Austin Sheldon – Top 5 Residency Lessons

Dr. Bradley Grohovsky, DPT did a guest post on his Top 5 Residency Lessons So Far. If you haven’t read it, then I encourage to do so. Here we have a guest post by Dr. Austin, Sheldon, DPT on the same topic. 

“Austin Sheldon PT, DPT is currently a staff physical therapist working at Box Butte General Hospital in Alliance, Nebraska. While maintaining a busy outpatient orthopedic caseload, he also assists with the Sports Medicine outreach program by providing pro-bono care for high school athletes, provides in-patient coverage, and occasionally helps with skilled nursing facility coverage. Austin is a 2008 graduate of Regis University’s DPT program. In December of 2013, Austin officially graduated from the Andrews University/NAIOMT orthopedic manual physical therapy residency program’s initial cohort. Currently, Austin is enrolled in Andrews University DScPT program and closing in on the dissertation phase of the program and also is a NAIOMT OMPT fellow-in-training. Clinical areas of interest include patient education, the cervical spine, hip/pelvic girdle, conservative management of pars defects, conservative management of avulsion fractures, pain management, and education. He enjoys the rural western Nebraska life and outdoor opportunities with his wife, son, and two Labrador retrievers.”

Enjoy the read!


Perhaps how I arrived at doing a post-graduate physical therapy residency will resonate with some readers: Put yourself in the shoes of a new graduate. You are ready to take on the world, ready to become a vital member of the healthcare force, and let’s be honest, ready to start making some money. You graduated from a great PT program, learned from leaders in the field, and made some great friends along the way. BUT, along the way, while you spent three years working hard to keep your head above water, your other non-PT school friends were already earning money, traveling the world, paying off undergraduate debt.  You, a newly minted DPT, with student loans from undergraduate AND graduate school, are faced with the reality that the grace period for loans is looming like an un-escapable thundercloud, the closer it gets the bigger it appears…

The situation above is what I was faced with and in talking to students and new graduates, the situation above is all too common. Faced with growing debt and diploma, I applied for and accepted the highest paying job I could get: a SNF. I worked in a sub-acute/LTAC/SNF for the next 2.5 years, earning good money. Don’t’ get me wrong, I enjoyed the patients I worked with, each with medical complexities that needed to be acknowledged, respected, and addressed. My heart warmed when the patients succeeded and left the facility for home; however, I felt a deep professional emptiness. I was burnt out with the bureaucracy of RUGS, of constantly being asked to “look for opportunities for more minutes,” of having my clinical opinions and recommendations trounced, lack of professional growth, and absence of any one to talk to about clinical questions.

Long story shortened: I quit feeling sorry for myself and changed jobs. I became proactive rather than reactive. I moved on to an opportunity where I felt I could flourish personally and professionally. After having accepted the position, I looked into residency options that allowed me to keep my current job and ultimately applied to the Andrews University/NAIOMT program. After a series of interviews, I was accepted and began a nearly two-year long residency program that was formative, both personally and professionally. Without further ado, here is my “Top 5 Things I Learned from Residency:”

1) Don’t Forget How to Read

My residency instructor, mentor, and friend told me this the night we first met face-to-face. I was in Seattle, WA for the first class of the NAIOMT component of the residency program. Brett Windsor PT, PhD(c), MPA, OCS, FAAOMPT looked directly at me and said, “If you want to be the best you can be, read. Read everything. And read it for understanding.” It’s through reading pertinent and relevant literature to the clinical questions you are faced with that foundational differential diagnosis skills and clinical patterns are developed. Too many clinicians use the professional journals they receive from their professional associations as coasters for their morning coffee, collecting dust and stain rings. Open those journals if you get them and aim to read at least one article of interest per week that is applicable to a current clinical case you are managing. Don’t forget that, though your library access to journals from graduate school may have lapsed, PubMed is free to everyone!

2) Don’t Stop Listening

This is applicable to both the patients/clients you interact with as well as the instructors in your residency. When interacting with the patient, take the time to listen to the story he or she is telling you. Don’t interrupt. Part of the therapeutic process is allowing the person in front of you to tell you why he or she is seeking physical therapy to began with. Don’t look at the clock or the phone (that shouldn’t be in your pocket anyway, right Dr.?) or talk through the curtain to a colleague about last night’s “Mad Men” episode.

Part of participating in a post-graduate residency program is to better yourself as a clinician. Again, in the words of my mentor Brett Windsor, “to become a better clinician, you have to learn from someone better than you.” Listen to your mentor and consider what he or she is telling you. Be open to constructive criticism and leave the ego at home.

3) Don’t Discount Mentorship and Relationship-Building

You don’t need to complete a residency or fellowship program to find an invaluable mentor or to build positive relationships with colleagues; however, I am of the opinion that mentorship and relationship-building skills are integral parts of a residency program that will only better your professional development and satisfaction. One of the precipitating factors that lead to my dissatisfaction early in my PT career was the lack formal mentorship. I did not have a senior colleague to bounce problems, ideas, successes, and failures off of.  My mentor and residency instructor made himself available to me via phone, text, email, and in person throughout the program. He selflessly gave of himself at the expense of his time and resources to mentor me. Find a mentor that will challenge you rather than stroke your ego and coddle you.

Social and inter-personal skills are important to become a successful clinician and businessperson too. As part of the residency program’s requirement, I interacted with orthopedic surgeons, interventional radiologists, MSK radiologists, physiatrists, physician assistants, and nurse practitioners.  Understanding other healthcare professionals’ perspective and being able to communicate effectively and positively can only lead to improved inter-disciplinary care.

4) Don’t Become a Technician and Don’t Pigeon-Hole Your Learning

Realize that the primary reason to participate in a residency program (in my opinion) is to improve clinical reasoning and critical thinking, first and foremost.  Upon returning from the AAOMPT conference in Cincinnati last year, I was sitting on a bus at Denver International Airport on the way to long-term parking when I noticed the conference program sticking out of a fellow bus rider’s gigantic purse. I then asked the fellow attendee what she thought of the AAOMPT conference. She looked at me aghast and asked me how I knew she was there; I just pointed at the program hanging out of her purse. Turns out this colleague was Kristin Carpenter, a fellow-in-training through EIM. We had a great conversation and compared our experiences with EIM and NAIOMT as well as our experiences and take-aways from the conference.  The biggest take-away from our conversation was the agreement that clinical reasoning and critical thinking are more important than the psychomotor skills of mobilization, manipulation, dry-needling, etc. that may be learned in a residency program. If you critically think and reason through clinical problems, then the psychomotor skills/techniques you arrive at (if you choose to do anything at all) will develop. Don’t carry out a particular technique and then retrospectively ask yourself why said interaction succeeded or failed; think about what you are doing before, during, and after the interaction.

I think the mark of a good residency program is the realization and openness of the faculty that, while the instructors and mentors may have some answers, insights, and techniques for most clinical situations most of the time, NOBODY knows what do all with every situation 100% of the time. So, as a resident, I was encouraged to participate in other learning opportunities with other programs, institutions, and continuing education providers. In this way, I wasn’t pigeon-holed into uni-lateral group think. Be open to other approaches. Use what you like and what seems to work and forget the rest.

5) Add Value (for the patient/client) to Your Clinical Encounters

Quite simply: What do you add to the patient/client’s well-being that they have not already received? Listen, engage, interact, and connect with the patient. Patient education and activity modification, in my opinion, are two of the most valuable interventions a physical therapist can provide. By educating the patient/client about what is going on (and perhaps more importantly, what IS NOT going on), you are providing re-assurance that improvement is most likely going to occur and providing a “green light” to the patient to explore the world in a safe and pain-free manner. Aside from patient education and activity modification, you also may be the first person to touch the patient and provide a comprehensive examination. Providing hands-on care that facilitates pain-free movement that can then be reinforced through active and independent exercise is also key to adding value to the clinical encounter. The patient/client has “bought in” to physical therapy.

So, those are my “Top 5 Things I’ve Learned from My Residency.” I hope that some of the insight, experiences, and opinions I’ve provided resonate with some of the readers. I’d encourage anybody that strives to become a better physical therapist to explore residency options. Structured learning is important to a point; however, the mentorship, clinical reasoning, and critical thinking that residencies provide are priceless and set the stage for life-long fulfillment in the physical therapy profession.

Find Dr. Sheldon on Twitter: @ASheldDPT


I am @Cinema_Air

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Interview with Bruce Wilk, PT, OCS

A couple weeks ago I interviewed running-injury specialist Bruce Wilk, PT, OCS. Many of you have met him on twitter, now you have the opportunity to know him better. He authored The Running Injury Recovery Program, owns a Running Specialty Shop in Miami, FL, and completed 27 Marathons & 4 Ironman Triathlons! Make sure you check out his fantastic blog – it’s full of valuable information related to running and running injuries. Read more about Bruce at PostInjuryRunning.com. There’s lots to learn from this interview, so read it twice! Enjoy!


What first drew you into Physical Therapy?

I began to run in 1971 as a way to get out of physical education, where I was the favorite target in dodge ball.  So the teacher told me to run around the track instead.  By 1972, I realized that running brought balance to my life, but it also brought running injuries that no one seemed to know how to fix.

Trying to fix my own running injuries is what led me to become a physical therapist.  As it turned out, I did not actually learn anything about running injuries in physical therapy school, but I did learn a lot about injury management in general. PT school also taught me the value of good, competent manual therapy — and I still emphasize that to the young physical therapists I teach in my clinic today.  Becoming a physical therapist was just the first step on my lifelong quest to understand running injury management.

How has your clinical practice evolved since your first days as a Physical Therapist?

At first, my practice was physician referral driven.  I was worried that what I told the patient would have to agree with what the physician wanted me to tell the patient.  It started out being profit-driven. But then, slowly it evolved into a patient-driven practice.  People came to my clinic because they heard from their friends how wonderful their results were.  And, that’s been a blessing. That’s what really inspires my work.

How have perspectives on running and running injuries changed since your early years as a runner?

My first running injury was as a kid running in my first minimalist shoes: Converse — and that made me think that a running injury has a simple external cause.

However, now that I have seen many hundreds of running injuries over the years, I know that treating running injuries is more like diabetic care: Some injuries are very simple and have external causes, but some of them are more complex and are caused by a combination of factors, both internal and external. Now when I treat a runner for an injury, I consider everything from psychology to running habits to training techniques — I try to treat the cause of the injury as well as the effects.

Minimalist shoes have been all the craze over the last few years. What are your thoughts on five-finger shoes and other minimalist footwear?

One of the interesting things about my life is that I get to see some things from the different viewpoints of a PT, a running coach, and a running store owner. For example, something odd happened a few years ago: As the owner of a running shop, shoe salesmen come to me every year to show me the new models of running shoes. One day, a sales rep showed me the Vibram Five Fingers (VVF) – which is a very flat, unsupportive shoe – and told me it was a minimalist running shoe. The funny thing was, that same sales rep had already introduced the VVF to me on a previous visit, when he had told me it was a water sandal! As a coach I know that some runners do well in a flat, unsupportive shoe, but many others do poorly. As a PT, I have seen patients with severe foot injuries from running in unsupportive footwear and not paying attention to red flag running injury symptoms. I also know it not safe to use an unsupportive shoe for many running injury tests and recovery interventions. I can see the different viewpoints of people who choose to run in minimalist shoes, but I don’t let my injured patients wear them to postinjury run. I do use them as racing flats and fashion footwear post recovery.

What prompted you to write your books? How can they be purchased? [Amazon, website, etc.]

I have been treating injured runners for more than 30 years and I found that, with many of my patients, I was able to successfully return them to healthy running after they had been to many other healthcare professionals, and they been put through many other treatments that had failed. That is the fault of the healthcare system, not the individual practitioners, because there are just no medical protocols that are designed to treat running injuries. The fact is that runners’ injuries are different from similar injuries in non runners and they have to be treated differently — so I developed very specific protocols to do that.

I used these methods in my clinic and published some papers, but I never organized them all together and wrote them down.

For years, people kept telling me — over and over again — “You should write a book” because there was so much confusion and misinformation out there in the world of sports injury management. I really believed that if I could educate runners about running injuries, then they could get the right treatment in a timely manner, or even treat their own running injuries.

Time is a critical factor in treating running injuries because if you keep training on a running injury it will get worse — and if you don’t train because of a running injury you can lose your conditioning and increase your risk of further injury.  That is why I wrote this book to speak directly to runners instead of to healthcare professionals, because the runner is the one who has to take the initiative in a running injury.  It is important that they know how to recognize a running injury and understand how to deal with it even before they see a healthcare professional, because they can get sidetracked and lost in the healthcare system. I wrote The Running Injury Recovery Program to help runners deal with that.  Coaches and healthcare professionals can also use these books to help their runners, or they can sign up for my classes and get a certification in post injury running management.

My website is called postinjuryrunning.com, and it has a lot of great information about running injuries for runners, as well as information on the certification course for coaches and physical therapists. You can buy The Running Injury Recovery Program book and workbook from the website or on Amazon, and there is also a Kindle e-book version on Amazon.

What are the biggest misconceptions out there today regarding running and rehabilitating running injuries?

One misconception is that running injuries are simple to fix. The most common treatments for running injuries include dope, tricks, tips and avoidance.

Runners are given medicine for pain and inflammation which actually makes it more dangerous for them. Running with drugs in their system not only masks the pain of a running injury and allows it to get worse; some drugs can also trigger chemical changes in a runner’s body that can lead to serious medical complications such as a heart attack.

Healthcare professionals also use several techniques that just trick the runner. They use tape or stretchy bandages on the skin that trick runners into thinking they are getting protection against injury. They get massages or electric shocks that block pain and make the injury feel better but do nothing to promote healing.  They can order redundant exercises that don’t address the injury or strengthen the body for running.  These are all forms of placebo medicine that have nothing to do with the problem but give the runner a sense that something worthwhile is being done.

Some may offer the runner tips which are just general information and not necessarily the specific professional advice that runners really need and deserve. Healthcare professionals need to get to know their runner.  They need to work with their individual habits, equipment and techniques. Otherwise it leads to avoidance and the feeling of failure.

Treatments should have clear goals with objective measurements and clearances that will take the runner through 4 management phases that are based on specific criteria, not a date on the calendar. Even physical therapists who have a good, phased injury management program may only take their runners through phases 1 and 2, which gets them over the acute injury, but does not strengthen the runner to return to running and reduce their risk of re-injury, which are phases 3 and 4 in my program.

Which authors/books have impacted you the most as a professional and an individual?

When I became a physical therapy student, non-fiction, self-help books, were on my personal priority list. Specifically, Be Here Now by Ram Dass — which is a simple, yet not-so-simple book of philosophy, and how to live life — helped me make the commitment to become a physical therapist.

Professionally, I was influenced by Treat Your Own Back by Robin McKenzie.  I like this book because it is an open protocol which is simple enough for the ordinary person to follow, and technical enough for the professional.  When I was writing, The Running Injury Recovery Program and the workbook that goes with it, I was influenced by this approach, so I tried to get as technical as I could for the professional, but easy enough so that the average runner could still understand it.

I enjoyed your blog post on “Running as Meditation“. Describe the psychology of a runner as s/he runs a marathon.

There really is a psychological condition that runners get while running, called the runner’s high, which is caused by very specific chemical changes in the brain. Even before a runner starts to run, he gets excited thinking about it and adrenaline is released.  That’s part of the runner’s high, and it kicks in very early into running.

Then, as a runner starts to run, there’s lots of bouncing and shaking.  The shaking of running causes a different kind of high than other types of exercise.  It stimulates a neurotransmitter, cannabinoid, which is a naturally occurring chemical similar to marijuana.   So, when runners are injured, and they have to bike or cross train, they’re often very unhappy that they can’t run because they are missing the runner’s high from the cannabinoid.

The third chemical effect is a kind of euphoria that runners get when they run for a long period of time, anywhere from one and a half hours for an experienced runner to 2 hours for a less trained runner. That’s when the pain-killing endorphins kick in, and they have a psychological effect that is similar to morphine.

The fourth effect is that running together with other people releases a social-bonding hormone called oxytocin. This is the hormone that bonds couples together, and it produces a similar effect with soldiers during combat that helps them protect and care for each other.

All these chemical changes mean that, when people run, first they get excited, then they get high, then they get stoned, and then they fall in love.

Which big ideas/concepts would help every Physical Therapist become better/smarter/wiser?

My big idea is: Every physical therapy session should be individualized as much as possible.  In my profession there is too much emphasis on “cookie cutter” treatments, meaning that every patient who gets the same diagnosis usually gets the same treatment. The problem is, the same diagnosis can have different causes and different outcomes in different people. For example, plantar fasciitis is a diagnosis of pain in the bottom of the foot, but there are actually many different types of plantar fasciitis because people do different things with their feet.  Some wear high heels, some run. The diagnosis of plantar fasciitis is completely different in a runner than it is in a person who walks, and I will treat them differently.

In my clinic, we don’t just treat the diagnosis, we treat the individual person. We customize treatments to each patient’s condition, their habits, and their preferences — which may change from day to day.  If a patient comes into my clinic for treatment and is depressed, or angry, or tired that day, then I will adjust his treatment and exercises on that day to optimize the outcome. A good P.T. must know his patient — just like a good coach must know his athlete to get the most out of his training.  In physical therapy, the best outcome results when the patient and the P.T. work together to create an individualized program.

You’ve just travelled back in time and are standing face-to-face with your 23 year old self. What advice would you give yourself?

It was 1980 and it was my senior year of physical therapy school.  I was disappointed because I was hoping to learn about running injury management and how to keep people running healthy. It took years to reach that goal, but I finally made it.

My advice: Stay the course.

Balancing work & life can be a challenge; especially as a small business owner. How do you manage this?

As a physical therapist, and owner of a running store, and a running coach, I have to make work play.

I make time to play with the people I love.

What is the best birthday present you’ve ever given? And received?

The gift of love and companionship:  My wife, Sherry, arranges trips and fun around my birthday, and gives us time to play together. (For her birthday I gave Sherry a hydroponic tower garden.)

Where would you like to see Physical Therapy in 5 years? How do we make your vision a reality?

I am hoping that in the future, more running injury patients will be treated with good physical therapy protocols instead of surgery. Too many physical therapy clinics are POPTS (which are physician owned). The problem is, a physical therapist who works for a physician cannot be objective or make an independent diagnosis.  In POPTS, physical therapists must follow doctors’ orders and many patients go for surgery.

Clinics that are financially independent from doctors, like mine, allow for checks and balances. The non-surgical core treatments can work and even produce better long-term results. We’ve treated thousands of patients who were scheduled for surgery and, after 10 minutes to 6 weeks of competent therapy, have cancelled their surgery.

For me personally, the FUTURE is my NEW course, The Post Injury Running Coach/ Physical Therapy Certificate Program.  All our information is at postinjuryrunning.com.

Life is an adventure. Tell us about one of your more memorable adventures.

It was 1999 and my focus in life was the inaugural Ironman at Lake Placid.  A week before the race I was trained and ready — then my wife, Sherry, had a suspicious biopsy that turned out to be a malignant breast cancer, and my world changed. Sherry became my focus, and I helped her through a long recovery process.  I kept on training, and I went to Lake Placid the next year.  At that point, I was finally able to think only about the race, and not about the cancer.

Bruce, thanks for the incredible interview! My readers & I have learned lots from it. Let’s do this again sometime.

Find Bruce on twitter – @BruceWilk

And connect with me @CinemaAir

Interview with Heidi Jannenga, PT, Co-founder of WebPT

I had the pleasure of interviewing Heidi Jannenga, PT, Co-Founder & COO of WebPT. I find her transition from a Physical Therapist to founder of a company – thriving in the young and growing sector of HealthCare Electronic Medical Records – nothing short of fascinating. This is a truly remarkable story & interview. I hope you enjoy it as much as I do. You can find her on twitter @HeidiJannenga and also connect with WebPT @WebPT


Your career has undergone a transformation over the last 8 years. What challenges did you have to overcome to allow this to happen? (Read the full story on WebPT’s inception here and here)

Most of us get into PT because we want to help people. That instant reward and gratification of seeing patients get better and improve under my care was exhilarating. That’s the reason I became a physical therapist. So, shifting my focus away from the day­-to-­day, hands-­on, direct patient care was definitely a challenge, and a major life change—both mentally and physically.  It took me about a year to get comfortable with the idea that my “need” to help people could still be fulfilled by helping my peers and my profession evolve. Plus, I could still help patients—even more patients—not through direct patient care, but by helping to educate and influence my colleagues. As for the physical part of it, I honestly never thought the day would come when I would have a desk job. We did just get a treadmill desk installed at the office, so I’m not ready to completely give up being on my feet for a good chunk of the day.

As a leader, the transformation from clinic director to business owner was a new and completely different challenge. Guiding my company through multiple transitions, including taking in a round of funding in 2010, really opened my eyes to a whole new business world I was unfamiliar with prior to launching WebPT. I sometimes think of it as getting your MBA through on-­the-­job training—except the stakes are high, because it’s your business and livelihood on the line with each and every decision, not to mention the livelihoods of our employees. Although I’m not traditionally a risk taker,  I now see myself as an entrepreneur. I have embraced the fact that we have made and will continue to make a few mistakes along the way, but that’s OK. It’s a tough pill to swallow when you are a perfectionist, but this is all part of the learning process—and my evolution as a person and as a business owner.

One of the challenges many start-ups face is keeping a low overhead while gathering the right personnel. How did you accomplish this in the early years of WebPT?

For the first few years, we all wore a lot of hats. And when I say “we all” I mean the three of us, really. I was the HR department, the accounting team, the lead salesperson, the entire marketing crew, and the PT subject matter expert—so, pretty much anything that needed to be done. Oh, and at this time I was still working full­-time as a multi-­site clinic director, overseeing a staff of 45. My then-boyfriend, now-­husband Brad created the software technology, but in the early days he was also our desktop support, customer service rep, system administrator, product manager, and user ­interface designer. He even taught our first employee, Matt, HTML so he could help us build the first WebPT website. We hired Matt to do sales, but like all of us, he believed in the vision, possessed an entrepreneurial spirit, understood why we did things the way that we did them, and pitched in wherever needed.

Hiring the right people and, of course, creating a product that meets the needs of our customers allowed us to bootstrap the company for four years before even considering outside funding. We have always hired for spirit and culture—true A-­players—over a stacked resume. The mantra “hire slow and fire fast” is something that we have abided by since our company’s inception. In taking our time to ensure we’re truly hiring the right people—people who truly share in our  vision—we’ve allowed for innovation to happen organically. Ultimately, when you’re a startup, you don’t have much to bargain with, so people really have to believe in what you’re doing, in what the company is going to achieve. And when people buy in like that and show that kind of loyalty, amazing things can happen.

I have enjoyed the responsiveness of WebPT on Twitter. How important is social media to WebPT and the world of Physical Therapy in general?

We pride ourselves on being forward thinking and innovative, so embracing social media is very important to us as a company and to the world of physical therapy in general. You have to be responsive. We want to be in the conversation, and that means engaging with the community, not speaking at them or selling to them. We are a business, so we obviously leverage social media for marketing purposes, but our social media team is actually part of the PR department, and if you follow our Twitter account, you know we don’t do a whole lot of direct selling.

Personally, I was hesitant to join Twitter. I wasn’t sure if I wanted to put myself out there like that, but our social media manager really encouraged me to test the waters, and I have to say, I am really happy I did. As for the world of physical therapy, social media can be huge. One of our challenges as private practice PTs is creating a unified front to accurately brand our profession in a concise and memorable way—a way that will resonate with the general public. Social media can help us combat that challenge. Through social, we can engage in meaningful conversation with other therapists, healthcare professionals, and—most importantly—consumers.

Congrats on making it on the list of 500 Fastest Growing companies in the US! “Company culture” is an integral part of a growing company. Tell us about WebPT’s culture.

Thank you! Making the Inc. 500 list of America’s Fastest Growing Companies is something we are incredibly proud to have accomplished. And you’re right, our company culture has been an integral part of our company and a catalyst for our growth and success. When Brad and I started this company, we intentionally set out to build a place that we would want to come to every day. We’ve always held ourselves accountable to a certain set of values, and those values served as the basis of our company culture. But we didn’t dictate our company’s culture. Instead, we held a massive company brainstorming session. There were about 40 of us at that time, and we met in our conference room and filled an entire whiteboard with words, phrases, and terms we  associated with who we wanted to be as a company, what we wanted to be known for, and the things WebPT employees considered most important when it came to their work environment.

We then boiled all of that down to our original six culture commitments. (Recently, we added two more to reflect our growing company, so now we have a total of eight.) These are the values that define our company and set the expectations for all of our employees. To stay agile, we promote autonomy at WebPT. When we need to make decisions, our teams know to vet the outcome  against our core commitments to ensure it’s consistent with our values. We hold each other  accountable for adhering to these commitments, and when we bring new people aboard the WebPT ship, it’s because they are rockstars not only at their jobs, but also in demonstrating these values. These core values are intimately intertwined throughout the entire company from interviews to performance reviews to strategic planning. I won’t go into detail here, but anyone interested can check out our actual Team Commitments here: WebPT Team Commitments.

How do you & your husband balance work & family life? Do you have unsaid (or said) rules to keep work from consuming your time together?

We get this question a lot, and it is most commonly followed by some version of “I could never work with my significant other.” I credit our differences as being what has made us successful—a balance of yin and yang. He is a risk taker; I am not. He sees the forest; I see the trees. He is the idea guy; I am the executor. Combine our individual strengths, and we’re a force to be reckoned with. We also started the company on equal footing. I didn’t know squat about building software and he didn’t know a CPT code from a talus. Our individual areas of expertise demanded mutual respect and didn’t allow or call for much overlap in our respective areas. It worked!

As for our working relationship, Brad and I did try to set some ground rules initially—like keeping work at work—but found it almost impossible to consistently stick to them. The key has been communication, especially setting aside time to simply talk as husband and wife, making work talk off limits. We go on occasional date nights and vacation together as a family, and since Ava (our amazing three­-year-­old daughter) was born, we adjusted our hours so we each get to spend time with her daily and make sure she’s a priority. I come to work later in the morning, after my daily breakfast with Ava, and Brad usually leaves a little early to get some father-­daughter time in the evenings. We also do a really good job sharing any sort of home chores. It has not always been easy, and as is the case with any relationship, it’s a constant work in progress. That being said, I am extremely grateful to have found a man who supports my goals and dreams and now also helps support my profession.

So to me, the word balance is misleading. There are days when I wish I spent more time at home with Ava, and there are days I wish I had more time for work. What’s important is that it all evens out in the end. Brad and I are also partial to that saying “If you love what you do, you’ll never work a day in your life.” We truly love what we do! That’s not to say it isn’t a challenge to achieve that balance you talk about, but it’s certainly a lot easier when you are passionate about your work.

Every founder & CEO seems to have a daily ritual. Some have morning rituals, others have after-work rituals. What’s your ritual?

To be honest with you, I don’t really have a daily ritual. I do make a point to have breakfast with Ava every morning before I head to work. Otherwise, I go to Yoga and/or the gym a few times a week and find other ways to stay active like hiking, but that’s pretty much it as far as a daily ritual goes. We also just added that treadmill desk to our office, so that may be a new daily ritual in the making. I’ll keep you posted!

You are involved in an amazing intersection of technology & medicine. Where do you see this movement leading us over the next 3-5 years?

Healthcare technology is obviously a hot topic, but let’s make this specific to PT. Where do I see it leading us? I imagine patient­-centered medical teams (with PTs as a vital part of that core  team of medical providers), giving patients access to true integrated care through technology. The healthcare industry isn’t using physical therapy to its fullest potential. That’s why I’ve been talking so much about the need for interoperability.

Interoperability occurs when diverse systems and organizations work together for an overarching goal—providing excellent care to our patients. In healthcare, interoperability focuses on successful information exchange across all healthcare platforms. Both communication and technology play massively important roles in achieving seamless data exchange.

And as patients become more technologically savvy, they’re quickly expecting the same from their providers—with some even deciding who to seek care from based on the provider’s ability to offer technology­-enabled solutions. That’s where EMR comes into play, and that’s not a WebPT plug (well, it is a little bit). That’s just healthcare­-specific technology. I am also passionate about using marketing technology to help elevate our brand as physical therapists and help get the word out about the value we offer patients.

What is your vision for Physical Therapy in the next 5 years? What are you doing to make this a reality? And how can PT’s across the country help?

I really embrace the APTA’s Vision 2020 statement. It’s a shame they’ve moved on to something less tangible. Physical therapists have a branding problem. No one knows who we are, what we do, the value we offer to patients, and the dollars we can save the healthcare industry. Therefore, we must brand PT. I just spoke about this at an industry conference organized by the Independent Physical Therapists of California (iPTCA) and the Physical Therapy Business Association  (PTBA). To the average consumer, there’s still a shroud of mystery around physical therapy and what it is that therapists do. And because of our reliance on referrals, we have diminished our brand as “lower on the totem pole” to that of physicians and even chiros. If potential patients don’t understand what we do, why would they ever think of physical therapy when they are injured or in pain? How could they possibly know to make that connection if it isn’t clear they can benefit from our services? We now have direct access in all 50 states, but is it making a difference? Do we know how to capitalize?

We have to put ourselves in a position to compete. I want us to make ourselves so relevant that when people think of, speak of, or experience back pain, knee pain, shoulder pain, surgery recovery, incontinence, they think of physical therapy—immediately—and know exactly where to find a PT within their community. When people have any one of these issues and they ask “what do I do now?,” there should be one clear answer: Get PT. It’s short, simple, and memorable, and it seems to work. We’ve market tested the idea over the last year and the imagery and messaging is resonating. #GetPT is recognizable and action-­oriented. It’s not the magic bullet solution to all our problems. It is, however, a tool we can all leverage to help brand our profession and ensure that we control our own destinies.

I hope you’ll join us in our efforts to better brand private practice physical therapy. We’ve talked a lot about the possibilities and the potential to take our branding to the next level, but none of this is doable without a united front and a unified effort. All of us would benefit from more patients seeking physical therapy more often. I want to set aside the silos and forget specialties for the moment and focus on one singular goal: getting patients through the doors of private practices across the country.

Life is more than just work. Tell us about one of your most memorable “outside-of-work” experiences.

Getting married to Brad on a beach in Hawaii comes to mind immediately. Of course, the birth of my daughter Ava was one of my most rewarding and memorable life experiences. We also just went on a family vacation to Austria, which is where my father was born. My mom and dad, my brother and his wife, Brad, Ava, and I all spent about two weeks traveling the country in a ten-­passenger van, visiting every place my father has ever lived and making what will surely be lifelong connections with my dad’s side of the family. It was incredible—not to mention the country and its rich history, breathtaking scenery, and delicious food.

Thanks for the opportunity to interview you! It was a pleasure to get to know you better and glean some of the lessons you’ve learned over the years. My readers & I wish you & WebPT the best of luck. The future is bright.

Find Heidi on twitter @HeidiJannenga

And connect with me @Cinema_Air

Brad Grohovsky: Top 5 Lessons from the Residency Trenches

I am a big proponent of doing a Residency program upon graduation from Physical Therapy school. Not only does it contextualize what you learned in PT School, but it also gives you valuable mentorship that fast-tracks you on your journey to become a better clinician (and more!).

Dr. Bradley Grohovsky, DPT serves on the APTA Private Practice Section Government Affairs Committee and is currently a Resident studying with the Institute of Physical Art at Encompass Physical Therapy in Annapolis, MD – specializing in Functional Manual Therapy™. Brad received his Bachelor’s degree from Western Kentucky in his home state prior to moving to Boston, MA for physical therapy school. While attending Simmons College he also served on the APTA Student Assembly Board of Directors prior to graduating with his Doctorate of Physical Therapy in 2011.”

You can read more of his thoughts here. I recently asked him about the top five lessons he learned from his Residency so far. He responded with this generous guest post. Enjoy!


“Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. The practice of evidence-based medicine is a process of life-long, self-directed learning…” (Sackett)

​Physical Therapy is a rapidly evolving profession that is experiencing some revolutionary transitions both in our position in the healthcare system, but more importantly in our clinical skills and approach to patient care. Our profession currently stands at a great pinnacle with an opportunity to integrate into a vital (and missing) medical role in our society as both movement and lifestyle experts. Residency education is a catapult towards clinical expertise – if our profession is truly going to step into this role then we must step up to the plate as clinicians. If you are a student who is about to graduate (or just passed the NPTE..congrats!), a new professional, or a burnt-out experienced veteran I encourage you to check out a Residency in a specialty that interests you!

Here are the top five most valuable lessons of my Residency:

1. There is nothing more valuable than a mentor you respect and who challenges you to be your best.

-Because if you are not being challenged to be a better clinician everyday, then really what’s the point? Having an experienced mentor that challenges you to be your best improves both your skills as a clinician and your patient’s outcomes.

2. Attempt to prove yourself wrong with EVERY patient.

-Develop a hypothesis and use objective pre/post tests to validate your treatment and direct your plan of care. This allows you to develop and test your hypothesis every visit – if your theory isn’t correct, then change your treatment next visit (don’t wait until the next re-eval)! Every treatment becomes evidence-based and the objective information can provide immediate positive feedback for the patient!

3. Use your eyes, but trust your hands.

-More often than not, we are the first clinician to actually touch a patient’s pain. Learn to trust what your hands are telling you – they are your most valuable tool. In the book Outliers, author Malcolm Gladwell claims that 10,000 hours is the amount of time it takes to master a craft and achieve “greatness”. You can’t be Yoda – a Jedi Grand Master PT without mastering the force – and you can’t understand the force without putting in your time in the Jedi Academy.

4. Make every patient understand that this is a team effort.

-This reinforces compliance and accountability, which will encourage long term success. We are the mechanic who can repair broken parts, provide a tune up and clarify sections in the owner’s manual, but it is up to the patient to maintain the condition of their vehicle to the best of his/her ability.

5. Be an intelligent teacher, but an excellent pupil.

-Evidence continues to mount in support of the neuromatrix components of chronic pain involving neural, psychological and social components in addition to the physical presentation (Butler, Moseley, Wardlaw). Patients often teach us how to best treat them, whether intentionally or unintentionally. During treatments, be an active listener – both treat and educate each patient based on his/her individual learning style!

For further Residency reading please check out my recent post on PTHaven.com – To a Residency and Beyond!

Follow me on twitter @DrG_PT

Resources:

1. Sackett: Evidence Based Medicine: What it is and what it isn’t, BMJ 1996;312:71

2. Butler, D: Explain Pain

3. Wardlaw C: Taming Pain

4. Moseley: A Pain Neuromatrix Approach to Patients with Chronic Pain, Manual Therapy 2003


I am @Cinema_Air