Many of you on twitter are already familiar Dr. David Browder, DPT, OCS. His bio is a bit too long to include here, but you can check it out at Texas PT Specialists. I had the pleasure of interviewing him recently. It was a fun interview, and I hope you get as much out of it as I did. Follow him on the newly launched browdering.com and on twitter @DavidBrowder_PT. Enjoy!
You have quite a unique professional background and evolution. I’d like to reflect on the steps you took to become who you are today. So let’s start in the beginning: what initially attracted you to physical therapy?
DAVID: I found in college that I had an intense interest in human anatomy, and then spent a Summer with an aunt who was a physical therapist at a pediatric clinic. I enjoyed the variety and challenge inherent in helping these kids learn to walk or function better. Of course, that’s totally different than where I ended up, and was a large departure from my initial plan of being an Air Force pilot, then a physician, then an electrical engineer…
You did your Orthopedic Manual Therapy Fellowship with the University of Pittsburgh. Tell me about the experience and how it has impacted you as a physical therapist.
DAVID: I had the tremendous opportunity to spend 2 years working with the late Dr. Richard Erhard, DC, PT. Dr. E (as he was known) had a very unique treatment style that stemmed in part from his background, but also from what seemed like genius level pattern recognition. He also loved to teach and allowed me to assist him and Mike Timko in teaching Spine courses while I was completing my fellowship. Any success I have had in patient care and in teaching I attribute in large part to Dr. E taking the time to foster my development. This time was also great in that I was able to complete several research projects with John Childs, Sara Piva and Julie Fritz… three other people that deserve a large thank you.
Think of your first few years after graduating from the US Air Force Academy; what would you have done differently?
DAVID: Other than perhaps a few girlfriends and speeding tickets I would have avoided, absolutely nothing. During this time, I met my amazing wife, Alexis Browder.
Did you work a PT in the Armed Forces? How does it compare to working as a PT in the civilian world? Was it a strange transition?
DAVID: After graduating from the US Army-Baylor PT program in ’99 I was an active duty physical therapist in the Air Force until 2008. The Armed forces PT world is dramatically different than civilian practice. A typical practice pattern in the large medical centers where I was stationed was to see 6 or so evaluations and 6 or so follow-up appointments. Wait time to get an appointment was about 3 weeks. PT technicians (in this case enlisted troops well trained but not licensed – approximately equivalent to PTAs) performed the vast majority of treatments. We technically had direct access but only used it for special populations, such as special operations troops or to run an acute care clinic for trainees. The transition to civilian care was difficult, particularly because I jumped directly into a solo clinic leadership role in Texas Physical Therapy Specialists.
Did you serve in the Armed Forces? I’d love to know more about what you did and how it impacted who you are today.
DAVID: One of the most professionally satisfying periods in my professional career was leading the PT/OT clinic at the second largest field hospital in Iraq during Operation Iraqi Freedom III in 2005. This was a great deal of responsibility for a Captain, and definitely forced me to grow into a leadership role perhaps faster than I otherwise would have. Working in mass casualty situations and leading a small team in high stress situations in my military career is something that I think makes it easier for me to deal with the (comparably low stress) operations of even a dramatic private practice day. The Air Force also paid for a bachelor’s degree, two masters degrees, a fellowship and my tDPT. I’m proud of my service but consider myself blessed to have been granted the opportunities the Air Force gave me.
Tell us about Texas Physical Therapy Specialists & your role with the company.
DAVID: Texas Physical Therapy Specialists is a large physical therapist owned private practice in South Texas. At the time of this interview, we have 18 facilities, staffed by what I think are some of the best and brightest leaders and physical therapists in the nation. While we utilize residency and fellowship training and have a culture that drives all of our therapists towards specialization, I am most proud of our culture of caring and customer service. I am responsible for the 10 facilities around Austin, TX. That might sound like I spend all my time managing, but it is not the case. I have 10 very autonomous team leaders who are responsible for the success of their facilities. My role is to support them and to make sure they have everything they need to make that success possible.
DAVID: We have close ties with EIM (we share 3 partners) and the EIM programs are an integral part of our success. I was privileged to attend the inaugural class of the Executive Program in Private Practice Management (EPPM) – and I credit much of the success we have to a combination of the culture created by the residency and the business wherewithal from EPPM (I think our current headcount is 10 alumni).
How is the PT business climate in Texas? (The Good, The Bad, & The Ugly)
DAVID: Compared to much of the rest of the country, Texas is in pretty good shape. Reimbursement has fallen as it has everywhere, but has not taken the dramatic downturns we have seen in the NorthEast and California. That said – the state recently adopted United HealthCare (UHC) as their choice of insurance providers for state employees. Combined with medicare payment reduction and increases in regulation the business climate will likely continue to look uncertain as it does for most of the country. Texas is substantially easier to own a business in than other states – with a low cost of living, no state income taxes and business taxation that is about middle of the pack compared to other states.
Healthcare is in a major state of flux. How can a Private Practice Physical Therapy Clinic prepare for the future?
DAVID: As more companies go with discounters like UHC I believe that wise practices will have to prepare to either focus on out of network patients or learn to be more efficient while still providing excellent service. We have to be able to not only demonstrate our value but also do it in a way that is cost conscious and efficient.
Browdering.com just launched! What is it about & why did you start it?
DAVID: Browdering.com is a blog that will launch in January 2014. It struck me this last year that I have been blessed with not only a rare combination of experiences and opportunities to learn from others, but also with a passion to share the things that I am learning. I love to get to know other private practice owners and to share in their experiences and knowledge. Starting a blog seemed like a great way to channel that energy as well as to hopefully provide a useful resource to the PT community.
My friend Chris Stanley came up with the name as I crowdsourced it to my Facebook network, giving it a definition and all. This was perhaps one of the best compliments I’ve ever received and seemed to capture the essence of my mission… so I went with it. He said I spend all my time Browdering anyway, so I ought to make it the name of my blog.
My goal is to help physical therapists to better manage themselves, manage their practices and lead their teams. Most PTs have little to no training in leadership and management. With my background and passion, I hope that I can provide this service and help us to adapt to the changes in healthcare and emerge stronger than ever.
What big/simple ideas and basic concepts do you believe will help all Physical Therapists become better, smarter, and wiser?
DAVID: I believe that listening is at the core of not only great clinical practice, but also the ability to lead others. Human beings have a deep need to feel understood. If we can be open and truly listen to our patients, our employees, our loved ones and the strangers we meet it will inform everything else we try to accomplish. Steven Covey describes it best as the habit of ‘seeking first to understand’.
What hobbies or extra-professional interests have impacted you as a PT? And how?
DAVID: One of my hobbies is woodworking. This requires focus, concentration and often many steps from visualization until the completion of a project. I have found that this is true for pretty much anything else meaningful as well.
Woodworking? I can’t leave it at that. What got you into woodworking? And tell us about your most enjoyable project(s).
DAVID: Woodworking – I’ve always liked this sort of creative but technically challenging hobby. It requires deep concentration over a period of time with instant feedback on results but driving toward an end product that is worth achieving. Look up the definition of ‘Flow state’ and you will find these are the requirements for a deeply satisfying task where time disappears and you can turn off all the demands of your work life, for example. I’ve built jewelry boxes (I started this with an engagement present for my wife), a chess set, furniture and a bunch of projects that help you build other projects.
Favorite books and/or authors? Any recommendations?
DAVID: I’ve got a bunch… my car doesn’t move without audible – book recommendations and reviews will be an ongoing theme of browdering.com. Here are my current favorites:
Seven Habits of Highly Effective People (Steven Covey changed the course of my life in 1996), Leading at a Higher Level by Ken Blanchard, The Advantage by Patrick Lencioni, The 4 Disciplines of Execution by McChesney, Covey, & Huling, Getting Things Done by David Allen, The Happiness Advantage by Shawn Achor, Y-Size your Business by Jason Dorsey, Outliers by Malcolm Gladwell, The Compound Effect by Darren Hardy, Drive by Daniel Pink, Good to Great by Jim Collins, and 15 Invaluable Laws of Growth by John C. Maxwell.
Podcasts: Michael Hyatt, intentional leadership
I also religiously script and plan my life using Darren Hardy’s ‘Living Your Best Year Ever Journal’, which I highly recommend.
Given the benefit of hindsight & your accumulated perspective, what’s your advice to new PT graduates?
DAVID: Daniel Pink, in his book ‘Drive’ lists three things that drive intrinsic motivation. 1) Autonomy, 2) Mastery and 3) Purpose. My advice is to seek opportunities to work in an organization where the purpose of physical therapy is embedded into the culture, and where they can gain mastery in the practice of physical therapy. For those so inclined seek out mentors who can help develop management and leadership skills. I believe that specialization is an excellent route to this. Autonomy is more difficult and can definitely be found professionally, but for those that have the ambition and determination to build their own practice – I think there is no better place than private practice physical therapy to find the confluence of these three things.
Great advice! What advice do you have for seasoned PT’s?
DAVID: Avoid golden handcuffs. The extra $10K you can make working in a miserable job is not worth it. Give up the extra income and see above.
Life is an adventure. Describe one of your most memorable adventures so far.
DAVID: My wife is an amazing woman. 2 years ago she earned us a trip to Paradise Island in the Bahamas, where, shortly after completing P90X, I got to workout on a pristine Beach with Tony Horton. That was pretty damn cool. I’ve also flown sailplanes on the slopes of the Rockies, saw Kuwait when the oil fires were burning and jumped out of a plane a few times. All that said, the biggest charge I get is standing in front of a group of fired up private practice owners and helping them to shape the future of our profession.
Dr. David Browder, thank you for an entertaining and enlightening interview. I look forward to your content on Browdering.com. Best wishes for the new year!
Find me on Twitter @Cinema_Air