About This Episode
In this episode of the PHW Podcast, Dr. Davis welcomes Jason Mettling, Director of Therapy Services at Phoenix, to discuss Jason’s journey to becoming a physical therapist and the distinct approach Phoenix takes toward patient care. Jason shares his experiences at Wichita State University and how those shaped his career, leading to the growth of Phoenix PT into multiple locations. The conversation highlights the differences between traditional physical therapy models and Phoenix’s more holistic, patient-centered approach. Dr. Davis recounts his personal recovery journey under Jason’s care, underscoring the importance of treating not just pain but the whole person. Together, they explore how stress, movement, and strength training play vital roles in recovery and long-term health, touching on the collaboration between Phoenix and PHW’s Movement professionals. The episode wraps up by emphasizing the value of advocacy in healthcare and the transformative power of personalized physical therapy.
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Episode Transcript
Auto-generated from the episode audio — may contain minor transcription errors.
Let's say you get your shoulder MRI right, tomorrow, yeah, they would have abnormal findings that the radiologists would see, right, but in reality those are absolutely normal findings, what would be completely abnormal is if they pull that MRI out and the radiologist is like, man, Dr. Davis's shoulder is clean, looks great, yeah, like there's no way your shoulder looks clean, right, it's going to show — I mean a lot of research studies will show, if you're over the — 50, you're going to have some sort of rotator cuff issue, yeah, and so it's going to show some rotator cuff, possible small tear, you know, your labrum might be frayed, or your bicep could be frayed, or you know, you've got whatever the case may be, but all of those things are normal, so they're not even just normal variants, they're just a normal part of the aging human. Yeah, we call it like wrinkles inside your body.
My name is Dr. Jeffrey Davis, uh, this is the Prairie Health and Wellness Podcast, the PHW podcast, and I'm very excited today, uh, to introduce Jason Medling. He's — I would say he's my personal physical therapist, but he might not, uh, admit to that. Um, Jason is a native of Kansas, uh, he got his undergraduate degree at the University of Kansas, and his doctorate in physical therapy at WSU. So Jason, welcome to PHW podcast, tell me what, um, you know, starting with WSU, what happened to you after you graduated, and then tell me a little bit about Phoenix PT and where you are today.
Yeah, so first of all, thanks for having me, um, so pumped to have this opportunity, um, anytime, you know, we get a chance, which is, you know, not as often as we would both like, but every time I injure myself — yeah, every time he injures himself — but it's always awesome to catch up, and shoot information back and forth, so thanks for having me on. Um, so yeah, so physical therapy, um, I graduated from WSU in 2009, so I've been in the game for quite a while, um, so worked in a couple different places, which was very beneficial, um, to learn, you know, some of the things that were important to me, and then also learn some of the things that were — you, I guess I think you learn more from some bad experiences than even the good.
And so I, looking back at my career leading up to Phoenix, um, everything happened for a reason and really set me up for this moment, so uh, about five years ago, um, was approached to be a partner and start a physical therapy clinic here in Wichita, and so we started with just myself, at our East office, which is only about 5 minutes from here, um, which is — you've been to a few times, um, so started with just myself, and now, we're four years in July, we have four locations, one on each side of town, so we have East side, West, um, North, and a South office, and we have another office in Hutch, so community's been good to us.
And how many therapists do you have now? So we're up to over 20. Wow, 20. Yep. So that's — now I would call that meteoric growth. It's been a lot of fun. So well, it's funny, the — how you and I met, it was kind of funny, I actually came into the office one day, and my nurses said, you have a PT appointment today, and I was like, no I don't, and they go, yeah you do, we made it for you, and I think what had happened is that you had come to introduce yourself to the clinic on a day when I wasn't there, and I had been complaining to my wife Julie about my shoulder, I was waking up in the middle of the night with shoulder pain, and it had been a problem, and I think my staff had just got so tired of me whining about it, that when you came they were like, oh, do you work on shoulders, and you're like, yeah, I can work on shoulders, like, great, we're making an appointment for Dr. Davis to come see you.
So so I showed up at your clinic, and I feel like — I feel like there was more than just you there, but I don't know. Yeah, that probably had a couple, three, at that point, so you'd probably been there for about a year, I bet. Yeah, um, and so I remember — and I've worked with physical therapists before, and I'd seen, you know, a surgeon who looked at my shoulder years ago, um, and I remember the day I hurt it, I was at my parents' place, and my kids were young, and they were swimming, and um, there were these — they're these insects called cicada killers, they look like these really angry wasps, they're completely benign, but the kids are terrified of them, so yeah, I pick up a tennis racket, and I'm just like, I'll just go swing at these things, cause you know, I started swinging away, and you know, I felt something that didn't quite feel right.
And I mean, and that was years ago, my shoulder's never really been the same since then, and so, you know, under my old practice model, I'm like, well, it's a shoulder problem, go see a shoulder surgeon, right, so I started with the surgeon, he gets some imaging, uh, you know, he looks at my shoulder, and he — I remember to this day — he goes, huh, I think I can fix this with surgery, and I remember thinking to myself, I'm going to need more than this "hm," it felt like it was a 50/50 kind of a thing, and I was like, I'm not going to do that. Um, so I ended up, I think, working with somebody at, um, Genesis maybe, and shoulder got better, um, and then had a recurrence.
And so then, when I came and saw you, um, I still remember, it was really — it was really interesting, cause I was kind of showing you, like, the movement that I was having pain, I mean, I was really wincing, and you took your thumb and you pushed on my scapula, and I mean, maybe two pounds of pressure, and I did the exact same movement again, I had, like, no pain, and I remember thinking, like, this guy is a wizard, right. Um, so so that was my introduction to you, and since then, you know, of course I've gone on to do other dumb stuff that I've needed to see you for, um, but it — I think I appreciated the most about you is that you really took the time to think through, like, okay, I know you're having pain up here, but I think this is really coming from — you know, in essence what it came from was that I had, you know, scapular instability, I didn't have the control necessary to bring that shoulder into the right position with the rest of my body, so that I could use full range of motion without pain, and the findings on the MRI were a red herring, right, they just — they didn't show a tear, what they showed is I kind of have a 50-year-old shoulder, mhm.
And so I think that's one of the things I appreciate about you, is you're always kind of going, let's go a little deeper, and figure out that thing, so I could go on with, like, nine other stories that you've done that with me, but anyway, I want to find out, like, why — what is that in you, what — why did you become a physical therapist, and why is your approach, why does it feel so different from what I've seen in the past? Yeah, so a couple things, it was super fun way to get to know you — now this is kudos to your office and your practice, is just how welcoming you guys are, you know, as a physical therapy, you know, clinic, and I'm just opening and trying to get just to meet some doctors and some folks, and um, by far and away your guys's office is the most welcoming, and I don't — I'm not just saying that — it's just a blast every time I come in, so that was so unique.
The fact that I come in and had never met you, and your staff was so great, like, you're going to see Dr. Davis in the office on Friday if you can, I was like, we're going to make that happen, so just what a fun — that's unique in itself, so kudos to you and your staff, it's just been — and then just how it's grown from there, it's been really neat, the relationship we have. So um, so that's awesome, but you — so with physical therapy, my story is very similar to yours, so I was a college tennis player, and had injured my shoulder, and was having just difficulty serving, so I had no idea about PT at this point in my life.
So I — same thing, traditional model, they send me to a surgeon, never forget it, I sit down, and he just looks at me, and it's like, so your shoulder hurts, and it's like, yeah, hurts when serving, yeah, and he's like, okay, yeah, I think we need to do surgery, and I just, you know, I'm — what, at that point maybe 19 years old, don't know anything about the shoulder, and he takes out a shoulder model, and kind of shows me what he plans to do, and I'd set it up, not knowing any better. And so thankfully he set it up like a week before finals, and it got closer and closer to the time, and I was like, man, I can't go through surgery before final exams and have a sling and all this stuff, and so I was like, I think I'm going to put it off till summer.
And the trainer at that point was like, have you tried physical therapy, and I was like, no, I haven't tried that, and so I went, and it was very successful, so shoulder got better, mhm, I've never had issues since, and so I was a week away from having a completely unnecessary procedure, shoulder surgery. Yeah, and you know, that's when PT really became something I was highly interested in, because it really changed, you know, the course of my life, in a sense — not that shoulder surgery is the end of your life — but you know, it really changed, helped me avoid something that was completely unnecessary.
Yeah, so, and you know, I know the shoulder surgeons we have, they're amazing, they do amazing work, and I think surgery is one of those things that — I mean, it is a miracle of modern medicine, the things that surgeons can do at the scalpel, and I think — but somewhere along the way it feels like there's — and I don't know if it's the incentives — we talked about this on a podcast previously, where we were saying, you know, obviously a surgeon, that's — they do surgery, so it doesn't surprise me that they pull out the model and say, here's the procedure I do. Do you feel like that is more something that has just naturally grown up because of the model of reimbursement, and how people engage with the medical system, or is this something that fundamentally in the orthopedic space needs to change, what — how does that get prevented in the next Jason Medling that comes in with shoulder pain?
Yeah, I think, you know, first off, like, research is very clear that if you come to physical therapy first, it's going to save a lot of money, most all the time, because it's — you know, not all, but it's primarily insurance driven, so if you go see your PCP, um, because you have shoulder pain, more than likely it's going to be an X-ray, which the X-ray is going to be — it's a complete waste, most of the time, because it doesn't even show soft tissue stuff, unless it's like a super arthritic shoulder, but even that, do we really need the X-ray, um, and then that leads to an MRI, mm, and then once you get that MRI, which insurance makes sure you have to have, before you go see the shoulder specialist, um, so it's really highly insurance driven with that.
So in some ways it's — there's almost like a diagnostic railroad that you get on, where, you know, again, most family docs, they've got seven minutes to see the patient, yeah, they want to help the patient, um, you know, we learn how to do a shoulder exam in medical school, I guarantee it's nowhere near the type of exam that you do when I send you a patient. Um, so one way to change that for our patients that are listening would be maybe to just, before the doctor says, well, let's get an MRI, cause I kind of tell patients an MRI really is a presurgical evaluation, right, um, my feeling is that if they would just ask their doctor, hey, can I see a PT first, you know, and I think that's what I appreciate about you, and I tell my patients, they're like, well, should we get an MRI, I'm like, why don't we see what your PT says, go there, have them do a full assessment, they're going to spend the whole hour with you, and then if they feel like, hey, we're hitting some roadblocks, we think there's something deeper structural going on that could benefit from surgery, you know, now you've got that in place — is it that simple, that it just maybe needs to be that the patient needs to advocate a little bit more for themselves, to say, why don't we, instead of getting the presurgical imaging, really start with a good assessment?
Yeah, 100%, so you know, there's — PTs have come a long ways just since I've been out, with direct access, so here recently, unless you have Medicare, then there's a few out-of-state insurances, um, but in general you can just come straight to physical therapy versus you used to have to have a doctor's order. A lot of people don't know this — you, the patient themselves, can make an appointment with PT with no doctor's order and have four visits — is that right? So depends on the insurance company, but yeah, so most of them you can have up to 15 visits. Oh wow. And if you're not showing progress, then you have to go see a doctor, which, you know, I would never see a patient ever for 15 visits without progress, like, that word, "plateau," after three visits, is like a curse word to me, so that would never happen.
Okay, but if somehow I did see somebody for 15 visits without any progress — yeah, the insurance, rightfully so, would want to go on that. That's interesting, because there's not very many ways for people to use their insurance without going through that primary care gatekeeper, you know, I mean, women can get mammograms, that's been, you know, allowed by Affordable Care Act, so I think I find it interesting that PT is one of those things that people can engage in without having an order. Yeah, a referral, yeah, so that's a huge — that's kind of step one that's helped. Yeah, um, but yeah, if you advocate, if the patient advocates for themself, comes in, you know, we can tell pretty quickly whether it's something like you say, because I've got amazing — we have amazing surgeons here in Wichita that are so good at what they do, and I've got some good relationships, so um, if somebody comes in and they come direct, and I can just tell, like, oh man, there's something, yeah, not right, you know, whatever the case may be, you know, I'll go ahead and refer him right away, um, to go get that, because I can just tell.
Yeah, was the second time I engaged with you, is when I tried to learn how to do a wheelie on a 350 EXF, uh, dual sport motorcycle, I don't know, looking back, I'm like, what possessed me with being like, I've watched a video of this, how hard can it be. So popped my ACL, you know, I come and see you, and you kind of had this look, like, hey, yeah, this is going to be a hard conversation, but you know, you need to go get some imaging, right, and it, to confirm what you had suspected, but that's the — that's the rarity, so the majority of cases are the opposite, where they come in and they think they need an X-ray, or they think they need an MRI, so we know what to do going forward when that's really not the case at all, the imaging for you doesn't really help, unless — like you said — you've reached that plateau, where there's been an unexpected, you know, or the expected outcome isn't happening, that's when you see that the imaging is helpful.
Exactly, so you know, what we've found is, you know, let's say you get your shoulder MRI, right, tomorrow, yeah, they would have abnormal findings that the radiologists would see, right, but in reality those are absolutely normal findings, what would be completely abnormal is if they pull that MRI out and the radiologist is like, man, Dr. Davis's shoulder is clean, looks great, yeah, like there's no way your shoulder looks clean, right, it's going to show — I mean a lot of research studies will show, if you're over the age of 50 you're going to have some sort of rotator cuff issue, yeah, and so it's going to show some rotator cuff, possible small tear, you know, your labrum might be frayed, or your bicep could be frayed, or you know, you've got whatever the case may be, but all of those things are normal, so they're not even just normal variants, they're just a normal part of the aging human, yeah, we call it like wrinkles inside your body.
So as we age we get wrinkles on our face, now there's things you can do to avoid those wrinkles, but in general we wrinkle up, and that's not a bad thing, it doesn't change anything, we still function well, so these findings, like in those studies, you know, show — let's say we have a thousand people, they all have MRIs of their shoulders, they're asymptomatic, and you know, if over the age of 50, you're going to have at least 70% — 50, 60, 70% — that have some abnormal finding. Okay, and most of those individuals, if not all, are asymptomatic, so they really don't matter, yeah, so clinically not important.
So I think, I think one thing that's interesting, I remember listening to a scientist talk about, uh, joint pain, is actually a phenomenon that's seen across the animal kingdom as animals age, and that it's universal, you know, and I always — I hate telling people when they have a complaint that, well, you're just getting older, but it seems like joint pain is something that's very common as we age, what are some things, um, that people maybe don't know, uh, about mitigating some of that pain in their joints, or you know, is it — poor movement pattern, man, we can go down a very long rabbit hole about this, cause we're — you know, one of the problems with my shoulder is that I'm sitting all day long, and I all of a sudden find myself hunched over a computer, and those little tiny muscles that are supposed to hold my scapula back are just being completely stretched out and not used.
What are some things that I think that people may not know, that they should be really engaging in, some very simple things they can do to mitigate joint pain, or be more functional as they age? Yeah, so trains of thought have changed a lot, just here re — I mean, I say recently, but um, for sure in the last 5 years, so you know, old school thought was, if you've got knee pain with some arthritis — and this still happens today, where doctors and other folks will tell their patients, or PTs, that, oh, you've got knee pain, and X-ray shows some significant arthritis in your knees, so you need to really just take it easy, yeah, you need to do less, do less, avoid weight-bearing, you know, ride a bike, get in the water, do some water aerobics, right.
And in, you know, in functional medicine, functional PT, like we know that that's not the right thing to do, we — what we have to do, it's really a non-negotiable, is stay active, yeah, we have to move, yeah, and you know, be smart, but we have to move, and learn proper ways to move, learn proper activities that fit that patient, but the non-negotiables, we will keep moving, and we're going to move more and more as we get older, that's the train of thought, that's the functional movement, functional medicine, not do less and less as we age, right. So when I talk to patients about that, I often talk about, you know, that it's a use-it-or-lose-it function, and um, you know, when you look at the areas around the world where people are successfully aging, that is one of the commonalities, right, they're moving more in their day than maybe we are here in the United States, they're moving over varied terrain, they're up and down hills, they're climbing over rocks, up and down stairs, and here in the United States we've made everything just as flat and easy and simple as we can, right.
I mean, even curbs now, you don't have to step up a curb, you can just find the little ramp that takes you, you know, four inches up, but there's a ramp there, um, you know, my son, we're getting ready to restore a 1994, uh, Ford F-150, he's 15, he's going to be driving soon, and we're in the car, kind of looking through the details, and he's like, where's — how do you roll the windows down, and I'm like, you see the handle there, you know, and I started thinking, I was like, in my car I don't even have to hold the button down, I just tap it, and I'm pretty sure we're just going to be able to say, hey Siri, open my — you know — left window, oh, now Siri's listening to me here, um, but yeah, so the human body is very much a use-it-or-lose-it.
So when you're talking about a healthy functional pattern for aging, what does that look like, what if you're on an elevator with somebody and they ask you, you're a doctor of PT, what do I need to do movement-wise to keep myself healthy for the long run, yeah, and you've got minutes to tell them what to do, what do you tell them? Yeah, so I'll — you know, tell them — you just nailed it, especially as we age, you know, we hit a point where things start going backwards, you know, no matter what, we start losing strength at a rapid rate, each decade we live, we start losing flexibility, we start losing balance, um, we start losing endurance, and so, you know, the things that you have to do as we age is we have to push things, we have to pull on things, so we have to get in the weight room, mhm, and that's a very odd thing for the majority of folks, is that you, especially, there's 60, 70 year olds, they're like, you want me to lift weights, I walk for exercise, you know, that's the best thing they do, which again, walking is great, but if all you're doing is walking you're losing strength at a rapid pace, right, it's sort of the lowest common denominator of what humans should be able to do.
Yes, and so you know, so quickly, we got to get you in the weight room, or get something at home to lift, you don't have to necessarily join a gym, right, but you got to have something to pull on, something to push on, and then, so for the upper body we got to be able to push things overhead, um, and we got to be able to squat, we have to be able to deadlift, we have to be able to lunge, yeah, those are the bare minimums, so those are the big ones — if we can't push, we can't pull, we can't lift overhead, mhm, we can't squat, deadlift — that's the simplicity of just functional movement.
Yeah, and then that's where you find the folks that, you know, they can't get on and off the ground, right, as they get older, it's just so hard, like, you know, common complaints, like, if I get on the ground, getting up is almost impossible, well, when's the — you know, when's the last time you did a lunge, or squat, or deadlift, so they're losing perhaps flexibility in the hip, they're losing flexibility in the ankle, um, they're lacking the strength to get from a seated position, you know, on the floor, all the way up. And I think where I find that, you know, we know that as people age, like you said, about balance, that tends to go, but when they fall — I mean, talk about the mortality after age 70 of a person who falls and breaks a hip, yeah, it's almost a goner, yeah, 50% mortality in the next year.
And I think some of that is not just about the fact that they fell, but if all the body systems are to the point where it's led them to where they're fragile enough that they fall and break a hip, there's a whole bunch of systems that have failed to get you to that point, right, so it's not the fall itself that's the mortality, it's an indicator that things have slid a lot. Yeah, exactly, that's exactly right, um, so being able to do deadlift, lunge, overhead press, squatting, um, those — you would say those are the exercises that all adults should focus on, even if there's no goal of, like, building muscle or anything like that, those are the things that will keep them the healthiest the longest, so it's not necessarily running, cardio, right, we always hear you got to do a lot of cardio, yeah, but those movement patterns, those are the — yeah, so those are the ones we have to do.
You know, and then of course, like, I love to push cardio on patients as well, like, I love people to go on a long walk and go on a bike ride, or go run, like, that's a big piece, keeping our endurance up, but the key to success, you know, with living and longevity and functionality, is being able to do those large functional movements, that's where you see people really go downhill. Yeah, yeah, that — I mean, and on my side of things, it's really talking to patients about sarcopenia, you know, I mean, the loss of muscle mass, you know, I'll go to church on Sunday, and you know, shake somebody's hand and grab their upper arm, you know, how you do — you got to do like a full body shake — and I'll just feel like, oh, this is somebody I've known since I was a kid, and there's just — there's no muscle left in that arm, and um, you know, so I tell my patients, like, hey, these are really important, because this is nature pushing down on you, so we've got to be able to push back against that.
Um, so what — so what is your approach, I mean, you know, one of the things we talked about with PT, that you and I have had this discussion a lot, is that because of this insurance industry, and the way things typically work in PT is, somebody does something stupid, you know — I, on my bike, can't use my knee — so I've had a loss of function, right, so insurance is there to protect against a loss and restore that loss, so I understand, from your side of things, the way I understand is, you set out, like, okay, well, what's the function that they lost, what are the goals we have, and then insurance kind of wants you to get them back up to where they've restored the loss of function, yeah, and you and I talked about, it's so much more important to go beyond that, because again, what happened to my knee, if I'd had better training, you know, maybe not so much bravado of thinking I can do things I shouldn't do at age 50, could have protected that knee a little bit better.
So what is it that's different about Phoenix PT, and you've come to learn that sets you guys apart? Yeah, in that sense, so yeah, so oh, the first side, um, so insurance totally dictates the game, so what I mean by that is, I mean, I can't even count on five hands, 10 hands, the amount of letters of medical necessity that I've written, really, to where I'm treating a patient, they came in with, whether it's surgery or non-surgery, they come in and — shoulder, let's just use your example — your shoulder was not moving well, and we figured, well, like, it looked stiff, but in reality it wasn't stiff, it was that your scap wasn't working correctly, and we strengthened that up, we got you back to normal.
But back to normal, so we got your pain gone, mhm, so there's insurance companies that will see, on one note that we write, you know, patient has no pain, and they'll stop paying that day, that's it, they decided good enough, good enough, right, where in reality, yes your pain's down, but you're not ready to push things overhead yet, right, you're not ready to get back into bench press, right, you know, you're not ready to do all the things that you need to do, whether it's lifting weights, or you're a golfer or tennis, you know, functionality — they want to see that pain's gone, yeah, and then you're done. And so, that's the most frustrating part, is you — step one is getting pain down, yeah, and so that's the old school PT, okay, was PT — what I call PT 1.0, okay, was — it's what I learned in school, yeah, so I, you know, again, I got out in '09, so this isn't that long ago, right, was the goal was, how few sessions can we spend to get people's pain down, period.
So it was really about pain, not even function, pain, and there's some function folks, but they needed to be able to do some things without pain, but those things might be getting through a workday, yeah, you know, man, I can't sit all day at work, Jason, my back's killing me, okay, so I get to where their pain doesn't hurt while they're sitting at work, yeah, but what good is that, we know that's not even close to living a healthy lifestyle, right, so they go out, start exercising, their back's probably still going to hurt at that moment. Um, so PT 1.0 is, whatever that function is, they want to get their pain down and get them back to that, mhm. So what I call is PT 2.0, and this is what has really evolved for Phoenix, and evolved for me in the last four years, is that's just the starting point, is getting people's pain down, so we have a lot of different cool techniques we use, you know, we dry needle, we do a lot of manipulation techniques on the spine, I'm cracking necks and backs, and um, I do scraping — IASTM techniques — and cupping, and um, we might use a little e-stim, but we have all of these modalities to get the pain down, and good exercises, good stretches, some good gentle strength training, yeah, you know, but we have to start gentle, we got to get that tissue — get the tissue calmed down, get the nervous system calmed down.
So we have all these modalities we do to calm things down, but that's step one, yeah, so that's PT — so what we've done, PT 2.0, is we now go to the next phase, and that's where we start looking at the functional movements, you know, goals, and if their goal's not to exercise, I'm going to do everything in my power to motivate them to make that a goal, okay, and so every patient that I see, my goal is to make them a healthy, active, happy individual, yeah, and we know what that takes, it takes exercise, right, it takes a decent diet, yeah, it takes decent, you know, sleep hygiene, sure, um, so it's a holistic approach now, versus the old — the old PT involved none of that.
Gotcha, so talk to me a little bit about, um, if the patient has gotten to that point where, okay, insurance tapped out, but you feel like, hey, they really do need more, what are the options patients have to continue, I mean, does everybody know that they can continue to see you without their insurance, I mean, that's an option, right, is that something that you would encourage a patient to do, is to continue seeing you, continue seeing a physical therapist working on those goals? Yeah, so yeah, great question, so again, PT 1.0 Jason, um, that I would have been done, yeah, you know, hey, sorry Dr. Davis, man, it's been great working with you, but the insurance, you know, your shoulder pain's gone, man, sorry, sorry you're still not back to doing all the other things, but keep doing these exercises, and because you've reached the end of your insurance, insurance is done.
And so, you know, our cash-based system is something that has blown up over the last four years, and yeah, it's like, every patient that you send that is cash based, it's like, I jump for joy, right, because you're no longer restrained by that system that says once you write that they don't have pain, you're not going to see them again. Yes, it gives — and I just had a patient reach out to me yesterday, and, deal with some really bad plantar fasciitis, and she's like, you know, I have insurance, but it's such a pain, yeah, she's like, can I just pay cash, and I'm — I start — she probably heard the excitement in my voice, I'm just like, yes, please. Um, so that we don't have to worry about the rules, the regulations, and you're not having to write letters of medical necessity, and you know, doesn't involve all this junk that doesn't need to be noted, other than the fact that they'll pay us for it, um, so it just makes everything far more efficient.
Okay, um, and then we can see them past — that I can see them, and you know, hopefully my patients — it's like, hey, what's your exercise program, oh, I haven't exercised in about 10 years, yeah, and it's like, you know, I don't hit them on that first visit, but as I build that rapport, it's like, hey, one of my goals for you, and I hope you can get on board for this, yeah, is that I want you exercising, and this is why, yeah, and then we go into what exercise does, and get them started again, weightlifting, and all the things that we want to get them into.
So that takes, I would assume, a different — almost a paradigm shift from where your training was, and I know one of the things you do with your PTs is you guys do some additional training in house, talk a little bit about how you're — because you're the biggest problem I have with you is you're not available to me all the time that I need you, and I recognize that you're very sought-after, and you know, the frustrating thing is I'll talk to patients about how great you are, and then they call and they're like, yeah, he's booking out for six months, and I'm like, all right, well, all the PTs there are very good at what they do, and so I'd love to know, like, how are you bringing the 1.0 PT up to a 2.0 PT, what are some things that you guys are doing at Phoenix that maybe is helping that young PT?
Yeah, recognize a different paradigm, love it. Yeah, so you know, there's quite a few things that I feel like set us apart in Phoenix, um, we can go into the others later, I'll stick to this one for now, but our mentorship program — so I, my passion is treating, like, you know, your — you're a business owner, and you're busier than could be with so many different things, but you still treat patients, yeah, love coming to work and seeing patients, and I'm the same, like, I could easily spend all day doing administrative stuff and training staff, but I still — about 80% of my day is still treating patients, because I just love it too much, but that 20% I equally love, okay, and that is training and mentoring.
Gotcha, and so I go out to all of our clinics and meet with staff, um, I develop processes and treatment philosophies, but you know, not to give me all the credit, because I tell people all the time, I thought I was a good therapist, yeah, when I came to Phoenix, I realized I was very mediocre, right, and so Phoenix has completely transformed my process, thought process, treatment process, and it really started with ICE, it's a group, Institute of Clinical Excellence, and we bring them in once or twice a year, they travel the world now, um, they're an amazing group of guys and gals that, um, they are huge into functional movements, okay, they're huge into lifting weights, uh-huh, um, and they're big into, you know, good manual therapy, being really good with our hands, you know, whether it's manipulation techniques on the spine or soft tissue work through the muscles, but just having really good hands, but it's all, again, we use these good hands to get pain down in order to load people up, right, and so we want to make that tissue as robust as possible, and we know that strong people are harder to injure, and strong people are harder to kill, and so those are the two things, you know, we're always trying to get people strong.
So but that's really how — my goal is to bring, like you said, I would love to treat every patient that comes in the door, right, and I've come to realize that I'm not able to do it, there's not enough hours in the day. Exactly, just like you, you've got an amazing team that you brought on board, so if a patient comes in and you're booked, they're going to see one of your other doctors that have the same philosophy as you, and I think the sign that that's been successful is when you start to hear the patients say, oh, I worked with so-and-so and it was fantastic, that's got to feel rewarding, because you know you've been a part of that, and helping that physical therapist see, there's more to this, right, there's a level that you need to be working at, but you've got to find the physical therapists that are wanting to be lifetime learners, right, and so that's probably somewhat in your recruiting, I would imagine.
Major, I just — just this morning, it's funny you say that, so I'm overly, overly, overly picky with hires, uh-huh, like even if we're in desperate need for another therapist, I will not ever settle, right, because you get one bad apple, as you know, one bad PT can — the company's everything we've worked for — yes, you send that one patient, and we have this one bad PT, and they have that one bad experience, they come back to you and say this therapist was terrible, so just this morning I had a third-year PT student come in, and one thing I love to see is that they're humble, uh-huh, they have confidence, but they're humble, yeah, um, they have to have a great personality, know how to talk to people, cause you know, with our profession, you guys are odd, that you guys see your patients for 30 minutes plus, but most doctors don't, so you can have a dry personality and be just fine, sure, but in physical therapy, you know, you're spending 30 to 45 minutes to an hour with a patient, if I have a dry personality, you're going to hate every second of that.
Well, and that, I think, is also something that — I mean, again, I want to touch on the things that I think separate Phoenix PT — other PTs I've been to, you see the PT for a few minutes, and then you're pushed onto a table for some — what are they called — modalities, and the PT is off, now seeing someone else, so I can see where the business side of me goes, oh well, you can drive a lot more revenue by doing that, because you can still bill for that appointment, I'm sure insurance wants to know how much face-to-face time you have, but that's about trying to squeeze as much productivity as you can out of a PT, and that may work in some environments, but I quickly figured out that's not what Phoenix is about.
I mean, um, so I think that's again, that's something that sets you apart, and maybe more PTs are doing that, but yeah, I found that to be unique. It's very, very unique, but I'll jump on that one too, um, but with that, this third-year PT student today, I'm talking to her, and we'll bring in — we heard some good things about her, so we love to get good people in the doors, and she just hangs out with me for the morning, I like to just kind of — not an interview — but just see how she does around patients, yeah, and me and staff, to make sure she'd be a good fit personality-wise, right, and she starts telling me, you know, I was like, so what are you looking forward to your first year at work, you know, what are some of your goals, and it was all about learning, uh-huh, and she smiled, and could talk to patients, and she wanted to learn, right, and by the end, I didn't even interview her, by the end of that morning I said, you had an idea, I was like, we need to talk more, love to interview, and I think you'd be a great fit for our team, cause she checked all those boxes, but the lifelong learning, yeah.
And so not only do we have ICE, but we're so big on this mentorship, and myself, um, but then we've got guys in Flagstaff, Arizona, we have a group in Sedona, uh, we have a group in Springfield, Missouri, and we all collaborate together, simply on learning, yeah, and getting better, and we meet with all those guys, all of us, every other week. Okay, wow, every other week. We have a mentor program, and this is — this is through ICE, this is something separate — Phoenix, this is just us. Gotcha, so you know, that's again, one of the things that separates us, like, like I said, I practiced from '09 to four years ago, yeah, and you know, did a good job, right, but like, I'm 10 times better a therapist than starting Phoenix, just because of that, high level CEU and this mentorship, it's — and it's made life so much — made my work so much more fun, um, it's more rewarding, it's so much more rewarding, and I'm so much more confident mentoring others, because I'm being mentored myself.
So this group that you're meeting with on a regular basis, do each of you have some core competencies, are you sort of the shoulder guy, or — I mean, I know you're also really good with knees, obviously — but how are you guys funneling the information through that process, I'm curious about how that process works, to then bring it down to the mentorship level of where you're sharing new information, how does that work? Yeah, it's a lot of fun, so um, so Flagstaff, we have Brian and Damian out there, and Damian, he works with, like, top runners in the country, running is his passion, and so he's like — but he's also, he knows, like, runners, like loading tissue up, he lifts too, because we know that that's the most important, even for runners, we have to build a load, but yeah, so Damian is kind of the running, weight training, knows a ton — Brian, his — like pain management, like, you're seriously chronic pain patients, he — chronic pain, and how our bodies perceive pain, he is the pain guru, which is a whole other thing, um, and then yeah, so anyway, so we all have our own things, but we all collaborate together within that.
You know, I actually — so I know I don't want to keep bringing it back to me — but um, when you talked about the pain aspect, one thing in my journey with you has been, you know, after the injury, I elected to do a, uh, quad tendon graft, which, you know, I kind of joke with patients, I'm like, I don't think I really looked at the brochure on what that involved before I did it, you know, it was sort of a presentation of, well, you could either go with cadaver or quad tendon, um, you know, at age 50, it's kind of a choice one way or the other, but if you're more active, we try to push people toward using their own tendons, and so I heard that, and I was like, great, and it wasn't until I was at my surgeon's office for a post-surgical evaluation from the, um, PA — I can't remember her name — but she was wonderful, that, um, you know, I'm asking questions cause I'm kind of concerned that things just aren't working like I expected them to be working, I'm going, figured this was like, you know, you're swapping out an AC joint in the car, like, you should just be able to start steering right away, and she stops for a second, she looks at me, and she goes, do you know exactly what we did to your knee, and I was like, I don't.
And so she starts going through in great detail, like, you know, we drilled this hole all the way through, we cut in the middle of your quad tendon, we're yanking it through this tunnel, and you know, it was at that point that I was like, oh yeah, that's very disruptive to everything that I've got going on here. But you and I had this discussion about pain, where, you know, I was — I told you I was really worried that, like, hey, I think they may have cut a nerve, because I can't — I can't squeeze this muscle anymore, and um, I remember you were like, hey, let me tell you how pain works, and I feel like I should have known this as a doctor, right, but this protective response in my body was saying something is very wrong, and it literally would not let me contract that muscle, like, the pain shut that muscle down, to the point where everything you and I were doing were trying to tease that activity back in, so that we wouldn't lose a bunch through atrophy, mhm, and really to wake up the nervous system, and almost convince your body that you can do this, you know, but man, it felt like baby steps, and the pain part of it, I still, looking back on it, was really amazed that pain could shut down that function the way it did.
Oh yeah, so that was — I don't know if that's something that you guys talk about in your group with your — all the time. Yeah, the pain science, it is fascinating, wildly fascinating, have you read the book, um, it's written by Dr. Paul Brand, called "Pain: The Gift Nobody Wants," mm, it's a fascinating book, this guy was a, um, I think he was a hand surgeon, um, who ended up working in Kolkata, India, with, uh, leprosy patients, and this was back when he was working with leprosy patients, they didn't really know what was causing leprosy, there was still this idea that it was a, you know, infectious etiology that was causing rotting of the flesh somehow, but he was observing people who would leave his clinic, and of course, you know, when a hand surgeon goes to Kolkata, they end up doing not just hand surgery, I mean, they're taking care of all orthopedic problems, but in the book he talks about, um, putting a brace on a woman's leg, I think, maybe wrapping a sprained ankle, and then he watched her walk away, she stepped off the curb, completely folded her ankle over, popped right back off, and kept walking on it, exactly like she had been before she folded it over, and he was one of the ones that figured out that really what's happening with leprosy is the bacteria is attacking the pain nerve.
And so you know, women will put their hands in a boiling pot of water and grab a potato out, and not realize that that was a painful thing, and so his book is really about that, this — that pain is a gift to the body, it is to protect us, in this response, and then you know, he went on to do some really amazing work, but it was fascinating to be a part of that, and see that pain was there to protect me, but then part of it is I have to push back against that, through the training that we were working on, to overcome it, cause otherwise my leg would be stiff and I wouldn't be able to bend it and use it the way I can use it today. So yeah, pain science, it would be a fun — we could spend an hour discussing, because there's just so much.
So like Brian, the guy that's kind of our specialist in pain, he educates us, but he got interested in it because he was at work one day as a PT and bent over and felt a little pain in his back — I'll make this as quick as possible — but so every time he'd bend over his back hurt terribly bad, and so he goes home and is just freaking out, because he could barely get through his day, and stresses out, and anyways, long story short, he continued to do less and less, uh-huh, he was literally at the point where he would have his other therapist help put his shoes on in the clinic, because he was too afraid to bend over, cause in the past we were taught, if you have a bulged disc, which he thought he had, you bend over, the disc is going to blow out your back, going to shoot out the back, and so he'd go firing right across the room.
Fire across the — so he was just — had created this thought, but long story short, he looks back, and this is what got him so involved, was so into pain science, was that he was in a very stressful time of his life, he had some depression going on, he was overly stressed in life, yeah, wasn't in a happy place, so that was a huge part of it, he wasn't sleeping well, his diet was junk, mhm, he wasn't exercising, because he was just not in a happy spot, and then he let his brain think that there was a disc in his back that was about to blow out, and so all of those things created this pain.
And then finally one of his colleagues one day was like, Brian, we're going to do some deadlifts, and he looked at the guy like, there's zero chance I'm bending over, yeah, I haven't bent over in weeks because it hurts so bad, right, the guy doesn't force him, but talked him into, yeah, deadlifting, and I — was like 50 pounds to start with, right, and he does like 20 of them, and his pain's down, they throw on some more weight, he does another 20, his pain's down, and then by the end of that day he was basically fixed. That's crazy, and it made him realize, like, there's a lot more behind our pain, you know, than what we realize, and that's that holistic approach that we utilize a lot.
I, you know, I find that fascinating, because I think a lot of the problems that we have, that we encounter in medicine, and that you encounter in physical medicine, I think they are normal, adaptive, protective responses that have gone off the rails and become maladaptive, right, so you know, we talked about — I mean, if you sprain your ankle, you should be very gingerly walking, and thank goodness that it swells, and let you know something is wrong, and you're going to ice it and elevate it and do all the things, um, but where that becomes maladaptive is where your brain gets stuck in this idea and convinces you that you can't do that.
I mean, I did the same thing with a patient the other day, she's, um, she's concerned about her bone density, we're talking about the importance of lifting weights, and she says, well, I lift weights, and I was like, great, well, tell me about what you do, so I do deadlifts, and I was like, oh, this is good, I'm like, how much weight are you deadlifting, she goes, I do 5 pounds in each hand, I go, well, you could do more weight, she's like, oh no, I don't think I can. And so I was kind of explaining to her, like, what a deadlift looks like, and I realized, I kind of run into — you know, I'm here, I'm in the clinic, I can't — I can't show her, yeah, and so I was like, you know what, the gym's open, let's pop across the street, and so I took her over to our, um, the prime, uh, trap bar, right, so trap bar deadlift, very easy, you can adjust the handles up and down, it's really nice piece of equipment, the downside of it is that it doesn't go less than 95 pounds, right.
And so I'm looking at this, going, oh, she's used to holding five pounds in each hand, and I was like, well, it's a deadlift, what's the worst that can happen, the worst thing that can happen is she's not able to pick it up. So I kind of show her the movement, I'm standing behind her, and I'm like, okay, and she asked me right before she starts, goes, how much weight is this, and I go, this is 90 pounds, and she stood right up right then, and said, I'm not going to be able to do this, I go, well, let's see. And so she squats down, and she goes to load, and then stops, and she looks at me like, see, I told you I can't do that, I go, lift it, and then she just goes, whoop, and popped it right off the ground, and the look on her face of surprise, I wish I had had a camera on that at that moment, cause all of a sudden her brain goes, that wasn't hard to do, and I go, great, do another one, and another one.
So what I was trying to get her to understand, is that for us to build strength in your body, we've got to get to a point where we force the muscle to adapt — or "force" is a bad word, yeah — send an adaptive signal, mhm, and I tell patients all the time that, like, if you do your last rep, you know, a curl for instance, and it's easy, when you set the weight down, your muscles essentially go, job well done, no need to build more muscle, right, cause we're very efficient machines, I mean, why would you build a bigger bicep if you didn't need it. So in that moment she was able to understand that it was her brain that was convincing her that this is not something that she could lift, and then she pulled that deadlift like it was nothing.
Yeah, and so I — you're sure you have those kind of experiences with people, that's the game-changing stuff, yeah, you could literally see, in her brain, go, flip the switch, all of a sudden, and think of her life, how that's going to change now, where she could lift a 50 pound dog food, you go to the grocery store and pick up all those groceries and not have to stress, and you know, that's the whole thing of, like, not just dealing with pain — such a good point — but that's the function, you know, that changes the game, for being able to tell the person at Atwoods, I don't need help getting to my car, like, I've been getting that question lately, and I'm like, do I look like I need help getting to the car, you know, but that's just something people are used to saying, like, hey, do you need help getting these groceries in your car, and to have that kind of, and be able to say, no, I got this, this is very easy to do, in the deadlift, like that.
You know, that's the one thing that all humans need to do, right, because we have to be able to — and again, you go back, and there's still PTs, there's still doctors, that tell people, if they've got — they had an MRI that they probably didn't need, and found out they had a bulged disc, which is completely normal for their age — but because of this MRI finding, they'd say, hey, so, you know, Dr. Davis, you've got a bulged disc in your low back, yep, and so you really need to be careful, you don't want that to blow out the back, you know, blast out of there, and you know, so you need to really not bend down and pick anything up heavy ever again, right, um, which means all those muscles that stabilize your spine are doing what, atrophying out.
Which — and how long does it take, I mean, I remember you telling me, like, oh, atrophy happens, you measure it in days, it's crazy, it's not like a year for things — atrophy, weeks, you can lose up to 50 — depending on what your age is, but you know, 50% of your strength in two weeks — and so you know, those MRIs are — chronic back pain patients, their paraspinals are just, you know, fat, and there's just zero muscle there, yeah, they've atrophied completely out, because they've said, don't bend over, pick things up. Right, now the key to that is, like, you can't just say, hey, go do deadlifts, right, go go jerk 400 pounds off the ground, because they do have a bad rap, because a lot of people do them incorrectly, so you know, it's learning proper mechanics, proper form, and then you just progressively load that tissue.
Yeah, yeah, that, I think, has been exciting, and you guys actually have a, um, you know, you have a squat rack in your PT space, I mean, that's something that I remember, one of my goals, when we were working on my knee, was I wanted to get back to squatting, and it was funny, one day I came in, I was like, hey, guess what, I got under the bar, and I was able to squat, and you're like, good, come show me, and I was like, all right, no problem, so I put the bar low, got down, did my squat, and you know, I expected you to be cheering, and you're like, now do one leg, and I was like, okay, well, I did two, one's not going to be hard — couldn't do it, mhm, and I remember looking at you going, all right, what the heck, how am I able to squat with two, and so that was, again, this other concept that we could probably spend an hour on, is the compensation that happens in the body to get you around an injury.
Yeah, and holy smoke, I've had to completely change my lifting routine, because I tend to go into this thing where this leg is going to take over and sort of baby, you know, the knee that was injured, um, but it was amazing, like, I couldn't do a one-leg squat, even though — two legs — so what's going on with that, and how — how fun is that coming into play in people's recovery? Oh yeah, a lot, and with the squat racks, that's the non-negotiable, and all of our clinics, they all have that, we — yeah, we have different things, but like, again, we are going to have that, with squats and overhead presses, and just those functional things we talked about, yeah, that compensation piece is absolutely — it was a mind-blow, it's absolutely huge, our bodies are very good at avoiding, yeah, avoiding pain, and our brains — we're very, you know, smart, people — sure — and so brains pick up on when we have deficits, you know, an injury creates a deficit, our brain picks up on that deficit, and then the other side compensates extremely well for that.
So that's one of the things that we always have to, you know, pay very, very close attention to, it was fascinating to see that play out. Yeah, and um, but you know, again, going back to that normal model, had I done that squat, and you were like, oh, that was one of the original goals you had, you just achieved the goal, you're done, mhm, like, most PTs probably would have — they would be like, pat on the back, out the door, let's get the next patient locked and loaded in here. Yep, it's very defeating at times, but I actually enjoy this challenge now, but it's something I get on a weekly basis, with new patients as they come in, and they're like, well, Jason, you know, I'm really not happy to be here, I've had physical therapy in the past, it was a complete waste of time — what did that experience look like?
Yeah, well, I'd come in and I'd ride the bike, and some guy would get me on the bike, and then some other person would, you know, get me on a few exercises, and then, you know, the PT would come over and talk to me for just a little bit, yeah, and then they'd hook me up on the e-stim, right, and I'd sit there with ice, and then I would leave, and the next day I'd do the same thing, same group of exercises, and the next day, it was this super passive, modality — e-stim, ultrasound-driven — treatment. And that's something probably that you can build for each one of those modalities, I would imagine, like insurance allows you to have a code associated with that, whether they need it or not.
Yeah, you know, and some of those modalities I found to be very helpful, like, you know, I had some pain in that tendon, and you had suggested, let's try dry needling, and you know, I'd had patients who had done dry needling, but again, here, I didn't go read the dry needling brochure to really figure out what it was, but it was amazing, with one or two sessions we were able to get 95% of the pain gone, and um, but that's — that's one of the — the history of PT, you're changing in that, and changing people's minds on PT is difficult, because, oh, I see it on my side, cause I'll tell people, I'm like, I think you need to see PT, and I'd say half of them will go, been there, done that, not going to work, I don't want to waste my time, I want to go see the surgeon, and so that's where I kind of have to say, I've learned that from you, I'm like, well, okay, not all PT is the same, tell me what you did, and thankfully sending patients to you, they come back and go, that was fantastic, like, I'd never had that kind of approach, they spent the whole time with the PT.
Mhm, and so so that's one of the cardinal things that we do different than most practices, right, is that we only treat one-on-one, yeah, and so like, when you come in to see me, you know, you're not seeing a tech, and we have wonderful techs who help, they keep us going, they get patients on the bike for us if we need, or they're there to rewrap the leg if you've had to unwrap a bandage or whatever, they'll hook up on a modality, um, they clean our tables between patients, and do the laundry, they just keep the clinic going, and they're amazing, a lot of them are wanting to get into PT, so they're awesome — but what we don't have them do, which a lot of clinics do, is provide treatment, yeah, skilled treatment, so like, I don't have a tech having you do a bunch of exercises while I'm treating another patient at the same time, right, and then I'm just checking over, hey, Doc, doing okay over there, you know, it's — we cater to that patient, so when you come in the door, you're working with me the whole time.
Well, one thing I appreciated about that is that, you know, even when I would do a movement, I could tell that, you know, I felt like, hey, I did this movement fine, and you would say, you need to go grab some rubber band, and you would be like, okay, I'm going to pull this way a little bit, now try it again, and all of a sudden I'm like, I can't do it, and you're like, yeah, I know, it's cause you're still compensating, you know, it was always that — you know, I felt like I'd come in and be like, okay, we're done here, and then you're like, I'll be the one to determine when we're done, right, there was always some little — you'd do where I would realize, okay, I'm not — I'm not quite fully there yet.
But I appreciate that, because I think it's, you know, allowed me to be a more functional human where I am today, but um, what are some things that you feel like that people need to — when they do engage with PT, what are some things that people are missing out on, I'm sure — doing their homework, right, the home exercises is probably a big struggle — is that an area where you see compliance being difficult, what are some things that keep people from having the best possible PT outcome they can have? Yeah, so I think — one of my things I say is, you know, I'm going to work very hard with you in the clinic, yeah, you know, I do a lot of hands-on stuff, whether it's dry needling to your knee, so you know, most people are coming in with pain, right, so it is our job to get that pain down, got to get that nervous system calmed down, get that tissue response calmed down, but that's — that is again, that's just step one.
And so so if I give you exercises, because we know that's just a little piece of the puzzle, that the true piece of the puzzle is getting strong, getting exercising, right, right, um, so if — you know, I tell them, we're going to work hard in here, but in order to have true success, this isn't — this isn't a "take a pill to get it better," right, which unfortunately a lot of Americans want, yep, fast, whether it's our internet, yeah, our phones, but we want fast, instant gratification. Instant, and so you know, if — it's educating them, like, hey, this is a process, and you know, it's not going to get better overnight, you've had this back pain for two years, yeah, so you know, next week, if you expect this pain to be gone, it's not, they're going to be disappointed.
But what I can pretty much guarantee all folks is, if you'll work hard, and you'll do our exercises at home, mhm, the research is pretty clear, that when we get strong, and we can move, we have good mobility, good flexibility, and your pain gets better, yeah, it's just the way it is. Yeah, and you know, it can take our bodies minimum of six weeks to truly make a significant strength gain, and so that's where patients have to understand, like, it's not going to be better next week, like, your strength doesn't get better overnight, but if you stick to a program, get strong every six weeks — your muscle tissue does turn, you know — so you do it six weeks, and then another six weeks, and then another six weeks, and then, you know, a year later of working out, it's like, holy cow, you know, totally different, a whole different human being than I was last year.
Yeah, so expectation setting is a big part of what you're doing, giving them a realistic path, I mean, I think that's again going back to our experience, you know, you said, hey, it's going to be a year before you're able to do some of the things that we want you to do, and then that was really helpful for me, because I had assumed, you know, six weeks after surgery I should be right back popping wheelies, right, um, so setting that expectation, I think the other thing I really appreciate is that when you talked about the exercises, you went into a lot of detail about, here's why I want you — you know, you really harped on one of the things, is, I want you to be able to get that leg completely flat, like, you were always, you know, checking with your caliper or whatever the instrument was, and you were like, they're not quite there yet.
And so, you know, I didn't understand why that was so important, to have that full range of motion restored, and I think we even did that before surgery, so you had this — I mean, people have this idea of rehab, you taught me the word "prehab," and so again, that's another thing I think is unique, is, like, what can people be doing when they do need surgery, they should be seeing a physical therapist to get ready for the surgery, right. Yeah, but that idea of knowing that the reason I'm doing these movements at home is so, you know, Jason's looking for these things, so that we can then go on to the next thing, right, so I think that's something that's really helpful, is this the education piece, right.
I mean, you know, you're a doctor of PT, I'm a doctor of medicine, the word doctor comes from the Latin root "docere," which means to teach, so we need to first be teachers, and this is why I feel like Phoenix, you guys do really well — really good at teaching why you're doing something — right, and that's why you're looking for PTs that are able to have a little personality, be able to engage and talk. And so yeah, one of my pieces with our training is how to relate to people, and it's the fun part of my job, just like you, I love being with people, and all PTs should like that, if I've got a patient or a person that comes in to observe, wants to go to PT, and they're a hard introvert and can't relate or converse, I'm like, I really don't think this is probably the right profession, you're going to be worn out by the end of the day talking to people all day.
Yeah, but dealing with personality types, because you know, if we can build strong rapport with our patients, and they can tell that we genuinely care about them, right, they're willing to work for you, you know, if I train my staff, like, how do we relate to people, you know, how do we deal with different personalities, and how do we educate certain personalities — if you're an engineer, you know, they want me to nerd out with them, yeah, totally — but there's other personalities that, you know, I'll ask them, like, do you really want to know exactly what's going on with the shoulder, like, I could care less, right, I just want you to get it well, sweet, let's get to work, basically your shoulder's tight, we're going to loosen it up, you're going to be good to go, you know, so it's just knowing when and how much to educate.
But yeah, I want — my parents are teachers, my grandparents are teachers, that's what I originally went into school to be, was a teacher, um, so I love teaching, that's just a blast, that's part of the fun of the job. Yeah, yeah, yeah, it's true, you do have to know your audience, I think, is really what that comes down to, is being able to say, you know, okay, I am speaking to someone who has an engineering background, and I always like using analogies, so I'll often ask, like, what do you do, and they'll tell me, I drill wells, and I'm like, oh God, how am I going to explain this, I got to think of an analogy that makes sense for someone who's a well driller, right, um, and that's going to be different from somebody who does, you know, some other job, so I think that is something that we as doctors really do need to be thinking about, how we can mold our message, and not change our personality, but just, we do have to change our approach, uh, depending on who's in front of us, and where they are in their whole, you know, experience of this.
So yeah, that's fascinating, that that's something that you do and look for in other people, because again, I mean, again, it's a different feeling when you walk into Phoenix PT, I mean, you know, and — therefore why, I'd walk in and never be like — it was like, hey Norm, like Cheers, hey Norm, you know, like, I'm waving at everybody, and um, but yeah, I'd say kudos to you, I think you guys have done just a phenomenal job at making a place where, you know, I have confidence that I can send patients there who are having difficult things, and many have failed with PT, um, you know, I still go back to — there was a patient I sent you who she had a frozen shoulder, and uh, had failed PT, and actually the surgeon even said to her, there's nothing I can do for you, you know, he had basically said, this isn't a surgical problem.
And um, I remember thinking, I'm like, well, gosh, send her to Jason, see what he can do, and um, you were very gracious, you were like, hey, thanks for sending this patient, this one's going to be tough, like, I remember you saying, like, I don't know if this one's going to be the knock-it-out-of-the-park, and I'd kind of lost track of the patient, but I saw them one day, uh, checking out, and they were at the other end of the counter, and I caught their eye, and I was like, hey, how's your shoulder, you know, I was kind of signaling to her, and she looked and got this big smile on her face, and went like that, and I — my jaw dropped, because you know, she had, like, I don't know how many degrees of mobility, you probably know the patient I'm talking about, but it was an unbelievable response that she'd had, but what was amazing about it was the gigantic smile that was on her face.
Mhm, and so I don't know, I mean, I just love that, that that's something that I know that I can send to you guys, yeah, and you're going to be able to tackle. So I appreciate that, she was a very meaningful patient, because it was, again, it was that holistic side, there's — you know, there's patients that they've got a lot going on in life, and um, it's not just a frozen shoulder in front of you, it's a person, yeah, and how can we get to the root, and a lot of times to get to the root we have to address a lot of different areas, sure, and boot camp, that's in their family, trauma they've experienced, all of that, if we take that holistic approach, and the patient can truly tell that you're trustworthy and you care, um, that was a really cool one.
And you know, and just, that's what I love about you guys, is like, you are always looking to get to the root cause, if somebody comes in with high blood pressure, mhm, like, you know, again, you're — you probably put them on some blood pressure med just to get it under control, yeah, but that's not where the story ends, right, like, now it's time to dig deep, you know, what is the problem here, yeah, what — what can we change in your diet, your exercise, your lifestyle, your stress, your sleep, all of those things, and you're not going to quit, right, until you fix that person holistically, you fix the whole, and I think that's where our thoughts align very closely, is, you know, we're not looking at them as just a diagnosis.
Yeah, you know, one of my favorite quotes from you is, um, was it, "the definition of health is not simply the absence of disease," yeah, yeah, and that is amazing. Well, we — I think we do have to look at the whole function of the body, and how we were designed, you know, I'm a very big believer in that this body is not here by accident, right, I mean, we are wonderfully, fearfully created, um, you and I both have a faith background where there is a design of how this body works, and so I think that's where we can help to reestablish some of these things, and get back to what the design was meant to do.
That's a pretty powerful thing, and what's amazing is it spills over into other parts of people's life, I mean, that person that you treated, you got their shoulder moving better, but what you did is you showed them that they could overcome, mhm, right, I mean, again, that smile that I saw, her — wasn't just about, oh, my shoulder works better, it was a smile of, I did something that was seemingly insurmountable, right, that I had not only failed before, but had seen a specialist that said, there's nothing I can do for you, and they were able to overcome that, I mean, that's a tremendous ripple effect that I think it will have, not only in her life, but the people that are around her that depend on her, right, so that's pretty special, to be able to do that.
Yeah, and you know, you've said some fun ones, he — you know, sometimes the tougher ones — you'll get another one, just quick was, um, he came in for his evaluation, and his neck was so painful, and pain down — nerve pain down both arms, and he told me that he used to be active, but couldn't walk even down the block anymore, mhm, and so I try to get him to lay down on the table, and he seizes up, yeah, completely seizes, and he stops breathing, and his — tense up — and he has to stand back up again, nerve pain shooting down the arms, yeah, we couldn't move him, and so I'm like, okay, and I mean, I've seen most things, I'm like, wow, like, I genuinely — like, this is crazy.
So his sympathetic nervous system — his nervous system was cranked up, cranked to the — high, yeah, anything was setting him off, and he told — he has the brain thought that anything, any movement, was going to set him off, so I'm, like, well, how about we go ride the stationary bike, yeah, and he looked at me like I'm crazy, like, yeah, I'm here for my neck, why would I go ride on a bike, yeah, so we crank that bike, I'm like, how are you doing, he's like — I start seeing that sympathetic system, I'm like, let's take some deep breaths while you do this, I start talking to him real calmly, and we start talking about breathing technique while he's on this bike, and all of a sudden we're going 5 minutes, he didn't stop, and then we get to 10 minutes, and we're talking about breathing and relaxation, how exercise is so healthy, and anyways, and then I was like, you know, how do you feel, he's like, I feel a little better, it's like, what if we just go outside and just go for a walk, something he couldn't do, something he never asked for.
An eval, I'm usually taking measurements, we just go for a walk, and we walked down the block and back together, yeah, we get back, how are we doing, he's like, you know what, not perfect, but I can't believe I just pulled that off, right, okay, well, let's go back in the room and let's try laying down again, and he could lay down, yeah, and we talk about — so all we did day one was talk about stress, right, talk about breathing, talk about the sympathetic nervous system, how do we tap into our parasympathetic nerves, you know, so it's just — you never know, but again, it's not just treating pain, 100%, it's treating the person, and meeting them where they're at, and that might look like that.
So yeah, that stress component was playing big on what was going on with that particular patient, and he ended up doing wonderfully, got back to pickleball and lifting heavy weights, all the things that we like to get our patients back, just another fun success story, but it's just, like you said, it's thinking outside the box, what do we need to do for this patient. When I think, you know, the word "holistic," um, it often has, uh, you know, in our industry, you know, other doctors hear that you do things holistically, and they roll their eyes, and think, all right, does that mean you're rubbing crystals on people's elbows, or you know, and they make it sound like it's some — that we're doing a bunch of, you know, voodoo stuff, yeah, but it's not, it's really just getting back to the basics.
Back to the basics, right, I mean, and I love that you keep touching on, you know, sleep and movement and nutrition, I mean, those, in our clinic paradigm, I mean, those are our three central pillars, mhm, and we just tell people, hey, if sleep, nutrition, and movement aren't working, we really don't need to dive into anything deeper, like, yeah, you know, let's not even talk about testing your hormones, let's not go measuring for heavy metals, it's like, we got to get these very basic pillars back up and working, and then we'll see what we're left with, and so many times, if you address just those fundamentals, you see an almost — an unfolding — like, the deficits fall away, the body restores its natural patterns.
I mean, and it makes sense, right, I mean, we got to get blood flow moving, we need to pump things through the tissue to clear out the waste products, so I hate that holistic gets this bad rap in some cases, but it really is just — take a step back and look at the person as a whole, it's that simple. It's that simple, yeah, it's not voodoo, yeah, it's simple, back to the basics, how are we doing on sleep, how are we doing on exercise, how are we doing on diet, you know, hygiene, just the simple things in life.
But you know, one of the other things that really stuck out, when I was like, man, we are going to get along super well, was — one of the first times, of course, all of our sessions were amazing, you were one of the many, but one of the few in reality — that I learned way more from you in our sessions than I guarantee you learned from me, about your knee and your shoulder — but you know, one of the things I was like, oh man, this is a relationship that's going to really work, is when you were saying how you got into this functional medicine, and not taking a lot of insurance, and you're like, you know, I was going to work every day and just handing out pills, mhm, and I was — I think you even said you're kind of pseudo depressed, like, it was like, what did I do, like, yeah, I went to school for this, right, and then you had the capacity to be like, you know what, the heck with this, I'm going to make a meaningful impact, and I'm going to involve my medicine, cause you're good at that, but medicine is just going to be a little piece to this puzzle, and that's when I was like, okay, this is like — you're talking my language, yeah.
And so I asked, um, one of our PTs, she's a patient of yours, and so I was asking her, you know, who's actually been in your office and in your group, I was like, so, hey, I'm going to go do a podcast with Dr. Davis, and just, just from some insight, you know, what are some things you see from Phoenix and Prairie Health and Wellness that align, yeah, like, what things do you think they do, and we do similarly, and she's like, well — she didn't even hesitate — she's like, well, one, they spend so much time with me, like, I've never been rushed, like, I get at least 30 minutes, whatever time I need, I get, and she's like, they search for the root cause of the problem, like, you know, when — she had some stuff going on that nobody, her doctor, nobody could figure out, I was like, well, you need to — anytime I have a patient that says that, I'm like, go see Prairie Health and Wellness — and she's like, and they got down to the root, hormone stuff, she didn't go into details, but you guys figured out the root cause, it wasn't a medication thing, she was on all these medicines, took her off medicines, got her hooked up with the right stuff, um, and then time getting to the root, and then she said she really felt heard.
Mhm, and so those were the things where you — like, she left mind blown, because she went into a doctor's office and felt welcomed, she had time, felt heard, and you guys got to the root cause, not just her symptoms, so anyways, those were some things I — like, man, that's the good stuff there. So well, you know, there is a lot of harmony between the way we're doing things, and I think that's what, when you and I first started working together, is understanding that we had this synergy that we understood, and you know, my hope is that we bring more providers, more doctors, more practitioners into that, I think the hard part is the system, you know, like you were saying with the insurance system, and like we were kind of touching on with Dean Jergo on another podcast, is that the system is designed for something completely different, and it's that, you know, rapid — I mean, in a seven and a half minute visit, you know, you barely have time to ask them how their, you know, wife is doing, or what the kids are up to.
Um, so I think at some point we have to move away from this traditional medical model, um, and I think that's just going to be a slow thing, but hopefully we can continue having these conversations, and for sure pulling people into this. So and you guys having us, you know, we, in your movement center, with Caleb, um, you know, I think that just, again, just fits so well, because you guys are doing it all, right, you know, you got your personal trainer, what doctor's office has a personal trainer, there's nobody, you know, you got that chiropractic, which is awesome, and massage, and then, then you have your, um, counselor, your — mental health side, right, um, so you guys are covering it all, and you know, like our little PT piece is, I think, so helpful, in the sense of, you know, there are those patients that are dealing with pain, yes, and if you send those patients that are dealing with pain, and you're like, hey, we need to go work out with this trainer, well, a lot of times it doesn't work so well at first, yeah, and so you know, how do we build confidence, how do we get that pain down, we have a lot of tools in our bag to do that, yeah, is like, we send over to Caleb, hey, I know you're dealing with some chronic back pain, go see Caleb, let him get you going, teach you how to move, and then he'll refer you off to a personal trainer, and you'll just carry it on, yeah, because in a perfect world, with all my patients, is they leave me and hit a gym, right, hit a personal trainer, again, if they're not interested in a gym, we're going to set them home, but anyways, the best case is, me to a personal trainer, me to a gym, where they can, again, go live life and go get healthy and strong.
Well, that's one of the things that really, uh, inspired your clinic, especially inspired that — of, you know, me realizing, we really got to take a more focused approach to helping people with that pillar of movement, um, and so we see that the PT is an absolutely integral spot, and having Caleb there, who can, you know, if I have a — you know, what's great is that there's this synergy where somebody might start with the trainer and think that's what I need, and you know, Caleb might be working with them and go, there's something that's not firing here, you know, or maybe he does a functional movement score, and they have pain with a certain movement, and so he can immediately go, you need to go see Caleb, right, and then Caleb can start working on him, and or, one of our chiropractors might be working on something and say, this is a — this is a PT problem.
What's been really fun is to watch Caleb integrate into that, and see, like, where is the overlap between everybody, and then really figure out, like, how do we guide people through, you know, when is muscle activation techniques going to be appropriate, when does somebody really need, you know, work on that parasympathetic, where just having a weekly massage, where they can just get the stress, literally, you know, the — that therapeutic massage is amazing for restoring that kind of parasympathetic and sympathetic balance, but that's been really fun to watch that. So yeah, so anyway, I really appreciate what you guys do, I — if anybody listening to this, if you've tried PT before and you feel like you've failed at it, I would just say, they've got to come fail with you first, or not just you, but you, or anybody you mentor, you know what I'm saying, I really feel like they haven't fully understood what PT can give them from a holistic standpoint, unless they've experienced it from you, so I appreciate you more than you probably know, so thank you for all you do for our patients, thank you for what you do for our community.
Yeah, hey, thank you for having me on, and the relationship that you've been open to us having, is just awesome, we'll have to bring you back and talk about more stuff. Let's do it, again, I don't think we'll run out of it, I go for a few more hours, probably.