#60 - Supercharge your Clinical Skillset, Part 2

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The business, then between between the
business. Hi guys, welcome to a
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new episode of The Factor podcast.
I'm your host Jessica Riddle. If this
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is your first time tuning in,
welcome and thanks for listening. Today we
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wrap up our two part training titled
Supercharge your Clinical skill Set with Doctor Benjamin
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Fergus. Doctor Benjamin Fergus is the
owner of Cornerstone Help, a clinic specializing
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and helping individuals overcome chronic pain and
regain their quality of life through their unique
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approach called the Grip approach. Doctor
Fergus and his team have achieved a remarkable
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ninety nine percent success rate in treating
chronic pain. They focus on helping their
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clients achieve their goals through foundational fitness
programs. In today's training, doctor Fergus
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will discuss how he asks questions about
the tasks and activities the patients find challenging
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in order to set objective and physical
goals rather than just basing their goal solely
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on pain. He will also discuss
the importance of setting macro goals and then
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identifying micro barriers that prevent patients from
achieving them, and walk us through his
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process for creating a recovery roadmap.
So pull up a seat and be prepared
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to take notes because this episode is
packed with valuable tips and practical advice.
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Let's get started. So let's talk
about drafting or building your perfect team.
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Now again, if you are a
solo provider, and maybe you intend to
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stay a solo provider, this might
not be directly applicable. However, the
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things that are listed here are things
that you can build within yourself as a
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skills tower. But this is really
geared towards those that are part of a
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team or are looking to build a
team to scale their impact and scale their
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success. At the top of the
team, you need an examining individual.
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I put clinician on here because I
run a clinical practice. The guy at
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the top or the lady at the
top is often the highest skilled person or
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they hold a license that has the
most privileges and allowances to make it easier
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for everybody to work under them.
Next, we need to find that first
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great treating provider. The treating provider
needs the top two here, one or
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both of the top two. First, they need to be able to deliver
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corrective exercises or rehabilitation, and the
second skill area for the provider is being
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able to deploy soft tissue therapies.
Finally, it's helpful to have somebody that
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has some specialization and a board certified
treatment skill like a chiropractic, adjustment,
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acupuncture, nutrition. And this can
also be the same person as number one,
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the examining clinician, until volume becomes
excessive, so at top it's probably
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you. We have the examining clinician. Then you need your number two person,
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you're treating provider that is able to
step into any case that you've pinpointed
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and effectively deploy a skill set that
you train them or that they have to
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use, corrective exercises, tissue therapies, etc. A lot of professions can
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be applied here. For your tissue
therapies, you might use a highly skilled
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massage therapist I think we've got one
tuning into this message. Or you can
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train an athletic trainer, a chiropractor
or a PT with these skills. Additionally,
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for the corrective exercises, you could
use a highly skilled and trained personal
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trainer, or again at a clinical
degree, with an athletic trainer, chiropractor
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or PT. Finally, I believe
the next step should be a fitness or
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exercise provider. Now you might not
think about using a gym or fitness in
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your clinic, but this is the
direction. A lot of the most effective
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practices are moving, including my own. Any of the above providers are treating
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providers can also deliver fitness that can
be part of their schedule. I've done
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it. All of my treating providers
have done it for a period of time.
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But when you get to a point
when you can hire a separate person
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as that personal trainer, it becomes
more efficient and it gives a little different
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flavor to the training side of what
we do. But again, number one
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or two can deliver number three,
but number three can't deliver number two or
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one. So we start at the
top and work down this list. Once
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you have your team, we need
to train them well. I've looked at
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a lot of teams and practices that
work extremely well and those that suffer.
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The most effective teams have a clear
mission, They communicate with the same system,
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they meet and train regularly, and
everybody knows their role. This is
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how you can train your team with
GRIP, whether it's a new hire or
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somebody that's been with you for a
while. First, it's observation. They
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join you for an exam, they
join you for a treatment, they fill
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out the charts, they learn the
language of the practice and the mission of
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the practice. Along the way,
they're going to meet a lot of patients
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and everybody gets aware of the team
approach that you're building. Next virtual training,
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your new hire can complete their Virtual
GRIP coursework and practice it on their
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own time. A dedicated learner could
learn the whole system in one to two
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weeks. Then they can begin to
use a Virtual GRIP as their quick reference
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to start contributing to care any case
do you have. There's some great techniques
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within GRIP to help you accomplish those
goals. Finally, and this is a
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spot where I think a lot of
teams struggle. You need either weekly or
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daily training. That is daunting,
but let's break it down. I have
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a team skills meeting three days a
week for about thirty minutes with my whole
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clinical team. Each of those three
days we tackle one movement, limitation,
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or one concept. We look at
it forward and backward and make sure everyone
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gets it and anyone could step in
for that micro problem and solve it.
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Then eventually, your most skilled team
member, your most skilled provider, can
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take over leading these they can begin
to educate those under them. It doesn't
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always have to be the person at
the top. Finally, when we complete
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a segment, we hold a little
bit of a longer session one to two
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hours, one to three hours where
we meet down in review and work out
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some details, or we attend a
full seminar together. Team training the big
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thing here as you think about committing
your time and resources to training, you
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have to remember the more skilled your
team is, the more they can accomplish
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for you. This is a struggle
for most practices that add somebody new and
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they want that person just to step
in and add value right away. Ultimately,
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a lot of providers feel one of
two ways. Either one they trust
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the person they hire they want to
hand the case over and forget about it.
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Or two, they hire somebody yet
they don't trust them, they don't
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trust their skill, and they don't
trust they're going to take good care of
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the patient. And in that scenario
they become deadweight financially. And it's not
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on that provider, it's on the
person who hired them and hasn't trained them
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enough that they can trust them to
be effective with care and communicate well.
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So every time I'm put an hour
into training, I'm remembering, I'm freeing
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up my own schedule. I'm allowing
more people to be trusted with the patients
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i'm trying to help, and that
allows us to scale. So we're at
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a spot now where my team can
pick up my chart for any case I
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examine and lead the entirety of the
care. Without me, I can still
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step in occasionally and provide a skilled
aspect of care or redirect, but our
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training has allowed me to maintain exceptional
skill and success, and that's what our
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reputation is based on. We don't
want to be known as the person who
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delivers X tool. We want to
be known as the expert that solves problems.
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It doesn't matter what the skill set
is, it matters how you deploy
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it and how you attach it to
the patient's goals. So, in summary,
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we need to focus our intake on
physical goals, not subjective pain.
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First, identify the macro goals and
get your patients motivated. Then identify the
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micro limitations that need to be overcome. Take action by utilizing your entire skill
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set to guide the patient to their
goals. Build your own clinician skill set
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to widen your range of treatment options. Then leverage your skills and degree and
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build a team. Successful teams rely
on a common mission, great systems,
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and consistent communication. GRIP approach was
designed to work in busy clinics, to
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be scalable and deliver consistent results based
on the research. That's the end of
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my presentation on supercharging your skill set. Today's training is brought to you by
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Southeast Professional Education Group. Are you
a healthcare provider interested in teaching? Have
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you developed content or a curriculum but
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wants to offer a virtual summit or
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and marketing are just too much for
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statements have you shaking your head yes, then it sounds like you could use
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our help. For almost a decade
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known as Southeast Sports Seminars, has
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For more information, visit the link
in our show notes to schedule a call
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with a member of our team.
We can't wait to speak with you.
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Thank you so much, doctor Fergus. We want to open the floor now
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to some questions. We do have
a few that have came through throughout the
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presentation today, so I can go
ahead and start asking those, Doctor Fergus.
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Towards the beginning, you were talking
in your assessment about the need to
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not catastrophize pain. Do you have
some guideline for how to address patient's pain
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and how to give them the appropriate
education about their diagnosis without catastrophizing it,
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or some best practices that you utilize
for that. Yeah, that's a great
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question, and this is the mindset
challenge that it's probably the one that's hardest
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to shift to. In fact,
even when I work with a patient,
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I often have to remind myself to
shift that language to an extent. We
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don't want to ignore pain. Pain
is a vital essentially a vital sign that
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we know what the person's experience of
the discomfort is, but we don't want
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to get in the habit of viewing
it the way we view other vitals.
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It's hard for a heart rate to
lie to us, it's hard for motor
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neurotesting to lie to us. But
it's really easy for the pain experience to
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be inaccurate to actual damage or threat. So we can acknowledge. And when
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I acknowledge, I typically still want
to go in a way that's not attributing
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extra value to the pain. So
let me demonstrate. If you come in
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you say, my hip really hurts. As a provider who doesn't follow these
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methods, you might say, tell
me about that pain. Is it sharp?
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Is it tingly? Is it throbby? And as you ask these questions
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you might get a little more info. But also the patient is now becoming
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more focused on the pain, and
their internal dialogue is, oh, it
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is sharp? Is that an issue? That it's sharp? Do I need
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to be concerned about cancer? If
it's sharp? Am I ever going to
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get better? These are the internal
catastrophizing thoughts that people with chronic pain and
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even those with a cute pain are
often thinking but not always saying. So
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we want to get detailed information about
pain without letting them snowball their concern about
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it and without attributing any false value
to it. So let's take that again.
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Somebody comes in and I say,
why are you here today? And
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they said, my hip really hurts. I say, I'll I understand that
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is so frustrating when the hip hurts. Help me understand this more. What
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are some things that you are doing
that you feel your hip is limited you
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from? So at that point,
I've acknowledged the pain, and then we
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can start to ask the question like
we might want to naturally say does your
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hip hurt when you flex it or
when you extend it? But I'm going
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to ask what things do you struggle
doing? And they could say a squat
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or I have a hard time shaving
my calf or I can't tie my left
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shoe. At that point, you've
learned some movements that are painful without asking
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them what movement is painful? So
we're gradually acknowledging and shifting the dialogue.
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And in our chart that we're typing, we can still talk all about pain.
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I'm just advocating that we don't focus
the language we communicate to our patients
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on pain. As a follow up
to that, in that slide, the
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file on the side called repair ruler. If you look at that. The
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first page is a diagram, but
the second two pages are in a printable
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format that you can print front and
back and laminate. The front side talks
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about healing times, but the backside
is all about transitioning your dialogue from pain
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focused to function focus. So that's
a really good guide and tool for your
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attendees. Absolutely, that's wonderful.
When it comes to going along this same
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discussion about catastrophizing pain, how have
you found that this is a bit of
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a different conversation or is it a
different conversation when you're addressing athletes who are
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actively playing and you want to make
sure that you're not you're instructing them on
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how they need to change maybe their
training or their even play schedule, but
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then at the same time without catastrophizing
so that they have really bad fear avoidance
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behaviors. Yeah, these are some
great questions. So just in this question,
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are we assuming that the athlete is
presenting to us with an acute,
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painful injury or any presentation? I
would say, if maybe we can address
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it from an acute presentation and then
any presentation, if there's a difference between
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how you would address it in each
of those scenarios. Yeah, So let's
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use an example. I was working
with a football player who was trying to
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get drafted in the draft this year, and leading up to training, somebody,
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a different player dropped a stack of
weights directly on his foot two weeks
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before he had to run his forty
yard dash for his pro day. So
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that's an acute injury, a painful
acute injury, and he has some really
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specific things he has to do.
He wants to run a forty yard dash
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in two weeks and get drafted in
the NFL. So we need to know
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both factors. And I think it's
that second group of factors that gets often
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ignored, which is those physical goals. If I sit down with him and
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all I'm focused on is the plates
that dropped on his foot, what hurts,
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and what's going on, we're never
quite getting to his clear goals,
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which are what he wants to do
two weeks from now. Now. Two
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weeks is an absurd time frame to
come back from a lot of injury things
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like this, But there's consequences if
he chooses to run his forty yard dash.
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He has the two consequences. One
he might not be fast enough,
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and two he might do more damage
to his foot. Neither of them are
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good. On the flip side,
if he chooses not to run his forty
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time, he might not have enough
data points to get selected for the draft,
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and he might feel like he misses
out on a big opportunity. So
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we need to know the consequences even
as we do the exam, because it
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might change the way we do things. So when I see this person,
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I'm going to be talking to them
some about their pain, and it's primarily
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a locating thing. I need to
know where the weight was dropped, and
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I still need to know what's limited, so I can ask him what movements
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are limited, what tasks he can't
do, and why. I'm not going
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to ask him any of those questions
with the P word with pain. I'm
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simply going to say, what happened, where did it hit your foot?
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What can't you do? And can
you show me what's not working? Now?
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He can tell me all he wants
about pain. I can acknowledge his
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pain, but I try not to
repeat and build up any question about pain,
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because that again builds concern for the
individual. He's going to tell me
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anyways, because it hurts and it
gets in the way of his goals.
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But by asking it directly and getting
way too in detail about the pain,
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I don't necessarily lead myself to more
actionable steps. He just builds up a
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lot of information in his head about
the quality of pain. So in this
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case, I still need to know, essentially, is it safe to proceed
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with treatment, and do I need
extra imaging? Based on the type of
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injury and what he wants to do, I know I need imaging, so
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I do an initial exam, I
determine what errors need to be imaged,
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and I send him off and I
get those findings, and when he comes
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back, we sit down and say, here's the situation. The imaging is
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showing us what kind of injury it
is, and fortunately it's not the most
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severe type. So we can train
and we can get better, and we
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ideally get you ready for the NFL. But we need to know the consequences.
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If we train really hard right now
and you get back to running your
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forty, we do have a risk
of doing too much and causing a slowed
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healing time. Also, you might
not run your best time. Now,
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I'm not going to advise you whether
or not to run your forty, but
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you should have that conversation with your
agent now. Conversely, if you choose
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today that you're not going to run
that forty and you're going to go into
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the draft without it, then we
can start to build up slowly and gradually
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on everything we need to do to
get you ready for after you sign with
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the team. So I'm talking about
all the things he wants to hear.
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I'm getting the information he needs,
but I'm trying not to build up a
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lot of doubt and a lot of
concern around pain discussion. Does that answer
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the question? Yes, that was
a very very thorough question. Thank you
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for that. Shifting now to building
your team, you mentioned a lot about
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how it really is important not only
to develop a team that has different skill
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sets that can compliment yours and essentially
help you accomplish more with your patients.
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What have you found are some best
practices that you've utilized in your clinic for
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sourcing these team members? Where are
you finding them? Where do you feel
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like are the best places for practitioners
who are looking to build a team to
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really start finding that talent. And
I think it's probably different for each regionality
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and country. For two reasons.
One, people look at different sites in
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each region, but also depending on
the state or country you're in, the
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provider that you hire may have different
allowances to them. For example, I
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can use an athletic trainer as a
clinical extender for ninety percent of the things
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that I do legally and bill for
it, but in some states that's not
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available at all. So there is
some regional variants to this. But I
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always start with the problem, So
the best thing to do before you make
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a higher is clearly identify what problem
you're trying to solve with that higher.
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Right now, I'm not going out
looking for another examining provider because if I
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see six or eight exams a week
myself and that's my role, that's enough
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new exams to keep my practice really
popping. So I don't need another examining
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provider right now. But I do
have a need for more treating providers,
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and specifically, right now, I
have a team that's really good at delivering
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effective corrective exercise, but I need
more team members that can deliver tissue therapy
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and other soft tissue therapies. So
I've narrowed my need down to the essentially
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the specific things that we can't do
enough of right now, and at that
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point you try to determine what the
best profession is to fill that role.
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And another thing I like to do
is do a little calculation of essentially how
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many hours I think this person would
have on a weekly basis. I try
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not to hire part time. I
do have some trainers at a part time,
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but I try to envision every higher
being a big part of the team
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where they can quickly progress to full
time. So once I have all that
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data, I write a job description
that tries to specifically find the person I'm
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looking for, and that's story.
Branding is a common way to do that.
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So we can say something like,
if you want to enhance your skill
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set as part of a team and
spend your day helping patients overcome chronic pain,
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I've had a perfect job for you. Learn and grow with us in
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Evanston, YadA, YadA, YadA. We try to highlight what somebody that
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we want is looking for in that
job posting, and for actual locations,
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I do a broad initial search.
I push that out to schools and profession
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boards of the profession I'm trying to
hire, and I've had great success finding
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good people on indeed dot Com as
well, and then we have a few
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layers of screening to get the right
person in. Because we've built a team,
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I'm actually the last person that any
applicant sees. First, my team
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has to approve them as an individual
that they want to work with and train
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with, and then they'll send them
to me and I make the final decision.
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Wonderful. So, kind of diving
a bit deeper into the interview process,
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do you have like a set list
of standards that you want to ensure
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that you're so that every staff member's
kind of on the same page in terms
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of making sure that they fit the
criteria that's needed before they come and meet
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with you. Does each individual staff
member have a different role in the interview
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process dependent upon the type of role
that you're looking to fulfill or the type
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of role that that existing staff member
fulfills. What does that interview process look
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like? Yeah, I think the
answers yes to all the above. We
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do have the process systematies that works
well for us. Now. Ultimately,
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no matter which position we're trying to
fill, every possible hire has to fit
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the following few things. One,
they have to have a energy and be
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enjoyable to talk with, because ultimately, when you work in healthcare, it's
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a talking profession. If you don't
connect well with individuals on the team,
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you won't learn well. If you
don't, we don't think you connect well
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with individuals of various backgrounds. That
can be a barrier to therapeutic success.
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So we would just want to have
fun talking to the person that's got to
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be there right away in a clear
communication style. Next, this is key,
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no matter who it is, what
professional want age, they have to
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be eager to learn. They have
to value education and learning because our jobs
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aren't easy. And for me,
I've been doing it for a while,
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I study a lot. I want
to get better every day, and I
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don't want to be slowed down by
team members that don't also want to get
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better every day. In fact,
right now, the next room over my
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head athletic trainer who's been with me
a little over three years, is leading
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a seminar to the rest of our
staff and some local referral people, and
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he's teaching them more about what we
do and he's honing their skill because he
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wants to learn every day and the
whole team does as well. So fun
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to talk to eager to learn,
and then they have to contribute some unique
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skill to what our needs are,
whether that's soft tissue or exercise. They
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have to have enough of a background
to not cause harm, and then we
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train them up to be able to
achieve success. Now on that interview process,
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another really important thing for us is
being reliable. So we have a
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few ways to screen people coming in. We make sure they send us an
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email resume, and we put a
couple of things that they have to fill
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out in a title page because often
when you put these job postings, people
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are just looking and they're sending you
a resume and they don't even know who
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they sent it to. And we
at least want enough attention to detail and
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reliability that they read the whole post
and they fill out a couple things and
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send it to us. So that's
screening. On next, we schedule a
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specific time for them to have a
call with our receptionist and that's just fifteen
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minutes of getting to know them and
seeing if they're fun to talk to.
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And I'll tell you what, eighty
percent of the time we schedule somebody for
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that meeting and they're late or they
don't show up and then the twenty percent
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that do show up right away,
Our receptionist says, Okay, I've narrowed
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it down to three that are the
most fun to talk to, and then
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we start to bring those three in
and we move them on to the next
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step about skills, and it's not
just fun, but engrossing, engaging,
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good conversationalist. Absolutely, and I
think across the board, what we've seen
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throughout several discussion boards that we've found
in Factor even is that those soft skills
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are so important, that interpersonal skills
are so important being a great team member,
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being reliable, but then also having
a great bedside manner with patients as
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well and being able to compact with
them in an engaging way. We're in
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a role where we're often guiding people
through some of the hardest time of their
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life, and there is a skill
set that needs to be somewhat natural but
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also built upon to be able to
have tough conversations with people in pain and
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to still guide them away from pain
into success. So that's something we try
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to identify, at least a basic
skill set and eagerness to learn. Absolutely.
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Do you find that your team approach
to treatment is something that really drives
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a lot of your local marketing in
order to bring new patients in the door.
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Do you really emphasize the fact that
you do have a multifaceted team approach
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to care. I've had this conversation
with another really good marketer, doctor Kevin
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Christie, who focuses a lot of
education on marketing for chiropractic offices. I
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initially told him that I don't market
at all, and he looked at everything
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I do and says, no,
You're actually really good at marketing. So
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I think there's some It depends on
the perspective. We don't do a whole
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lot of advertising, but we do
a lot of educating what we do,
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how it's different, and essentially that
we help people get back to things like
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Tom's golf trip, for example,
And when somebody comes in they see some
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videos in our lobby that shows our
whole team working with people. And I
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will often make sure that anytime a
new patient is in the office that our
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individual team members see them say hello, say I'm doctor so and so,
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I'm part of the team here.
We look forward to helping you achieve great
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things. So we're always introducing the
team so that it's not a surprise when
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somebody other than the examining physician picks
it up and runs with it. Also,
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when we meet with other practices,
I always emphasize that we have a
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lot of different skills in our practice, that we have a team approach,
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and we like to go and help
to share our knowledge base with other practices.
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But I don't think we do anything
that directly markets to patients that hinges
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on the idea idea of us being
a team. But it's pretty evident when
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you're here that different people can add
something really unique to care and that there's
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a benefit for them to be able
to schedule whenever they want because they're not
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trying to only get on my schedule, which is booked out. They know
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they can work with anybody and have
really good results. Absolutely, and I
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think that's a really important component that
a lot of practitioners sometimes lose sight of
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in terms of building their business,
is making sure that it's built with the
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ability to have an exit strategy in
mind, and not even from a I
369
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want to leave or sell my practice
one day, but in the case of
370
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something happening to me and I'm hospitalized
and are injured or Lord forbid, that
371
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the worst happens and I'm no longer
here. Can my practice carry on without
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me? Do those patients still have
the same high level of care if I'm
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there or if I'm incapacitated for a
certain period of time, And then,
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of course it's nice to be able
to take things like vacations every now and
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then. I'm sure you would agree
as well. Yeah, I think to
376
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circle back on that, one of
the biggest stressors for practices of solo providers
377
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is feeling like they can't step away
because nobody's going to care for their patients.
378
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And when I think about my learning
and training and this staff, I
379
00:31:18.640 --> 00:31:22.559
try to think about everything that I'm
the only one that can do it.
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And when I look at that list, initially I thought, I'm the only
381
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one that can do this corrective exercise, I'm the only one that can do
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this tissue therapy. I'm the only
one that can do this adjustment. And
383
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what I started to do at that
point is change that as fast as I
384
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could and say, if I feel
like I'm the only one that can do
385
00:31:41.400 --> 00:31:45.759
this tissue therapy, then I need
to do a better job of training my
386
00:31:45.839 --> 00:31:48.960
hire and I train them and train
them and train them until I can say
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everybody can do this tissue therapy,
you don't need me, and I start
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to take away from what makes me
unique as the only person that can care
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for them, until the team is
the one that cares for them and I
390
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only have to step in for the
thing that nobody else can do. And
391
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I want that only to be two
things complex exams and right now the chiropractic
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adjustment until I have another chiropractic adjuster
on the staff. Absolutely, and I
393
00:32:19.079 --> 00:32:24.920
think that goes even beyond a clinical
setting because oftentimes we find that practices because
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of that doctor patient relationship. It's
really hard you mentioned for practitioners to kind
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of put their business hat on and
step outside of the thought process that I'm
396
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the only one that can provide care. The business world, we talk about
397
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things like genius zones and kind of
discovering like, what is your specific contribution
398
00:32:45.680 --> 00:32:50.920
to this business? What is your
specific contribution to patient care that no one
399
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else can do quite the way you
do? Ye? Was that evolution and
400
00:32:55.519 --> 00:33:00.720
decision process for you and kind of
deciding, okay, these are the two
401
00:33:00.759 --> 00:33:06.839
to three things that I absolutely want
to be the person to handle versus here
402
00:33:06.839 --> 00:33:09.880
the other components of treatment and care
that I feel very strongly about having a
403
00:33:09.960 --> 00:33:15.640
staff takeover. Yeah, there was
nothing wrong with being a solo provider that
404
00:33:15.720 --> 00:33:20.400
skilled at everything, but it is
pretty exhausting to operate in that way,
405
00:33:20.839 --> 00:33:24.880
especially when the demand for your time
exceeds what you have available for them.
406
00:33:24.960 --> 00:33:30.759
And ultimately, I think I think
initially when people are building up their skills
407
00:33:30.839 --> 00:33:36.880
tower, they think about separating themselves
from competition by becoming the best. I
408
00:33:36.880 --> 00:33:42.440
think that's part of the drive to
keep educating, and that's fine to motivate
409
00:33:42.480 --> 00:33:45.680
yourself early on. But ultimately,
any of us in these health professions,
410
00:33:45.720 --> 00:33:51.720
we really only see a small segment
of the population. I'm in an average
411
00:33:51.720 --> 00:33:55.480
sized town of a quarter million people
that's right next to Chicago, so maybe
412
00:33:55.519 --> 00:34:00.759
a broader reach of three four million
people in my Needd area, and there's
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00:34:00.799 --> 00:34:07.079
not enough chiropractors and rehab specialists to
service that whole population. And that's okay.
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00:34:07.079 --> 00:34:12.320
I mean only a segment of the
population seeks care for non surgical,
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00:34:12.400 --> 00:34:16.559
non pharmaceutical care. I don't believe
there should be a competition from provider to
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00:34:16.679 --> 00:34:21.559
provider. In fact, the other
chiropractors in town, I invite them in
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00:34:21.599 --> 00:34:23.519
for education. If there's a patient
that's a good fit for them, I
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00:34:23.599 --> 00:34:28.000
send them that way. We want
to be a service to those individuals,
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00:34:28.079 --> 00:34:32.800
not a competition, So ultimately I
don't need to distinguish myself as the most
420
00:34:34.000 --> 00:34:39.280
skilled individual for let's say a chiropractic
adjustment. The way we distinguish our practice
421
00:34:39.719 --> 00:34:46.440
is we're a practice that is the
best at clearly identifying what the problem is
422
00:34:47.239 --> 00:34:53.960
and finding a solution to get the
client or the patient back solving that problem.
423
00:34:54.000 --> 00:35:00.119
And once we've identified it, they
can seek the treatment portion care anywhere.
424
00:35:00.599 --> 00:35:05.760
So technically I could probably have an
office filled with just exams if I
425
00:35:05.800 --> 00:35:07.639
was a solo provider, and all
I would do is exam, write down
426
00:35:07.639 --> 00:35:12.000
exactly what needs to happen, and
get them off to another provider. But
427
00:35:12.400 --> 00:35:15.119
it's helpful to have that all in
the same location. That solves a lot
428
00:35:15.159 --> 00:35:19.719
of problems. So we had to
build a team that could provide the care
429
00:35:19.960 --> 00:35:23.920
that I knew that person needed.
So for me, I quickly understood that
430
00:35:24.000 --> 00:35:29.840
my unique value was in the way
that I examine and diagnose a patient.
431
00:35:30.199 --> 00:35:35.719
And that's also where I found the
most fulfillment and the most joy. If
432
00:35:35.760 --> 00:35:37.960
I had a day of just exams, I'd be really happy. I know
433
00:35:38.079 --> 00:35:40.559
some providers that don't want to examine
at all, and if they had a
434
00:35:40.639 --> 00:35:44.440
day of just adjustments, they'd be
really happy. And if they're in a
435
00:35:44.480 --> 00:35:46.719
position to do so, they can
build a team that does the exam,
436
00:35:46.760 --> 00:35:51.199
they rehabing the soft tissue and they
can just adjust, or they can seek
437
00:35:51.239 --> 00:35:54.320
a position where that's all they do. But I think knowing what leads to
438
00:35:54.360 --> 00:36:00.199
your own personal fulfillment is a good
way to start understanding what other pieces you
439
00:36:00.239 --> 00:36:05.679
want to bring in and be a
team. And now, because my business
440
00:36:05.840 --> 00:36:09.960
doesn't rely only on what I do, it's an actual business. It's not
441
00:36:10.079 --> 00:36:16.400
just a brand where everything's about doctor
Fergus. It's a brand where Cornerstone Health
442
00:36:16.480 --> 00:36:23.559
solves chronic pain in Evanston and Chicago
and people come here to overcome pain restorabilities,
443
00:36:24.039 --> 00:36:29.159
no matter who they're with. And
I love that mission because it allows
444
00:36:29.199 --> 00:36:34.079
us to be the most flexible and
the most effective with our approach. Absolutely,
445
00:36:34.119 --> 00:36:37.119
And I think that kind of goes
back to the old adage of do
446
00:36:37.199 --> 00:36:40.280
you have a business or do you
have a really expensive job? But yeah,
447
00:36:40.440 --> 00:36:44.480
that's right. Sometimes when you're the
one wearing all of the hats,
448
00:36:44.480 --> 00:36:47.559
it can begin to feel that way. I know that within your Grip approach
449
00:36:47.679 --> 00:36:52.599
framework, you have a clinical track
and you have an exercise track, much
450
00:36:52.679 --> 00:36:55.960
like we in Factor have the Factor
rehab system, and then we have rehabed
451
00:36:55.960 --> 00:37:01.360
a fitness which is more oriented towards
post rehab and going into fitness. You
452
00:37:01.480 --> 00:37:06.760
talked a little bit about having exercise
professionals as part of your team, but
453
00:37:06.800 --> 00:37:10.559
then also having rehab specialists that are
more clinical, such as your athletic trainers
454
00:37:12.039 --> 00:37:17.719
in your practice. How do you
determine at what point someone can do rehab
455
00:37:19.000 --> 00:37:23.320
with your needs to do rehab with
your rehab specialists, your athletic trainer,
456
00:37:23.880 --> 00:37:30.559
versus when they can work with your
exercise specialist. Because nowadays there's a lot
457
00:37:30.599 --> 00:37:38.559
of controversy around kind of the gray
area between rehab for pain versus exercise for
458
00:37:38.679 --> 00:37:45.360
fitness and kind of where those two
converge. And I think exercise is an
459
00:37:45.360 --> 00:37:50.880
effective pain management tool as well,
but often should be guided by a clinician
460
00:37:50.960 --> 00:37:54.000
if it's being used for pain management
versus being guided as a personal trainer.
461
00:37:54.519 --> 00:38:00.159
So ultimately, fitness is a progression
of forces from rehab, so they're not
462
00:38:00.320 --> 00:38:07.320
distinctly different things, but I think
it's a good idea to use language that
463
00:38:07.400 --> 00:38:15.320
describes them as slightly different things in
some ways. So when somebody's ready for
464
00:38:15.440 --> 00:38:20.679
fitness, I want them to feel
like that is victory, like that success
465
00:38:21.280 --> 00:38:23.880
that they're no longer working with a
clinician and now they get to move some
466
00:38:23.960 --> 00:38:28.760
weights around, work up a sweat, and feel great. Even if it's
467
00:38:28.800 --> 00:38:31.880
clinically minded. They need to know
a distinction that they have now had enough
468
00:38:32.000 --> 00:38:36.920
wins that they're well on their way
to their ultimate goals, and fitness is
469
00:38:36.960 --> 00:38:40.960
going to accelerate at that point.
So when somebody starts care with us,
470
00:38:42.079 --> 00:38:45.719
it's rare that we drop them right
into fitness from day one. We need
471
00:38:45.760 --> 00:38:50.519
to stabilize and if you look at
that recovery roadmap file, it kind of
472
00:38:50.599 --> 00:38:54.039
separates our phases into phase one,
two, and three. So Phase one,
473
00:38:54.159 --> 00:39:00.880
we're going to stabilize symptoms. We're
going to begin some movement training with
474
00:39:00.960 --> 00:39:05.639
a clinically certified and minded individual,
and we're going to start to address their
475
00:39:05.679 --> 00:39:10.079
specific limitations. And once we start
to meet the initial goals in the box
476
00:39:10.159 --> 00:39:15.480
to the right of that, we're
going to reevaluate and move on to Phase
477
00:39:15.599 --> 00:39:22.400
two. Phase two involves improving movement, control of movement, and introducing clinical
478
00:39:22.480 --> 00:39:28.679
exercise. So essentially, when the
case is stable and we can use if
479
00:39:28.679 --> 00:39:31.119
you're in the pain mindset, you
can view pain as being stable. But
480
00:39:31.519 --> 00:39:37.519
again, I think that's a pitfall
when you start to view that the movement
481
00:39:37.639 --> 00:39:42.920
as being stable and the activities is
being stable. And let me define that.
482
00:39:43.199 --> 00:39:45.840
If somebody comes to you and they
say I can't wash dishes at the
483
00:39:45.920 --> 00:39:50.760
end of the day for an hour
and I need to, and now they
484
00:39:50.840 --> 00:39:53.280
can wash dishes at the end of
the day for an hour, we've now
485
00:39:53.480 --> 00:40:00.320
stabilized that initial complaint. So once
we stabilize symptoms, then we need to
486
00:40:00.360 --> 00:40:07.280
say the progression for this to make
everything that you're struggling with today much easier
487
00:40:07.320 --> 00:40:12.199
for you is to get stronger in
the movements, the muscles and the joints
488
00:40:12.199 --> 00:40:15.239
that are used. And we're going
to do that using fitness. I'm going
489
00:40:15.320 --> 00:40:20.480
to introduce it nice and slow with
our clinical teams so that you learn how
490
00:40:20.519 --> 00:40:28.320
to move your body and what positive
soreness can feel like. And once you
491
00:40:28.360 --> 00:40:31.880
get the basic foundation down, we're
going to confirm that you're ready to jump
492
00:40:31.960 --> 00:40:37.599
into one of our foundational fitness classes. That's phase three. That's where your
493
00:40:37.639 --> 00:40:43.119
advanced recovery happens. And I love
to use this dialogue with my patient at
494
00:40:43.159 --> 00:40:47.679
that final re exam, I congratulate
them, I say, Tom, I'm
495
00:40:47.880 --> 00:40:52.239
so happy that your hip isn't bothering
you anymore, that you win on your
496
00:40:52.280 --> 00:40:55.280
three day golf trip, and that
you're about to go on this hike.
497
00:40:55.880 --> 00:41:01.280
You have now just created a new
feu for yourself, and today you're at
498
00:41:01.320 --> 00:41:07.320
ground zero and you get to decide
what you want to look like and feel
499
00:41:07.360 --> 00:41:09.440
like when you're eighty five, not
just for your eightith birthday, but when
500
00:41:09.440 --> 00:41:15.639
you're eighty five. So let's look
at what success would be like five years
501
00:41:15.679 --> 00:41:19.599
from now, and I can position
fitness as a way to help him go
502
00:41:19.679 --> 00:41:22.559
from where he's at today to his
wildest dreams of what his body would do.
503
00:41:22.880 --> 00:41:27.239
And that's when we'll start to work
into more of the fitness model.
504
00:41:28.239 --> 00:41:31.639
Wonderful. Thank you for that really
great explanation there. Thank you so much,
505
00:41:31.679 --> 00:41:36.800
doctor Fergus. This was a really
great presentation and a wonderful discussion.
506
00:41:36.840 --> 00:41:42.079
I think about different ways to advance
practice and to really maximize patient care and
507
00:41:42.559 --> 00:41:45.679
to be better practitioners, which is
what we at Southeast Sports are definitely in
508
00:41:45.719 --> 00:41:51.360
the business of helping to support our
our network with coomes. So thank you,
509
00:41:51.400 --> 00:42:02.760
doctor Fergus. Have a great day. Okay, thank you. That's
510
00:42:02.760 --> 00:42:07.599
it for today's episode. Be sure
to tune in for episode sixty one,
511
00:42:07.639 --> 00:42:10.400
where we will kick off a new
training with doctor Shay Stark. We're going
512
00:42:10.480 --> 00:42:15.239
to have an open conversation about being
a female leader in sports chiropractic, and
513
00:42:15.400 --> 00:42:20.639
we'll discuss the ways that we can
encourage the next generation to step up and
514
00:42:20.760 --> 00:42:23.320
step into more of these roles.
You won't want to miss it. Episode
515
00:42:23.360 --> 00:42:29.039
sixty one drops in two weeks.
You can subscribe to The Factor podcast on
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00:42:29.079 --> 00:42:32.400
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517
00:42:32.800 --> 00:42:36.840
Give us a five star rating to
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518
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little bit helps, and last,
but certainly not least, be sure to
519
00:42:39.639 --> 00:42:44.360
visit our show notes for special promotions
from our sponsors, a link to download
520
00:42:44.400 --> 00:42:49.039
the PDF of today's full presentation,
and a link to view the recorded replay
521
00:42:49.079 --> 00:42:53.880
of our full webinar. We'll see
you next time. Hey guys, If
522
00:42:53.880 --> 00:42:57.960
you like what you heard today,
I encourage you to visit our website at
523
00:42:58.000 --> 00:43:06.519
Factor hyphenstore dot com that's spelled fak
tr hyphenstore dot com to find out more
524
00:43:06.559 --> 00:43:09.039
information about all that we have to
offer. We have a variety of online
525
00:43:09.079 --> 00:43:14.760
offerings as well as our hands on
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526
00:43:14.760 --> 00:43:17.360
the globe. Be sure to also
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527
00:43:17.400 --> 00:43:22.320
of these upcoming live webinar dates coming
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531
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