor: Now what are your biggest challenges that you have and the easiest things for you guys overall? Cause you guys have grown together, but what are just the constant things that you expect to be like, okay this is a little challenging and this is like easy. Keaton Ray (15:58): So this is a hard question. That's a great question. But I think that the easiest thing that we have now is a baseline understanding of how each other operate. The first few months in definitely year plus was just learning each other's habits, learning each other's needs and learning each other's emotions. And now I think we have such an intricate understanding of how we each operate that it's much easier to move the company with speed. Knowing that, I think the hard part is, is we're now in a place with the company that we're really truly starting to grow and we're going to run into barriers that are unlike anything we've ever had. And so, so far we've been able as a team to come together and hustle and make this thing work and create an amazing movement. But we're going to max out of our own knowledge. And so we're going to have to find new team members who come into our company who do not have the same intricate knowledge of one another. So now it's not just managing each other, it's managing other people and having them fit into the culture as strongly as we do. Scott McAfee (17:00): I think that's perfectly said because we agreed too much. No. because it's going to be so special and like I said, such a wild ride ahead as we do grow and with as many things that are going to change and as many new obstacles that we're going to face, I truly do believe that we do have a very strong foundation and like you said, baseline understanding and respect for each other and how we both operate. And that goes for everybody in our team and in our community. The more that we can better understand how we operate and all speak the same language they all have the same core beliefs and core values and share so much of the same culture. If you know from a deep level that binds you together, I definitely believe that no matter what obstacle may come your way, you can adapt your team in a very nimble way, in a very strategic way, in order to accomplish that. We're with as many problems as we face and with as much as we have accomplished you know, the sky's the limit. And, I think there's so much growth waiting to be had that it's just so important to have that foundation before you have anything else. Jenna Kantor (18:21): I love it. Thank you so much. You too, for coming on here at this crazy, magnificent time here at Graham sessions, you two really set a great bar that is possible for anybody to achieve at their business partnerships. So thank you. Scott McAfee (18:36): Appreciate those words, Jenna and I couldn't echo the same thing about you and Karen. You guys are great. This podcast has inspired me when I was a student. So I just feel very fortunate to have the opportunity to speak to your audience and hope that we've spread something valuable worth listening to. So I appreciate you Keaton Ray (18:58): Agreed all around. Thank you so much for this opportunity. The one thing I'll leave the listeners with is if you want to build a team and you want to grow a mission, you have to be vulnerable. You have to put yourself out there and let people see what you do know, what you don't know, your hesitations, your fears and your vulnerabilities. Because without that, there's no way you can connect with people enough to build something as meaningful as we're trying to do. So be vulnerable. Put yourself out there, let go of your ego and you're going to create an amazing company culture. Jenna Kantor (19:37): Thank you so much. I was wondering where can people find you online if they want to try to reach out to you? Scott McAfee (19:44): So we are on Instagram @movementXinc and we are a online also www.movement-x.com. Keaton Ray (19:55): Note, our company name is movement X. No space, no dash, but our website is movement-x.com. Jenna Kantor: Wonderful. Thank you so much. So thank you listeners for chiming in to this great discussion. This will also be in the bio as well. If you want to just check that out too, if you're having a hard time remembering what was just said on how to reach out to these fantastic individuals. Thank you so much. Keaton Ray: You can also reach us at info@movement-x.com. We want to hear from you. We're always willing to hop on a phone call. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

25mins

19 Feb 2020

Rank #1

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262: Prof. Peter O'Sullivan: Reconceptualizing Pain

LIVE from Combined Sections Meeting, this episode of the Healthy Wealthy and Smart Podcast features Professor Peter O’Sullivan discussing elements of the biopsychosocial model for chronic pain management. Peter O’Sullivan is Professor of Musculoskeletal Physiotherapy at Curtin University, Perth, Australia. In addition to his teaching and research at Curtin University, he works in clinical practice as a Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2005) in Perth, Australia. He is recognized internationally as a leading clinician, researcher and educator in the management of complex musculoskeletal pain disorders. In this episode, we discuss: -Why you should validate your patient’s pain experience, understand their beliefs and fears, and disconfirm them through behavioral learning -The link between a practitioner’s language and self-efficacy -The informal and non-threatening art of Peter’s initial examination -Maintaining professional boundaries with chronic pain patients and avoiding burn out -And so much more! One of the strongest influences to better treatment outcomes for chronic pain patients is trust in the therapeutic alliance. “You’ve got to build a strong therapeutic relationship,” Peter suggests if you want to see patient’s engage in their program and take more control over their pain. Treating chronic pain patients can be challenging. With the right evaluation framework and understanding of neuroscience, Peter believes you can make instant impact for the patient. Peter stresses, “The nervous system is so damn plastic. If you can get to the heart of what someone is thinking and feeling. Validate it and take them on a journey—it can break that schema up.” Peter is critical of therapeutic techniques in physical therapy when in fact a majority of patients would benefit from relaxation strategies and progressive loading. He suggests, “I think we undermine how smart the body is…someone who gets in trouble is someone who is too hyper vigilant and probably obsessed with their technique.” For more information on Peter: Peter is the Professor of Musculoskeletal Physiotherapy at Curtin University, West Australia and is a Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2005). His private clinic is Body Logic Physiotherapy in Perth www.bodylogicphysiotherapy.com.au. Peter has an international reputation for clinical research investigating the development, multi-dimensional assessment and targeted management of chronic spinal pain disorders. He has also developed a management approach for chronic low back pain – called ‘cognitive functional therapy’. He has published over 190 papers with his team in international peer review journals, has presented the findings of his research at more than 90 National and International conferences and has run clinical workshops in over 24 countries. Peter’s expertise is linking of clinical research to the clinical setting. (see www.pain-ed.com) Resources discussed on this show: Blink by Malcolm Gladwell NOI Group Body in Mind Pain-Ed Adriaan Louw Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my blog post on the Top 10 Podcast Episodes of 2016!

1hr

13 Mar 2017

Rank #2

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112: Adriaan Louw, PT explains central sensitization

Adriaan and I discussed the ins and outs of central sensitization. Adriaan shares his knowledge on what central sensitization is, how it can be diagnosed and what the role of the physical therapist is in the treatment. Adriaan is a wealth of knowledge and has the ability to take these very complex ideas and break […]

59mins

10 Jun 2013

Rank #3

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269: Dr. Bart Dingenen, ACL Rehab & Return to Play

On this episode of the Healthy Wealthy and Smart Podcast, Dr. Bart Dingenen joins me to discuss rehabilitation following an ACL injury. Dr. Dingenen is currently both a sport physiotherapist at Motion To Balance in Genk, Belgium and a post-doctoral researcher and lecturer at Hasselt University. In this episode, we discuss: -Physiological and psychological considerations for return to sport following ACL reconstruction -How to structure treatments to promote motor learning -The fine line of early return to sport and the risk for re-injury -Integration of sport prevention training at follow-up -And so much more! More traditional approaches to rehabilitation following ACL reconstruction are limited to the physiology of the athlete. Bart believes, “Knee focused outcomes can be valuable but probably don’t tell us enough about the big picture of that patient in front of you.” One outcome measure isn’t adequate enough to determine how an athlete is progressing through therapy and Bart stresses, “We don’t treat a structure, we really treat a person.” Bart stresses that the most effective intervention addresses the sensory motor system considering the neuroplastic changes that occurred following injury. He states, “If we just continue to consider the ACL as a pure mechanical problem, I think you miss so much.” The clinician’s role is to provide a rich environment that is sport specific, fun and challenging to ensure compliance and reduce risk of re-injury. Bart recommends, “People have no time to be consciously aware of their knee. They have to have fun and they have to move. These aspects have to be there in your training.” Treatment sessions should seek to mimic an open and dynamic environment which challenges the athlete physically and cognitively. Bart warns, “If you do [ACL injury prevention training] the traditional way you see indeed the compliance rates are really low.” For more information on Bart: Dr. Bart Dingenen is a sport physical therapist from Belgium. He is currently working as a postdoctoral researcher and lecturer at the University of Hasselt, Belgium, in combination with his work as sport physical therapist in the private physical therapy practice Motion to Balance, Genk, Belgium. He finished his PhD in 2015 at KU Leuven (Belgium) on postural control in relation to knee and ankle injuries. Bart published numerous papers in international peer-reviewed journals over the last 5 years on ACL injury, chronic ankle instability, athletic screening, injury prevention, postural control and jumping and running mechanics, and is a well-respected speaker at both national and international conferences, workshops and symposia. Resources discussed on this show: Bart Dingenen Twitter Bart Dingenen Publications Return to sport Video International Knee Documentation Committee Questionnaire Optimization of the Return-to-Sport Paradigm After Anterior Cruciate Ligament Reconstruction: A Critical Step Back to Move Forward Tim Gabbett Publications Email: bart.dingenen@uhasselt.be Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my blog post on the Top 10 Podcast Episodes of 2016!

55mins

1 May 2017

Rank #4

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356: Tom Goom, PT: So, You Have a Pain in Your Ass?

On this episode of the Healthy Wealthy and Smart Podcast, Tom Goom joins me to discuss a gluteal tendinopathy case study. Tom has gained the nickname ‘Running Physio’ after years of combining his passion for physio and love for running together to specialise in management of running injury. He’s written widely on the topic with over 200 evidence-based articles for his own site, running-physio.com as well as contributing to the BJSM Blog, Runner’s World and the Telegraph. In 2016 he published a masterclass on proximal hamstring tendinopathy in the Journal of Orthopaedic and Sports Physical Therapy. He presents his Running Repairs Course in the UK, internationally and online, covering a range of topics from training load management to bone stress injuries, strength and conditioning and more. In this episode, we discuss: -Crafting the subjective portion of your evaluation -Objective measures at the impairment, activity and participation levels -Multimodal treatment approaches to manage gluteal tendinopathy -Intrinsic factors that affect tendon health -And so much more! Identifying what running really means to your patient will help guide your goals for therapy as Tom stresses, “I want to know about the impact the injury is having on them.” Modifying activity levels is an important aspect for your exercise prescription and you have to convey to your patients that, “It’s this kind of balancing act of risk versus reward.” It is important for clinicians to avoid iatrogenic language in their patient education and only, “Highlight the good things.“ Establish at the onset to, “Expect flair ups.” as managing patient expectations during their rehabilitation is key to long term success. Treating gluteal tendinopathy is both challenging and rewarding and Tom believes, “There’s an art to it as well as a science.” For more information on Tom: Tom is a physiotherapist with over 10 years of experience and a very keen runner! He graduated with a BSc (Hons) degree in 2002 and since then has worked in clinics in the UK and overseas. His career started in Winchester where he worked in the NHS and developed a specific interest in lower limb rehab and joined the physio team at a semi-professional football club. Following the Tsunami in 2004 Tom travelled to Sri Lanka and did voluntary physiotherapy work in a hospital, teaching local staff, treating patients and fundraising for new equipment. Tom returned to the UK in 2006 and started working in Brighton as a senior physiotherapist. His interest in rehab continued to grow and he ran lower limb and spinal rehab groups as well a chronic pain programme. Tom started RunningPhysio in March 2012 to help those training for marathons that spring, since then it’s developed into a resource used by runners all over the world. Tom has written for Running Fitness, Men’s Running UK, and the British Journal of Sports Medicine blog. His work has featured on Kinetic Revolution, Bartold Biomechanics and a host of online sports sites.  A few words from Tom… I’m learning about running all the time, one thing I’ve found is that there are a lot of opinions out there! No 2 people will give you the same advice and I respect that. My plan with this site is to share my view on injury prevention and management when running. I welcome different views and ideas so please feel free to comment. I don’t claim to have all the answers but I hope people will find this site helpful. I’ve got a few miles under my belt and a few good PB’s – 39:30 for 10km and a 1:28 half marathon. In April 2013 I did my first marathon and loved it! I finished in 3:12:28 – full story here. I work at The Physio Rooms clinic in Brighton. For more information or to arrange an appointment see our Clinic Page. If you have any questions feel free to leave a comment or chat to me on Twitter via @tomgoom. Please note that due to very high numbers of comments and questions we aren’t able to reply to everyone Resources discussed on this show: Running Physio Website Running Physio Twitter Running Physio Facebook Tendon Health Questionnaire Pain Catastrophizing Scale Hudl Technique Plinsinga et al 2018: Psychological factors not strength deficits are associated with severity of gluteal tendinopathy: A cross‐sectional study Ganderton et al 2018: Gluteal Loading Versus Sham Exercises to Improve Pain and Dysfunction in Postmenopausal Women with Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial. Mellor et al 2018: Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

1hr 1min

11 Jun 2018

Rank #5

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256: Andrew Vigotsky: Do Biomechanics Matter?

On today’s episode of the Healthy Wealthy and Smart Podcast, Andrew Vigotsky joins me to answer audience questions and translate biomechanics literature to clinical practice. Andrew is currently a Master's student in Biomedical Engineering at Northwestern University in Evanston, IL, concentrating on musculoskeletal biomechanics. His thesis work aims to elucidate the relationship between the shear-wave velocity of muscle, as measured using Supersonic Shear Imaging, and muscle stiffness in vivo. In this episode, Andrew answers: -What is your biggest surprise on engaging clinical practitioners with research evidence? -How much do you feel biomechanics matter when looking at injury and pain development across various exercises? -If you were building your own program to maximize muscle hypertrophy what parameters would you use? -What can we draw from EMG studies and what conclusions are fair to make? -And so many more! The goal of biomechanics research is to ultimately translate results to the clinic and enhance how clinicians treat their patients. Andrew states, “It’s only after you find those answers that you really understand what your results mean and how your question can affect society.” Despite the large amount of research done each year in university labs, very little reaches practioners. Andrew notes, “There is a time lag from research to practice in the medical field of about 17 years.” Andrew believes clinicians can improve this transmission rate through a greater focus on science literacy and improved dissemination of new findings. Best evidence based practice encompasses all elements of a biopsychosocial framework. Andrew believes, “Biomechanics still matters… It’s just in what context does it matter. From the people that are purely biomechanical, the neurophysiological and the pain science stuff matters a lot and we can’t ignore that.” For more information on Andrew: Andrew is currently a Master's student in Biomedical Engineering at Northwestern University in Evanston, IL, where he is concentrating on musculoskeletal biomechanics. His thesis work aims to elucidate the relationship between the shear-wave velocity of muscle, as measured using Supersonic Shear Imaging, and muscle stiffness in vivo. He is completing this work in two different labs: the Neuromuscular Biomechanics Laboratory and the Neurobionics Lab, under Drs. Sabrina Lee and Elliott Rouse, respectively. Before attending Northwestern, Andrew graduated with a BS in Kinesiology from Arizona State University (ASU). It was during those undergraduate studies that he started getting involved in research; Erin Feser supervised him in ASU's Motion Analysis Laboratory, where he carried out two data collections that resulted in three publications. The studies investigated the effects of load on good morning kinematics and EMG amplitude, the acute effects of anterior thigh foam rolling, and the validity of the modified Thomas test. In addition to Erin's mentorship, I also grew close to Dr. Rick Hinrichs, who taught me a lot about biomechanics both inside and outside of the classroom.  While at ASU, Andrew was also able to secure an internship under Dr. Bret Contreras while he was completing research for his Ph.D. Bret has had a profound impact on how he thinks about movement and sports science. Together, they have published over a dozen papers related to strength, muscle hypertrophy, and physical performance, and have much more in the pipeline. Moreover, he has introduced Andrew to other great minds and researchers, such as Chris Beardsley and Dr. Brad Schoenfeld. After graduating from ASU, Andrew completed pre-requisites for graduate school (i.e., math, physics, and engineering courses) at a local community college while splitting time between two laboratories: the Leon Root, MD Motion Analysis Laboratory, at the Hospital for Special Surgery (HSS), and the Human Performance Laboratory, at CUNY Lehman. At HSS, he worked under Dr. Andrew Kraszewski to develop a 3D-mesh model of the gluteus maximus. At CUNY Lehman, he worked under Dr. Brad Schoenfeld to train participants and collect data for a training study, and also designed and carried out a cross-sectional study that investigated the determinants of squat strength, which is currently in peer-review. If you are interested in learning more about what Andrew has done or reading works that he has published, you can check out it out at ResearchGate, Google Scholar, PubMed, or my CV. Resources discussed on this show: Andrew Vigotsky Twitter Movement Science Blog Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my blog post on the Top 10 Podcast Episodes of 2016!

1hr 4mins

21 Feb 2017

Rank #6

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223: Dr. Kelly Starrett: Movement, Pain Science & Non-profits.

Today’s show is with Dr. Kelly Starrett where he answers audience questions concerning how he optimizes human performance. Kelly is a coach, physical therapist, author, speaker, and creator of the blog Mobility WOD. Kelly’s work across these mediums has reached large audiences and revolutionized how athletes think about human movement and athletic performance. In this episode, we discuss: -Allied relationships between physical therapists and strength and conditioning coaches -Do anatomical variations impact ideal posture and movement? -Why we should be taking a 30,000 foot view in our culture -How Kelly reconciles pain science and biomechanics in his physical therapy practice -How to build a large platform with the use of social media -And so much more! Kelly advocates that every human should be incorporating a mobility regime into their day to day lives. He states, “What does it mean foundationally to be a human being, what are the things we should be able to do? We remain agnostic about the way you want to train, but you better have a movement practice or at least express full range of motion if you plan on moving fast, lifting heavy, going up and down stairs, or picking up your kid.” Kelly stresses that enhancing movement is a continual process and every day is a movement screen. “We don't expect movement competence to happen overnight. This is a process but eventually we should all be moving better and better and better because that is what it means to acquire skills as a human. It takes 10,000 repetitions as a baby to integrate a movement pattern. That means we have some tolerance in the system to buffer some less than ideal biomechanics. Overtime we should be refining that.” Kelly challenges the physical therapy profession to focus more attention on educating the public on preventative care. He stresses, “When you have a fever, you take some Tylenol. If you have a cold, you don’t go see your doctor. If you have a cut, we teach people basic first aid. [Physical therapists] are not doing a good job teaching basic first aid around the body to everyone.” We also discuss Kelly’s widely successful online fitness platform and the best ways to target and gain influence in your own local community. He states, “People are looking for advocates, they are looking for help… if you set out to influence a bunch of people, you influence no one. It’s not authentic, it’s not real. Solve a set of problems and be of use to your community and people will find you.” For more about Kelly: Kelly Starrett is a coach, physical therapist, author, speaker, and creator of [mobilitywod.com], which has revolutionized how athletes think about human movement and athletic performance. His 2013 release, Becoming a Supple Leopard has become a New York Times and Wall Street Journal bestseller. [His] blog was voted #4 in Outside Magazine’s Top 10 Fitness Blogs of 2011, Breaking Muscle’s Top 10 Fitness Blogs of 2011, and Health Line’s Top 100 Health Blogs of 2011. Kelly and his work have been featured in Tim Ferris’ Four Hour Body, Competitor Magazine, Inside Triathlon, Outside Magazine, Details Magazine, Power Magazine, and the Crossfit Journal. He teaches the wildly popular Crossfit Movement & Mobility Trainer course and has been a guest lecturer at the American Physical Therapy Association annual convention, Google, the Perform Better Summit, the Special Operations Medical Association annual conference, police departments, and elite military groups nationwide. Coach Kelly Starrett received his Doctor of Physical Therapy in 2007 from Samuel Merritt College in Oakland, California. Before starting his own physical therapy practice at San Francisco CrossFit, one of the first 30 CrossFit affiliates, he practiced performance-based physical therapy at the world-renowned Stone Clinic. In his current practice, Kelly continues to focus on performance-based Orthopedic Sports Medicine with an emphasis on returning athletes to elite level sport and performance. Kelly’s clients have included Olympic gold-medalists, Tour de France cyclists, world and national record holding Olympic Lifting and Power athletes, Crossfit Games medalists, ballet dancers, military personnel, and competitive age-division athletes. Kelly’s background as an athlete and coach includes paddling whitewater slalom canoe on the US Canoe and Kayak Teams, and leading the Men’s Whitewater Rafting Team to two national titles and competition in two World Championships. In his free time Kelly enjoys spending time with his wife Juliet and two daughters, Georgia and Caroline, surfing, paddling, Olympic lifting, hot-tubbing, and so-you-think-you-can-dancing. Resources discussed on this show: Stand Up Kids Chris Powers Dan Pfaff Functional Movement Screen Lorimer Moseley David Butler Greg Lehman International Spine and Pain Institute PTPintcast Kelly welcomes you to stop by his clinic in San Francisco, California and see what he’s all about. You can find more from him at Mobility WOD and follow him on twitter! Join me and other professionals for PT Day of Service this October 15th and give back to your local community! Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and as always stay Healthy Wealthy and Smart! Xo Karen P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

1hr 39mins

1 Aug 2016

Rank #7

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378: Mick Hughes & Randall Cooper: Melbourne ACL Rehabilitation Guide 2.0

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Mick Hughes and Randall Cooper on the show to discuss the Melbourne ACL Rehabilitation Guide 2.0. Mick is an experienced Physiotherapist & Exercise Physiologist who consults at The Melbourne Sports Medicine Centre. Mick has expertise in ACL injury management and ACL injury prevention and has previously worked for elite sporting teams such as the Collingwood Magpies Netball team, Newcastle Jets U20s Soccer team and NQ Cowboys U20s Rugby League team. Randall is an experienced Sports Physiotherapist, Founder and CEO of Premax, Adjunct Lecturer at the La Trobe University Sport and Exercise Medicine Research Centre, and Fellow of the Australian College of Physiotherapists. In this episode, we discuss: -The six phases of the ACL Rehabilitation Guide -Why pre-habilitation objective measures are better comparisons to reconstruction outcomes -How to assess return to sport after ACL surgery -The importance of mental readiness for return to play -Strength and conditioning for injury prevention throughout the athlete’s career -And so much more! “Every ACL rehabilitation protocol needs to be individualized and clinicians need to take a clinical reasoning approach. It’s athlete specific. It’s sports specific.” “If you can combine a good story that resonates with the athlete or patient with the statistics and research that’s out there, you can usually paint a powerful message.” “We shouldn’t be doing protocols.” “Every ACL reconstruction patient shouldn’t be painted with the same brush.” “An injury prevention program is really important.” “Time is a poor indicator for future success.” “The whole rehab process needs to be criteria driven.” For more information on Randall: Randall is an experienced Sports Physiotherapist, Founder and CEO of Premax, Adjunct Lecturer at the La Trobe University Sport and Exercise Medicine Research Centre, and Fellow of the Australian College of Physiotherapists. As a Sports Physiotherapist Randall has worked with some of Australia's most notable sporting organisations including the Hawthorn Football Club, the Australian Winter Olympic Team, and the Victorian Institute of Sport. He consults from the internationally renowned Olympic Park Sports Medicine Centre in Melbourne. Randall has also attained the title of Specialist Sports Physiotherapist as awarded by the Australian College of Physiotherapists in 2008. Randall is the Founder and CEO of Premax. Premax in an Australian company that manufactures a range of sports skincare and massage creams. Premax is available in Australia, Asia, UK and Europe, and will be launched in North America in 2019. As an Adjunct Lecturer for the La Trobe Sport and Exercise Medicine Research Centre, Randall advocates sport and exercise medicine, physical activity, health and well-being for all. He provides support to the Centre, activity assisting in translating research findings to key stake holders including the international research community, health practitioners, and the general public. For more information on Mick: Mick is an experienced Physiotherapist & Exercise Physiologist who consults at The Melbourne Sports Medicine Centre. He is currently completing a Masters of Sports Physiotherapy. Mick has expertise in ACL injury management and ACL injury prevention and has previously worked for elite sporting teams such as the Collingwood Magpies Netball team, Newcastle Jets U20s Soccer team and NQ Cowboys U20s Rugby League team. Resources discussed on this show: Premax Website Randall Cooper Twitter Randall Cooper LinkedIn Mick Hughes Website Mick Hughes Twitter Mick Hughes Facebook Mick Hughes Instagram Melbourne ACL Rehabilitation Guide Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

52mins

3 Sep 2018

Rank #8

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437: Dr. Kelly Duggan: How to Grow a Physical Therapy Practice

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Kelly Duggan on the show to discuss her hybrid physical therapy business model.  Kelly is the creator and owner of Physical Therapy U, a successful insurance based PT clinic in Bridgewater Massachusetts. PTU is focused on changing the healthcare experience for their community with a focus on youth athletes.  In this episode, we discuss: -How Kelly’s hybrid practice has married quality patient care with financial freedom -Marketing strategies that have exponentially grown Kelly’s practice -Top key performance indicators Kelly tracks to ensure her clinic meets its mission -Why your life vision should align with your daily life -And so much more! Resources: PTU Clinic Instagram PTU Clinic Website PTU Clinic Facebook Strive Labs Email: PTUclinic@gmail.com For more information on Kelly: Kelly J. Duggan is a physical therapist with over a decade of experience in both inpatient and outpatient settings.  Kelly is the creator and owner of Physical Therapy U, a successful insurance based PT clinic in Bridgewater Massachusetts.  PTU is focused on changing the healthcare experience for their community with a focus on youth athletes.  Physical Therapy U is a hybrid clinic offering PT, massage and sports/fitness trainings.  Kelly uses this hybrid approach to combat the typical decline in revenue that most insurance based outpatient clinics (that aren’t tied to a hospital) experience over time.  Kelly is also a proud wife and mom of her three young children.  Kelly has worked hard to show that although the timing doesn’t feel “perfect”, you can open a clinic at any time of life.  Physical Therapy U was created during the 3 months after her third child’s birth, while she also had her 1.5 year old and 3 year old home with her.  Kelly encourages others to go after their dreams and although being in the spotlight causes significant anxiety, she continues to push herself forward so that others can see what is possible.   In just three short years Kelly has successfully tripled her small business from a 1200SF space to a 4500SF space without the need of tripling her patient visits.  Kelly enjoys sharing her highs and lows with others so that they can learn the best techniques even faster than she did.  Physical Therapy U continues to grow and evolve and Kelly welcomes any and all advice for the future success of her business.   Read the full transcript below: Karen Litzy:                   00:01                Hey Kelly, welcome to the podcast. I'm happy to have you on. Welcome. Kelly Duggan:                00:06                Thank you so much for having me. Excited to be here. Karen Litzy:                   00:09                And today we're going to talk about your business, the growth of your business. I would say the very fast growth of your business over the past three years. So PTU opened its doors three years ago. It was you and your sister working 10 hours a week. And now let's fast forward to three years. You have 17 employees, four PTs, one PTA. I mean that's a huge growth in three years. So I'm really excited for you to come on and let the listeners know how you did it. So let's first talk about how you started. So take it away. Kelly Duggan:                00:49                Yeah. So how we started, I was actually nine months pregnant and trying to decide which direction I was going to go with things. I had always been an employee that worked like around 30 hours a week and I would have one day off with my other kids. And when we got pregnant with our third, we realized that financially that was not going to be an option anymore. I needed to work full time. So I started looking at different options to do that, who I would work for, what I would want to do.  I've always really enjoyed, the program development and the marketing aspect of physical therapy. For me, you know, I've always needed a creative outlet and that was kind of my outlet in physical therapy. But where I was and kind of what I was looking into, that wasn't going to be an option. Kelly Duggan:                01:43                So it kept getting thrown around. Like what about your own place? What about your own place? And so finally, as the pregnancy progressed, I sort of started looking into it. So what do you, what do you do when you first start looking into stuff? You start googling it. So that's where this all came from, is kind of a few Google searches of like, how's this going to work? And, what I did at the time, was reached out to a few other people that were in my situation, parents of multiple kids that own their own practice to see because for me, that was the big hangup of, you know, this is going to take a lot of time away from my family. Am I going to be okay with that? And how, you know, how is that gonna work with my family and work with myself or my kids in the future. Kelly Duggan:                02:31                So I reached out to a few other moms of multiple kids who had opened their own practices. And, you know, I got some feedback that I liked. I got some feedback that I didn't like and, you know, I kind of just hung on to the words of advice from the people that said, go for it. And Yeah, I think my son was like one month old when we finally committed and I said, you know what, I'm just going to do this. And I think, and I always laugh about this, but I think that I was so massively pregnant and then postpartum that my husband was just like, yeah, whatever you want to do, whatever that sounds great. Whatever we have to do, we'll find the money and just kind of like on board. So yeah, we started out really small. Kelly Duggan:                03:20                I found a clinic that allowed me to do a one year lease because for me, I was just preparing for, well, if it doesn't go well, what are my options? I'll always have my license. So, you know, where could I work if this doesn't go well and it doesn't build and it doesn't grow, like I want it to grow. So I found a clinic that did a one year lease. I looked at all the bare minimums of what do I need to make at the bare minimum. And I just laid it all out. You know, I always say I'm not a huge numbers person, but I think owning your own practice turns you into one. So now I'm like all about the numbers and that's, you know, my mom took this photo of me sitting at my laptop. Kelly Duggan:                04:05                Like, I dunno what I was doing either making the website or trying to crunch the numbers and I've got a coffee in one hand, one hands on the mouse and somehow I'm like balancing my newborn like on me. And it was just like very kind of how my life was at that moment. And for me it was if I want to do what I'm really passionate about in PT, which is marketing program development in sports, then I have to create it myself because it's not there. The option is not there for me. So it's just figuring out what I had to do to do it myself. Karen Litzy:                   04:58                And I mean to do this massively pregnant and then with a newborn, I mean that is ballsy.  Like that is no joke. I mean, I don't have children, so I don't know what those first months are like, but I mean, and this was your third. It's not like it was your first, you had two other children. I mean what a leap. Kelly Duggan:                                        It was. And again, it was just kind of like, all right, it's go big or go home. Like if we're going to do this and I'm very much a determined person. If something is not there that I want, I'm going to create it or make it or somehow make it happen. And this was an opportunity for more time with my family in the long run. So in order for me to have more autonomy in the long run, it had to be done and it had to be created and it was, you know, it was for me and it was for my family and it was kind of like that, you know, you see like the parent lift a car off their kid, you hear those stories of was that sort of situation, it was like, okay, here’s this person with no business background, who hates numbers. Kelly Duggan:                06:01                Who is going to like create this massive thing because I have to, that was the option, so it had to be done, you know? Karen Litzy:                                           Yeah. And so that's when you started three years ago. So let's fast forward now to today where like I said earlier, 17 employees four PTs, one PTA. So can you break down for the listeners how you did that because that is massive growth and Kudos to you. Kelly Duggan:                                        Thank you, so it's funny because I didn't plan it that way. It's not like I was like, you know what, my three year plan is this and my five year plan, 10 year plan says this again, I was very naive going into it. So I thought this is my plan and this is where I'll be, you know, three years from now if it's successful, I'll just stay in that same location. Kelly Duggan:                07:00                So we opened our doors in May and in September I looked at my sister, I'm like, well, this isn't going to work. You know, we were in a 1200 square foot space, you know, it took about a month and a half, but we went from no patients to I had a full schedule and I was prepared on the opposite end of that. Like I was prepared for all right, maybe I'll have three days or whatever it is. But we scaled really quickly. So starting in September, I started looking for additional staff and it took me until January to actually hire someone. So I would say anybody that's kind of in this position is just make sure you're preparing ahead of time for if it does go well. Cause I did not. And so I hired someone in January and then I hired my second person in February and that's when I said, okay, I'm not even gonna make it to a year in this location. Kelly Duggan:                07:56                Like we need to expand. So it was probably March so not even one year in where I started looking into what is this location need to look like in order for it to be a success because the demand was there and I didn't want to not provide the same service for more people. Like, you know, you see clinics that ended up getting stacked in their booking. People on top of the next person is just crazy and busy. And I didn't want to do that. I wanted to still be able to provide the same level of service just for more people. So that meant expanding. So I started looking at additional locations and how that was going to work and started hiring and scaling is the big word that we used, but we scaled up from March when I started looking to the following March when we moved into our new location. Kelly Duggan:                08:57                It was just kind of a slow scale and I was lucky enough to find a team of people that understood the importance of where we were going. And they were willing to adjust their hours as needed, but also work anywhere between like 28 and 40 hours as needed as we scaled. So for me, you know, I don't like to use the term, I was lucky because I busted my ass for everything that I've done. But in the sense of hiring people, in a kind of a team and a family that understood the importance of that, I was lucky. I mean these, these people kind of worked as hard as I did to get us to where we need to be. So that was good because you don't always find that in employees, you know? Karen Litzy:                   09:44                Yeah. For sure. And now let's back up for a second. How did you go from zero patients to a full schedule? Cause that's what everybody wants to know. How do I get more patients on my schedule? How do we let people know we’re here and we’re ready to help? Kelly Duggan:                10:03                So. MMM. Yeah, you know, I hustled basically. So in whatever that term means to you, you know, like the older generation are horrified by the use of that term. But, I worked really, really hard. And I just networked and got my face everywhere. And you know, it, I think we've talked about this before, but I feel really uncomfortable when I'm talking in group settings or in front of people Karen Litzy:                   10:34                I know, but I don't get it. Kelly Duggan:                10:38                Thank you. The Facebook lives, but again, it was there was a need to do, I knew that if I wanted to grow my practice, people had to know who I was. And I had to be seen as kind of an authority in the PT World, in my community. So in order to do that, you have to put yourself in front of people. So I was putting myself in networking groups, putting myself in business associations, talking, volunteering to talk, I'm doing all these live videos and posting it to different groups and doing all these things that are way outside of my comfort zone because I knew that people had to recognize me and my brand as, you know, as healers. So, on top of that we did like a lot of online marketing or I always say we, but I did a ton of online marketing. Kelly Duggan:                11:29                As well as, I did some print ads, not a lot because they're so expensive. But what I did do, which I tell everyone to do, cause it's such a good idea, is I think it's everyday direct mailers is what it's called for the post office where you can either create a postcard or a letter and you can map out on the US Postal Service website, who you want to get your letter. And so within like a three mile radius of my clinic, I sent out a postcard, which one side had who we were and what we did and the services we offered. And then on the other side I did a baseball schedule. Right. Or you do a football schedule or basketball or whatever. Because for me, like when I get mail, if it's junk, I throw it out unless it has a sports schedule on it. Kelly Duggan:                12:24                And then it's on my fridge. And then I don't even know who these people are and they're on my fridge, the entire sports schedule because it's the sports schedule. So I put it up there. So to put the sports schedule or whatever that is, you know, in your community, it goes right on people's fridges. And then every day they were opening the fridge and they see your logo and they see whatever it is you put on there. And that helped. And I did have a lot of patients that came to me because they got the flyers and they're like, oh yeah, you're on my fridge. Karen Litzy:                                           Yeah, because don't they say it takes like x amount of touch points before some of them will decide to pull the trigger and make a purchase. Kelly Duggan:                                        So I did a ton of marketing, you know, and even, you know, the patients that we did have asking them, but I don't want to use this as like a copout as to why we scaled so quickly. Kelly Duggan:                13:16                But you know, I also take insurance, so that obviously is a lot easier than convincing people, you know, over your cash rate. But in the beginning I wasn't contracted with every insurance, so I was actually seeing, you know, a handful of patients that were paying my out of pocket rates because I wasn't contracted with their insurance yet. So that was kind of cool. Karen Litzy:                                           Yeah. So you had a little bit of a hybrid in the beginning and then, and now, do you take all insurances in your area or just a couple? Kelly Duggan:                                        I take most insurances there. Again, from the business side of things, there are a couple of insurances that financially, we wouldn't just lose money, but I'd lose like a lot of money. So we can't take every insurance, but we do take most and then we do offer our cash rate or a prompt pay rate if people don't want to use their insurance or some people don't even want to use their insurance benefit. Kelly Duggan:                14:21                So, even though they have an insurance that we would contract with, they choose to still pay us a cash rate and then you know, we have additional services since moving into our larger location that cause again, PT insurance, it doesn't, unless your really savvy is the word I'll use, it doesn't make good money. We basically we paid the bills and that's how we get by. But if we want to make additional incomes of that, you know, my employees can get raises and we can buy new fun equipment. We had to take on all these additional ancillary services in the new location. Karen Litzy:                   15:02                Okay. So what are these ancillary services? Because this is something that I think we really want to touch upon because listen, not everyone has a cash based service. I would say the majority of people by and large do not. Yeah. And that most physical therapy offices around this country take insurance. And like you said, sometimes the insurance does not reimburse a lot. I know New York state, it's very, very low. So what ancillary services have you added? So again, kind of make that hybrid practice. Kelly Duggan:                15:40                Yeah. So in our previous location, which was really small, what we did, and it was a much smaller scale, but we would hold classes every now and then, so we'd have, you know, a yoga class or a strength and conditioning class or something so every now and then we could get a little bump of money, in our new location, which is 4,500 square feet. We're able to add in a lot more. Kelly Duggan:                16:10                So we're looking to make it a little more consistent, but we've had yoga. I hired, so I didn't like rent out, but I hired two massage therapists, and they work on kind of like a per diem rate. So they're not there all the time, but you know, when they have clients. So we've built up and that's really been a huge compliment to our physical therapy services, not only for our patients, but for our therapists in kind of taking the load off of not having to do as much manual because if people are getting massages with it, it just helps that much more and then people are carrying over better. And, so that's been a benefit all around financially and for our patients. And for our therapists. We hired massage therapists. Kelly Duggan:                17:11                I had massage therapists and I have a program that we call the elevation programs so that, we all know that insurance doesn't cover everything, right for physical therapy. They don't really cover the sport based stuff or transitioning someone back to crossfit or whatever it is. It's not always covered within their plan. And then, you know, there also insurances that cut you off after 60 visits or at 90 days. So what we did was kind of bridged the gap between physical therapy and a patient's return to sport or return to their full activity. So we created something called like an elevation plan where people can purchase it on a monthly basis, you know, similar to how you would purchase a gym membership. And the elevation plans include, you know, PT visits, massages and an exercise prescription by a personal trainer, which one of our rehab aids is a personal trainer. Kelly Duggan:                18:21                So we utilize her and kind of kick people off with this really great program. And it's really meant to be a transitional program. So people will do it for a month or two, and then they have the confidence in order to get back to sport or gym or whatever it is they wanted to do. And maybe they're like getting back to, but maybe they're starting it for the first time. So we have yoga, we have the elevation plan, we have massage, and we do like sport performance clinics. So, you know, sometimes we do two hour ones. We just had a dance one for our dancers. Sometimes we do, you know, like a six week program for our youth athletes. We really focused on, at the new location, kind of like, my big thing was, okay, you know, I love to work with athletes. Kelly Duggan:                19:15                I think it's an underserved population. The youth athlete, I think we get lost in the shuffle. So that was for us kind of a big part of what we're trying to do with PTU. So we have all these programs for our youth, for flexibility, coordination, the things that the coaches can't necessarily allocate time for in their practices. We again, are just trying to bridge the gap and support where there is a need. So we created all these programs. So all of that is additional money that helps to run our insurance based practice. Karen Litzy:                   19:54                Right. Fabulous. And I love the sports performance for our kids because you're right, that is not something that is widely used. You know, kids they go to their practice, they do their sport, and then that's it. And I mean, I see a lot of kids in my practice having very adult injuries, ACL injuries, you know, knee pain, a torn labrum. So things like that. So I think what a great idea. And then that's also great for your marketing. Right? Karen Litzy:                   20:37                It’s also great for your marketing because then you have the kids coming in, the parents know you’re there. So if something happens to anyone in the family, they're going to come to you because they already know you, like you and trust you. Kelly Duggan:                20:53                Yeah, absolutely. I think, you know, with having like kind of the youth athlete as your main population, you know, they can't drive themselves. So someone has to bring them, whether it's a parent or an aunt or you know, and then they're exposed to your facility and exposed to what you do. And, I think once they see that you're providing something different, that's of quality and the services, the customer service there, it just spreads like wildfire. Karen Litzy:                   21:28                Yeah. Fabulous. And now so we spoke about what you did to get patients in the beginning, how you've expanded and how you've expanded so quickly, which is all awesome. Now can you tell us, were there any mistakes, any pitfalls along the way that you can share? Kelly Duggan:                21:50                I mean, there's always, pitfalls. I'm trying to think of something. Karen Litzy:                   22:00                Yeah. Like if there's something that you're like, oh man, if only I knew I would not have done it this way. Kelly Duggan:                22:10                Yeah. Well, you know, a lot of pitfalls that were kind of, if I had known I probably would have done differently. The billing aspect of things in the beginning we outsourced, which was fine because again, it wasn't like I was learning so much at the time anyways. It's not like I could learn another skill of the billing side of things. So I outsourced. But we lost a lot of money in outsourcing. And I think not only did we lose a lot of money, but I think there was a lot of opportunity for me to have learned more about why we bill and what we bill and that aspect of things that I just wasn't paying attention to for the first year and a half. I was just kind of filling out and assuming that everything was fine and coming back on in it and it was fine. Kelly Duggan:                23:10                It was just once we decided to take on billing and hire someone, the learning curve there of what we're billing, how much we're billing, why we're billing it, what we get paid. I learned a lot in those first like six months of bringing on billing that in hindsight probably should have just figured out like how I could have done that earlier on. Because once we took it on and we started learning more about what you know, actually pays and what doesn't pay, we were able to make some adjustments in what we do to make more money through insurance. So that was definitely kind of a big eyeopener for me switching from outsourcing billing to taking it on. Karen Litzy:                   24:01                Great. Yeah. Know your billing know where your money's coming from, where it's going and why some things are being paid and others are not. And I mean the list can go on and on. Right, Karen Litzy:                   24:14                That's great advice for people who are wanting to start their own practice, especially in an insurance based practice. Kelly Duggan:                24:24                Yeah. And a lot of those outsourcing companies, they will train you, you know, that's an option. I just kept saying, Eh, I'm like, like this one more thing I don't need to know. And it was like once I learned it, I'm like, wait, what was I doing? Why did I not want to know any of this is so important. Making more money. Karen Litzy:                   24:42                Right. And now what are the things that you look at now? So in business, you know, we talk about key performance indicators. So what are let's say for you and your business, what are the three most important KPIs that you look at? Kelly Duggan:                25:08                Yeah, we look at cost per visit. So obviously you're looking at what you make per visit cause that's important for me. I'm looking at cost per visit and obviously I want that to be lower than what we make per visit because my overhead is so high, our cost per visit is a bit higher. Which is why in going to the new location and tripling in size. It's funny cause a lot of like insurance based PT clinic owners were like, no, like that doesn't like, you can't do that, it's not gonna work. Insurance doesn't pay enough money for that model to work. That's why people don't do it. And I just kept going back to like, yeah, but it's a service to our patients. It's exactly what they need and somehow we're gonna figure out how to make it work because it's what people want and it's going to just provide so much for them. Kelly Duggan:                26:12                So a huge one for me is cost per visit cause it's high. But we want it to be below what we make per visit. So I'm looking at cost per visit and then I'm looking at how can I make that lower? I pay attention a lot to like how many elevation plans were selling in a month, how many massages we're selling in a month. Because again, that is going to bring down that cost per visit for me so I focus a lot on there. I used to focus on, you know, the average amount of visits we were getting out of people. But over time it's been similar over time, so it's not like I'm like, you know, worried about it. But there are certain key performance indicators that I don't know how I want to say this without sounding like, I don't want my therapist to be aware that all right we need every patient to have 12 visits because that's what we need financially. Kelly Duggan:                27:26                You know, you don't want someone's treatment to be affected by the bottom line. So I track it, but that's not something I share with my employees or even try and like, oh, we got to get that to, you know, 13 visits or 14 visits because I mean, it's a wonderful thing if you can get somebody better within four visits or six visits, cause then they're gonna, you know, talk about, Oh my God, I felt better in six visits. So you don't want to focus on those numbers. So I think, you know, you do see that number of listed a lot when people are talking about key performance indicators and how many visits you're getting out of your plan of care. But I think going into it and focusing on that number is not a good thing for us as PTs. Karen Litzy:                   28:15                Right. Yeah. And, also it then puts these perhaps unrealistic what's the word? When they have to meet a quota, is that a thing? Like PTs have to meet a quota or something like that? Yeah, some clinics. It incentivizes the wrong thing, right? I think what you're doing is you're incentivizing patient care. Versus incentivizing patient visits. Those are two very different things. More visits doesn't equate better care. It just equates more visits. Kelly Duggan:                28:59                Yup. Exactly. Exactly. And we've talked a lot about in talking to my coworkers and stuff of, all right, well, what do we have to do? How many visits do we need to do? And how many massage appointments do we need? How many elevation plans do we need so that we continue to deliver the level of care that we're delivering. I don't want to change my business model to seeing a patient every half hour, or, you know, forcing that sort of way to hit our bottom line. I'd rather have it, well, you know, can we get more people in? Can we do performance clinic? Can we, you know, add in yoga again, like how can we add additional services? Because you hate to really like turn into a mill to hit your numbers, you know? So for us, we need to encourage more people to, you know, sign up for massage or maybe we need another deal because we're getting close to that number of we're not gonna, you know, make our minimum requirements and we don't want to change our model. We don't want to change the level of care we're able to provide to people. So I think that therapists knowing that they are getting so much better with like, mmm, you know, wanting to do these additional programs and wanting our patients to do these additional programs. So it's been good in that sense. You know, and I've heard from other business owners and other PTs that they’ll get a bonus if they hit their productivity. Karen Litzy:                   30:42                That's terrible. Kelly Duggan:                30:46                That’s not what we want to do at all. You know, it's like, it's just, again, it's the quality of care and it's then the PTs just thinking about their numbers and not, am I getting people better? Karen Litzy:                   30:58                Exactly. And then, you have PTs saying, oh, I can work through lunch or I'll stay later, or I'll come in earlier because they're just so focused. I mean, let's be honest, a lot of PTs are type A, right, so focused on hitting this arbitrary number to get a bonus. Right? So let's say they get $1,000 bonus. Well, right, that thousand dollar bonus down to all the times coming in early and lunches that you worked through, guess what, that thousand dollar, $2,000 bonus that it doesn't equate to what you're making per hour. Right. And then it just, I think it's a great way to burn out your therapists. And I'm not sure, is the care better? Is it not better? I don't know that I can't say, but I think it's, like we said, just incentivizing the wrong thing. So glad you brought that up. Is there any other big KPI that you look at regularly and that forces you to maybe change the way your business is being run? Kelly Duggan:                32:17                Not really. I mean, I look at a lot of stuff just to monitor for myself. You know, I look at average codes for treatment, you know, and are we in line with the national average. You know, how can we make that in line with the national average while still providing the quality care that we're providing. I mean there's nothing that I, again, it's a lot of stuff that I look at kind of the behind the scenes stuff, but nothing that I would want my therapist too be concerned with I guess. Karen Litzy:                   32:59                Yeah. And what about cancellations? No shows? Yeah. It's always one that everybody always touted as being one, but I dunno. Kelly Duggan:                33:10                We track that and if it starts to get higher than like, you know, a certain number, we were like, okay, what's happening? But we have things in place that, kind of limit the amount of cancels and no shows. You know, we do our reminder calls. We, you know, people that are dropping off, patients that drop off. We use like an automated email system we use. We're integrated with strive, so we use strive, but I know some people use infusion soft. Karen Litzy:                   33:45                Infusion soft is very expensive. Kelly Duggan:                33:48                Yeah. I love strive. It's really user friendly. And the customer service has been awesome and you don't have to like build your own sort of stuff. It's, you know, you create your own content and all of that, but you don't have to like be a computer genius to use it. Karen Litzy:                   34:12                And is that strive labs through web PT? Kelly Duggan:                34:16                We were using them before they were integrated with web PT and they do work with, you know, if you don't use webPT, I believe, you know, but I do use webPT. Karen Litzy:                   34:28                Cool. Very cool. And so we talked about where you came from, where you're at, what you're looking at, how you're growing. So now where do you see yourself going in the next three years? Kelly Duggan:                34:43                Yeah, so, you know, I’m always thinking about that. But you know, one of my biggest struggles I would say right now is because we're so busy as just like, how do I get through the day? How do I get through the day? And I would say a couple of weeks ago, I'm like, what am I doing? Like all of my energy is focused on how am I getting through today and this week? And I'm not thinking of kind of the long term. And every time we have either a student or someone interviewed, they're like, what's the longterm plan for PTU? I'm like, well, you know, I don't really know.You know, people ask, because for me it was, I opened PTU because I wanted that creative outlet. You know, I wanted to support our athletes, but I wanted autonomy and I wanted time with my family. And I'm starting to get that so I don't want to, you know, it's not in the cards for the next three years to expand to another location. Kelly Duggan:                35:42                It's just to get this PTU central location successful in the insurance world. And, you know, I'd like to be able to give everybody raises. And all of that. So I want the next three years is figuring out how do we make this insurance hybrid model, successful so that we can, you know, give people raises and continue to treat at the level that we're treating. And you know, so that I can get the time that I wanted with my family. And then if we're able to do all of that in three to five years, maybe, you know, I've talked about adding on a second location, but I don't even want to think about it because I'm, again, like you mentioned, a lot of PTs are type A, I'm so type a that if I decide that I want to have a second location, I can't say, well, I'm going to do it in five years. Kelly Duggan:                36:39                Like it'll be here in six months. Like that's just how like I work. So I just, I want to keep putting that off. And for right now it's just PTU. It's our central location. I want it to be, you know, successful. And when I say successful, you know, I don't want to sugar coat it. I want it to be lucrative. I want it to be a business that makes money. Karen Litzy:                                           Of course you got, why wouldn't you and what other business world outside of like PT, the healing world do people say I really hope it's successful. Like of course yeah I still want to make money though. Yeah! That's why you started your own business for some freedom, for stability to be with your family, to help the people in your community and to make money. You didn't start a business to not make money. Karen Litzy:                   37:32                He didn't start a non for profit, which is a totally different world. So like if you opened up a clothing store, you wouldn't be like, man I just, I just hope I can make money one day. Kelly Duggan:                                        Yeah. It's funny cause it's the PT struggle, you know, it's like I want to support my patients. But you know, you have to put on that business owner hat and be like, well we need to make money to support our patients. Karen Litzy:                                           So that's right. It's your responsibility to make money so that you can be present in your neighborhood and that you can be present in your community and help people. Because if you didn't make any money, you'd have to close your doors and all those people who depend on you, what do they do then? Kelly Duggan:                                        Yeah, exactly. So in three years, you know, I want, you know, hopefully two more PTs is like the goal, you know, and I'd like to have that within the next year. And I want one of those PTs to take over the performance side of things because I feel like that's one area that we can continue to grow and we could have, you know, we could constantly be hosting some sort of sport related supportive group or clinic or camp or whatever. But I don't have time to plan all that. So I want to hire, I want one of my PTs to kind of take over the performance side of things. Karen Litzy:                   38:49                Very smart. Well, it sounds like you have a good plan in place and I love the fact that you said, you know, I just want to make this into a well oiled machine. This is what I want. And that's amazing because not everything, like you said, not everything has to be scaled to infinity. I mean, knowing where you are in life and knowing what you want and knowing how you want to live your life and if you can achieve that Karen Litzy:                   39:20                Achieve those goals within the parameters that you have. It just has to be, like you said, little tweaks here and there. I think that's amazing. So congratulations on such a huge, huge change in three years. Kelly Duggan:                39:34                Thank you. Thank you. And I want to actually bring that up. I want to say something to that because, I think again, PTs as kind of type A, and especially PTs coming out of school, we are so on this really, really like fast train of trying to be successful and achieve our goals. And, for PTs a lot of people are so focused on their career and their career ladder in their career growth. And I just want to say a reminder to people to kind of pull yourself away from that for a second and just think like, what do I want out of my life? What are my life goals, right? Is it that I want to travel more? Is it that I want to have a lot of money? Kelly Duggan:                40:25                Is it that I want more time with my family? Whatever it is for you. Think about that for, you know, a few minutes and then think about, okay, so how does PT fit into that? And not the opposite way of like, let me like reach the top of this career ladder and then like, well, is PT my life? Or like where am I now? So just pull yourself away from that and think of, you know, like for me it was and it might take a life event for you to figure out that. Like for me it was having my third kid and like, wait a minute, what the hell am I doing here? And it was okay, I want more time with my family. How do I do that? How does PT fit into that? And I just want to encourage more people to do that. Cause I think as type a people, we get so obsessed with climbing this kind of career ladder that, you know, we can get lost in it. Karen Litzy:                   41:19                And great advice. And I am in this, speaker's group, which is really a bit of an entrepreneurial group as well. And the woman who runs it Trisha Brook, at one of our first sessions, she had us write out kind of what do you want your legacy to be? And that's if you think about that you're doing exactly what you just said. You know, you're putting forth what do you want your legacy in this world to be? Right? And it sounds like for you it was too, you know, be with your family to have an influence over your children and to have that be such a great legacy. Have your children, your family, be your legacy, have the community that you're in, be your legacy. But what I didn’t hear from you, and correct me if I'm wrong, but what I didn't hear from you is for PTU to be your legacy. Karen Litzy:                   42:21                Right. It was, I want to make a change in my community and my family and that's the legacy. PTU is part of the way I do that. But it's not everything. Excellent advice. And now I feel like I'm going to ask you this last question, but you might have just answered it. But the question is, given where you are now life, career, what advice would you give yourself as a new grad out of PT School? Kelly Duggan:                42:57                That's it. Don't fall for the trap. Kelly Duggan:                43:12                Don’t fall for the kind of trap of just trying to, you know what, nevermind, I wouldn't say that. Because I feel like all of that got me to where I am right now. You know, the struggle of how do I get high around the career ladder and how do I do all of this. And, so I guess what would I say to myself straight out of PT School is take jobs that you have fun at. If it's not fun at the end of the day, if you didn't laugh, if you didn't enjoy yourself, get out of that situation sooner than later. I think I held on to certain things knowing that they were good for my career and I should have let go of them sooner. Karen Litzy:                   44:08                Excellent advice. Couldn't agree more. And now where can people find you and the clinic if they want more info or they want to talk shop with you. Kelly Duggan:                44:17                So I'm on my website is PTUclinic.com. The email is PTUclinic@gmail.com. I'm on Facebook, I'm on Linkedin. I'm not on there too often, but I'm on Facebook pretty regularly and my clinic is on Instagram. So any of those realms reach out if it's something that you're thinking of doing. I love talking with people that are thinking about opening their own clinic. I love to just encourage it, I think, you know, if it's something that you want to do then to go out and do it and yeah, reach out to me. I'd love to be of any help if that's what you're looking for. Karen Litzy:                   44:57                Awesome. Well thank you so much, Kelly, for coming on and sharing your entrepreneurial journey. I think you gave a lot of people a lot of help today, so thank you so much. Kelly Duggan:                45:07                Thank you so much for having me. Really appreciate the opportunity to talk about it and I hope we encourage some people today. Karen Litzy:                   45:15                Yeah, I hope so too. Thanks so much. And everyone out there listening. Thank you so much for listening. Have a great couple of days and stay healthy, wealthy, and smart. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

48mins

3 Jun 2019

Rank #9

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219: Dr. Greg Lehman: The Beauty of Simplicity

Happy Independence Day to the American Healthy Wealthy and Smart family! On this week’s episode, Greg Lehman and I review the evidence and rethink effective treatment strategies. Greg is both a physiotherapist and chiropractor who treats musculoskeletal disorders within a biopsychosocial model and simplifies pain science for clinicians around the world. In this episode, we discuss: -Why explaining pain leads to better treatment outcomes -The case for and against repeated spinal flexion -Does glute activation or inhibition affect pain? -Functional training and the carry-over effect -And so much more! Greg stresses that most physical therapists should rethink what is valuable to their patients. He states, “The technical mastery is less important…It probably has more to do with how your patient feels comfortable and how you respond to them rather than you being a good robot who knows lines of drive and the biomechanics. That isn’t what is valuable and isn’t supported in all the research that we have.” Greg also questions the effectiveness of being so specific with our interventions and takes a broader approach in his treatment philosophy. “I don't think there is any treatment that ever has to occur… It’s actually a neat, big question for therapy I would like to see addressed more. Is there ever a treatment that is absolutely necessary for a specific condition or are there a number of things that can be helpful? I tend to believe there are a number of things—I have my biases—but I think most things aren't that specific.” Greg builds patient self-awareness with education and believes it is his most effective treatment tool. “I go right into education for low back pain. I am not too worried about getting them super active right away. I want to encourage them to getting back to doing the things that are important. If they tell me they are afraid to do a number of things that they like doing and they are meaningful activities, my go to intervention is to convince them they can start doing those things again.” Greg suggests shifting our focus as clinicians from a purely biomedical approach to treatment and instead developing our psychosocial expertise. “I really believe it is okay to be simple. We don't really need the complexity that we try to do, especially the biomechanics. The big point of that is if you simplify your biomechanics, your physical interventions, it can allow you to develop your skills in the other areas, the psychosocial stuff and start taking more classes outside our typical training—psychologists, social workers, that type of stuff. That’s where we can build our skill set. There's not a better manipulation, there’s not that special exercise technique that you need to learn. It’s fun but it’s not necessary for patients with pain.” For more about Greg: GREG LEHMAN BKIN, MSC, DC, MSCPT He is a physiotherapist and chiropractor treating musculoskeletal disorders within a biopsychosocial model. Prior to his clinical career he was fortunate enough to receive a Natural Sciences and Engineering Research Council MSc graduate scholarship that permitted me to be one of only two yearly students to train with Professor Stuart McGill in his Occupational Biomechanics Laboratory subsequently publishing more than 20 peer reviewed papers in the manual therapy and exercise biomechanics field. Greg was an assistant professor at the Canadian Memorial Chiropractic College teaching a graduate level course in Spine Biomechanics and Instrumentation as well conducting more than 20 research experiments while supervising more than 50 students. He has lectured on a number of topics on reconciling treatment biomechanics with pain science, running injuries, golf biomechanics, occupational low back injuries and therapeutic neuroscience. His clinical musings can be seen on Medbridge Health CE and various web based podcasts. Greg is currently an instructor with therunningclinic.ca and with Reconciling Biomechanics with Pain Science.  Both are continuing education platforms that provide clinically relevant research that helps shape and refine clinical practice. While he has a strong biomechanics background he was introduced to the field of neuroscience and the importance of psychosocial risk factors in pain and injury management almost two decades ago. Greg believes successful injury management and prevention can use simple techniques that still address the multifactorial and complex nature of musculoskeletal disorders. He is active on social media and consider the discussion and dissemination of knowledge an important component of responsible practice. Further in depth bio and history of my education, works and publications. For more information on where Greg will be lecturing next, make sure to visit his website and keep up with Greg on twitter! Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

54mins

4 Jul 2016

Rank #10

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138: Dr. John Cryan, neuroscientist on the gut-brain connection

John F. Cryan is Professor & Chair, Dept. of Anatomy & Neuroscience, University College Cork. He received a B.Sc. (Hons) and PhD from the National University of Ireland, Galway, Ireland. He was a visiting fellow at the Dept Psychiatry, University of Melbourne, Australia (1997-1998), which was followed by postdoctoral fellowships at the University of Pennsylvania, […]

51mins

18 Jan 2015

Rank #11

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350: Dr. Josh Payne, PT, DPT: The Anatomy of a Cash-Based Physical Therapy Start Up

On this episode of the Healthy Wealthy and Smart Podcast, Dr. Josh Payne joins me to discuss how he began his concierge physical therapy practice. Dr. Josh Payne is the owner of Freedom Physical Therapy, providing concierge services to his clients in Denver, CO. Josh started his practice after getting tired of the traditional physical therapy model in multiple outpatient clinics that he worked in. He is an advocate for the growth of the physical therapy profession, and for the trend towards more personalized care. In this episode, we discuss: -Why Josh decided he wanted to open his own private practice and how he laid the foundations for his business -Josh’s top referral sources he used to build his patient case load -Some mistakes made along the way while growing his practice -What the future has in store for Freedom Physical Therapy -And so much more! Josh believes confidence in yourself as a therapist will go a long way in helping you grow your practice. Josh stresses, “The whole reason why I want to start a practice is to give my patients what they truly deserve.” Entrepreneurs can invest an abundance of time in their business and setting boundaries at the beginning can be an important consideration. Josh found that, “I took away everything that wasn’t helping me go in the direction I wanted to go forward with.” Job burnout is becoming more and more common in physical therapy. Find the right blend for your practice as Josh advises, “Don’t be afraid to be different in the world of PT.” For more information on Josh: Dr. Josh Payne is the owner of Freedom Physical Therapy, providing concierge services to his clients in Denver, CO. Josh started his practice after getting tired of the traditional physical therapy model in multiple outpatient clinics that he worked in. He is an advocate for the growth of the physical therapy profession, and for the trend towards more personalized care. Dr. Payne believes that a holistic approach is what is needed for truly effective care. In his free time, he enjoys mountain biking, camping, and hiking with his wife Shelby. Josh graduated with his Doctorate in physical therapy from Texas Tech University in 2013. Resources discussed on this show: Josh Payne Instagram Josh Payne Facebook Freedom PT Concierge Website Email: drjosh@freedomptconcierge.com Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

33mins

17 May 2018

Rank #12

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392: Dr. Tim Gabbett: Debunking the Myths of Training Load

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Tim Gabbett on the show to debunk myths about training load, injury and performance. Tim holds a PhD in Human Physiology (2000) and has completed a second PhD in the Applied Science of Professional Football (2011) , with special reference to physical demands, injury prevention, and skill acquisition. Tim has published over 200 peer-reviewed articles and has presented at over 200 national and international conferences. He is committed to performing world-leading research that can be applied in the ‘real world’ to benefit high performance coaches and athletes. In this episode, we discuss: -The acute:chronic workload ratio and how it relates to risk of injury -Is the 10% rule foolproof? -Ways to quantify training loads -Practical ways for practitioners to translate research into the clinic -And so much more! “Social media is great for sharing information but sometimes those myths get perpetuated on social media and they grow.” “Risk doesn’t equal rate.” “We don’t coach the number—we coach the athlete, we coach the patient.” “Load is just part of the puzzle.” “When you’re in the basement or when you’re in the ceiling, keep the percentage changes in load from week to week quite small but if you have moderate to high chronic loads then you can probably progress a little quicker.” For more information on Tim: Dr. Tim Gabbett has 20 years experience working as an applied sport scientist with athletes and coaches from a wide range of sports. He holds a PhD in Human Physiology (2000) and has completed a second PhD in the Applied Science of Professional Football (2011) , with special reference to physical demands, injury prevention, and skill acquisition. Tim has worked with elite international athletes over several Commonwealth Games (2002 and 2006) and Olympic Games (2000, 2004, and 2008) cycles. He continues to work as a sport science and coaching consultant for several high performance teams around the world. Tim has published over 200 peer-reviewed articles and has presented at over 200 national and international conferences. He is committed to performing world-leading research that can be applied in the ‘real world’ to benefit high performance coaches and athletes. Resources discussed on this show: Gabbett TJ Debunking the myths about training load, injury and performance: empirical evidence, hot topics and recommendations for practitioners Br J Sports Med Published Online First: 26 October 2018. doi: 10.1136/bjsports-2018-099784 Gabbett Performance Website Tim Gabbett Twitter Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

42mins

29 Oct 2018

Rank #13

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363: Felicia Wenah, SPT: Networking for PT & PTA Students

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor, DPT guest hosts and interviews Felicia Wenah on networking as a physical therapy student. Felicia enjoys managing, branding and marketing for those in private practice within the health and wellness profession (especially Boss Women in Physiotherapy). In this episode, we discuss: -Advantages to networking as a student -How to maintain professional relationships with a busy school schedule -Felicia’s top conference recommendations -And so much more! Felicia seeks guidance from physical therapy professionals and has found that, “As you seek knowledge and you are able to apply it, whether it’s instantly or later on in the future, you feel more confident and comfortable with taking the steps you need to take in life.” Managing school on top of new professional connections can be a juggling act but it allows you to “better decipher where [your] priorities need to be for that moment.” Maintaining relationships doesn’t have to be forced. From Felicia’s experience, “I let them come to my mind and then I reach out to them.” For more information on Felicia: She enjoys managing branding and marketing for those in private practice within the health and wellness profession (especially Boss Women in Physiotherapy). She is most likely with a client, training and development staff/mentee, traveling to a conference/seminar OR most importantly spending quality time with mi familia. Contact her to see how I can guide you with connecting your YOU-nique skill sets to obtaining and maintaining the interest of your target audience in the health and wellness profession. 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 Resources discussed on this show: Felicia Wenah LinkedIn Felicia Wenah Facebook Felicia Wenah Youtube Felicia Wenah Twitter Felicia Wenah Instagram Smart Success PT Live Ascend Conference Women in PT Summit Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

9mins

5 Jul 2018

Rank #14

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133: The Cynical PT: What to look for in a potential new hire

In this episode of Healthy Wealthy & Smart @cynicalPT and I discuss what employers may want to look for when interviewing potential candidates. We cover everything from education background, to personality, hobbies, empathy, and the ability to relate to your patients. We also talked about if as an employer should you be Googling potential new […]

50mins

20 Oct 2014

Rank #15

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413: Dr. Mohammad Rimawi: The Importance of the Foot in Overall Health

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Mohammad Rimawi on the show to discuss foot and ankle health.  Mohammad Z. Rimawi, DPM, AACFAS, brings a wealth of knowledge and expertise to Grand Central Foot Care in Midtown East, Murray Hill, and the surrounding New York City area. As a board-qualified foot, rearfoot, and reconstructive ankle surgeon with specializations in traumatic foot and ankle injuries and complex deformities, he is able to offer his patients top-tier care no matter what problem they bring him. In this episode, we discuss: -The anatomy of the foot and ankle -The most common foot and ankle injuries -The differences between a high ankle sprain and low ankle sprain -The importance of the diabetic foot check -When surgery may be an appropriate intervention -And so much more! “If your body says something is wrong, chances are it is.” “Proprioception is very key for me in the rehab process.” “Preventive medicine is the best medicine.” “Establishing ties with other professions is important.” “The feet can be a window into your overall health.” For more information on Dr. Rimawi: Mohammad Z. Rimawi, DPM, AACFAS, brings a wealth of knowledge and expertise to Grand Central Foot Care in Midtown East, Murray Hill, and the surrounding New York City area. As a board-qualified foot, rearfoot, and reconstructive ankle surgeon with specializations in traumatic foot and ankle injuries and complex deformities, he is able to offer his patients top-tier care no matter what problem they bring him. Dr. Rimawi earned his doctorate from the New York College of Podiatric Medicine, where he made his mark. Not only did he graduate above the 90th percentile of his class and serve as class president for four years, but he was also recognized with the Student Service Award. That award goes to the student voted by the graduating class as making the biggest impact on the field of podiatry. Beyond his peers’ recognition, Dr. Rimawi was inducted into the Pi Delta Honor Society for his achievements in his research and his studies. With those accolades to his name, Dr. Rimawi continued on to a three-year reconstructive foot and ankle surgery residency at DeKalb Medical Center and Jefferson Health. His colleagues and the hospital staff at the latter named him the Podiatric Resident of the Year.                              It’s no surprise, then, that Dr. Rimawi is still impressing in his field. He’s a published author and accomplished lecturer, as well as an associate of the American College of Foot and Ankle Surgeons.                                                                                       In the spare time Dr. Rimawi manages to carve out, he loves to read, hike, and root for his favorite sports teams. Resources discussed on this show: Grand Central Foot Care Website Mohammad Rimawi Instagram Address: Grand Central Footcare 122 E 42nd Street, Rm #2901 Midtown East and Murray Hill New York, NY 10168 Phone: 212-697-3293 Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart!  Xo Karen

33mins

4 Feb 2019

Rank #16

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366: Brianna Battles: Pregnancy and Postpartum Athleticism

On this episode of the Healthy Wealthy and Smart Podcast, Shannon Sepulveda, DPT guest hosts and interviews Brianna Battles on training post­partum athletes. Brianna Battles is the CEO of Everyday Battles LLC. She specializes in coaching pregnant and postpartum athletes, as well as educating coaches on how to help athletes navigate the physical and mental considerations of athleticism during these chapters in a woman’s life. Brianna has online courses and resources for both fitness professionals and athletes and is the founder of the movement and online education, Pregnancy & Postpartum Athleticism. She has built an international team of coaches who are equipped to work with pregnant and postpartum athletes. In this episode, we discuss: -Common diagnoses following pregnancy that impact an athlete’s performance -How trainers and physical therapists can collaborate for the postpartum athlete -The good and bad of social media during the postpartum period -Cultural expectations surrounding what postpartum should look like -And so much more! Adjusting a training regime during pregnancy and postpartum can be a huge psychological hurdle for athlete’s to overcome. Brianna has found that, “We have to make the most informed decisions possible without ego getting in the way.” Shifting cultural expectations surrounding what you should look like or be able to do during postpartum is one of Brianna’s biggest goals. She stresses, “Birth is a big deal. Pregnancy changes your body. And postpartum is not just a six week timeline it’s an ongoing change.” While social media can be full of inspiration, it may also only show us the highlight reel of how someone has been progressing through postpartum. Brianna reminds, “Never compare yourself to who you see on social media and what their story is.” For more information on Brianna: Brianna Battles is the CEO of Everyday Battles LLC. She specializes in coaching pregnant and postpartum athletes, as well as educating coaches on how to help athletes navigate the physical and mental considerations of athleticism during these chapters in a woman’s life. Brianna has online courses and resources for both fitness professionals and athletes and is the founder of the movement and online education, Pregnancy & Postpartum Athleticism. She has built an international team of coaches who are equipped to work with pregnant and postpartum athletes. Brianna is an advocate for women who want train during pregnancy and make a sustainable return to performance, lifestyle, function, career and activity in the postpartum chapter. She has been able to accomplish this not just with her own coaching efforts, but by also educating coaches to do the same in their communities and online. Brianna has a local strength and conditioning program, but has shifted her focus to working online and traveling for seminars in an effort to reach a broader audience. She has experience in coaching in Division 1 collegiate athletics, corporate wellness management, personal training, strength and conditioning, presenting, remote coaching, mentoring and habits. Brianna has her Master’s Degree in Coaching and Athletic Administration and her Bachelor’s degree in Kinesiology. She is an active member of the NSCA where she is a Certified Strength and Conditioning Specialist (CSCS), and a USAW Sports Performance Coach. She has completed multiple continuing education courses and mentorships in the women’s health and strength and conditioning realm. She lives in Southern California with her husband, 2 sons (Cade and Chance) and 2 boxers. 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. Resources discussed on this show: Email: briannabattles@everyday-battles.com Brianna Battles Website Pregnancy and Postpartum Athleticism Website Brianna Battles Instagram Brianna Battles Facebook Women’s Health APTA Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

59mins

23 Jul 2018

Rank #17

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305: Dr. Ebonie Rio: Talking Tendinopathy

On this episode of the Healthy Wealthy and Smart Podcast, I had the pleasure of welcoming Dr. Ebonie Rio onto the show to discuss tendinopathy. Ebonie is a physiotherapist and researcher with extensive experience in tendon pain. She is a post doctoral researcher at La Trobe University, and completed her PhD in tendon pain, researching “Corticospinal responses associated with patellar tendinopathy and the effect of externally paced strength training.” Her research has changed rehabilitation practise around the world. In this episode, we discuss: -Tendon Neuroplastic Training -Motor cortex changes with tendon pain and the powerful role a metronome can play for your brain excitability -How to utilize time under tension and load to reduce tendon pain -The importance of patient input for goal setting -And so much more! Ebonie suggests, “We are not winning the battle with musculoskeletal pain. It is so common.” Physiotherapists need to be aware of and utilize the best evidence available to treat the growing problem of musculoskeletal pain. Ebonie believes a skillful examination and evaluation can guide differential diagnosis and she stresses, “It’s critical that our rehab, as we go forward, becomes much more tailored to what we are seeing in front of us.” Ebonie is a proponent of utilizing isometric exercise in addition to other adjunctive therapies to reduce pain and develop adherence into a loading program. She suggests, “When you see someone with pain, we need a way in. And as physios, we’ve got some really great tools.” Ultimately, to treat tendon pain, the research evidence supports that, “Load is our primary modality.” Manual skills have a role in the examination but from Ebonie’s perspective the information specifically from palpation is more limited. She outlines, “The problem with palpation is that it is nonspecific. Lots of things are going to hurt to poke.” Due to the nonspecific nature, Ebonie has found that, “Our hands are incredibly important; poking is just not that useful when it comes to diagnosis.” For more information on Dr. Ebonie Rio: Ebonie is a physiotherapist and researcher with extensive experience in tendon pain. She is a post doctoral researcher at La Trobe University, and completed her PhD in tendon pain, researching “Corticospinal responses associated with patellar tendinopathy and the effect of externally paced strength training.” Her research has changed rehabilitation practise around the world. She currently is involved in a variety of projects investigating tendon pain, especially in the lower limb, however also other areas such as investigating innovative new rehabilitation techniques. Ebonie also still consults clinically, having been previously involved at the Australian Institute of Sport, Australian Ballet, and Winter Olympics. Resources discussed on this show: Leung et al 2015: Motor cortex excitability is not differentially modulated following skill and strength training. Professor Jill Cook Email: e.rio@latrobe.edu.au La Trobe Sport and Exercise Medicine Centre Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen

47mins

13 Nov 2017

Rank #18

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116: Karen Litzy, how to create a successful home health practice

In this episode I talk a little bit more about what I do everyday! I talk about how I came to own and operate a private home health business. In this episode I share I used some of the lessons I learned from Marie Forleo’s B-school to grow my business over the past year. I […]

57mins

15 Jul 2013

Rank #19

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436: Dr. Megan Rigby: Becoming an Online health Entrepreneur

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Megan Rigby on the show to discuss how she found success with her online nutrition and fitness consulting. Dr. Megan Rigby is a doctorate prepared pediatric GI Nurse Practitioner, IFBB Figure Pro, blogger, macro lover and online coach. She is on a mission to help others become fit, healthy and happy. In this episode, we discuss: -How Megan started her side hustle and when she decided it was time to leave her corporate job -The pro’s and con’s of being an online entrepreneur -The importance of vulnerability and integrity on social media -And so much more! Resources: Macro Mini Website Macro Mini Instagram Megan Rigby Twitter Macro Mini Facebook Macro Mini You Tube For more information on Megan: Megan Rigby is a Doctorate-prepared GI Nurse Practitioner, Certified Nutrition Consultant, IFBB Figure Pro, and Owner of MacroMINI. She is passionate about educating others through her coaching, as well as publicly speaking on topics surrounding food, fitness & healthy mindset. Megan has helped hundreds of people experience great physical and overall lifestyle changes. She is on a mission to empower others to become healthier, happier versions of themselves while still enjoying food as one of life’s simple pleasures.  In 2018, Megan left a corporate position as a Digestive Nurse Practitioner to open her own coaching business & has made over 400k+ within her first year. Megan has been featured in Oxygen & Strong magazines as a content creator, along with appearances on News Channel 12. She has been recognized as a top industry leader within her community. Read the full transcript below: Karen Litzy:                   00:01                Hi Doctor Megan Rigby, welcome to the podcast. I am happy to have you on. Megan Rigby:                00:06                Thank you so much for having me. I'm excited to do this with you today. Karen Litzy:                   00:10                Yeah. And so what we're gonna do is we're going to talk about your sort of entrepreneurial journey, your business story, because, as I said in the intro for you, you are a doctorate prepared GI nurse practitioner and a nutritional consultant and a whole bunch of other stuff. But, something that I think the listeners of this podcast can relate to is there's a lot of healthcare workers, things like that who are listening to this podcast who maybe have started their careers in a hospital and clinic, but maybe you want something a little bit more. So I would love for you to kind of share your story of how you made that transition from, I love that you say you were like a corporate girl in a hospital or clinic, but when you're in healthcare, that's kind of the equivalent. So go ahead and tell us your story. How'd you do it? Megan Rigby:                01:03                I never planned on being an entrepreneur having my own business. That's just not something I ever saw in my future. My Grad program, I had focused on family and childhood obesity. It was my dissertation. I love health and nutrition. I think it's the preventative to a lot of health care. So I always tried to teach all my clients that, but I started to get frustrated a few years in just because working for corporate, you're kind of inside a box. And I think there's a time and place for complimentary medicine and modern medicine and sometimes that can be hard when you're working for a hospital. And so I started having more and more people talking to me on the side about health and nutrition and fitness and people would just start asking, Hey, can you give me an advice? Give me tips and I'll pay you. And so slowly I started doing nutrition plans and education on the side. Megan Rigby:                02:05                And over time I was able to build it into an online business. I realized that my limitations that I have within the clinic are able to actually be kind of removed online. I get to spend more time with my clients, educate them, and truly provide a service that's unique to them. So with time it took probably, I mean two years I was doing a lot of my own online stuff, while working full time in clinic. And then I gradually dropped down to more of a part time position once I started picking up online. And then within the two years I was actually able to make more than what I was making clinic with the online business and I transitioned over and I left September 2018 and now I run my own company doing health, fitness and nutrition. Karen Litzy:                   02:57                And I would imagine that there are pros and cons to this. So I'm just going to name one pro and one con. Right. So the pro, obviously you can probably help more people with online programs. Con would be, do you miss having that person sitting in front of you? Megan Rigby:                03:16                I do. I missed that. But the beautiful thing about online is you can still do zoom calls face to face. So there is still that where you can talk to them. So almost like a telehealth. I would say one of my biggest cons is when I used to leave the clinic, it was kind of like my work was done. Like my charts were done, I was done seeing patients. Now, I feel like I'm on a lot more so my day doesn't end nine to five. I work a lot more around the clock. I feel like, and that's something I'm still trying to work on as a new entrepreneur. Karen Litzy:                   03:50                Yes. And that is absolutely true. I think a lot of people when they think I'll just start my own practice, they think you can leave it at the door when you leave, but you cannot. You're always doing something. I mean, there are times like last night it was midnight and I'm working. Megan Rigby:                04:09                Yes. It never goes away because it's now your business, you're responsible for everyone you're taking care of and you're responsible for bringing more clients in. And so definitely you work, I think a lot more being an entrepreneur, but at the same time you have more freedom, which is nice. Karen Litzy:                   04:26                Yes. You have a little more flexibility, you have a little more freedom. So there's pros and cons to all of this. But let's start, how, if you can get even a little more granular into your kind of transition from hospital to on your own. So my first question is how did you have this conversation with your employer? That's a question I get asked all the time. Megan Rigby:                04:51                Yeah. So I think you have to just be honest about it. And that was something that they knew that I loved the nutrition aspect of things. I love being able to teach and spend more time. So when I went down to part time, you know, I let them know that I was, you know, on my side I was, you know, just educating and teaching people about nutrition and health. And that was not going to interfere with my job. And I think that's the biggest thing. If you can, you know, let them know, reassure them that you're not letting it interfere with your work and how you come in every day and interact with your patients there that you know, helps them as well, as well as not ever taking any of the businesses patients. Karen Litzy:                   05:37                Of course I think we say that of course, but maybe people do. I don't know. Megan Rigby:                05:46                Yeah. And that was something where it's kind of drawing, you know, a line in the sand and making sure that both of the jobs stayed away from each other and they never came together. And I think that's something that a lot of people have to remember. Like I would love to have been able to work at work, but you can't do that. I mean, I came home at night and I saw my clients from online at night and there was no crossing that during the day at all when I was clocked in and I was being a nurse practitioner in the clinic. Karen Litzy:                   06:13                Yeah. And I think that's great advice. And it's just dry and clear boundaries for yourself and also being respectful of your employers. Megan Rigby:                06:21                Yeah. Because in the end, if you decide to go back to clinic, you need recommendations and burning bridges is not something you want to do because who knows? I mean the venture that we have or I have, it may, may die down one day and I do need to go back to the clinic. So I never want to slam that door shut because it provided me so many opportunities. Karen Litzy:                   06:42                Absolutely. And I remember when I left the physical therapy clinic I was working at, it was really hard to do because I really loved working there. But they now refer patients to me and I refer patients to them. Right. So it's like you don't want to burn those bridges because guess what, they can help you and you can help them. And I think you want to really make this a win, win for everyone. So you have this conversation with your employer, they're understanding, you go down to part time for you, what was, if you can describe kind of the hours worked in clinics or are you down to like 20 hours a week or less and obviously we know you're working then on the online part, but what was the breakdown for us? Megan Rigby:                07:33                They let me go to three and a half days a week, which was nice. And so that was considered more of a part time position there. So I worked Monday, Tuesday, Wednesday, and then half day Thursday and I was off Fridays. So I would make sure that all my check ins and my main communication with my clients would be on the weekends. That works best for me. So Thursdays I would do all of my prep when I got off work. And then Friday, Saturday, Sunday, those were my days that I was really able to devote to the actual online business and evenings whenever I, you know, was able to after work I would come in home and I would do what I needed to do. But otherwise it was an 8:30 to 4:30 Monday through Thursday, half day. Karen Litzy:                   08:21                And since going completely on your own, do you give yourself a schedule? Because it must be difficult, right? Megan Rigby:                08:28                I'm still close the computer when there's still work to be done and I always want to make sure that everyone is getting the, you know, service and communication that they deserve. And I think that just comes from being a healthcare professional that you know, you want as much time devoted to each and every client. And so it can be hard to kind of turn that off and feel like you still have unanswered questions or things going on. Karen Litzy:                   08:59                Yeah, there's no question. And again, that's where kind of setting boundaries for yourself comes in handy or making sure that you know, you have scheduled times that you're working even with the online clients and that they know that. Not that they're taking advantage because I don't think they are, but if you allow yourself to be available 24 seven then guess what, people will take you up on that offer. Megan Rigby:                09:27                Yeah. So it is, it's creating boundaries too. And that's what I have learned. It's been hard, but yeah, working, you know, maybe nine to like four and allowing lunch in there, is something that I'm striving to be more consistent with. But it is nice because if you have appointments, you know, you can schedule those in and that's where the flexibility has been really good. But also drawing the line of when you kind of cut it off at night. Karen Litzy:                   09:52                Yeah, absolutely. And now how do you advertise? How do you market yourself? Megan Rigby:                09:56                So social media is kind of where it's all at, as exhausting as it can be. I have, you know, my page and that's where a lot of people find me word of mouth has been the biggest thing and I value that the most. I think if people can refer other people to me because they've had great experiences and outcomes, that's where I've actually gotten a lot of my clients. I don't really do a lot of paid advertisement or anything right now. Like I said, it's just word of mouth and then making sure people who do follow me or start following me understand, you know, where I'm coming from and really being open and vulnerable on social media so everyone kind of knows who I am and there's no hiding. Karen Litzy:                   10:44                And what advice do you have for the listeners on how to be vulnerable? Because that's hard. Megan Rigby:                10:50                It is really hard.  I think it's just to be true to you and stand by what you believe in and how you practice. And provide honest, you know, education, advice and share yourself I think with people has been the hardest thing because a lot of people will look up to healthcare professionals, you know, and think that there may be on a pedestal or something. And I think making yourself relatable is the most important thing because we're all humans and so we all have struggles as well. And I think putting those out there so people can relate to you is going to bring more clients in and more, you know, followers as well. Karen Litzy:                   11:30                Okay. So how do you make yourself more relatable? Because isn't social media is supposed to be like, it's your highlight reel. We don’t want to show people that we have any problems. Right. Megan Rigby:                11:40                With me, it's a pretty easy with the nutrition and the fitness and health because I think, you know, as a female we struggle with appearance. We struggle with, you know, day to day eating healthy, making the right choices, preparing food for our family. So I can relate to a lot of that. You know, I've had my own insecurities and I'm not perfect every day with how I eat. There are days that I want to go to dairy queen and have a blizzard. So I'm able to really relate to people in that spectrum and then talking about, you know, different health issues that so many of us women struggle with and it can affect how we lose weight and really making sure that we stay on top of those. So whenever I talk about something, I try to draw in my past experiences with it and I think that usually helps a lot. Karen Litzy:                   12:28                Yeah. I think that's really good advice. And what would you tell people who maybe have these great stories and we know this is what you should do to kind of get people to get to know you, like you and then eventually right purchase from you. Right. What if you're scared to put yourself out there? Like how do you overcome that fear? Megan Rigby:                12:53                I think you have to jump in with both feet. Like if you are truly passionate about starting a business, that's vulnerable in itself and then putting yourself out there on social media. Like you just have to realize that people are gonna love you or hate you. And as awful as that sounds, it's the truth. I mean, people are going to be drawn to you. So just jumping in and sharing it, whether it's just the writing at first. I know a lot of people are camera shy, so sometimes they say like blogging at first is really good. Or just sharing it on your Instagram through words, before going into any of the videos or anything like that. Even you know what sharing with your family sometimes too because you can be vulnerable with them and getting feedback sometimes can be a little bit comforting if you're not ready to just jump. Karen Litzy:                   13:40                Yeah, I think that's great advice kind of sharing with friends and family are sharing within a trusted circle. Megan Rigby:                13:47                Before it's scary. You're going to get judged. That's human nature I feel like so people will judge, but people also will be able to relate to what they hear from you. And those are the people you want following you and interacting with you. Karen Litzy:                   14:05                Yeah. And do you have any sort of memorable comments or notes or things that people have sent to you that have stood out because you've been a little bit more open? Megan Rigby:                14:17                Yeah. So when I do stories I try to talk about topics that have affected me recently. I usually always try to keep things kind of close to my heart. And so when people message me and say, oh my gosh, I needed this today. It's been such a struggle, like it, it's so nice to know someone else's out there going through it with me or I appreciate the advice. So those things always help to kind of reaffirm like there are people listening and what I am saying is holding others. So, you know, it makes me want to keep doing that more and more. Karen Litzy:                   14:52                Yeah. I love getting those notes. I think it's so cool. And I always think to myself, Gosh, you never know who's watching, sitting, listening. You just don't know. Megan Rigby:                15:01                Cause you're always impacting someone. There's always someone out there watching and listening. Like she said, you never know. So if it's something you're passionate about, something you love and you want to be heard, then it's worth sharing. Karen Litzy:                   15:15                Absolutely. I agree. 100%. We’ve been talking that you're in that nutrition, fitness realm, very crowded field. Every time you turn, everywhere you look, someone is talking about nutrition, whether that be good or bad evidence based or not. It's out there. So what advice do you have to stand out amongst all this competition? Because I'm sure it can be applied to almost any industry. Megan Rigby:                15:49                It can. I always say be true to you. So whatever you believe, stay with that. It's so easy to get into the comparison game of you know, what they're doing or you know, this is the new trend, but you have to do your own research. You have to believe in what you believe in and talk about that. I think that's the most important. So many people in the fitness industry just jump from one trend to another. And so it's whatever the hottest topic is. And I think when it comes to, you know, this industry, you have to really stay true to the basics and what is science saying and what you believe in. Because if people hear it consistently and they can expect the same thing from you, which is the honest truth in what you believe in, they will trust you. It's the people who kind of jump all around that, you know, you kind of start to say, Hey, wait, last week you were talking about this. And that was the best thing there was. So that's what I found is people, they expect the consistency from me and they know that I believe in what I'm talking about. Karen Litzy:                   16:52                Yeah. So not jumping on the bandwagon every time something comes out, but rather look at it critically. Megan Rigby:                17:00                And not comparing yourself. I think that derails a lot of us is when we start to look at what other people are doing in the same field and we feel like we need to mimic that or we need to jump on that. And that can be very distracting too. Karen Litzy:                   17:20                But it's so hard. Megan Rigby:                17:24                It is so hard. I do my best actually not to follow a lot of people in my industry. I'll follow the people who I think provide me motivation, but if there's anyone who evokes jealousy, or you know, kind of gets under my skin, I figure that's negative, you know, vibes and I don't need that. So I really tried to just stay with the people who motivate me the most. I think social media should be a positive outlet. And it's so easy to make it negative. And I really tried to avoid that. Karen Litzy:                   17:58                Yes. As a matter of fact, I'm part of a Oxford debate in a couple of weeks at a physical therapy conference. And so the debate topic is social media and it is, we believe that social media can be hazardous to the profession of physical therapy. And you know, people will argue in favor of that and against that and that can easily go either way. But in the end it's a tool. It is a tool and it's not the tool, but it's the user. Megan Rigby:                18:36                It is. It's how we allow ourselves to use social media. No, I agree. I'm curious to hear how that goes. So I hope you will talk about that. Karen Litzy:                   18:48                I will talk about that. I'm curious to see how it goes to, I hope it goes well. I'm a little nervous about it, but I think it's supposed to be this like fun debate, like lively, fun and funny. But you still want to win the debate of course. So we'll see what happens. So is there anything else about kind of your entrepreneurial journey that you really want people to learn from? Megan Rigby:                19:13                I think starting small, and a lot of people when they tried to start a business feel like they have to dump a ton of money into it. And I've learned that you don't, with starting small and using the skills that you have, you're actually able to start a business that may, you know, not be as profitable as you want in the beginning with time you can reinvest that money you make back into it without taking up such a huge loan in the beginning, especially when it comes to the online type of business. I think there's so much that we can do on our own before we have to really start spending money. And I think that's something that, you know, a lot of new entrepreneurs who are wanting to go the online business, just have to remember that it doesn't take a ton of money to get up and going and get clients. It just takes, you know, the passion and the time and the knowledge. Karen Litzy:                   20:09                Yeah, absolutely. And I have one more question for you. The question that I ask everyone and that is knowing where you are now in your life and in your business, what advice would you give yourself, not to someone else, but what advice would you give to yourself at like the day you graduated and we'll say with your doctorate, why not? Because you’ve got like advanced degrees here. So let's go with the doctorate. What advice would you give to that gal? Megan Rigby:                20:40                Okay. My advice would be to not change anything, to enjoy the ride and kind of allow it to take you where it's going to take you. Because there are times that I wondered, you know, why was I where I was and what I was doing and it all led me here. So I think the biggest thing is enjoy the ride. So often we keep wishing the years away and if only I was here, if only I was there. But every step and every moment you have is leading you to where you really need to be. Karen Litzy:                   21:09                Very nice. It's like that sounded like from Game of Thrones and that's not a spoiler or anything for anyone listening. If you haven't seen the finale, it's not a spoiler, but that was very Bran like of you, it was great. Now where can people find you if they want to get in touch with you, if they want to work with you, they want to follow you. Where can they go? Megan Rigby:                21:36                Yeah. So on Instagram, I'm macro_mini. And then why a website is www.themacromini.com. Karen Litzy:                   21:47                Awesome. And just so in case you know, you don't have a pen and paper and you're not taking notes right now, like I am, you can go to podcast.healthywealthysmart.com. We'll have all the links, one click will take you right to all of Megan's info so that you can get to know her, like her, trust her, and work with her. So Megan, thank you so much for coming on and sharing your journey. I think it will give a lot of people in health care a bit of a boost, maybe a little kick in the butt too, and the confidence to go out and kind of do what you're doing. Megan Rigby:                22:23                Thank you. I appreciate that. And thank you so much for having me on. Karen Litzy:                   22:26                Yeah, my pleasure. This is a great conversation and everyone who's out there listening, thanks so much. Have a great couple of days and stay healthy, wealthy, and smart. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

27mins

30 May 2019

Rank #20