Twitter Interview!

I decided to close out 2015 with an interview with questions from twitter.

Check it out!

@therapyinsiders: Which Bourne movie was your favorite and why?

This is a tough one. I really enjoyed all three – yes, I’m excluding the one with Jeremy Renner. I’ll choose my favorite Bourne flick based on 2 things: villains and motorcycle scenes. And the winner is… The Bourne Ultimatum! Desh was the perfect roleplaying villain. I loved his fight scenes which seemed like a mix of Wing Chun Kung Fu and Capoeira. The motorcycle scenes were incredible! Watching Bourne ride through Tangier at a fast clip while negotiating daunting street obstacles in narrow alleys was thing of beauty.

@MattBobman: Biggest professional regret and/or failure?

I should’ve casted a wider net in my first few years as a PT. While I was lucky enough to have a role and gain experience on both sides of the business, I could have developed a wider view and started developing a Framework of thinking and action much earlier than I did. Here’s what I would recommend:

Experiment enthusiastically with different approaches of treatments.

Connect with a wide variety of professionals within driving distance and through social media.

Take more risks in terms of: creating new products, developing new platforms, re-inventing yourself.

Read a kaleidoscopic selection of books and authors. And, follow Jeff Bezos’ “Regret Minimization Framework.”

This is a great question! Jeff Goldblum – not because I look like him, but because he plays some interesting roles and for some reason his personality resonates with me. Anyway, check out his Top 10 Moments:

Anonymous: When are you going to Haiti with STANDHaiti?

Hopefully some time in 2016. In the meantime, check out STAND’s 2015 Re-cap and this inspiring story.

Doesn’t matter. Just get moving in anyway that you enjoy – play sports, lift heavy things, dance, run, yoga, climb things, conquer things… If I were forced to pick team or exercise, then I’d say go with whichever fits your personality the best.

@DrBenFung: If you could change one thing about the person that annoys you the most, what would it be?

This is a tricky one, and here’s why. If you find someone that annoying, then odds are this person means something important to you. Maybe s/he is someone you want to hold onto and have agree with you. Maybe s/he is someone you want to impress. Maybe you believe changing him/her will make your professional or personal life complete. Here’s what I think: maybe you should work on yourself & your environment before you think about think about changing someone. Changing someone is often a futile effort. Changing yourself is a much more powerful endeavor with compounding returns over time. Book Recommendation: The Education of a Value Investor by Guy Spier.

@Eric_in_AmERICa: If you could put a billboard anywhere in the world where would it be and what would it say?

@rupalPT: what is your pride and joy?

Spending time with my family & friends and providing as much value to the world as I can are my prides & joys.

Careful whom you marry.

Explore wider and faster. Do not ignore your instincts. Learn widely from outside the field of Physical Therapy. You need a framework – work hard at developing a foundational framework on which you can build further. And, don’t fear failure. Just make sure you learn from it. You might get more out of my interview with Dalin.

Hello. My name is Indigo Montoya…

Thank you everyone! And, best wishes for a fantastic 2016!

Connect with me @Cinema_Air

Edo, Nelson, & I chat about the new KinetaCore Educational Center

Dr. Edo Zylstra, PT, DPT, MS, OCS, IMSP recently reached out to me about the latest KinetaCore evolution: The KinetaCore Educational Center in Ashburn, VA launching on March 19th.You can find some introductory information about it here, and the interview you are about to read will go in-depth into the intentions, hopes, and experience of the new Facility. He partnered with Nelson Min, PT, MS, ATC to launch this First-Of-Its-Kind facility. Not only is Mr. Min a lead instructor for KinetaCore, but he is also a practicing clinic-owner. Many of you are already familiar with Dr. Edo Zylstra; if not, then check out our first interview.

Congratulation & Good Luck to KinetaCore, Dr. Zylstra & Mr. Min on their latest venture!

Enjoy the interview!

First, let’s get to know Nelson Min. Nelson, what lead you into the wonderful world of Physical Therapy?

Nelson: I am very blessed to be a physical therapist.  I think the PT’s I came across early on were amazing people and they had a strong and lasting influence in my pursuit of being a physical therapist.  I grew up in Delaware and they have an incredibly strong PT program there at the University of Delaware.  These were some amazingly skilled PTs who had such a good presence in the community.  They were also such a close knit group.  I just saw how interactive and rewarding this field can be because of these individuals who were really good PT’s and even better people.

Nelson, tell us about your history with KinetaCore. How did it start? And, how has it grown to where it is today?

Nelson: One of the keys to being a good PT is drive for continued learning.  There is so much to learn and I am continuously amazed at how much good info is out there.  I really enjoy taking continuing education courses and I realized that the more I progressed in my training the more these highly respected educators recommended incorporating dry needling into my skill set.

I took my first course at Regis University in 2009.  The professionalism and expertise of Edo and his staff for that class was such an inspiration.  The immediate results I noticed on my self over a weekend were undeniable.  Dry needling is such a great adjunct to any physical therapist and I knew I had to be a part of this company.

So, Edo & Nelson, there’s a new venture that’s about to launch on March 19th. Tell us about The KinetaCore Educational Center. What motivated its formation? And, what is it that you hope this will do for the profession of Physical Therapy?

Nelson: Functional Dry Needling® has changed my practice and how I practice.  It has made my already successful clinic into an even more successful and thriving one.  We want to share this with as many PT’s out there to hopefully make them even more successful in their businesses.

We also want to share this technique with the public.  It helps with such a diverse number of dysfunction that patients deal with, improved function is the goal but it also helps with pain and increased mobility and muscle function to name a few other benefits.  It has dramatically helped me in improving my patient’s outcomes.

We started the Kinetacore Education Center to achieve the goal of educating our profession with this technique in a setting that promotes the learning experience.  What typically happens with con-ed is to offer it in a PT clinic or facility and adjust it to the needs of a con-ed course.  In other words, you work with what you have available.  Our teaching center has no associated clinic. The design is for learning.  Three HD ceiling projectors and total surround sound gives any participant clear audio and visual regardless of their vantage point.

The other speakers we will be featuring include some of the most influential and sought after educators in our profession.  These educators have incredibly tight schedules and share a passion of advancing our profession.  We now have a facility where we don’t have to worry about the logistics of closing a PT clinic which often interferes with hosting some of these professionals.

How did/do you choose the instructors for the new KinetaCore Educational Center? What qualifications and qualities are you looking for?

Nelson: We are looking for instructors who have a passion for the advancement of our profession.  We look for skilled, intelligent and caring individuals who invest in the goal of advancing our profession with this technique and want to further our understanding of its mechanism and how to teach it more effectively.

All instructors are trained in Functional Dry Needling (FDN®) and require one year of clinical use before being considered as an instructor.   They are then required to go through a training process over three separate audits to safely and carefully progress them to independence in supervising and instructing. The training process concludes in a final check off with our senior instructors (Edo if possible)  to ensure quality and consistency with what and how is it presented.

We require that you are trained in our technique to be able to teach our system of dry needling.  These gifted individuals usually stand out during training process and it usually comes as no surprise when they first inquire about the opportunity.

I’m glad you mentioned not just the clinical aspect, but also the business dividends of Functional Dry Needling®. What is KinetaCore doing to promote Dry Needling to increase public awareness in the US?

Nelson: Edo has done such behind the scenes work with working with the APTA and several state boards to help incorporate dry needling into the state’s scope of practice acts .  He is one of the individuals who drafted the resource paper on dry needling for the APTA in 2012 and was recently accepted to be a part of the Federation of State Boards of Physical Therapy Dry Needling task force.  I think Edo brings public attention to this skill the right way by approaching this from the top down.

We also want to empower our participants.  Our website is a labour of love with marketing materials and electronic brochures.  The most important part of the website, however, are the educational videos that are constantly being updated for continued improvement of techniques and also the “Find a Therapist” feature.  This allows the clinician to market their practice.  Our google ranking is so fine tuned that our participants who sign up for the website membership can expect to get a number of people finding them through this feature on the web.  Ultimately, we feel the best way to market this technique is by delivering a good product which is a skilled PT  focusing on safety and proper technique.

Our goal is to be the support for all of our participants in this.  We have a system for participants to communicate with our instructors to answer any questions that may come up as they integrate this technique into their practice.  Each lead instructor receives dozens of emails a day from our past participants with solid questions.

How expansive will the course offerings range?

Nelson: We will be offering our course series of Functional Dry Needling® level 1 and 2, and Functional Therapeutics throughout the year.  In addition we will be hosting several manual therapy courses including Extremity Manipulation by Gail Malloy, The Changing Dynamic of the Scientific and Clinical Rationale for the Treatment of Selected Knee conditions by George Davies, Spinal Manipulation by Louie Puentedera, and SFMA for dry needlers by Kyle Kiesel.  I am still working on adding more courses spanning a vast topic range for the remainder of this year and next.

Edo:  I also have a goal to open up this teaching model and center up to other medical professions to give them a cost effective way to host educational courses for their specific professions as well.  That is as goal that we will try to realize over the next few year.

To the best of my understanding KinetaCore requires 200 treatment session of practice/experience after Functional Dry Needling® Part 1 prior to taking Part 2. Why is it set up this way? And, is this something KinetaCore pushes for when lobbying for inclusion of Dry Needling in State Practice Acts across the US?

Nelson: As expected the skill of handling a needle for people coming into our FDN1 course can be pretty limited.  Our bottom line is safety so we limit some of the more challenging muscles to level 2. Muscles that we feel need a more refined skill level to treat are placed into the level 2 course.   We require 200 practice sessions for our participants so that they are better prepared for the requirements of the level 2 course.  We feel that this skill level can only come about with practice.

Walk me through what it would be like to take my first course at the KinetaCore Educational Center. Class size, number of instructors per course, course progression, lab/hands-on time, etc.

Nelson: The class size varies but shouldn’t affect the learning experience because of our adherence to an average instructor to student ratio of 1 to 7.  We have a rule with our participants that if they feel they are not getting enough supervision, they need to indicate this so we can fulfill their needs.  It is the responsibility of both the instructor and the participant to make sure they have the optimal learning environment.  Exposure to as many instructors as possible gives the participant a much broader understanding of the application of the technique, so we purposefully rotate instructors and have the participants work with various body types through the weekend.

The first part of the course is our didactic lecture in order to lay down the framework of dry needling with its history, theory, research and integration.  We are then in lab for the remainder of the course systematically covering the entire body by regions in our small group labs.

Each of these small groups is first led by our instructors reviewing anatomy and then demonstrating technique.  We then have our participants pair up and practice the demonstrated technique for that region while carefully sweeping the room providing close supervision.

At the end of the second day, we have everyone go through another review process so that they can pair with another partner and get a different instructor to watch them.  We just want each participant to get as much supervision from multiple instructors as possible.

On the third day, each participant is tested both practically and theoretically.  There is no guarantee of passing and we have options for people who do not pass the testing.  We take this very seriously and give our students as much time as possible to practice, often staying late on Friday and Saturday evening working with our participants and giving them more one on one instruction.

Is there anything else you would like to share about the KinetaCore Education Center that we haven’t addressed?

Nelson: Our teaching center was designed to offer the best in continuing education.  We have some high end AV to show our detailed lecture notes as well as an interactive approach to see the anatomy simultaneously.  There are some high end anatomy apps out there now very conducive for learning and we incorporate them with our lectures and labs for a wonderful learning experience.

Because of the layout of the course, there is no bad vantage point.  You get a great view of the screen regardless of where you sit.  We have high end audio spread out uniformly throughout the venue as well so you get a clear sound regardless of where you are sitting as well.

Edo:  This is our first venture specifically developing a center devoted to higher learning for the medical professional.  If this is successful, I anticipate this as a first of many centers around the United States.  We are so thankful for all the support we have received from our families, friends and colleagues as we go faithfully into this adventure.

Thank you Edo & Nelson for this informative interview, as well as for allowing me the opportunity to share it with my audience. I wish both you the best of luck in your latest venture!

Connect with Dr. Edo Zylstra and Nelson Min on Twitter: @EdoZylstra & @NelsonMin2000

Also, find me at @Cinema_Air.

Interview with Nick Nordtvedt – The Remix

It’s officially the Holidays, and I’m feeling a bit nostalgic. So I decided to catch up with @NickTNpt. I’m extra grateful to Dr. Nick Nordtvedt, DPT, Cert MDT for being my first interviewee and getting my interview series rolling. You can read the first interview here

Enjoy Round 2!

First, what did you have for breakfast today?

Eggs everyday!

What sparked your initial interest in Physical Therapy?

I spent my first two years in college bouncing around between a few different majors. I hadn’t studied anything that really excited me. I started working at a physical therapy clinic for about a year, and I really enjoyed the interaction with people and helping improve their quality of life. I also liked the private practice atmosphere.

What is it about the Private Practice atmosphere that you find so attractive?

I like the idea of “being my own boss.” I have never owned a practice that I’ve worked at, but I have always been involved in day to day operations of running a clinic. I like to drive my own referrals and network with other medical professionals and businesspeople around me.

Per our first interview, you were reading Lore of Running by Timothy Noakes. What did you make of it?

Honestly, I haven’t finished it yet! I think it’s about 6 inches thick. I’ve read it on and off over the last year, and have used a lot of the information to apply to patients seeing me for orthopedic issues besides just running.

I just finished reading The Zappos Experience by Joseph A. Michelli. This is a great book about Zappos focus on the entire customer experience, a must read for anyone in business or private practice.

What ideas or concepts from The Zappos Experience stand out to you?

Wowing customers by providing them with an exceptional customer service experience. Most people don’t go to physical therapy because they want to. Something has happened, known or unknown, where they find themselves in need of rehabilitative services. My first goal, and what I tell all my support staff, is to make every person that walks through the door feel as comfortable and welcome as possible. Next, you have to go out of your way to make the patient’s treatment about him or her, not about you. You can talk about yourself or share a story, but it should always be to engage the patient so you can learn more about them. Finally, give more than they expect. This isn’t necessarily giving them an object or something they can possess. This means taking the time to listen and understand what they are trying to tell you, and going the extra mile to provide them with an unparalleled customer service experience that they won’t receive any where else.

Imagine you had an unlimited budget to set up your Private Practice. How would you spend this unlimited budget on your fantasy clinic?

Wow! I’m not sure where I would end, the possibilities are endless! But, I definitely know where I would begin. I think that the most important things to invest in off the bat in a new business are a great support staff and community support.

If you don’t have the right people in place, your business will struggle. This goes for front office staff just as much (maybe more so) than clinical staff. The initial contact a patient or physician’s office has with your clinic is so important. If they don’t get a feeling of welcomeness and understanding from the non-clinical staff, that makes for a much more challenging experience for the clinician. With my unlimited budget, I would first make sure that I had the right staff with the right training.

Second, I would invest in community activity and support. This should actually not be all that expensive if you look for the right opportunities-community festivals, sporting events, health fairs…the list could be endless. Being a part of the community and talking to people will get you a whole lot further than a fancy TV ad!

Let’s fast-forward to your retirement party. What would you want to be able to say about yourself as a Physical Therapist?

I can’t say that I’m looking forward to retirement anytime soon, but when (if) I retire, my hope is that people say that I listened to them and had a genuine interest in helping them.

Top 3 favorite blogs?

Limit to three?! I can’t limit to any less than 5-in no particular order:

Allan Besselink
Dr. Ben Fung
PT Think Tank
The Manual Therapist
Body In Mind

What are your best ideas to increase APTA Membership?

We HAVE to make students understand the importance of membership and maintaining membership once they become professionals. This has to be done in both arenas of didactic education. Engaging students to participate in APTA events would go a long way to seeing the value of APTA membership. I think PT schools discussing current events in PT practice on a weekly basis would be an easy way for students to further understand the value of APTA. In the clinic, CIs need to take students with them to chapter meetings, state meetings, and legislative events. What worries me is that we will lose some aspect of our practice before people wake up to the need to be an active member in APTA.

How do you decide which Continuing Education Courses you take? What factors play the biggest role in your decision-making?

The biggest factor in deciding which CE courses to take is word of mouth from other clinicians that I know and respect. There are some courses that years ago I would have never expected to take. In talking with other clinicians that have taken certain courses, I discover ways to integrate new ideas and techniques into my current mode of practice to get better results with my patients.

Pick one of the following you want as a Mentor? And why did you choose him/her?
• Jason Bourne
• Wonder Woman
• James Bond
• Princess Leia
• Prof. Charles Xavier (of X-Men)

I would have to choose Jason Bourne. I was on the fence between him and James Bond, but I think Bond gets lucky a lot of the time! Jason Bourne is very self aware and deliberate in his actions which is how I try to act in practice. Plus I’m pretty excited about the new Bourne sequel coming up!

Thanks Nick! Hope 2014 was a great year for you!

You can get in touch with Nick on Twitter @NickTNpt

And find me on Twitter @Cinema_Air

Interview with Dr. David Browder, DPT, OCS

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 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.

Elaborate on the relationship between Texas Physical Therapy Specialists & Evidence In Motion.

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. just launched! What is it about & why did you start it?  

DAVID: 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  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.

PodcastsMichael 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 Best wishes for the new year!

Find me on Twitter @Cinema_Air

Interview with Nick Nordvedt, DPT, Cert MDT

I had the pleasure of interviewing Nick Nordvedt, DPT, Cert MDT. Many of you have met him on twitter via @nicktnpt. First, a little background on Nick; then we’ll jump right in to the fun stuff.

Nick graduated from the University of Tennessee Health Science Center in Memphis with a Doctorate of Physical Therapy in 2007.  He has worked as an outpatient physical therapist focusing on manual therapy in Memphis and Jackson since graduating, and he completed his certification in the McKenzie Method of Mechanical Diagnosis & Therapy in 2012.

All of us go through professional growth and evolution. Describe your progression through the years.

I think an insatiable desire to learn and grow professionally has been the backbone to my evolution as a physical therapist.  Being happy with the satus quo is something that has never felt right to me, so I believe this has given me the desire to grow professionally.  The biggest influence on my thinking and treatment of patients has been the mentors I have had over the years.  I have had several mentors emphasizing different aspects of physical therapy along the way: everything from scientific reasoning to patient satisfaction to business, but all leading to a patient centered approach to care.  Providing mentorship to students and new grads is naturally the next part of this process, which again, helps me grow professionally as well.

What hobbies or extra-professional interests have impacted you as a PT? And how?

I am a very motivated person, so I always love treating patients who are motivated to return to function.  I love to run, and I’ve always been interested in sports/sport injuries, so I really enjoy treating patients rehabbing from injury.  While I’ve never had a serious sporting injury, it keeps me grounded talking to patients about how & why they got injured. It can be quite a challenge to treat the non-motivated patient, but the feeling of accomplishment for both the pt and the PT can be quite rewarding.

How do you tackle the non-motivated patient?

Every patient has some sort of motivation.  It is a matter of determining what is important to that patient and helping them achieve these goals.  If they are still in the pre-contemplative phase of whether they will use physical therapy services, you have to do a lot of education of what you can do to help this patient.  Ultimately, it is up to him/her to make that decision, but sometimes the therapist needs to put his beliefs and needs secondary to the potential patient’s.

How is the PT business climate in Tennessee?

The private practice PT business is tough, as I would imagine it to be in any market.  But I believe that hard work will pay off in any market as well.  It is a matter of defining and going after your market (this could be defined as your niche).  The ugly is just how little I think PTs know about how a practice is run from a business perspective.  Even if a PT works for a POPTs, HOPTs, or large corporate practice, I think it is his or her duty to know their personal value.  Basic value of an employee is production/cost (production and the quality of production could be discussed further, but even this basic value is not understood by most employees).

What big ideas/simple ideas/basic concepts do you believe will help all Physical Therapists become better/smarter/wiser?

Critical thinking & listening.  I see too often PTs who want a protocol or a road map for every patient which inherently decreases the PTs critical thinking and clinical decision making.  Simplifying patient care should be something we all strive for (“Make everything as simple as possible, but not simpler” – Einstein), but we must remember how complex each individual person is!  Listening (not hearing!) also seems to be a lost art not only in PT, but healthcare in general.  How many more people would get better just from having someone they believe listened to their story?  As Robin McKenzie said, “Everything I know, I learned from my patients.”

Favorite books and/or authors? Any recommendations?

I read To Sell is Human by Daniel Pink earlier in the year. A great book that ll physical therapists should read (he even Mentions PT!). Simple by Alan Siegel & Irene Etzkorn is another great book I read earlier this year. Right now I’m reading Movement by Gray Cook, Lore of Running by Timothy Noakes, and The Hit by David Baldacci.

Give the benefit of hindsight and your accumulated perspective, what’s your advice to new PT graduates?

LEARN and find a mentor. PT students and new grads that I meet are frequently surprised by the vast amount of knowledge still to learn after graduation. We graduate as generalists, but must find our practice niche after graduation. I think the best way to do this is through taking advantage of every learning opportunity available and find a great mentor that shares core practice values with you.

What advice would you give to seasoned PT’s?

Continue to seek and embrace a mentor, but pay it forward.  Share what you’ve learned with anyone willing to listen, PT or non-PT.

What advice would you give to yourself?

I try to give myself the same mentorship advice.  I am always telling people that if I didn’t enjoy doing what I do, I would change.

Do you (or your clinic) offer clinical internships or mentorship opportunities? If so, then how what is the best way to get DPT students in touch with you?

I do accept physical therapist students for clinical internships.  The best way to get in touch with me to set up a contract with a school is to email me at or get in touch with me on Twitter @nicktnpt

Life is an adventure. Describe one of your most memorable adventures so far.

Starting a family has by far been the biggest and best adventure I’ve had!  I have a 2 year old son who keeps my wife and me busy 24/7, but I wouldn’t change it for anything!

Nick, thanks for the interview! It was a pleasure. I hope you enjoyed it as much as I did.

Really enjoyed it! Thanks!

Find me on Twitter @Cinema_Air