In this episode, Dr. Greg interviews the newest addition to Judice Sports & Rehab, Dr. Jen Rispoli. Dr. Jen has always had an interest and passion for women’s health and worked hard to seek out specialized training as she moved through her education. Pelvic pain, sexual pain and dysfunction, and incontinence issues are extremely common, especially after pregnancy and childbirth. Unfortunately, over the years, women have been led to believe that pain and incontinence are typical and unavoidable side effects to childbirth and the aging process. Dr. Jen is committed to educating women that these issues are preventable and treatable. 

Email: drjen@stlouispt.com

Website: stlouispt.com

P) 636-686-0503

 

(transcribed by otter.ai.com) 

Hello, and welcome to STL Active St. Louis’s premier health and wellness podcast. STL Active aims to give listeners in the St. Louis area the information they need to succeed and progress with their health and fitness. This podcast is brought to you by stlouispt.com and hosted by Doctor of Physical Therapy, Greg, Judice.

Hey everyone, it’s Dr. Greg, owner and Physical Therapist here at duty sports in rehab. On this episode of the show, I’m interviewing Dr. Jennifer Rispoli. Our newest Doctor of physical therapy here at Judice Sports and Rehab. Jennifer has over a decade of experience helping people maximize their body’s potential and achieve their goals. Jennifer has a special interest in pelvic health physical therapy with experienced treating bowel and bladder incontinence, pelvic pain, sexual dysfunction, and constipation. With a quarter of women experience some degree of pelvic floor dysfunction, Jennifer provides relief and life changing solutions for women in all stages of life. Whether it be childbirth, trauma and abuse, abdominal or back surgery, or menopause. Women deserve to have a healthy, happy and fulfilling life. And Jennifer’s passion is to help all women understand their body and achieve these goals. Without further ado, let’s get into the interview with Dr. Jennifer Rispoli. All right, welcome to the show, Dr. Jennifer Rispoli. From Judice Sports and Rehab. That’s me. I know that was kind of an odd intro. But just for you listeners who don’t know, we have hired a new physical therapist. So this is Dr. Jen, she will be our new pelvic floor physical therapist. So we’re excited to have her. I wanted to get her on to the podcast so she could tell you a bit more about what she does, and how she helps people. So welcome.

Thank you. I’m very happy to be here.

Awesome. So let’s start with you telling the listeners a little bit about your background.

All right. Well, the basics. I was raised in central Illinois, outside Peoria, a little town called Morton, which is the pumpkin capital of the world. Fun fact. And I went to school for PT at Maryville University here in St. Louis. And I have just never left. I became interested in physical therapy, I was a huge softball player when I was younger, and I tore my meniscus in my knee. So I had to have surgery. And then I had PT after that. And I remember thinking I was only 13. But I was like, I am so much stronger after I had surgery, and then PT of course, than I was before. And so I was just super interested in PT from that point on. And that’s what I went to school for. And then somewhere along the way, I kind of became interested in women’s health physical therapy. I kind of always been interested in women, I guess you could say I thought about being an OB GYN for a while. And then like I said, PT kind of took over, but I’m stole your heart, it did. So and then I guess I found that these two specialties in a way could kind of collide into women’s health pt. And so I pursued that route. And I’m super excited.

Awesome. So what was it that that sparked the interest in the women’s health side of things.

I think just knowing that there was so much like misinformation out there for women. I was you know, I have a child of my own. And so kind of going through that process of you know, labor and delivery and being pregnant and recovering and all of that. And it just kind of made me realize that there’s a lot of information out there, that’s not known. There’s a lot of help for women that they don’t even necessarily realize that they need. I see a lot of women suffering. And it doesn’t have to be that way. When I was in school, I took some kind of like little offshoot classes that were specific to women’s health, and they just really interested me and that’s just a small area of the body that has such a huge impact in so many areas of life, you know, the pelvic floor is like 1% of your body but it packs you know 75-80, 90% of daily function. So that ratio of you know, size to importance was really intriguing to me as well.

You know, I think it’s it’s interesting the way that pelvic floor and core is taught in school, you know, it’s a lot of you know, you break it down into regions. So it’s you’re gonna work on the shoulder this for the next two months and then ankle for the next two months and you learn everything you can about that. And then it’s like, oh well gals, you might learn some women’s health after You’re finishing it’s like, the pelvic floor is part of the core right core is used in most activities, if not all right, why are we not talking about it as part of the core? And I don’t know, if it’s like, oh, these 20-24 year old kids, like, are we just, like embarrassed to discuss this? Like, I know, there’s a bit of a stigma behind talking about intimate, you know, parts of the body. Right, right. It just seems like it wasn’t discussed enough.

Absolutely. Yep. I mean, you know, we learned about the glutes and abdominals and all of that. But yeah, when it comes to that section, I mean, the only reason I learned anything about it in school was because I took the extra class master class, right. And then when I was on my clinical rotations, I spent, you know, over half of that time with women’s health therapists that I deliberately sought out. So I could have graduated with zero knowledge of the pelvic floor, which is what 90% of PT’S do, because it’s not their interest. And that’s okay, that we need specialty specializations and other things. But yeah, so it’s, it’s really as amazing that you can leave school with minimal knowledge of core parts of just life, right? I mean, we all go the bathroom multiple times a day, right? And how you can leave school. Just being like, oh, there’s, there’s a muscle down there that that helps with that. And that’s all you know, it’s kind of kind of crazy.

And I think that’s the the fact that there’s so little known right out of school leads to a lot of, oh, just do chemicals or however you want to pronounce it, right. But that’s that’s not the answer for most people. And it’s, it’s so frustrating. And I am going to equate this to chronic pain, because our education through our DPT program was minimal on chronic pain, minimal and pelvic floor. But I feel like those two are super interrelated chronic pain and pelvic floor issues. But they also apply to most orthopedic things. Absolutely. Yes. And that’s where it’s, it’s, I’m super excited to have you here. Because, I mean, I’ve only gotten maybe 15 clients this week, and I’ve already sent more than 10% of them to you. Right? Yes. Yeah. They have other things that you can help with that coincide or, you know, go in adjunct with what I’m working on with him on that strictly orthopedic side. Yep.

Yes. Yeah, it’s kind of going back to I said earlier, like, you know, people, people just don’t even know, it’s an option. You know, when they go in there, tell their doctor, they have a problem, and the doctor just really kind of blows them off. Or going back to what you said about the, like keagles. Know, people think that’s all you need to do. And it’s kind of crazy how they’re, you can be doing them wrong, like people don’t realize those people are doing them wrong. And that usually exacerbates the problem. So once again, kind of lack of knowledge misinformed girls, all you need to do is do some keels, and there’ll be good and you’re probably doing them wrong. That’s just not that’s not the case. And there’s probably a lot more to it than just strengthening shirt though.

Right? And that’s, you know, one of the things I guess I got most introduced into the pelvic floor therapy side of things. I’ve got a friend who right out of school started pursuing her WCS, and she’s now in Indiana, but you know, her, her big quote, right after school was sexism, ADL. Right? And it was like, it is you’re absolutely right. But, you know, it was interesting learning from her that, you know, it’s not just things are weak. It’s not always that things are weak. Sometimes things are too stiff, or too loose or too, you know, there’s all sorts of different issues. It’s not always a one size fits all approach. And, again, from someone who didn’t know anything about how it works, from a PT standpoint, that was all like, mind blowing, roll new, right. But it is just so interesting that people are as misinformed as they are

right? I have a friend who not in the area that does a woman’s health as well. And she was telling me that she had a lady come in, and she was just having. I don’t remember what the issue was exactly. But she said, if we know we need to start doing some keagels, she hadn’t been doing any of them. Okay, just generic advice, you’d get off the street, right? And now that lady has come back because she was doing them improperly. And well. Now she has another problem on top of it. So that whole just Google search, what do I do for my incontinence? What do I do for this that and you know, Do a kegel. Okay. And then it’s out of the article, right. And Yukiko and yeah, and it’s not. It’s, it’s absolutely gonna be part of the part of the answer, but rarely, rarely is it is it all the answer? Right.

So just a piece of education here, a lot of people when they picture core, right when I do quotations here that the core, a lot of people will picture the abs. And that might be all they picture for the core. But there’s way more to it than that, of course, your abs are part of it. But that also includes your obliques, your low back muscles. For me, I even include lower shoulder blade muscles, right, they’re still the upper part of the bucket, if you will. And that’s a good way to picture things. If you picture the core as a bucket. It’s pretty effective. Core also includes your hip muscles, your glutes, but the bottom of the bucket is the pelvic floor. And if you don’t have the bottom of the bucket, there’s no point in having a bucket. So it applies. It does leak. Exactly. There’s more to it than just having strong abs. Yep. Right. It’s more than just the glamor muscles. You gotta have everything working together. Yep. Very cool. So how do you feel we got into this misinformation? Space? I mean, it seems like everything is just poor information. Like I now follow other pelvic floor therapist on Instagram. So I feel like I’m getting some more edutainment, if you will, from that side of things. But it’s I just feels like like you said, if you Google something, it’s just not good information.

Right. I think no offense, you being a male, but I think part of it stems from way back way back in the day, right? When like, men were were kings, right? And women were just accessories. Right, you know, not not as important. We’ll say that, as women didn’t matter as much. I know, in some cultures, I think that’s kind of, you know, still the case. But when you have a population, that doesn’t matter, as much, you aren’t inclined to figure out what’s going on. Right. Kind of, you know, so I think there’s that piece a little bit of it. I think a lot of doctors until more recently, right? were male, they didn’t know, they maybe didn’t want to know, they felt uncomfortable sharing. And I think women also probably felt uncomfortable sharing our culture has really changed. And last, you know, I don’t know, 50 years say, but we’ve come up more open with these things, which is why I think it’s starting to become more well known starting to take off a little bit, and women are seeing that it that it can be helped. Then if you just look at the media, you know, it’s like women you need, you need to be this way, if you aren’t behaving an XYZ way, if you don’t look, you know, this way, if you have can’t do this, you know, then there’s something wrong with you. And the truth is that there’s probably nothing wrong wrong with you, we just have this misconceived perception of what things are supposed to be how things are supposed to be. And it’s just gotten passed down generation to generation, probably because nobody really talks about it. It’s a sensitive topic sensitive area, people are embarrassed, no one wants to shout the problems from the rooftop. Or conversely, they just think it’s it’s normal, you know, how many times you know, you have you get older, you know, you’re gonna have some prolapse, your hands are gonna fall out, it’s fine. You just go you get some mesh surgery, and you live with the pain and you go through surgery and, and you get a little bit better. It’s just kind of the, the way our medical model has had to always has been right. And it’s just not the best way. The truth is, you know, and it shouldn’t definitely, surgery shouldn’t be the first step. But somehow, along the way, it became the first step. But so I think there’s a lot of cancer, it’s a very roundabout answer to your question. There’s a lot, I think there’s a lot of different factors that go into it, which is why there’s I mean, the education for this is kind of extensive, because there’s so many different factors you have to take into, you know, social, socio economical, you know, it just goes so far to how many different things can be involved with these issues.

And I totally agree that I feel like, to some extent, in the past, probably not going forward, but men have kind of ruled the world. Right. Right. And have you have you ever heard of the pink attacks? Yes. Yeah. Yeah. So it basically for listeners that don’t know what that is, is basically like, any female product that’s geared toward females is going to be more expensive, because it’s specific to females, right? If you buy a pack of black pins, versus if you buy a pack of black pens that have pink grips on them, that ones that pink grips are going to be more expensive. Yep. Do you go buy a pack of razors from Walgreens? The one that are geared to women or you know, the venous line or whatever Oh, Those are going to be more expensive than the men’s razors. Yep. And I’m not exactly sure what the rationale behind that is. But it sure seems like you guys are getting the rough end of the deal over the last long number of years. I’m not sure what the right number is. Right. You know, it’s just one of those things. That’s the way it always has been. Right. So I think things are certainly changing, especially this newer generation that seems to be more vocal about things that are more open to dealing with mental health, dealing with other things that might have been a stigma or too personal to talk about in public before. that public health is one of those things as well. I think over the next 10 years, you’re gonna see a huge boom. In women’s health care.

Yes, yep. I agree. Because you know, a woman may I say, it’s not shouted from the rooftops, but you have your close friend that, you know, you open up to I have this problem, and then oh, so do i right. But everyone thought they were in the same boat, you know, I had a kid. And now I have a little bit of incontinence. I was just told it’ll get better. But I went to PT, and it got better. Oh, I also have this issue. No, but no one’s getting on Facebook and saying, Hey, guys, I have incontinence after I had a kid. Is this normal? Can I fix it? We just hold it all in. And then it just gets worse. So yeah, and they came with this more open generation, you know, starts with friends, telling friends, you know, being open there, and

just telling friends, but also just general public education, right, just part of why I wanted to do this podcast because the fact that I’m having to refer to people to you that I’ve been seeing for weeks, I didn’t even know that they had these issues, right? Because they’ve literally never told me. But I say, Hey, I’ve got this new therapist, and I’m bringing it in. And they of course, they’re like, Oh, well, maybe I should see her, right. I you know, it’s one of those things as a male, I don’t necessarily feel comfortable asking my clients about that. So it is, it is something that has to change, when it comes to the communication, whether it’s from a PT from a physician, public health, whatever you want to call it. So maybe that’s something that I need to change within my practice to make sure that that question is asked in a less probing kind of way,

right? Yep. I think just generically asking, you know, do you have it’s just so far reaching, you know, incontinence, bowel and bladder, incontinence, pelvic pain, sexual dysfunction, abdominal surgeries, you know, it just IBS endometriosis.

They’re just 10 questions in one. And if anything is a yes, then Yep, it’s all Yes. Yep. To You know, so that I know when to send them to you. Yep. Yep. So tell us a little bit more about the types of things that you can help with.

So it’s a very, it’s a very long list. Yep. So start off, you know, any bowel or bladder incontinence. You people somehow have gotten women especially gotten the misconception that, you know, it’s normal to leak a little bit. And the truth is, that’s not normal. Common. Common is not normal. So any thing that’s not in your control, whether that be gas stool, or urine, we can help with that. Kind of called nocturia. So going to the bathroom more than once a night once a night. Normal No need no need to be concerned about that more than once a night. Not ideal, right? If you if you’re okay with it, okay, but I like to sleep more than a couple hours, four hours at a time. So that’s another one there any overreactor overactive bladder so kind of feeling like you need to go a lot of urge incontinence or just constantly feel like you need to go having pain with that. Incontinence with coughing, sneezing, lifting, once again, like very common after pregnancy, labor and delivery, a lot of stress on those muscles down there. After labor, they’re super weak, you know, and so a lot of times it’s a common complaint. People are told Oh, that’ll get better than doesn’t get better than 20 years down the road. Still having those issues so we can definitely work with that. Any pain, pelvic pain perineal pain, bladder pain. interstitial cystitis is one no after we’ve ruled out that there’s UTIs we still have the pressure, pain urge going on. We can help with that. Pelvic Floor tension muscle spasms, painful sex. Those are a lot of times related usually. All due to muscle tone, and muscle not behaving as it should what’s called vulvodynia, which is just kind of pain superficially, I mean, people can have pain wearing clothes, just sitting, any superficial touch or pressure in the pelvic region vaginismus, which is a very big word for a painful insertion of anything into the vagina. So whether that would be a tampon intercourse, I’ve had some people that just want to be able to tolerate a gynecological exam, you know, just to get a pap smear to make sure they don’t have cervical cancer, right? That’s huge. You know, that’s just basic kind of health 101 Right there people like avoiding those because of pain, right? And it’s, it’s, it’s a fixable thing. Constipation, any prolapse, kind of management and prevention, kind of getting worse. With a lot of kind of a lot of people, I always think in this case of, I know someone who called me up, she was kind of like, almost close to tears. And she was like, you know, I, I went to the bathroom, and I felt some like pressure down there. And like, I know, when I have had this mess surgery, and I know that you have one, you have to have another one, then you have like pain. And I was like, well, let’s pump the brakes here. I was like, just, this is preventable. This is this is fixable, you know, you’re catching it early, but it was really sad to me, you know, like her friends. Again, her first response was I’m after this horrible surgery that’s going to further impact my life. So that’s something any kind of like, a lot of times, women with endometriosis, which is you know, the tissue lining that grows outside the uterus, and ovaries, fallopian tubes on the intestines, or PCOS, which are the, you know, ovaries have some cysts on them. A lot of times those cause pain. So while we can’t necessarily address those symptoms, I wish I could wave a magic wand and take that away, a lot of times you have pain, which leads to inflammation, which leads to pelvic floor dysfunction. So a lot of women that have pain with those diagnoses can be of find benefit from pelvic floor PT as well. I’m not, I’m not a psychologist, but a lot of people after unfortunately, going through abuse or trauma, kind of going back to that sexual dysfunction, you know, have issues having intercourse, or being comfortable with it. kind of work through that, you know, I’m absolutely not afraid to refer refer to someone new.

And I think that’s important for any PT’s is if there’s something where there’s psychological trauma, right, you have to work alongside the psychologist. And that’s certainly something that you and I have talked about, you know, yep, before this recording, right is something that we’re both comfortable with is knowing when to draw the line of is this something I can help with? Is it something I need to refer,

right? So a lot of abuse survivors will hold their stress in their pelvic floor a lot of people everyone’s familiar with, you know, your, your traps, being tight, you know, your upper traps, your shoulders, getting knots in them, people hold stress there, you know, or you might find yourself clenching your jaw a lot. Those are kind of common places that people hold stress, the pelvic floor is a very common area that people hold stress, especially in that kind of situation. So a lot of times I’ll see people who have had some trauma in the past, that’s kind of manifested itself in the pelvic floor. And then I would say the last kind of a couple things that I that I can help with, you know, abdominal surgeries part of the core, right your abdomen or abdominals, insert into your pelvis, any muscle that attaches to your pelvis basically falls into my, you know, expertise here. And then coccyx pain, which can be very, very painful, anyone’s broken, their tailbone knows, that’s, it’s horrible to have the worst bones to break, you know, and the effects of that, you know, continue to linger. Your coccyx is is right there right on that pelvic floor. So it’s kind of find the short long list of everything that I can help with.

So there’s a couple things that kind of stand out there. You know, you mentioned the incontinence first and from our previous conversations, it sounds like that’s one of the most common things that you treat. Yes. Is incontinence. You know, it’s interesting to me, if you go into a big box store, they have an entire aisle dedicated to incontinence management. They do. There’s an entire aisle of depends and other brands similar when I’m not going to give a percentage but a high percentage of the time that incontinence could be managed with PT. Absolutely. Yep. That’s fascinating to me. Yeah. Why do you feel like is it just because it’s a bandaid, right, it’s easy to easy to do that to an extent

Right. I think that’s harder right? To go to the store, right? spend all this money, you know? Yeah, it’s I don’t think that’s the way to go at all. But for some, I guess, I think it kind of goes back to where the stigma like, oh, I don’t want to maybe admit I have a problem,

or do you think it’s normal? I don’t know. I don’t know that there’s another option. I

think that’s 99% of it. Okay. There have been so many people that I’ve worked with whoever, like I had no idea. I thought I just, you know, needed to buy Pads, because that’s what my, my aunt did. That’s what my grandma did. And that’s what I’ve always seen done, right? And like you said, it’s there. You know, what’s the message our society is telling us or society, you walk in the stores like, you have a problem? Here’s your answer. Pick one of the top 10 brands, right. And if that doesn’t work, try our other line. And so that they gets Yeah, and they get the combination of it’s easy. It’s it’s there or embarrassed to talk about it, or we think it’s normal. I got older, I went through menopause, I leak a little bit when I cough or a sneeze. Apparently, that’s just the what happens when you get older, and doesn’t have to be that way.

Right. One of the other things you mentioned was that people just assume surgery is the only answer. Is it? Is that kind of the same? Same kind of answer from you is that that’s just what people know, have they had a family member that had to have the sling? Or the mess surgery or any of that stuff? Yep.

I think that’s a good part of it. And also, I mean, think about people are watching TV, what do you see on TV, this new medical procedure, you also get followed up by if you’ve had mesh surgery, and you had a problem where it did this that other no call? 100? Lawyers, right. So but so you know, it’s out there, right? You don’t see any commercials saying, Oh, if you had if you leak, you know, try PT, nope. If you leak by this bad fuel leak, go this urology office, you know, and those people apps, you know, can’t get rid of 100% of everything. Right? You surgeons have their place, there’s a reason surgeons exists. So I don’t, I don’t mean bashing on any urologist here, there are plenty of good ones out there. And you know, they’re, you know, they’ll say, go to PT before you, you know, come in, we don’t want to jump to surgery. But there is another group, like there isn’t every occupation, right, that are just like, Oh, you have this, you have this issue, only way to fix it with surgery. And you know, depending on how bad things are, that that may be the case, but 90% of people who go through pelvic floor PT, report improvements, to some degree, if not completely. One of the great things about pelvic floor PT is pretty much nobody like really gets worse with it. I mean, you don’t get you don’t get to try and strengthen your grade. Right. So it’s kind of a risk, low risk potential for super high reward intervention. So yeah, I think that’s why people go to surgery first for those those reasons.

So I’m going to ask this question from an orthopedic PT standpoint, it sounds like a lot of people will wait forever to deal with whatever their pelvic floor issue might be. Are those folks going to take longer, to feel better to get better in the same way that someone with like low back pain, if they wait 10 years to deal with it, there’s going to be a lot of other things going on, it’s going to take me longer to help them if they’ve waited forever to come in? Versus if they come in three weeks after their back started, bother them bothering them? It’s usually fairly simple. Fix is that similar with pelvic floor?

Yes, absolutely. Yep. Because, you know, say you start with an incontinence. Okay. And then. So, in that case, it’s really kind of simple, say simple, but some key goals, a variety of different pelvic floor strengthening exercises of that strict law you have going on. Just like you know, if you’re injured your knee, right need to strengthen your quad. Do you just get your quads a little stronger, and that’ll definitely, at least help take care start taking care of the problem. But if you put this off, right, then you start to have anxiety about oh, I’m leaking, I have to go to the store. It’s putting a stress on my finances I don’t want to go out with with friends because I have to go to the bathroom too often, you know, and then you start to hold on that tension your pelvic floor on the pelvic pain. Now you are prevented from you know, enjoying life as much maybe intercourse starts to hurt because you’re to have all this pelvic pain, right? Well, now your relationship, your spouse might start to suffer. I mean, that that doesn’t happen like two weeks time, right? But But over time, yes, kind of you’re saying it just starts to one problem kind of piles on to another nun. Now you have 2,3,4 problems that you need to fix. So sooner, sooner is always better.

Got it? And that was kind of my assumption, but I didn’t want to be wrong right now. That’s why I’m asking. Yeah. So what would you say your favorite thing to help people with is,

that is a tough one

favorite population to work with,

or population. I really like postpartum women, I know, I’ve been there, that’s I connect with, I’m 33, you know, I’ve had a kid, I think those woman that woman had that aid that stage not that age stage of life have, they have a lot of hats to try and wear a lot of, and that’s just one thing, you can kind of help take off their plates. You know, just helping restore that pelvic floor. Because that is a lot of times the beginning of the problems, you know, you may not have incontinence right away after you have a child. But if you don’t work on getting that pelvic floor back to baseline back to where it should be, you’re more predisposed to having that, you know, later on. Same with pelvic pain, it’s a lot of trauma. Especially if you have you know, if you if you tear that many people do a PC atomies anymore, but if you happen to have one of those deliveries traumatic, right, and that can lead to a lot of pain, which can, you know, affect your relationship with your spouse for a variety of reasons. And I just really like the idea that you will kind of nip all that in the bud from the beginning, you know, especially if you have want to have another kid shortly thereafter. You don’t want to enter a big event week, right? Like you don’t go into a marathon without having trained right and so a lot of times these women that you know, have a child and then how child again, right after you haven’t recovered from your you just ran a marathon, you’re trying to run another marathon and it’s just be a lot for the body. So I really wanted loves for some OB GYN, some have started to just kind of refer just like you go six weeks after to get checkup after delivery. Why not go see a pelvic floor PT six, eight weeks after, you know whenever you’d be cleared.

So that’s something that you would recommend for pretty much every woman that’s given birth? Yeah,

yeah. A lot of like in Europe, that’s common practice. So it’s being proactive, right, nip it in the bud before it becomes a problem. So yeah, that’s probably my, one of my favorite populations to work with.

Yeah. And I mean, I know for a fact that you had someone call us in September and schedule an appointment in December. That is correct. Yes. That’s awesome. Awesome. Super proactive. Yep. Still had six weeks left before kiddos due. Yep. And sure enough, scheduling that first appointment with you.

Yep. And you know, and you know, they may be great. And I hope I hope people come in, they don’t necessarily need my services. But yeah, the more the more proactive you are, the quicker you’re going to get better right.

Now, is there any prep that a pregnant woman can do before kiddo comes? Or is it typically just recovery after the fact?

Absolutely. core strength? Of course, right. And a lot of times, you know, what, what can we safely do? There’s kind of another thing out there that if you’re pregnant, you are delicate little flower that can like collapse that like the least bit of activity, right, which is so natural, you’re getting ready to have a kid right like that, that takes a lot of effort. You know, even I guess you know, I don’t want to leave C section mom’s out to a huge abdominal surgery. So just because you didn’t necessarily have a vaginal birth doesn’t mean you wouldn’t have trauma doesn’t mean you can’t do something to prepare yourself to come out on the other side of that, you know, better. Lost my train of thought here, when you ask

me like prehab. Right, you’re right, you’re basically knowing that an event is coming. Right? Yeah. How can I be better prepared for that? And I recommend the same thing for people having a joint replacement or rotator cuff surgery, right? Yeah, be stronger, going into that be more flexible going into that shoulder surgery? Yep. And guess what? You’re going to do better on the other side? Exactly. The same thing can apply here?

Yep, you can. There are also some kind of like pelvic floors, I don’t wanna say like stretching mobilization activities that you can do to help just know all the soft tissue down there and be more receptive to being super stretched, right. Which can what’s more likely to decrease any tearing or need for an episiotomy? Which is huge. That takes out a huge chance of complications, infections, pelvic pain afterwards, so that’s definitely not a bad idea to get a visit in For 234 visits, at least to get a baseline of some information, because the internet will tell you, like, do these three exercises, but be careful that you don’t do something in the meantime, that will you know, cause something bad happens.

But I think education is the biggest thing right now. Even just having someone do a phone call with you. They’re going to learn something. Yes. And whether that Yeah, even even if that’s just okay, well, I need to see her after the fact. That’s, that’s good. I mean, yes, the fact that they know something is, is good, because a lot of people don’t like we talked about the education on, you know, the physical impacts of giving birth, they’re just not talked about,

right? Yep. You give a birth, you go see your doctor six weeks after they say you’re good to go. And you’re supposed to resume life as if nothing has happened.

So let’s change topics a little bit. So one of the, well, I’ll just for the listeners, I always send our podcast guests a questionnaire. And that questionnaire asks a bunch of different questions just trying to figure out what would be a good topic to discuss on the podcast cuz I want to make sure that it’s something that they are passionate about, right? I don’t want to ask Jen about the St. Louis Rams, if she’s a chiefs fan, right? That would be pointless. But you know, one of the things that was interesting to me in reading your answer, I, one of my questions is, tell us about your passion. What are you passionate about? And out of every single person that I’ve ever sent that interview to years was by far the longest. Okay, so I definitely wanted to get into this. And I think we can kind of sum up the, the topic here as How does pelvic floor therapy affect family life? Right? So let’s, I’m going to let you kind of tell us a little bit about why more than just, you know, pregnancy postpartum? Why is this important to you? Right?

So, where to begin? Yes, it’s very near and dear to my heart, I kind of started off by saying, I think I would say the quality of your life is like, directly proportional to the quality of your relationships through so as a side note, my, my husband is a marriage coach. And so I’ve kind of seen a lot of not seen kind of heard a lot of his stories about marriages, and what causes them to dissolve or have troubles or what not. And this is a lot of times are done to intercourse is a problem, okay? Not the main main issue, but definitely a factor. And I just hearing these women’s stories, you know, these women want to have a relationship with their husband. That’s why they, that’s why they married them. And a lot of times, they just can’t, whether it’s pain, whether they’re ashamed of women are embarrassed or just misconception that they’re supposed to look a certain way, it’s supposed to act a certain way. And it’s just not, it’s not true, that what what society thinks is normal is like 10% Are women exhibit what society portrays as normal. And these women, they just want to be there for the people in their lives. And these issues are holding them back. Go to like, you know, from an incontinence perspective, you know, maybe they want to go out with their friends kind of thing earlier, but they can’t, because they don’t want their friends know, they have to go to the bathroom every 10 minutes. Or that they have pelvic pain, they just can’t barely manage to author their friends because they’re just in misery the whole time. So then they go and they stay in their house, and they become depressed and isolated and lonely. And that’s no way to live. Right. And this all stems from something that’s so simple as being able to, you know, improve the pelvic floor muscles. Back to kind of segue there, back to the family units. I mean, I think family is one the most important things when when life goes wrong, where do you want to turn to you want to turn to your family, right? You have children involved, they’re their whole. Usually children are your whole life, right? And you want to have the best one to provide the best life for them that you can, and with the with marriages that are struggling due to pelvic floor issues, it’s just kind of have the snowball effect. So to say. A lot of times infidelity happens because there’s no intercourse. There’s no intimacy in the marriage. And it’s can be all It just makes me really sad, you know, I’m kind of struggling to put all of my emotions into words right now. But you just, you know, then you have an affairs happen, and then that just creates more anxiety for the woman and then it just kind of becomes a circular effect. And then your marriage crumbles and no one is happier after divorce. They think they are but but you’re not the site, the science proves that. So that is really kind of one of my one of my passions here is I just want to keep families together and relationships together. Because this reaches so far into social aspect people’s lives that they don’t even realize it, you know, they don’t even realize that the reason I’m not going out just because I’m in pain, the reason going out is not going out is because I’m embarrassed. I want to be with my husband, but I’m just in so much pain for something that could be fixable. Yeah,

there’s a lot there. Yeah, there’s a lot there. Yeah. And I can tell that it’s important to you, it’s hard to kind of verbalize all of the thoughts there. But, you know, to kind of summarize there, one of the things that we as PTS are taught are about is about the biopsychosocial model of pain. You know, if we look at 50 years ago, it was truly a biological model, right? If you if you have, you know, get hit with by a hammer, that’s the problem. And that’s kind of the obvious example, but there is more to the pain than just the pain itself. It’s the psychology behind it right then not wanting to socialize, not wanting to not feeling comfortable in certain situations. And those are all things that can be helped by physical therapy. Yep. And a lot of people just think that we’re just, you know, strengthen this stretch that there’s more to it than that. It’s helping people achieve their goals, and their goals can be vastly different. Yeah, absolutely. Some people’s goals are going to be I want to climb a mountain. But some people’s goals are I just want to be able to go out to dinner for an hour and a half. Yeah. Yep. And we can help with that.

Yes, yep. I saw one lady a little bit ago. And she would not go out. Because she didn’t know where the nearest bathroom was going to be. She would before she left her house, she would plan like, okay, 10 minutes down the road. There’s a Walgreens, second step in and then 10 minutes down the road after that. There’s a Walmart or whatever, but she had, she had she planned out her bathroom routes prior to leaving the house, and sure table at the restaurant that she was going to shoot like I had to be by the bathroom because I didn’t trust myself to be able to walk across the restaurant to go to the bathroom. So yeah, it is so far, far reaching. It’s crazy.

So one of the things we talked about before is just the fact that there’s just so much of a lack of education in society, whether you you know, in media and culture, it’s just not something that is discussed. How do we change that whether as PTS as business owners as people, how do we change that?

Well, I think this podcast is a great start, right? Yeah, just gotta have people have to talk, right? Know that you’re not alone. And be willing to reach out for help. Be willing to, you know, share your successes with others. I think also just being as practitioners being open to research that there’s there’s always new things coming right that’s, that’s why we’re in the field to continue to further our ability to help others. You know, there’s always there’s tons of books out there that you can read for Whatever, whatever setting you find yourself in whatever issue you feel like you’re having whatever population you want to help, you know, I highly recommend just reading as much as you can. There’s a couple of great books I recommend to everyone to read that address. It’s kind of basic knowledge education, that is really life changing. There’s if you want yeah, there’s one’s called the vagina Bible. And other called Come As You are this by Emily Gaskey. And Jen Gunter, Jen, Gunter is the vagina Bible. That one is just chock full of basic women’s information that will tell you that that you are normal. Your world is telling you you have a problem. You’re not normal.

Kind of destigmatize all this. Yep.

Yep. And then you know, the more you know, there are I’m always surprised by the number of women who they just the things that they don’t know about their own body. And it’s not through no fault of their own, you know, they just, they just didn’t know. So it’s not even so much that the, the stigmas in the world, it’s just, it’s just you don’t know, you know? And just knowledge is power, right? That’s when you know what’s going on. It’s that in itself can just be life changing.

Cool. What else would you like to share with the listeners? Just we’re kind of getting close to the end here. So what would you say to someone that might be dealing with these things? And they’re not sure what the next step should be?

I would say, definitely reach out to me. Ask, you know, ask me any question you want to ask. I’m, I’m an open book. I’ll. And I’m a pretty straight shooter. You know, I’ll tell you, if you can help with them. Yep. And if it’s not, I’m out to waste anyone’s time or money. We only have a finite amount of both of those. So not not about waste in that. I said, if I mean, next steps, if I was, if you’re curious, want to know, if something’s normal. If something’s a problem, check out those those couple books I mentioned. And then if you this podcast is spoken to you, if you’re like I know, I have something going on, I think you could definitely help with this, then absolutely. Give us a call. And I would love to work with you and help you reach those goals.

Awesome. So Dr. Jen is offering a free 15 minute phone consultation. And that’s where she will ask a bunch of questions, let you kind of tell her what’s going on. And if she’s able to help you, she’ll let you know. And then from there she can you can book an in person assessment, and then she will be able to do a bit more thorough evaluation, figure out exactly what you need help you achieve those goals. And so you can call her by calling our office at 636-686-0503. Also, you can schedule online. So if you go to our website, stlouispt.com. You can book an appointment with her straight from the website. Anything else?

No, I guess it’s one more thing. I’ve you know, I’ve I’ve seen it all, you know, so a lot of people kind of think, Oh, this is different. You know, she didn’t mention that. She gave me a huge long list of like, all this stuff, and my thing was down there. I say this is always a judgment free zone. 100% I’ve seen it all. I’ve heard it all. Nothing. Nothing surprises me. Nothing shocks me. You are normal. We can we can fix whatever’s going on. So very cool. That’s it.

Very good. Well, thank you for being on the show. I appreciate you agreeing to do this. Even though I kind of it’s fun. It is. So hopefully you had fun. Thank you for sharing and I think it’s good stuff to share with the audience here. So I appreciate it. Not a problem. All right, this has been STL Active.

Thank you for listening to the STL Active podcast from stlouispt.com if you enjoyed the show, please spread the word. Thanks again and see you next time.

Transcript

Hello, and welcome to STL Active St. Louis’s premier health and wellness podcast. STL active aims to give listeners in the St. Louis area the information they need to succeed and progress with their health and fitness. This podcast is brought to you by stlouispt.com and hosted by Doctor of Physical Therapy, Greg, Judice.
Hey everyone, it’s Dr. Greg, owner, and physical therapist Judice Sports & Rehab. On this episode of the show, I’m interviewing Dr. Matt Zimmerman, owner at Sage Family Practice. Dr. Matthew Zimmerman is a second-generation osteopathic family physician who has been in practice for 10 years. On this episode, we talk about his practice the healthcare system as a whole, and even a little bit about a shared hobby of ours. Without further ado, let’s get into the interview with Dr. Matt Zimmerman. All right, welcome to the show. Dr. Matt Zimmerman from Sage Family Practice.
Yes, go. Good afternoon. Thank you.
Happy to have you here.
Me too. I’m excited to be here.
Awesome. So let’s start with you telling the listeners a little bit about you.
Oh, boy, me. So I’m a family physician. But I think more about me is that I am a dad. I’m a husband. I guess I’m a son of that aspect too. But I am a Michigan native. I grew up in northern Michigan. I went to school at Michigan State. I ended up doing my medical school also at Michigan State University in the College of Osteopathic Medicine. I have been in practice of medicine for over a decade now, which seems like a really long time, but learned a whole lot of things. I have been in practice for myself for last six months with my own practice Sage Family Practice and this is a whole new venture. But yeah, I do a little bit of everything. I like being a doctor. I like being a dad. I love family time. I’m an amateur woodworker,
too, right. Okay. Yeah, happy to talk about how about this,
I’m better at being a hobbyist. And I like being a maker. I’d love if I was a better woodworker. But that’s where I’m at. I get that. But yeah,
I’m really good at watching YouTube videos and woodworking. Exactly and wishing that I had the tools.
Oh, my guess I have. I have a few tools. I have a few things that you know, there’s that one tool that you need for that one project. I’m kind of that guy. But then I’m not sure when I’m ever going to use that tool again. Or I found like recently, I got a multi-tool. And those are the best and most fun tools isolating. Yeah. Oh, yeah. And I didn’t know that. I needed it all the time. And I there’s They’re awesome. You can use it for everything. Since we moved into our new house. Here in St. Louis. I think I got that as like a Father’s Day gift. I’ve used it like 20 times burnt out like two blades already. Yeah. So.
Okay, well, we’re gonna have to revisit that. So go back. Alright. So you have your own practice now? Yes. And we’re gonna talk about that. Yeah, I want to know, kind of your background with medicine.
Oh, sure. So I’m a second-generation physician. My mom was an osteopathic physician in northern Michigan. She’s been in practice, gosh, I think for like 35 years. She’s just amazing. So I grew up learning, you know, that, you know, I was the kid on the playground when somebody skinny I ran and said, Hey, I know what to do. And that’s kind of who I’ve always been, is taking care of people. I, I knew what family practice was, for a long time before I even thought about medical school. Went into college. I have psychology as my background and my bachelor’s degree, but I always kind of did pre med work. And I did a Bachelor of Science for psychology, but all my curricular stuff that worked for my degree happened to be pre med. So it’s like, oh, it’s just a nice little insurance plan going in. And then sure enough, it’s like yeah, I really want to do med school. And, you know, during the first like, few months, I was like, What do I want to do? Do I want to be like, you know, going to anesthesia or something crazy. And I just kept going back like now I think I want to do family. And I did get sign up for the National Health Service scholarship was in school. So by doing that, I kind of you have to be primary care. And if you if you skip and decide to do something else, you owe them a lot of money very quickly. And so I didn’t know that I didn’t want to change anyways, I knew from a long time ago, anytime I talked with a doctor or listen, I loved every specialty. You know, when I was on surgery, love surgery when I was an internal medicine, loved it. OB GYN, loved it, pediatrics loved it. In one place, I found that I can do all of that as family practice. And I can do I can see and do just about anything within my scope. Obviously, I’m not a surgeon, but I do small surgery. And so yeah, so I’m a deal family physician, so osteopathic physician, and I get to use my hands to diagnose I get to use traditional medicine the way we all understand that. And then yeah, I think I’ve lost sight of the question. For a second, but I’ve grown up doing this practice for a long time, and I kind of fell into family practice knowing like, this is where I fit. I love building relationships with people I like, you know, being, you know, someone’s resource for things I I’m not an expert in my field, but I know quite a bit of what I’m doing. You know, I think the same thing goes like when you take your car to the mechanic, I’m not mechanical, I don’t know how to fix a car. I love it when people come to me that they’re knowledgeable about their health, but they want to learn more. And that’s kind of my goal with things is to, to, to bring people in, but also to, you know, learn and listen with what they’re doing and how they do it. And then how can I help with what I know. And so I think I take that to my practice, too.
Yeah, I think that’s admirable is you’re the quarterback of the situation, right? You have to know enough that you can direct people to where they need to go in each individual situation. Know Exactly, yeah. And I think being a generalist is a good thing. Right. And you know, these days, it’s so specialist driven. That it, it gets to be a hassle, right? Because if you’re, if your nephrologist, doesn’t talk to your pulmonologist doesn’t talk to your cardiologist, then those systems that all work together, yeah, aren’t getting addressed together.
Right. And, you know, I’ve heard the fun metaphors, you know, you said, quarterback, I like that one I’ve heard, you know, you got to be the captain of the ship. You know, I want you to take the lead on this. And I like all those roles. I like being the guy that, you know, can sit and look at the information and go, Well, it’s, you know, this med didn’t get changed when you went to this one, because like you just said, you know, if you if you have two specialists, you know, they get two different med lists, if they’re in different health systems. They don’t have that piece of information when you’re in the hospital two years ago, because it was a different hospital, you know, and then you follow up with your primary, your generalist, your family doctor, and I get to sort that information. Sometimes it seems like it’s hectic, and it’s like, oh, gosh, I have more paperwork. But it’s also like, I get to learn and live those things with people.
That’s awesome. Yeah. So when you finished up med school, is there a residency for family practice? How does that work?
So sure, so yeah, you do four years of medical school. And then so family practice is three years of residency. So a lot of people see the stuff of like intern and versus resident. Well, the way it is now is that your internship years, your first year of residency, so I was in Lansing, Michigan, for my residency, and I did family practice is three or four years, and I was chief resident with my co chief resident the last year, so that was really fun being, you know, leading the other residents teaching as I’m still learning and the student I mean, we’re still learning in the student always. But, you know, being in in different levels of that hierarchy of stuff was really great. It’s a good program. And then yeah, after that, so that was seven, eight years ago, something like that. Launched into working here in Missouri after that, so Okay, worked for a bigger health organization, but in a rural critical access hospital doing outpatient family medicine for last seven, eight years, learned a whole lot, especially jumping right into practice. I felt like I was really ready to be, you know, working probably from my first or second year of of residency, because I did some moonlighting when I was trim training, I did some filling in for doctors that were sick and things like that in the community. So I’ve been working actually, before I finished residency, I’ve been seeing patients and that that was the good thing about our residency program was we had our own patient panels. So I’ve been independently seeing patients with supervision for a long time. Sure, before I even did my own. And so yeah, I learned all kinds of things on how I want to practice. And then I learned a lot of things on how I don’t want to practice. And that was a big change over probably the last probably four or five years ago, I really started seeing the things I wanted to change. And that’s what kind of brought me to where I am now. But yeah, so and then been in St. Louis now in the St. Louis area since April, doing my own practice. And, yeah,
so what were the things in your previous job that you didn’t love?
So I didn’t love you know, I heard this really good. And I think I even heard you, you you speak to it recently. But I heard it again, in a lecture I was at at the Chamber of Commerce meeting a few weeks ago, this transactional versus transformational kind of relationship with the people and I don’t think I had any transformational realizations or anything like that. But I was getting really bogged down with the idea of these, you know, 15 minute appointments, these quick visits. You know, trying to fit somebody in a week or two weeks out fully knowing that my schedule is really busy. And I like like I said, I love spending time with my patients. I built it into my schedule eventually that I wanted 30 minute appointments and so I could spend some time but even then I still knew to fit somebody in was going to take away that time it was going to take away my time and then it meant more time for me to do charting afterwards. And so I could feel the strain on myself. I don’t like the phrase burnout but I do think that that was relevant. And I think a lot of It had to do with that time. You know, I slowly and it wasn’t even that slow. But once I realized it, I had a patient panel of greater than 4000 patients. And yeah, and I had a couple nurse practitioners that helped out with that. And where we work face all patients kind of like as as primary care Doc’s and we did supervision, we talked a lot, they’re wonderful. But when you you’re over 4000 patients, and you know that really, in my mind decreases access, when you have a physician that wants to spend time with patients. I really did not like the 5-10 minute appointments where you don’t get enough time to spend and figure out what you did. Or if you feel like he left the room and you’re like, I really didn’t get the answer that I was even trying to figure out how to help somebody or you space, you probably felt that too. I hope not, but I would assume somebody did. And then you also refer a lot more. And there’s a lot that like I said, I’m I loved all the specialties that I grew up learning in medicine, and I love doing some of those things. I love procedures. I love hands on medicine, I love trying to figure out the cardiac stuff that I can do their stuff I can’t do I can’t do a Cath, I know that. But I can definitely manage someone’s AFib I can manage someone’s heart failure. But when you know you’re rushed for time, it’s not safe. And it’s not as easy to do. But in a different setting. It could be and so I think it really came down to you know, the balance of, you know, how busy things were, how decreased access, and I could see the the dissatisfaction with patients because we had a great relationship, but they couldn’t see me. And you know, like I come back from the weekend like, Well, we tried to get in, and we called Two weeks ago, and like, I didn’t know you called Two weeks ago, if I would have known I would have tried to see you and I worried about that. And then I worry about when I see somebody on the schedule, I’m like, oh, gosh, two, they have something happened, because I haven’t seen them in a while. And so that always made me nervous. And I think those were the things that continue to strain. There’s other things to the bureaucracy of big medicine. And I learned that over time. And I think some people it’s it’s great to be an employed setting where you don’t have to worry about the overhead, you don’t have to worry about hiring in an acquisition of patients and things like that. And there’s just different ways to do that. And some people that’s a blessing, because it’s it’s much easier. And I think for me, it was something that bothered me, it just didn’t fit with the way I want to do things.
It sounds like you value the quality time that you can spend with people now.
Yeah, and I think whether it’s patience, or like things like this is where you can share the space of you know, healthcare happens to be my aspect of what I can share with people. And I like talking about it. And so but but sharing that space, being able to, you know, be there for when a person has those questions and be, you know, a resource in authority on something, or at least, you know, a trusted person that you can ask a question to, and you’re going to get a straight answer. And then you have a conversation about what to do with that answer. Right. So
I think one of the things I like most about what I’m doing is that I get to joke around with people, right? Like, I get to know my people well enough to know that the lady with the really expensive car likes to go to White Castle for coffee. Like that’s hilarious to me. Right? Like, getting to know them as people not just a shoulder injury or not just a heart failure. Right? That’s what’s so rewarding.
Oh, yeah. Well, it helps to I think, you know, it’s it, it’s, it helps on different levels, because I think you, you know, you break down some barriers, when you do those things, when you can have, you know, better communication with people, you usually, you know, I found this with a couple of, of med students and nurse practitioner students that, and we all have this, but there’s certain personalities that can break down information with people faster, you get that extra piece of information that, you know, if you interviewed somebody with the same questions, you’re going to get an answer. And I’m going to get different answers just on how we deliver and how we say those things. And so, you’re completely right, is trying to find those cool shared spaces with people in those, you know, like, how is your daughter doing? Or if someone brings their spouse or their kid or their, their, their, you know, adult parent with him. You know, you learn about people and you learn behaviors of people, but you also learn Yeah, those those things that make you know, a relationship, kind of this wonderful thing where you can, you’re literally spending time with them. It’s not so much that like I said, that transactional piece where yes, you know, I’m your doctor, there’s a payment model, there’s all those things that you know, I went to school, we all pay for the services we do. But there’s also that, again, you’re finding someone that you trust to give that information to you in in a setting that’s safe and comfortable, and that you can give all the information because you probably know this if you didn’t get all the information, you know about an injury or about something that hurts or doesn’t hurt. You’re gonna maybe not know all the things as you do a treatment for somebody or as a plan for somebody you might miss out or you might do too much. Even it’s
You know, at the end of the day for me, like tomorrow, I’ve got seven patients. And that’s, that’s pretty much as many as I can possibly see in a day. Yes, we do a full hour every single time. Right? So with time in between, that’s about as many as I can do. I know for a fact, tomorrow when I’m done, I’m gonna be exhausted. Yeah. Right, because I am thinking about every single thing that I do with every single client. And I think that’s a good thing. Right? If I am not on my game and trying to problem solve 90% of the day, we’re missing something. Yeah. And I think that in a different setting where you may only have 5-10 minutes, yes, you’re problem solving. But you’re also kind of just running around, right? There’s just a lot of logistics, in that not as much critical thinking when it comes to patient care. And I’m not saying that that, you know, was a detriment to your clients, but it may have been a detriment to you. And I would think that having a happier, healthier Doc is probably a good thing for your clients.
I do think so there’s lots of things out there. But like I said, that mindfulness that burnout, though, was a moral injury. I know that that’s a phrase that goes on there, too. And I think that time is so interesting, because, you know, if you look at traditional schedules for physicians, you know, I think I don’t know the average, but I’ve heard roughly about 20, some patients a day is the average, that’s a lot of patients, I was at one time seeing 30 people a day. And, you know, I’ve trained with some doctors that they see upwards of 40 patients a day, but they have, you know, one to two students and one to two residents with them, while they’re doing that, and seeing four people at a time, basically. And they enjoy it. And it works for them because of the pace of things. And because he you know, he knew his patients super well, he had built relationships for 3040 years. So I think that was easier for him to do. But for me, and the way to spend time with people, even 20 patients, you know, because there’s phone calls, there’s faxes, there’s signatures, there’s insurance, phone calls you have to make and then, you know, did you really eat lunch today? Or did you do charts for 45 minutes, you know, your administration time, and I have air quotes about administration time. Is that? Because those are times for you? Like you just said, Did you? Did you have that time to decompress to think about what you want to do for that next patient? You know, and there’s all these models for physician wellness, about what take five minutes in between each patient like, well, if I’ve got, you know, a patient scheduled every 15 minutes, and I’ve got to take five minutes in between each eye, that’s where my sarcastic thing comes in really big when when I’ve been in those conferences with people I’m like, okay, so you know, please do the math with me, right? And where do you want me because in traditional model, medicine, that fee for service thing is, if I don’t see you and do something to you, we don’t, I don’t want to talk too much about money, but it comes down to we don’t get paid. And then that corresponds to poor outcomes with patients. And so it just never worked. For me, I love being able to spend time and like you said, having a full day is awesome. Being able to use those skills in your mind critical think, I think that’s amazing. And having that time that you’ve got a little bit of time in between. So you decompress you wait for the next one. And yeah, if you have a full day, it’s mentally exhausting, but you got to do the things you want to do. I think that is, like you said, a much better fit for a clinician, a health professional, if you will, then someone who’s at the end of the day, doesn’t remember how the day ended, is, you know, 15 charts behind and has 10 phone calls to make and you know, has to answer like, all the scripts that didn’t get sent yet. And so it it changes how your perspective at time,
right? So I don’t know why that reminded me. But I’m, I’m in the process of training a new therapist. And when I say new therapist, she’s new to this business. She has more experience than I do as a PT. But she’s not worked in this type of setting before. Yeah. So day one, you know, showed her all the computer stuff and the software and all that. But I wanted to run her through just kind of a roleplay evaluation, see how it went. And I was using an old injury of mine. And she took eight to 12 minutes or so doing like a subjective history. And we didn’t do objective, but then we did more of like the plan side. I spend probably 25 to 35 minutes on subjective. And when I told her that she was like, how do you do that? I was like, because we have plenty of time you have an hour, right? Like, use it. Yeah, get to know them as a person. Because for us, we’re working on specific functional tasks most of the time, right? If I have knee pain, that doesn’t mean I’d have knee pain. That means I can’t go to the gym. I can’t run I can’t compete. I can’t play kickball with my kids. I can’t. There’s all the stuff that goes along with it. If I just know, knee pain. That doesn’t mean anything that is not emotionally moving. What would you use the word transformation? Yeah, right. Transformational versus transactional. Yeah, knee pain is transactional. Yeah. Being able to play kickball with your kids as their high school senior, something whether that’s transformational, like, you may never get that opportunity again, I want you to be able to do that in six weeks.
Yeah, no, I think that’s great. I think you’re right. I think when you when you try to, you know, we’ve said all these things, breaking down barriers, but finding the cause holistic type of, of healthcare and things, I think those those all come in. And you’re right, when you can sit and you find one, you know, I used to say this thing, you know, I tried to be very stark and objective when it came to people that came in for pain specifically, you know, I wanted to say, you know, I did, we did a bunch of stuff in residency about, you know, opioids and all these things, and trying to block that. But that, Mike, my phrase, in the beginning was Why don’t care about pain of like, Oh, that’s not a good thing to say that you shouldn’t say it like that. And I stopped, because I think I always qualified it. But it was, it was always rude. And so I stopped saying it. But I always said, you know, we have to look at what do you want to do? Like you just said, What do you want to do functionally? Because pain is going to be there and we got to augment it, we got to get through it. Sometimes you treat it sometimes you you go through it. Sometimes you do therapy, or you do whatever. But what does that functional goal? What is it? Like? You just said what is it you’re doing now that’s limiting you from getting that function. And so there’s those pieces, you’re not going to find that information, you’re not going to be able to get those goals with somebody, or get that treatment plan that encourages people to keep coming back to you to keep using you as their person when they need that. You’re not going to get those relationships. If it’s like, okay, you have knee pain. Well, I know this treats knee pain, and I’ve got to see the other person. And so the ear right that’s that takes transaction versus transformation. I love this phrase, I’m I have to go back to the Kirkwood high school track coach, she’s an amazing speaker. And she’s been doing it for like, I think she said 34 years and her whole method, you should call her. Her whole methodology of how she takes on relationships with people. And she does it with high schoolers. is amazing. And then she I stole this phrase from her. So I credit her so but it was a wonderful speech. But I took that to heart. And I’ve heard it other places in different pieces, but
maybe not those exact words. But the sentence the same, right? That’s cool. Yeah, I like it. I know. So we’ve kind of been skirting around this, this question that I’ve wanted to ask you is about building relationships. Yeah, right. Basically, what we’re saying is spending more time with people typically will assist in building relationships. But I’d love to kind of hear your perspective on a why is that important when it comes to dealing with clients? And B, how do you do that?
Well, you know, we talked about time, and I think time is important, because time is is you get to spend doing it because you have to put in time to learn people’s trust. And to get people’s trust, you need respect, and you have to value what someone is saying and the information they’re giving, you have to listen with intention. And those are all going to happen with time, you can’t just do that, you know, on a quick questionnaire or you know, one to two questions and pop out, you’re not going to get the whole history, not that gonna get the whole picture. But I think also building the relationship is how people get to you how so so I’m talking specifically about my practice and why I’ve made the changes I do. And I have my little things that I you know, I have three little pillars of sage family practice, and it’s, you know, I’m accessible, I’m affordable, and I’m personal. And the idea is personal is the really big one is because I want people to feel comfortable with who their doctor is. I want people to be able to reach me when they need to that’s a little bit of the access, but it’s still personal. And then the affordability, you know, I don’t want to break people’s bank, but I want to also make this approachable for people. And I think when you you know, have very transparent pricing, I think when you have a high value, high value health care, but low cost, you meet people where they’re at. And I think that’s that’s an important thing, whether it’s time or whether it’s due, you know, access. So do they need to do maybe they don’t need an hour appointment, you know, not everybody needs or wants to sit. You know, I had one patient this a couple weeks ago. It was the first time that he actually looked at his watch after about 45 minutes and said, Am I taking up too much of your time? I said, No, we’ve got all kinds of time and I felt like super excited about that moment. And, but then again, it’s that access again, I have somebody else who I’ve gotten a couple text messages today. And we talked last week. I’ve only seen him once in the last month but communication wise and access wise, he has my you know, the office text message line, he’s got an email to me. He knows how to call me we do video visits, we do you know all the ways on which you can communicate with somebody. So communication and access for people I think is just as important as building those relationships. And so, like we said before, I want to make sure that for me healthcare is like a conversation. You know, when I give somebody information that they should do based on what we we talked about in terms of what the concern is. I don’t be you know, I give the information. You have to go out there and do the thing. So whether it’s exercise Is that a pill? Is it a fish is a physical therapy, you’re the one that has to go do those things. So I want to make sure that what we recommend and talk about what you’re going to be able to do, you are motivated to do it. And then is this going to be something realistic that we can continue to work on to reach whatever that goal is. And so those are like, I think that’s a big blow up picture of like, a relationship with somebody, like, you can’t do all those things. Without communication, you can’t do it without people being able to access you. You know, in healthcare, there has to be an affordability price piece to it. And then, you know, it has to be a personal approach, because, you know, if I just walk in, say, Wait, you got to go to therapy, and they don’t, they don’t understand or their person, it’s really been bogged by PT before. And you’re like, Yeah, but you didn’t do therapy the right way. You know, and I know, that’s gonna light you up. But I said it for purposely, but you know, the same thing with pills, like, you know, everyone, no one wants to be on a medicine, right? But you know, from from, from personal experience with blood pressure issues myself, I hated the thought, and I’m a doctor, I hated the thought of taking a pill, I resisted it for a little while. And then it’s like, this is silly, you know, I’m putting myself at risk. And I say the same thing to patients, when they come in, like, well, it’s only 148 over 92. And it’s like, okay, that that’s high, you know, and it’s documented, it’s been that way for a while, and then you start, you know, telling the realistic things, you know, it’s like, well, that that’s a risk factor for this, this and this, and it can lead to really bad things. You know, not everything’s that severe. But if you don’t have that relationship with someone, they’re either going to be turned off and move on to another provider that gives them exactly what they want, which may be in their cases, nothing. Or they’re going to listen, and they’re going to say, Well, is there another way to do it? Is there something to do that doesn’t involve this, and we can, we can try different methods. And so I love that bit relationship piece, that conversation piece that you can have with someone to really get to know who they are, how you can help them. And then what can we do to keep this moving forward? For sure.
I think most people are going to be somewhat resistant and somewhat stubborn until they trust you. Yeah. And I think that’s, that’s part of it. It’s not just saying, Oh, well, I went to such and such school, and I’m this smart, and I pass this test. It’s, here’s why I care about you. And this is what I know, that could help you. Right. And I think building that trust with people is crucial. And that’s done through building a relationship. Yeah, I think they go hand in hand. Yeah, I
think so too. I think you got to put in time with people, and you got to be able to listen. And yeah.
I don’t think I’ve asked this question on the show before. What is a DO versus an MD? Yeah, I see them both. Yeah, I’m not 100% sure exactly. What the difference is, is there a difference? Yeah, I know, school is different
school is a little different. So Doctor of Osteopathic Medicine do versus medical doctor MD. So yep, I might do. deals have been around, I think the first schools like 152 years ago, or something like that. So started in Missouri, actually. So at still, in Kirksville, he was actually an MD and a chiropractor, I will maybe do a fact check later, but I’m pretty sure about that. But at the time, when he was practicing medicine, most of the culture of medicine was based on there was a lot of bloodletting. There was a lot of exploratory things are non looking, not looking at ways that the body can take care of itself. So when we talk 150 years ago, we’re saying, bloodletting versus trying to do things that allow the body to heal naturally. So we fast forward, you know, decades and century later, Andes and do is I really think anymore, it’s, it’s a little bit of a school of thought. And then it’s, it’s just a different medical school. And so, there’s, there’s two ways to think about I know, you know, MDs that are super holistic, that think about all kinds of things outside the box. Typically, you know, kind of what we were just talking about, for that transactional piece. A long time ago, my explanation that was given to me is when I was starting school, and again, I grew up with a deal mom, I didn’t know what an MD was for a long time. So I was like, Oh, it’s just a deal. That’s a doctor. And so but, you know, the thought was, is that, you know, I have knee pain? Well, we’re going to treat that symptom with something that takes Rid of Knee pain, whereas the older holistic approach would be, is that okay? In osteopathic approach, is that what causes that pain? You know, is it that you know, are we talking about an injury? Are we talking about you know, do you do you have a problem with your foot, you know, is there swelling? Why do you have swelling, you know, it taking into account all the factors, is there a weight issues? Is there a back issue that’s causing you to favor a knee, you know, all the little things that might contribute in that bigger picture? And then the other thing with osteopathic medicine is we’re all trained in osteopathic manipulative medicine, or medic manipulative therapy. So OMT, or OMM, depending where you went, and some people call opp that’s a different phrase, but it all means using our hands to diagnose and so there’s, there’s ways in which to treat the body and the best way I explained to patients what is OMT what is hands on medicine means that you can use your hands to help diagnose, prevent, and treat things. And probably similar to some techniques you use, and probably they’re, they’re probably named even the same, they’re probably the same technique is, you know, muscle energy, you know, having the patient give you a little resistance while you hold certain isometric or isotonic positions. You know, myofascial trying to loosen up tissue, without trying to give a massage or massage is actually a form of this therapy. Also, there’s some overlap a little bit with chiropractic things, my experience, and there’s some excellent chiropractors that I’ve worked with, is that, you know, not everything is cracking and popping, there’s a lot of other things too. And so the idea is that there’s a lot more holistic approach to health care is what is what my always foundation for osteopathy was. And again, that being said, is modern medicine, you have to have take a holistic approach and everything we’ve just talked about, I don’t think we you really get to take care of people and have the respect of people if you’re not taking some of those approaches. So I think more and more than more than any more today, a do is a practicing physician went through all the same credentialing training that a medical doctor does. The schools of thought are a little bit different. And then
has the same ability to prescribe. Oh, yeah, surgeries and neurosurgeons that
are DOs. There’s yeah, there’s neuro there’s DEOs in every field of medicine. I think we’re up to like 37 medical schools now. But now we make up like 25% of the population of physicians.
So it’s for all basically the the facts, the data, the research, the same. Yeah, philosophies, a little bit different
philosophies a little different. And then there’s that that aspect of hands on medicine also cool. Yeah, not everybody uses that. But it is taught when you when you start school?
Absolutely. So tell me a little bit about your practice. I know we’ve kind of touched on a few different things. Right. You You said accessible, affordable, personable, right? Yeah. So those are kind of the principles that you use or that you promote? Thrive? I’m not sure when the right
we’re gonna go with my scripting from my website. So is it those are the values? I think that that’s that so my practice is sage family practice? Those are the values that I want to make sure that I stick to with people values can always change. But those are what, when I was thinking of how to create this DPC or direct primary care practice for myself, what are the things that I would look for, to one to be a patient of, but also, what would I look for and want somebody else to if they were going to take care of me? How would I want that to look, and so I would want to make sure that the things that frustrated movement with my prior prior position is that access, I want people to be able to get in with me. So in this direct primary care model from a three stage family practice, my patient panel is not going to be 4000, I’m looking somewhere between three and 400, I don’t have a final number, I think it’s going to be what that looks like at the time, but to not be bogged down with 1000s and 1000s. of patient. And because it’s a monthly membership, that continues, that’s a little bit easier to do for for myself and for people. But you know, so that’s that accessible, affordable piece, my rate is for adults is 65 a month, every month, kids are 30 bucks a month. You know, there’s some Doc’s that make that much higher, there’s concierge physicians that you can spend a lot more. But my biggest thing is I don’t bill insurance. And so because of that, you know, you can take your doctor with you, you know, I’m not in network, I’m not out of network, I’m not in anybody’s network, so that again, drives my access is that I’m available if you want a doctor that’s willing to take time and be personal with you. And that will make sure that you have access to your physician when you need it. Because you know, it’s very typical, you know, we’re calling you call for an appointment for someone. And well, next appointments, you know, in November, where it’s it’s not even October yet. We got October at the end of the week and the next first appointments November, well, you may not need something, or it might be too late November and things can get worse. And so I’d rather if you’re established, we may be able to see you now and take care of things as they’re happening and be a resource now. But yeah, so sage family practices is built on the direct primary care model. I know you’ve had some other DPC Doc’s on. But I just fell in love with this model. I think it’s great way to take care of people.
So you’ve been doing the DPC model with sage for six months, you said six months like that. So I know you’d kind of mentioned earlier that some of the things that prompted you to do your own thing. Were just the frustrations of the typical model. Yeah. So what and you’ve certainly touched on this already, but like what sets sage apart?
Right? So, so definitely so I think those pillars that we talked about again, so that accessibility the affordability of personal healthcare And I think, you know, I love like we’ve talked about getting to know people. I love the idea of kind of like what everyone thinks is what is sick. I only ever saw one episode but isn’t Marcus Welby? It’s like, or like your community, Norman Rockwell, like community doctor, like the doc, I don’t do house calls, but the doctor that, you know, you go to their office and you know, there, it’s comfortable, you know, people come in and we sit in regular chairs. And by the end, we do the exam, you know, but for the most part, it’s it’s a conversation that we sit and talk and we figure out what we’re doing. And then we still do the traditional stuff, you know, I take vitals, you know, I do my exam when it’s pertinent for people and stuff. But a lot of times it’s trying to, you know, letting the patient talk to figuring out how and where I can help. And what is it that we need to address? Is it screening stuff? Do we need to maybe just go down the list and say, you know, are we checking all the boxes for screening? Or is it a specific thing that we have to cover? And what I love in the in this model is that I’m able to do those things that frustrated me, I’m able to take that time, I’m able to say, You know what? I don’t have anybody for another half hour, do you want to keep talking? You know, or, you know, I’m going to check in with you tomorrow. You know, and I know that tomorrow, I have time to check in on somebody. And I know that, you know, when somebody calls me at Friday, at like two o’clock, I know that if I need to I could see somebody I could fit somebody in right away. And that’s really important to me is to is to make sure that again, that’s that’s my role, right. I want to be able to fulfill that reset
accessibility piece. Yeah. Very cool. So DPC. Yeah, right. And and you’re right. We’ve had some other DPC folks on the podcast here. So maybe, well, let me preface this. Each of them has had a slightly different definition of what is DPC? Sure. And how does it different from concierge? Sure. And what what’s the difference? So I’m going to I would love to hear your philosophy on Yeah, DPC in general. But then how is it different?
Yeah, so I won’t lie. I think I probably had the same questions a long time ago, I thought it was, you know, I at one point, I thought it was only occupational medicine. For some reason. I don’t know why I thought that I thought it was just the entrepreneur, people who, you know, are about to retire and want to kind of, you know, figure out a way to do medicine still. That when it boils down to it, my understanding is that it is it’s a membership based service. So think about it kind of like a gym membership, is that you know, you sign up for it, you’re only going to get out of it, what you put into it, and but it’s there when you need it. So when you want to go to the gym, when you want to come see me, I’m available. And but you know, if you don’t use it, because you don’t need it, or you’re healthier this month, really good. It’s still there. And so I’m still here, and that’s that provided providing that access piece for people. And the bigger the big thing that separates it from other health care models is the no insurance piece. So a true DPC is one that doesn’t take insurance. So it’s just a membership fee patients should have or keep whatever they’re comfortable insurance. And I, I stress that whether it’s us health shares, whether you have like that really high deductible plan or like a catastrophic plan, or if you just have regular coverage your employer provides, but you just want that different level of personal care. This is on top of that, or this is this is beyond that. But I put my price point at 65 and 30. adults and kids, because I want it to be affordable for people that do want to use it in whatever situation they’re in whether it’s uninsured or under insured, or even if they’re over insured, and I just want that aspect. But again, I don’t bill insurance. I don’t you can’t turn my bill into insurance. And the difference between that in my mind is in concierge is I do think DPC was kind of born out of what concierge purpose was. But concierge is where you do bill insurance still. And then there’s more of like a retainer fee is the way I’ve always thought about it. So typically the concierge practices I’ve talked to or read about it somewhere between two and $5,000 a year plus your insurance gets billed every visit. So there’s a copay every visit. There’s, you know, when you go to the office, and it’s still fee for service, they just happen to collect a little extra for me too. And I just think healthcare is already really expensive. You know, and that’s the the niche for DPC is it’s not expensive. There’s ways to look at, you know, we offer let I have some special contracts with a couple local labs, that I can get loud pricing much cheaper than someone’s insurance. Same thing with medications. There’s just other ways to keep the costs of healthcare low. And I think that’s what DPC and that’s what I want to do through sage is to keep healthcare available for people because it is really important for people. And then if you can find those avenues with all the things we’ve talked about, I think that’s the difference with DPC, especially with concierge and then definitely different than traditional medicine, you know, where you like, as we said before, is if you go there and to, you know, for the office to make money, they have to see you and do something to you. It’s very different.
Interesting. So I think that definitely sums it up. And I think the and this may have been touched on before but I think the way you described the yes, they’re gonna bill insurance. Also there’s a retainer, right. I think the way you describe that makes it make more sense to me. cuz I’ve, I’ve asked other people like, what’s the difference? Like? Well, one’s more expensive? Well, yeah. Why? Why is it different? I don’t know. Well, you’re
when you when you do that also, you know, and I’ve never done seen a concierge doctor and I have not dove too deep into what they what they do and don’t do. But they have to also figure out how to so if you’re going to bill insurances, how are you taking money also for this is where we’re getting some legal stuff that I know a little bit but not enough, is that if you’re taking money on top of the insurance, you have to be able to provide a service that goes beyond the regular things that the insurance carrier would pay for. So
in my world, that’s what’s the difference in wellness and physical therapy, right. And it’s such a gray line, right? There’s no definition of wellness
until I see typical practices. And indeed, sometimes there weren’t, but like, the different genetic testing that can be done the super cholesterol, cardiac profiles, you know, stress tests that have like extra bells and whistles to them. And sometimes they’re necessary, sometimes they’re not. And sometimes they have really great validation for a patient with their appropriate risk score for those things. And sometimes they don’t. And to be honest, if you want to do that, that’s great. But that’s just not what I’m looking to do.
Understand. So one of the things that we were talking about before we started the recording here was work life balance. Yeah. Right. You had mentioned that in previous positions you’d had often you’re taking your chart home, or you’re not necessarily taking your work home, but there’s stuff right, that admin stuff. Yeah. When you’re clocking in for eight hours, it’s, well, more than eight hours. Yeah. So I’d love to kind of hear your philosophy on work life balance, but also, what’s the difference for you these days?
Yeah, so you know, and I honestly can’t complain, I’m an outpatient physician, you know, I don’t have inpatient responsibilities or anything like that. So my work life balance in the traditional sense of that word was, was probably okay. But when you you know, your work your eight or nine hours a day, five days a week. And you know, the, you have to have so many patient facing hours every week to meet your protocol for the salary that you do. And then yeah, having between at the end there, I was doing 16 to 22 patients a day. And, you know, revolving door notes don’t get done every day, there’s phone calls you I hated leaving phone calls that at least an answer that just bothered me, if someone didn’t get their question answered. You know, at the end of the day, when it’s like 4:30-5 o’clock, you’re like, Okay, well, that question can wait till tomorrow. But what if I answered it right now, and didn’t have to do it tomorrow, because then it just keeps building. And then you go home with some stress, and you go home, with sometimes you go home and do charts. And sometimes that carried over, I think a lot into, you know, the only time I had for free time or for doing things was Saturday and Sunday, or, you know, after we, you know, had dinner, or we put the kids to bed, we had a little bit of, you know, time with my wife to chat and do those things, some personal time there. And then it’s bedtime, you know, and I’m not I can’t I try to I can’t stay up late. And I like getting up early, so it doesn’t work to stay up too late. And so there’s not a lot of time for the woodworking that we can talk about, and all those other things in, you know, that lifestyle piece. And I think today, you know, I still am doing charts in the evening, I’m still making phone calls in the afternoon. But this model of care is it leaves so much more time for, you know, the best thing is, so So one of the other people you’ve had on Dr. Otto, who’s a close friend and colleague with his, with his practice is that, you know, it leaves more time for even medical knowledge, curiosity, like I’d love to in the future to take you know, an ultrasound course for for for medicine, I’d love to take a classical, yeah, but the point of care ultrasound and acupuncture and, and things that have always made me curious, but I’ve never been able to spend time on them, let alone hobbies, and I love being so much more present for my family over the last few months is that, you know, being able to run and pick up the kids without having to juggle like seven patients left at the end of the day to try to schedule and basically saying, Well, I can’t. And so there’s all those little things that always come up. But I think before it was more of like a work work balance. It was like, I did my work there. I thought about my work all day when I was at home. Now it’s there really is a separation. And I really noticed I think patients notice it, you know, and I had some patients that followed me, which is super a super good blessing, very humbling. But they notice it, which was fun. They’re like, there’s something different about this. And I was like I just keep trying, I wish I could just sit with me every day and see like this is totally different. And there’s just, it’s a lot more rewarding. Doing it this way. And even like we said, All this time I spend with patients and I feel like there’s a couple patients that I had when I was in my previous spot and I see them still now. I feel like I know him better in the last couple months than I did for like seven years. And it’s just it’s just, it blows my mind and it’s so hard it the biggest thing with DPC and especially how sage family practice I feel like I’m doing it is it’s simple. And that’s the hardest part to wrap my head around is that it’s not complex, right? And I can even
just like insurance codes, like there’s 25,000 of them, like, how could you possibly keep that in some sort of simple way, there’s a big
book they give you every year from the administration department ash, they say you should probably look at this and it sits in stops the door over in the corner, until
it’s stuff like that. I mean, that’s one aspect of the complexities of the typical model, right, you know, and then and then productivity standards, and then this, and then
you have your metrics, and then you have it, you know, but and I love metrics, because most of the metrics are based on what patients do. It’s not, you know, I give them like we talked about, I give them all the information, and I try to help them with motivationally things. But there at the end of the day, the ones that have to go do it, but yet, we’re out there the administration’s that some of these places, they’re, you know, I use the wording or penalize or, you know, bring down numbers or scores for doctors and healthcare providers, because someone’s a one see with their diabetes wasn’t a goal. Well, I tried really hard to do that. I got them in several times in the last month. But it didn’t happen. And it and maybe we’ll get it next quarter. But then that reflects poorly on the physicians like, that just doesn’t make sense. Like, I get that we want to get that goal. I want to get that down because it creates better health for everybody. And someone has less risks, but that’s just not the way to do it.
Right. Yeah. So with work life balance, we got to talk about some woodworking. Sure. So I kind of rotate hobbies. Right. So like I get super into woodworking for like a year. Yeah. And then I do this huge project that kind of burns me out. And air quotes burns me out. Sure. And then I kind of switch to a new priority. So I’ll admit, over the last year, year and a half, I’ve been super into Disc Golf, frisbee golf, too. So woodworking has kind of been like, Oh, I’ll design something. But I haven’t quite pulled the trigger on buying them. We’re doing the project, right. My last big project, I rebuilt our deck. Whoa. So we we got a quote on getting our deck finished. Yeah, the week before COVID. Right, when all of my patients couldn’t come in, and my wife was furloughed. Oh, no. So needless to say, that was not a priority to spend 15 grand on a deck, no necessity for the right way. Right, right. So I’m thinking okay, well, if this is two weeks, I could I could probably build a deck in two weeks. So it didn’t take two weeks. It took four weeks, but the point is over 80 to 100 hours. I rebuilt our deck that’s more, you know, a sixth of the price. That’s amazing. But I had the ability because it’s a real life skill. Mm hmm. But I learned on YouTube. Yeah, well, I learned on YouTube if you can do anything for Right, I’ve never actually had a lesson or no learn from a person how to do any woodworking.
I would love that. I’ve looked into that actually. Right. So there’s a woodworkers guild. Okay, that’s it. I have met with somebody like Well, the best thing to do is to find a guild. I’m like, Okay, well then, like as we said before, before, I would like when do I have time to go drive and sit in the guild meeting? In fluster? Sounds fun when you keep saying the word guild? That’s an awesome a deck. Wow, that’s a big thing. Right?
It was not quite fine woodworking by any means. But I think I mean, I it’s still challenging. It still requires a lot of planning and measuring. And, yeah, it’s not something I’d ever done before.
That’s, I mean, that’s a big undertaking. So yes, I think that counts. I will give you a green light that that counts. Excellent. Yeah, I’ve I haven’t you have like a favorite project that you’ve done? So I think I’ve got lots of projects. Oh, my, my wife’s a graphic designer. And I think she’d probably still listen to this eventually. I think that she’d probably labeled herself as a maker and a creative person. So she comes up with amazing designs. I’m halfway decent with tools. Except I have no like, I love to say that my creative abilities gotten better. But my like crafty like really polished is is it’s lacking in some areas for my woodworking but my favorite projects are I’ve done some really fun cutting boards. They’re kind of the entryway I think for most people to get into woodworking, but I’ve done some fun shapes. I’ve done some foam cutouts. I’ve done some fun, you know you put a different wood mixed in with it a little bit. I built in our previous home, it was more in the country. I built the furniture for under firepit so a three seater pieces to a chair a love seat and then it’s like the love seat with a little table in the middle. So two chairs that I’ve built. I built a light fixture for a friend of mine it was mostly That was a weird project. I kind of did like a very Asian culture like block wood with like a little Edison bulb on it and I like electrical things too. I’m currently our big project right now. So I just finished the Scotia which is a fun word underneath the treads are wood steps. Okay, so it’s the little fancy tiny quarter half inch piece of like trimmed wood underneath, okay, just cut it and put it in. I didn’t route it or anything like that. But I am we are going to tackle we have all the parts, we only have like a five run stair way up to the upper level, I am tackling a newel post a railing and balusters and it is really daunting.
Yes, lots of angles. Yeah.
I don’t Yeah, yes. I just want to like put it in place. And then I promise you can’t waste too much.
Because what is crazy expensive right now, it’s less than it was three months ago, it’s still
pretty expensive. But this and this is all red oak isn’t super expensive. It’s the cheaper of most of them. But it’s like the newel post like it has to be the right height from the start. And I got to trim it down to start and then have to drill a hole in the bottom and then like the two holes have to meet a perpendicular to each other. It’s really a cool thing. I’m more nervous over that than I think of some of my practice things at the moment which aren’t the best. But that’s good. I’m worried about woodworking. I’m not worried about my medical practice.
That is a good thing. I think my next project is a dollhouse inspired bookcase for my nice. Whoa. Yeah, we’ll see. We’ll see. That’s intense. This is like a project where I can’t paint it to cover up any mistakes. So this is going to have to be kind of a big one. So anyway, yeah, that’s later we could have a different podcast. Yeah, commissioned for my for my sister in law. That’s awesome. We’ll get there. Alright, so one of the other things we talked about before starting this was, you mentioned sharing space. Yeah, right. And there’s multiple ways to describe or define sharing space. But you mentioned, especially within medicine, being uplifting rather than competitive, right? I see that so much, right? Like, there are a lot of PT’S in St. Louis, there’s three big PT schools here. Now, we are so bad at competing with each other. We’re so bad at competing with chiropractors, rather than living in that mindset of abundance, and I want to help the people with x. And if they know that I’m great at that, then they’ll come to me. Rather than like, oh, well, I could do that better than them. Right. So I’d love to kind of hear your perspective.
Well, I think mine stems from a couple of things. One, you know, being in the traditional health care, you know, being employed by a large health organization, you kind of look at everybody’s competition, and you don’t share information with the other big health system, you know, you don’t you reach out to your colleagues and talk about things, but you’re not really supposed to share the payment model you’re supposed to share, you know, how you got your patients or what their marketing teams doing, or, you know, being on the recruitment board for things and the executive board for things, you know, you just keep some things, you know, close to your chest. And, well, that’s good. I get the model of business. I didn’t go to business school, like I said, I’m a psychology major, and I went to medical school. So I’m very much in the category of like this. This is in and we talked about YouTube videos of people sharing content, people sharing information, I think that space has is opened my mind up to how I want to do medicine, and meeting doctors like Dr. Otto and Dr. Allen and Dr. Fox, and there’s another Dr. Helen, and Dr. Hicks. And those are just a few people in the category of this space. And I’m finding more people that do PT that do they do wellness? Or they do women’s health? Or they do Oh, who else did I meet? They do a very specific fertility type of medicine. We’re all we all do something a tiny bit different. Like you said, we do the same thing, but maybe differently. And there’s enough patience to go around. We all have you. I’d rather have a patient choose me because they want to choose me not because I forced them to choose me. And so I think also in you know, like you were talking with me before I said, you know, we I’d love to share every patient that needs physical therapy with you that just might not fit for everybody. Absolutely. But I also can say to my colleague that hasn’t met you, like why have you met Dr. Greg yet? You know, cuz he does this a little differently. And they might know somebody, you know, it’s his his connections and networking. And this is not something I’ve ever done before. And being in this space where, like you said it, I don’t feel any competition with us. And I think the direct primary care world too is like that this or direct model of healthcare, whether it’s PT or primary care. You know, I’m not looking to fill up my patient panel with 4000 patients so I can hoard all these people so that they’re just mine. I want a small niche of that. I’d love the people stay with me. Yes, that’s my own ego and there, but I’m not going to try to take care of everybody. So there’s other people out there and I want, you know, if somebody else came to me, just like I’ve had the really great experience with some of these other doctors. Somebody came to me and they’re like, I want to learn how to start a DPC practice. I’m going to give them all this information. There’s no reason to hide it. Because if they’re doing well in the rest of they’re doing well, too, right? And it’s it’s just as cool space. And I think joining things that do networking, I’d like I said, I’d never did that before. And plus, I never had time to do it Sure. I never kind of needed to do it, right. But I also probably didn’t want to do it before. And now I do kind of have to do it. But when I go there, you know, you build yourself up and you do it. And you know, you’re handing out cards, which is a new thing for me. And, you know, you’re you’re sharing information. How do you do this? And, you know, I’ve explained what DPC or what sage is, hundreds of times at this point now, and, and I get better at it every time. And it’s it’s so fun, because you’re, I’m really sharing I think, you know, Sage family practice, that’s what I’m promoting, but I’m sharing myself, I’m sharing what I want to do and how I want to do it. Right.
I love that. So we’re getting close on time. Okay. You mentioned that you have an offer for listeners, I’d love to have you share that.
Yeah, so I am accepting patients. I’d love some new patients. But if if you if you heard me on this, if you’re a new patient joining me, I’d love to give you half off your first month. That way, we can start things off on a discount, but also start off on trying to build that relationship and see how things go. Very cool. I think I said that correctly. Yes, definitely. That’s fantastic.
Anything else that you’d like to share with the audit? Let me start over. Let’s, let’s get you your your contact info on the recording. So let me have you shot with Sure. So
say to me, practice We’re located at 111 Prospect Avenue, in suite 202. I share the practice some other people but sweet 202 the office phone number is 314-530-6525. And the website is sagefamilypractice.com. That’s…. And I’m also on Facebook and Instagram. I haven’t really jumped other social medias. But those are the ones I’m on. Happy to communicate with you I have on my website a link, you can click for a 15 minute get to know if you’re not really sure what this is happy to chat with you happy to do that in person too. If it works out, we can schedule something. Or if you’re really excited about it, there’s an Enroll button and people can kind of jump right on the website that sends information to me, and then we just get started.
Very cool. Yeah. Anything else you’d like to share with the audience? For we hop off the microphones here?
No, thank you so much. This is so fun. And again, I think this is help your listeners know. And I think they do that this shared space I think that people you talk to is exactly what I was talking about before. It’s just it’s so neat to define this atmosphere and find this place.
Yeah, you know, I think you watch me prepare for this. Right? Did Yeah, you got here 25 minutes early. It’s not a big deal. But I used to be so nervous about talking to people and like, what is how do I talk to a doctor? And how do I talk to such and such? It’s like, do I did I ask the right questions? Right? It’s like, you’re just a person. Yep. You’re just a person like, yes, you might have gone to school for longer than I did. But
you’re not. No, like, a different type of person. Right? Yeah, I think that’s,
that’s important. We’re all people. We’re all going through the same crap, right? We’re all here for similar things, hopefully, to make the world a little bit better. We have
a purpose to be doing some right. And this is it. Whatever we’re doing right now is the right thing. And I love that you said it that way. Because I actually had a mentor that whenever he introduced himself, he was a physician. And when he met a new patient, he introduced himself with his first name. He never said Dr. So and so he said his first name. And I’ve done that for a long time. And you know, I think it I think it breaks some things down. It makes things more approachable. But just like you said, still a person. I just happened to went to medical school. That’s really the big difference.
For sure. Yeah.
So you know, it’s it’s one of those things. I’m glad I’m doing this. Yeah. It’s been fun. Like, I don’t remember exactly which episode this is 35-36 Something like that. But anyway, this is fun. This is great. I appreciate you being here. Thanks again. Thank you. Any last parting words?
No. I hope everybody has a great day. And yeah, thank you so much.
Absolutely. This has been STL Active.
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