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E586 | Clinical Check In With Andy Chen

Mar 07, 2023
cash based physical therapy, danny matta, physical therapy biz, ptbiz, cash-based practice, cash based, physical therapy

Doc Danny and Andy Chen are discussing the current state of the performance-based clinical world. Andy is the founder of Moment Physical Therapy and Moment Education, a mentorship program to help others learn faster than trying to piece it together themselves.

Andy is based in New York, where the business is booming and the weather is constantly changing. The conversation focuses on the current best practices within the performance-based clinical world, as well as the advantages of having a mentor to learn from instead of trying to do it alone.

They also discuss the exciting things going on in New York, and how it's always something new to experience. Overall, the conversation is about the current state of the performance-based clinical world, and how having a mentor can be beneficial.

The conversation between Danny and Andy focuses on the idea of a performance-based clinician. They define a performance-based clinician as someone who can work with individuals in debilitating pain and get them back to high performance. They explain that they can help people get back to Jujitsu and MMA but not be able to help with any super specific technical skills. 

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Podcast Transcript

Danny: [00:00:00] Hey, real quick before we start the podcast episode, I want you guys to check out our new YouTube channel for PT Biz. We are putting out a weekly video on the most common questions that we get, and we are breaking those down in a way that's more engaging. Where you can learn better and really focus on one thing at a time.

So if you're interested in really learning more skills to upgrade your cash and hybrid practice, head over to YouTube. Subscribe to the PT Biz Channel and check out the weekly videos that we're coming out with to help you win in the cash-based practice game. So here's the question. How do physical therapists like us who don't wanna see 30 patients a day, who don't want to work home health and have real student loans create a career and life for ourselves that we've always dreamed about?

This is the question, and this podcast is the answer. My name's Danny Matte, and welcome to the PT Entrepreneur Podcast.[00:01:00]

What's going on guys? Dr. Danny here. We're the PT Entrepreneur podcast and we got any chan on today from moment Physical Therapy and Moment Education. One of my buddies that I like to check in with when it comes to the clinical world that I'm not super involved in anymore, aside from the business side of what's going on, but really.

The performance-based clinician side of things that we love so much that we work with so much, and that we're thankful to see, continuing to grow and evolve over the better part of the last 10, 20 years. One thing that I thought might be cool for you guys is to hear what's happening in the performance-based world as far as best practices, things that are happening and evolving with somebody that's actually.

Building a lot of these people right now, and Andy has a super cool education company and mentorship that he's doing. And really a good way to, learn this stuff faster with mentorship instead of trying to piece it together on your own, like I did by going to a dozen different Con-Ed courses and then trying to find somebody to talk to that was busy as well.

And and it just is, it's I [00:02:00] think it's been very helpful, especially from some of the people that we work with haven't gone through. When Andy's going through. I figured it'd be fun to check in and. And talk a little bit, put our clinical nerd hats on and see what's up in the performance base world.

Andy, first of all man, thanks for your time. How's everything going up in up in New York with the practice and of the business is obviously booming, but like, how's everything going with you guys? Andy, appreciate you for

Andy: having back on Super to talk. All this kind of clinical nerdy stuff is like stuff I love to talk about.

Yeah. But yeah, everything is going well up here in New York, which had a nice, like 60 degree weather. Now we're back down to 2030. It's so random. Yeah. But New York is, there's always something exciting going on, which I

Danny: like. Yeah. That's cool. It's a fun city man. Oh, also great restaurant recommendations.

When we were up there for the holidays, Eddie Annie sent me, I. I feel like there's certain people you must get this question a lot because what you sent me as a recommendation, for where to eat, it was curated to the level of coffee shop, Italian food. Very specific, very part of different parts of the, and I, the funny thing, I laughed.

So hard cuz I [00:03:00] told Ashley, I go, we do the same thing when people go to Hawaii. We send them these elaborate Hey, go here, do this, don't do this bullshit. Go over here and this is a better thing to do. Yeah, that was awesome. We really appreciate it. But here's what we wanna do, man.

I, we talk about the performance-based clinician a lot but I don't know if we've ever really defined it. Like how would you define a performance-based clinician, if that's even like the term that you prefer to use. And if not, what do you like to call it?

Andy: No, for sure. I just call ourselves like performance-based physical therapists or performance minded physical therapists.

And for me, when you're performance-based or performance minded, you're able to work with someone that's in debilitating pain and get them back to high performance and maybe not back to high performance as good as someone that's super specialized in the respective field. Like I tell people like, Hey, I'm not gonna be able to shave.

Time off your hundred meters sprinting. Cause I don't watch track and field runners for a living. There's people that do that, but I sure thought can get you back in sprinting healthy and prepare you for training. Now there's other stuff now that I [00:04:00] feel, more prepared to do based off of my pre, experiences like, I can help people get back to Jiujitsu grappling sports mma, but I just won't be able to help you with this super, super specific technical skills.

But from making sure that all of the hardware is in play and everything's where it needs to be, and things are working in unison, like I can help you with that. For me. That's what that's

Danny: about. I'm seeing like what you're talking about even, right? Let's say, okay let's say jiu-Jitsu, something that you're actively doing, you have a unique knowledge base in, right?

And let's say a cyclist comes in to see you, right? You can definitely work with a cyclist, but where do you stand on let's say you got a good friend that's they just, they're just cyclist pt. That's what they do. That's their thing. Are you. On one end, there's the business, right?

It's oh, I got a client. And on the other end it's man, who's the perfect person for this? So what do you do in that situation with a client?

Andy: Honestly, I think I, I have an idea of what I'm capable of doing, right? Like my framework and what my limitations are [00:05:00] personally. So whenever I'm talking with someone or betting, whether or not can help somebody, I'm always thinking about Hey, am I the right person to serve this?

And then if I do know someone better, that I think would help them in the long run, maybe I can connect them with a performance based coach or a trainer afterwards. Yeah, it's if someone wants to get better at their marathon time, maybe I'm gonna help them get back to running a certain amount of distance.

And it's Hey, Casey, like I have a client that's looking to, run a sub three marathon. Can you take this over

Danny: now? Yeah. I love the collaboration with coaches. That's something that, that I always looked for. As well, because I, I'm not trying to be somebody's coach, but I'm always looking for who's the best coach for that person, for what they're looking for.

He brings back to like sprinters, right? So let's say you're working with a sprinter and you want them to work with a coach that, so they're stopped. Pulling their hamstring or whatever they keep doing because of their technique. But yet the underlying sort of chassis that we can work on to help improve, can be optimized by someone that knows what they're looking for on, [00:06:00] on that side.

And this is actually a challenge I see for people in this space is I. Them realizing like what they're good at and where they need to bring other people into the equation and evolving into having this ecosystem of people that can, they can help each other out. But, I think that just comes with time and with practice, but then also with building out a veted system of or network of people that they can really they can really help you.

For you. So this, I would say this is, it's far more common to see now than. I graduated in 2010. Is that right? Yeah. Two, 2010. I forget. And I remember being exposed to the functional movement screen for the first time by Johnny Owens of all people who does a lot of the blood flow restriction training stuff.

So he, he was actually a I think he might have even called himself a performance rehab specialist or something like that. And what he was doing was working with limb salvage patients. At the time. They had, they didn't have like such muscle or bone loss that it was best to remove the limb.

They had a salvage of some sort and they were using. [00:07:00] Like a f o braces with the ankle and stuff to help with them running and moving. And he had these elaborate progressions and regressions of movement patterns that he wanted to see people be able to hit before they could move on to the other things.

And he included the F m S screen as part of that. And I remember him teaching us the FMS screen and I was completely lost what is going on? Because it wasn't similar to anything we had learned in school. I think that's changed quite a bit. But in, in your experience now, like where are you seeing this performance driven approach within students or younger clinicians coming outta school?

Are they like more aware of this because of school or are they still not really teaching this at all?

Andy: Yeah I don't think, it's just I guess you can call it the politics, right? Like you have to pass the board exam. That's based on dated evidence and Right. The data, your movement science class, your exercise science class really is just gonna be PN F patterns and some basic ir er with the theban or some sidestepping, whatever is used at a clinic that the professor teaching it to do.

Yeah. But [00:08:00] I do think like fitness in general is becoming more popular, more mainstream, right? Like people nowadays, you don't have to be a gym rat to know what a deadlift is or a barbell. And 10, 15 years ago that was rare. Like you would have to go to k nation.com to read articles about something.

But now, like everyday people might know what progressive overload is. So I do think, school hasn't changed much, but there are some forward-thinking alumni that try to be as active as they can. I know Columbia University does a good job of it. There's another school in Boston that does a good job of it, and they're plugging like these strength and conditioning optional classes in the curriculum.

And I think that's a great idea.

Danny: Yeah. Yeah. I think it is hard, right? We look at the federal. A criteria for testing. And I thought what was funny is like when I took the federal boards, I remember our, we had instructors that were like, look, we're gonna show you this cuz it's on the test, but you're never gonna do this.

And I remember thinking, what a waste, like why are, why don't we spend some time going over some stuff [00:09:00] that we're actually gonna. That we're actually gonna do, but it's because they wanted us to pass. And the pass rate is incredibly important to them. Obviously, they wanna make sure that they're pumping out people that are actually passing and becoming licensed physical therapists.

I think it's trending that direction, but it's obviously slow. So I think for a lot of people what happens is they look for. Mentorship and they look for continued education courses. When they come out with the things that they're interested in. Where would you say, cuz you've taken a lot of different influences and you've applied those to, to what you're doing, what would you say the biggest influence is in the performance?

Clinical kind of realm are, at least in your experience and what you've what you've done and what maybe it's worth people checking in checking out themself because, you've gotten a lot out of as well.

Andy: For me it's just lifting yourself, like training yourself. I got into working out, I was a senior in high school and I was a whopping like 115 pounds after I had a stomach flu. And I remember looking [00:10:00] at my friends, I'm like, listen, like I'm gonna enter a bodybuilding competition by the end of this year. And I just got into working out and I was on bodybuilding.com looking for any article I could find.

Yeah. And then you get into college and you see a bunch of people lifting heavy and you're like, damn, I feel so weak. So I got into power lifting, and then after power lifting, you're just, training and you're like, man, I get winded after walking a flight of stairs. I should improve my endurance.

Get into kettlebells. And then you go for a run and you're like, man, I feel terrible when I'm running. I feel like I just don't feel as fluid. Okay, now I'm gonna get into sprint training and running mechanics. And for me it's like looking at like your training as a way of learning. I think every physical therapist should put themselves through a rigorous program.

Like you should follow certain things over a period of time. You should say Hey, this is my hypothesis based on of what I've programmed for myself, and this is the outcome that I'm going to get. I'm gonna follow this training for a couple of months and see if I get that outcome. Because again, if we're not being honest [00:11:00] with ourselves, how can we do that for our clients who are looking to develop some of these qualities?

Danny: I think programming is where I would. I don't think programming is where I would see the biggest efficiency with people coming outta school. And it was like this this language that people didn't know how to speak. And it's like good strength coaches can really put together well thought out programs.

And even in when I was an undergrad, and that was a big part of what we did with my undergrad in exercise physiology was like, a lot of it was to program development stuff and. But yet in school we get very little of it in terms of actually how to design a therapeutic exercise program that's not dog shit.

That's not just like super basic that has this understanding of progressions and regressions. And I think for a lot of clinicians, that's where they feel really weak and. I never really even thought about like programming for yourself as a good way to do that. I always like, like you program for yourself, but I always [00:12:00] looked at like friends and family and just make mistakes on people that aren't going to, that you're not charging.

They don't care, but how do you see that with the people that you're working with? Do they struggle with program design? Do they struggle with being able to like, put together something and feeling confident with, the outcome that they're gonna get or how to make adjustments if people aren't doing well or are they coming out and having a much stronger understanding of it than when I graduated?

Yeah,

Andy: the people that we work with, they tend to be the people like ourselves, right? Like they've learned a shit ton. They've read every article in the sun, blogs, listen to podcasts, attending weekend courses, and they come to me like, Hey, I have all of these things and I have no idea how they connect.

I have no idea how to have a formal process of training, rehab, performance, biometrics, locomotor stuff, multi-directional speed. Like how do I. Even structure a training session, cuz there're very basic things that you want to be able to accomplish, right? All your higher cns, higher intensity stuff in the beginning of the session.

And then going down into like maybe your compound [00:13:00] movements and then your isolation movements and whatever kind of tissue purchase piece stuff that you wanna put at the end. That's how we structure things. Because if you put your high TNS stuff at the end of the workout, you might be too tired to actually have a good output.

So when people come to see us, it's a lot of different problems. But I think the overarching theme is that they've learned a lot of things. They just dunno how to structure it and how it all connects.

Danny: No, that makes sense. I think there's so much information out there too, right? I, God, I just feel old as shit talking to you about this.

Now I'm like back in my day I don't even think. Instagram existed. I don't actually know when it came out, but I sure as hell wasn't using it. And the place that I was learning a lot of stuff was just on blogs and YouTube and books. That, that was really it.

And going to connet courses and trying to get organized information. From from different groups, but it I think that's hard too, because you go somewhere, you spend a couple days, some in, some course, and they're going through their methodology. And most people, [00:14:00] at least for me, I took away like one or two things that I would just do from that.

And that was okay I didn't actually grasp the whole methodology in a two, two-day period, but I had some tricks that I could add that would help me in certain, certain cases with different types of patients and injuries that we had, so for you, are you seeing more struggle with Context to what people are seeing and or helping organize that?

Or are you seeing that they basically just need to learn certain skills that they don't have on top of that or at all?

Andy: Yeah I would say it's more the context thing. I think people needed to learn how to learn, right? We're going to this course. What is your expectation for coming to this course?

Instead of blindly giving someone your money, what is the outcome that you're looking to get outta spending this money? I'm very intentional with who I learned from. It's okay, I'm learning from, let's say, lead tap. I'm going into this course because I wanna learn multi-directional speed.

Okay. I'm gonna go to Derek Canon. Okay. I'm going to this cause I wanna learn running mechanics. Now I'm going to, let's [00:15:00] say, The See Marty Gallery. Cause I wanna learn power lifting. I wanna learn how to structure training. So it's if you're going to a PR I that's very common. Now I wanna understand how respiration works and making sure that you get that from the course.

Take it back and just put everything you know into pen and paper and then see how this fits with your own framework or your own model. And if you don't even have a framework or a model, I would start there, like how do you, I guess the most, one of the most common questions I get is like, how do get so consistent with content?

I'm like, write everything you know on a piece of paper, and that's your model. That's what you got now. Anything else that you learn, plug it into there. And if there's conflicting information, figure out the similarities and you're gonna take that and cancel out the other stuff. And that's how you so slowly start to continue to refine everything.

Danny: Yeah. Yeah. I think that's a really good. Approach that's more systematic. [00:16:00] And the, I think the challenge with anybody coming outta school is that we don't have that, we don't have a ton of reps under our belt and we don't have a lot of pattern recognition of things that we're doing and that you can learn You can learn plenty from a mentor, from school, from a course that you go to, whatever it might be.

But I really think that the progress is made in the reps in the day-to-day. And it's also in the ability and willingness, which not everybody's willing to do this, to really look at is what I'm doing working and could it be better? Cuz complacency runs rampant in. Not just our profession, but many professions.

But I see it it's a shame in the healthcare profession because it's continual research that comes out and it's a area of lifelong learning. So if you wanted to be complacent, why would you go this direction? Go do something else that doesn't maybe change as much. So I think that's the challenge, but how do you convince, I don't have to convince the right way, but how do you mentor people to realize [00:17:00] that?

It's somewhat exhausting to constantly be testing, refining, evolving, and get them to really realize that's the way, like that's the way they're gonna be really good.

Andy: I kind of position it that way, right? Like when I send out a newsletter, when I open up the mentorship, like out, share genuine stories from my past, things that.

Things that I think will resonate with all other people. Like I've always had a lot of people tell me like, Hey, don't take your work home. And I just I always thought like, how can I not take my work home when someone in front of me is coming to me in their most vulnerable state and I can't help them get better?

I'm gonna take my work home because that's what I wanna do. Like I wanna be able to help this person get back to living the life they want to live. And I think you're. Your scaling is significantly limited if you don't grow, right? Because if your skillset is something that you can get coming outta school, there's literally people graduating every single year, every single month, with the same exact skillset.

[00:18:00] So how are you gonna leverage that? You have 40, 50, 60, a hundred thousand people with the same exact skillset as you, so you have no leverage, cuz everyone else can fix that problem. Yeah. But now you have people that are coming to see you with mult pain and multiple body parts nerve tension in certain areas.

They've physically inactive, there's some comorbidities. Can you help that person? Because if you can, you're probably one of maybe a hundred to 200 people within, the US and maybe one of five people within your city that could. And when if you have that, now you've got leverage. But if you wanna solve the same exact problems everyone else can solve and most of those problems.

Honestly would just get better with time. Yeah. Not a specific skillset, then you don't have any leverage. And for me it's all about increasing your leverage. Said again, you can charge what you're worth and you don't have to compete for price.

Danny: Yeah. And I think there's also a unique difference between I'll give you a good example.

Like my dad had. He had a little bit of on and [00:19:00] off back pain recently. And he just likes to golf, so it's taken away. The thing he likes the most 1, 2, 2 things likes the most yard work and golf. That's like his jam, right? So he is having some problems and he just goes to, he went to just a run of the mill, PT in In Augusta where they live.

And my mom calls me and she's this is pathetic. She's like showing me, she's like showing me the exercises they give them. And I had built a program for him. After he had knee replacement a couple years ago, but a lot of it was just like, this is the buy-in opportunity I've been waiting for to get him to actually do some shit because he hadn't really done anything since he left the army.

He was inactive aside from your yard working golf. So I get him in there and he's like hitting deadlift prs and he is doing all kinds of stuff. Like he's just getting strong and He brought that program in to the PT practice where he was being seen, and they were like, we don't do that in here. I don't know did you get this from a trainer or something?

And they're like, no, my son was a physical therapist. He wrote this for me. Can we do something like this? And they're like, no, we don't do that. I don't even know where you would start. And they had no idea what was [00:20:00] going on. So I think that it's, most people don't know what bad is until they ex they don't know how different it can be until they've experienced both and then all of a sudden it's, man, this is totally different.

But. It's also, I feel like one is so much more beneficial because the relationship gets left off traditionally, oh, pain is gone. Cool. Go back to whatever you're gonna do. Whereas I feel like where we fit in is this. This interesting sort of almost collaborative relationship long term where it's like, Hey, here's where you're at.

Let's check in here and let's look at these things proactively. Or let's talk about this and teach you about sleep. Or let's talk about if we talk about blood panels before the podcast. And it's like I got super into blood panels for myself cuz I was not doing so hot. And then I started to do that with my patients and they were so like obsessed.

They were like, this is awesome. This is internal data. I think that. The evolution of it, from what I see is you go from a churn and burn, get 'em better discharge model to all of a sudden it's like an, a health advocate for life that you have in your corner, which is great for the business side, obviously, [00:21:00] but also for the people.

So when you see that side of it and with what you're doing with folks, with the mentorship work that you do, how much of that is on like longevity optimization, not necessarily just like getting 'em out of pain.

Andy: Yeah, I mean I wanted to bring at one point that you had, when your dad was showing you the exercises and I smirked cause I was like, Danny, like me and you, we could probably tell you exactly what those exercises were.

It's probably like little cat cow, little poster steer pelvic tails and stuff. Marches. Yep. A sideline, clamshell and maybe bird dog if they're like, throw a bird dog in there for sure. But it, that's kinda. I would argue that that turn and burn, get people better. If you're just letting people go without actually teaching them these fundamental skills, they're probably not getting better or they're probably not getting to where they wanna be.

And when I talk to people, especially coming into our practice, I tell people, what are your goals? And it's usually, I just wanna get outta pain. I just don't wanna have to deal with this anymore. Like I just wanna be able to take care of myself due the day to day [00:22:00] stuff, every low level thing.

And then afterwards I usually say, no, this is really tough cuz you've been in pain for a long period of time. But I want you to think bigger. If pain wasn't part of the equation, what would you be doing? Yeah, and it's usually, I've always wanted run a marathon. I've always wanted to climb this, et cetera.

Like perfect. Let's work towards that. And I know it sounds crazy right now, but I'm gonna slowly show you that it's a possibility. And those are the things that I think are super valuable. Like giving people back what they wanted or like they were too afraid to really speak out to their world because they didn't think they were capable.

Because who knows? That person that you're seeing might have been told for the longest that bad needs run in their family and running is just too much impact, right? And now you got someone that's too afraid to say anything else. But when you're like, Hey, let's say painted outta the equation, what is it that you want to do?

It's I just wanted to run, always wanted to be able to do an orange theory class. I've had people like, I just wanna be able to take so-and-so's Kettle Bug class. I'm like, perfect, I'm gonna get you there. Yeah. And [00:23:00] seeing people's face light up and it's oh this guy's serious. And he means it.

He's not just saying it, to say,

Danny: dude, that's so great. I love the. Just sitting down with somebody and consulting with them. That's what I always felt. I felt like I'm gonna consult with you on your body and you're gonna learn some things and I'm gonna help you, put together an intelligent plan of where we're gonna go, next, and what your goals are.

But yeah, How often does somebody get asked what do you wanna do physically? And also I think the how finite the window is for so many people too, to really realize dude, you're 50, right? You're, that's not old, but you also, you aren't young. And are there things that you want to do physically that.

You're gonna regret not doing one day if so, what are those? And I don't know if people really have the time to think about that, but think about how much of an impact that has on their life to even just be asked that question. [00:24:00] To where, you, you're like, no, seriously, think about it. What would you want to do?

In a perfect world, right? Let's say Badies don't run your family and you don't have the back of an 85 year old man what would you do? All the shit that they've been told probably. What would you do? And I think that's just such an impactful question to, to ask people and listen to them, right?

I don't, we don't listen enough. Dude. And I'm sure you talk about that quite a bit with what you're doing with mentoring other clinicians.

Andy: Yeah the listening part, it's always asking what are people looking to get out of this interaction, right? Because what they're looking to get out this interaction's exactly how I'm gonna frame everything for the person so I can position myself the solution for the person, but it's also, I can start to connect the dots, like how these exercises relate to what they're trying to do.

If someone's oh, I'm just, what are you looking to get outta session? Oh, I just wanna make sure that I'm not gonna have to get surgery on this knee, et cetera, et cetera. Alright, perfect. Now when I see them do a split squad, I'm gonna say, Hey, that's amazing. Oh, why is that?

Because this [00:25:00] split squad's eventually gonna be a lunch. This lunge is eventually gonna be a lunch stop. And now you're able to decelerate. And that's gonna be the start of changing direction. That's gonna be the start of you getting back to your sport. And if I have every progression and regression. Of every single po possible pattern that you can do as a human being in my head, I know once I get you on that map, I can progress things or regress things as needed to get you back to doing what you wanna do, and I can show you how it's relevant to

Danny: your goals.

Yeah. And it's such a cool experience too. Like I think that's clinically I don't see patients anymore, but like the thing that I think was just so cool clinically was. When someone has like a light bulb moment and not just. It's oh, okay, this is making sense. When most medical interactions do not make sense to people, they just assume you have a code on and you have a big degree on the wall.

I'm just gonna listen to whatever you say, even though it's literally making no sense to me. The words you're using aren't making sense and. But I think for us, we have enough time and we can really spend the time [00:26:00] to explain things in a way where people really understand. But it's not just that, but it's the little progress that they make.

And like the excitement that they have with some of these things. And I, we just I think we get co used to that. But man, dude, like that is such a cool moment to experience with somebody. And in, in our profession, I think that there's a lot of. Burnout to any healthcare profession because it, there's so much structured time with patient visits, but one of the things that if we really focus on and can reframe are these little moments of magic we have with people where it's not just yeah, it's a big win for them, but it's also, frankly, it's changing their outlook on what they think they can do physically and what their and what their family sees that they can do as an example, and that's such a compounding effect.

It's one of the reasons why I'm so passionate about the business side of this is because I know the better that Andy is at selling you're selling this person into what they need to do for their homework or whatever, where the diagnosis is. But [00:27:00] the better you are at that, the more people are gonna come and wanna work with you, and then it's.

How do we hire people effectively? How do we run a business? How do we optimize these things from the like systemization of this standpoint so we can have more Andys and help more people do the same thing? And it's just such a cool thing to hear, how you put it and what you're working on with people and how you're building this little army of Andys to go do the same thing cuz we need

Andy: it.

Yeah. I, on the, one of the first calls. I'll always share a story and I can always share a new story every single cohort because I always meet someone that's been absolutely fucked by the healthcare system. Yeah, and I should have asked you if I could curse the podcast. Oh,

Danny: of course. This is very curse friendly.

It's podcast,

Andy: but it, there's probably. Every single quarter I meet someone that has seen, you get the couple of people that have seen that doctor, another chiro physical therapist trainer. I was seen people that have seen 20 different people spent money up the wazo. Yeah. [00:28:00] And they just never got better.

In fact, they got worse cause of the story they were told. And it's it doesn't matter who you are. Because if you're delivering a service that has a secondary effect, You're indirectly providing healthcare, whether you're a trainer, if you're a trainer that can help someone back pain feel better through movement.

You're indirectly a healthcare provider. If I'm a physical therapist, that helps someone's back pain, improve, and now their partners are allowed to have, intercourse, et cetera. I'm indirectly potentially a marriage house. There's so many secondary effects that we don't even consider. Yeah.

If you don't get good at what you do, You just have people that are constantly paying these insane amount of money to get things that aren't better than placebos, aren't better than a treatment, aren't better than doing nothing at all. Had someone that just came in through a call that paid $12,000 for an injection.

They're waiting to see what happened in three months. And I'm like, I can tell you what, it's gonna happen In three months, you're not doing anything. Yeah. In those three months period, you're just gonna [00:29:00] get worse. Your function's gonna decrease. So it's just super frustrating that, the standard is super low,

Danny: dude, 12 grand, that's a used car.

It's it is so interesting to me, especially depending on the type of injection it is, I won't get into the numbers on that stuff, but it definitely didn't cost them that anywhere near that to actually do the injection and yet they assume that's gonna solve with their problems.

I think that's just generally people overall with, if you can gimme this pill, if you can give me this injection and then I can just sit here for three months. That sounds awesome. Let's do that. Versus, you're gonna have to. Do some work. We're gonna have to do some things that are maybe a little uncomfortable.

You're gonna have to put the time and effort in. That's just hard to sell. No one wants that. Could you imagine if you could just like, you could touch somebody and then all of a sudden they're, that lift goes up a hundred pounds. You could charge for that. It.

Andy: That, we wouldn't be doing this performance based physical therapy model.

Yeah. [00:30:00] We'd just be

Danny: tapping people. You're just, boom, a hundred pounds. That'd be awesome. So big debt to me. But, like I, I think it's hard to sell hard work. It's hard to sell effort over time and delay gratification and that's

Andy: tough. I, yeah. And one of my unique, I guess selling propositions is I sometimes tell people isn't gonna get better until you get good at these.

You can try everything, but if you don't do these things and you don't get better at these qualities, you're never gonna be able to get back to running. You're never gonna be able to get back to this sport if you look at life, everything is just handling forces. So there's nothing that's gonna get you stronger to handle forces unless you do something to your body to make it adapt.

And I think having someone sit down and realize that and telling them very bluntly, Has built a lot of trust with some of our clients.

Danny: Definitely. Even other clinicians. And I, I wonder for you, if you, [00:31:00] how many older clinicians you, you have, that you work with but even for me, like I've had, I.

I've had quite a few older clinicians that I've had that come in as patients and it's always interesting. It's cuz we can talk a little bit more in depth and I had a lady that she had pretty, I would say pretty mild scoliosis and she ended up, she lived about an hour from where my office was.

And she would come down and the main thing that we really realized with her was she just was not, Very strong. She'd gotten she hadn't been working as a clinician for years. And so she, previous to that was like relatively strong. We're as physical therapists we're oddly strong because if you're doing any sort of manual therapy, your grip strengths relatively strong.

You're doing like a. Basically payoff presses all day on somebody's knee or hip, and you're mobilizing ankles and it's like hard work. You're showing exercises and you're demonstrating you're moving. And so she just gotten deconditioned and she thought that her 12 degree curvature or whatever was mild curvature was the problem.

And.[00:32:00] I was like, this hasn't really changed. It's probably not gonna change, but we definitely want to get you strong so that you're resilient enough to stop adaptation and also to be able to do things you wanna do. And what was so interesting for me was I just took her through like basic okay, strength training.

That was it, just like basic body weight to then loaded to the, movement progressions. She just was like so interested in learning. She was like, this is amazing. Why does no one teach us this? No one taught me this and. I don't know if you've experienced that with older clinicians that do mentorship stuff with you, because I see two sides of it.

I see some, and I try not to ever get to this point where it's just, I'm so set in my ways and it's like, why did it this way? And why are you trying to change whatever? And then other ones that are like very open-minded and wanna learn, they wanna learn more. So have you noticed that with older clinicians that you have a different approach with them?

Is it harder to work with them? Easier? What's your process been with them?

Andy: No I think just a couple of things. I think it takes a certain type of person to reach out. A physical therapist to reach out to another physical therapist, they need [00:33:00] help. So those, the people all the respect, because that's not easy, right?

To be like, Hey, I don't know what's wrong with my body? And I study the body for a living. We've actually had a couple of people that are clinic owners go through the mentorship. And they're just like, Hey, just letting you know everyone that we hire is gonna go through this mentorship. You're gonna be responsible for onboarding all of our clinicians.

Because I've never been, I've ne I've done these things tripped to me, different avenues. But I've never had something so structured and so organized and ready to implement like yours. So I've actually had people go through mentorship. Message me after to become a client. Cause it's just I just need help.

I need to, I wanna learn hands on. I wanna know exactly what you think. Cause I've been dealing with multiple pain and multiple body parts injuries. But I find that the older clinicians are just amazed. Like they're, they have a couple of things that they know works. [00:34:00] And if, you know from a manual therapy standpoint, oh, when I see this, I do this and it works, then yep, there's definitely that.

But when you start to work with more active population, Those hands on treatments can only get you so far, right? When that person has to, once that person put, hits the ground, a lot of impact going up the chain. So it's like, how are you preparing yourself for that? So I find that the older clinicians that are willing to reach out for help, they tend to do pretty well.

We actually have an e-book back to an e-book that we have on our website, and I found that a lot of clinicians were signing up for the ebook. Sure. And we're creating a CRM and the trip sequence behind that ebook. And one of the things where thinking is hey, we should probably classify whether or not someone's a a therapist or a potential client and see what sequence they get.

And then I realized half my caseload is trainers and other clinicians, so we don't even have to classify it cause of the same trip. Cause they might end up being fine as well. Yeah.

Danny: Dude, not [00:35:00] only that, but I think that's one of the best ways to learn. Like I've hired. And paid for the time of other clinicians for stuff that I was dealing with.

And but also as we're going through working on something, we can talk about the thought process of what you're looking at, what you're seeing why does this create this problem? And, what's the solution? What are we need to do over time? I found that with, when I started to implement using like p r I stuff is going to work with P r I.

Certified providers and being like, why are you pushing on my ribs and have my hand over my head? I know I went the course and I understood at the time, but like, how does this apply to what, whatever overhead mechanics or something, and then they can just synthesize it so much better, and it's always, I always appreciate it too as a clinician. When somebody was a clinician or a coach, they would come and would value my time enough to want to book a visit with me and. And to work on themself, but also open to have a [00:36:00] conversation and learn. So I think that's a really good sign.

And to the older clinicians, what I've seen, and this is where I'll say, if you're older like me, usually a you're great subjectively, you're, you've had so many more conversations. And then the other thing they're usually really good at is manual work. Cuz they have so much more time and they have Oh yeah.

They're just more, actually more intricately, better at that. But it's the program design, it's the. It's getting somebody from the table to real life is where I think the gap is. And if you can add all that together, you have a super clinician. And that's what we need a lot of super clinicians that know how to apply all that together.

And that's, I think, where the missing link is, which has been cool for me to see you try to pull all that together and take a crack at it. Cuz nobody's, lots of people have opinions and they have methodologies, but I just don't think it's really been all that well organized to get people up and running.

Fast enough, like you're talking with these clinic clinics that are bringing you in to work with their staff and, I, it's very needed. It's something I've been hoping somebody would do for a long time.

Andy: Yeah. This and with nuance, [00:37:00] and especially with exercise, you sometimes you might be selecting to right exercise, but just executing it wrong.

You don't know what's exactly what you're looking for. So having the context instead of saying, physical therapy school, whenever you ask your professor a question like, Hey, is this the right answer? It depends. Yeah. And say, okay, when does it depend? That's not for the scope of this class. Yeah.

You never get your an, you never get your question answered. Sometimes you're at a con weekend, they'll tell you. It depends. Say, oh, we'll get to that by the end of the weekend, hoping that you forget they don't have to answer that question. Yeah. And these things sound so great. It's oh, when you see this plug this is always gonna work.

And it does, maybe for the next two to three patients then the next five are like, oh, that is. Striked out, and that was just not the outcome I was looking for. But how do you pivot in those situations? You know what's your thinking behind how you do everything? And that's the hardest thing to teach.

But I think that's where, that's again, creating leverage, right? Are you able to teach all these little [00:38:00] nuances, the when you might change and make a pivot? Again, continuously get good outcomes.

Danny: This is a great segue to of the last sort of talking point that I wanted to have with you. And last question really is just you at, to this point now you've been mentoring quite a few clinicians.

What have you learned about being a mentor? What have you learned about helping develop young professionals within our profession that. A maybe you found that was hard and also anything that you found that you're like, man, I didn't expect this to be as important as it is. Yeah, so

Andy: the main thing is being completely honest with yourself, right?

There's gonna be things that you thought you taught well. And then as the criteria moves on, it's oh man, they did pick up on so and and having a checklist of making sure that they understand how you can Almost check off if someone has confidence. Cause the content would always keep building every single week on the previous week.[00:39:00]

So for me now I put a little bit more repetition in the actual content itself and I'm always connecting things back to what was previously taught. So the hardest thing for me is being really honest with myself of like how much is actually being learned, how much of it's just like going in one ear and out the other.

Cause there wasn't enough context that I provided. And what I've done more now is teaching everyone, like I'm teaching a client of mines and I think that's really helped a lot. Instead of trying to sound super, super smart, how would I explain this to a client that I'm working with? And that's the approach I've been taking.

I think people are now understanding things even more, even better, and even more. But you have, in our cohorts, we have cohorts of 20 at a time, so that's what we capture that. There's gonna be trainers, there's gonna be coaches, there's gonna be people new into training, there's gonna be physical therapy students.

It's slowly gravitated towards more, more established clinicians and established trainers. But we still have people that are [00:40:00] new to the industry. And again, we're all on this call together. And to be able to explain it in a way that everyone understands, I found the only way to do that is to explain it to them.

They're a patient of mine. And that's been

Danny: really helpful. No, that's super smart that, you've, you realize like you already know how to do that one way with one type of person. And it applies the same with with clinicians. And I think simplicity is the key, right? And what you're talking about is development of frameworks and going back to those things when things don't work out the way that you expect because.

No matter who we are and how much experience we have, we're not always a hundred percent right. Like the human body is complex and it's not a transmission it's not as simple as just like a mechanical, thing that we might want to compare it to. And having those basic frameworks and understandings of like why you did what you did and what you'll do next, whether they get better or whether they get worse is just.

That's it, man. That's the key to constantly being right more often and helping these people really achieve, what they want to do physically and [00:41:00] getting them back that best they can. Andy, this has been fun, man. I don't get a chance to talk clinically too often. I just mainly nerd out on Sales and marketing and but I got a degree, dude.

It's right there. And it used to be the only thing that I ever focused on. I just love this stuff so much and it's just fun to be able to catch up and chat about it. And if people are interested in learning more about, what you're doing, in particular, the mentorship you have going on, like where can they where can they learn more?

Andy: Yeah, so my Instagram is at Dr. Chen and at Moment education will be on my bio. The moment, education is the the brand. And we have two things under it. One's a mentorship and the other's foundations, which is our seminar. And New York City sold out nice. But we got Miami and LA coming

Danny: up. When are you coming to Atlanta?

You gonna, this is a big market. You coming down here? Yeah.

Andy: I was tossing around an idea of having a bigger tour, I guess you can call it. Yeah. But for me it's always Hey, let's do. Let's do a [00:42:00] few and let's figure out what could be better. And then when you have a really nice launch, let's have that, refined product need to launch.

So everyone in this first year does get a nice little price and everyone in the second year will just have a more refined product at a little bit more expensive price. But my goal is to always keep getting better, keep being honest with myself and see

Danny: where I can improve. Man, I appreciate your time guys.

Check out what Andy's got going on. I think it's a really well thought out. Framework of what's going on with the cl the performance-based clinical approach, which if you're interested in that and you're tired of ConEd hopping, which you know, which a lot of us do and you want something that's a little more organized and structured I think it's totally worth it.

I've gone through it, I've checked it out and learned a ton from it myself, even though I'm not even treating anybody, although I see friends and family, my neighbors. That's our gentleman's agreement. You jack yourself up, come to the, come to my garage, I'll help you out. So I still gotta stay sharp for them.

So anyway, Annie, thank you again for your time, man. I really appreciate it. And as always guys, thank you so much for listening to the [00:43:00] podcast and we'll catch you next week.

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