Return on Impact: Why PTs Need to Think Bigger

0:03 All right, this episode is brought to you by Get the Message Out. If you ever want to launch a podcast or a YouTube channel or finally get consistent about with the social media content, I built that. I built Get the Message Out to help you do exactly that. Are you ready to stop thinking and start creating? Just hit me with an email, jimmy at ptpinecast.com, and let's roll. This episode is powered by Brooks Rehabilitation Institute of Higher Learning, the place physical therapists go when they want to get really good Whether you're thinking orthopedics, geriatrics, or pediatrics, their residencies and fellowships help you become the clinician people rely on. Check out what your next level looks like at brooksihl.org. All right, what do Dr. Pepper, knee pain, biomechanics, wizardry, and a survivor application all have in common?

0:54 It's this episode. It was rhetorical. We're diving into today why runners aren't broken by running, why PTs need to stop acting like the person you end up with, and how a small clinic in Arkansas is making a big move to blend performance, prevention, and rehab into one seamless system. He's part coach, part clinician, and part community builder. From treating injuries to directing races, please welcome to the show, Logan Dockery. How was that intro? It's pretty smooth, right? I saw the Dr. Pepper reference in there. I like it. Yeah. So you and I have a love for Dr. Pepper. I don't drink. Admittedly, I don't drink a lot of soda.

1:34 But when I allow myself some, if Dr. Pepper is close, that is my go to. So what's what's your what's where's your thread there? What's your love of the Dr. Pepper? Too much is the thread. Yeah, too much. I drink too much Dr. Pepper and Mellow Yellow. That is a classic as well. Wow, a throwback to Mellow Yellow. Now, is that a Southern thing? I'm from New York, but I remember drinking Mellow Yellows at my grandmother's condo in Florida. That's the only place I think I've ever had it. i have no idea i have no idea i i am one of the few that still drink it though yeah you are keeping it that and i remember it was one of the sponsor cars in the tom cruise movie days of thunder but we're not here to talk about dr pepper or mellow yellow but i'm sure we could we're here to talk about you so logan welcome to the show you are in the great state of arkansas and you are a physical therapist for how long give us like the sort of the context when did you graduate how long you been practicing Yeah, I graduated in two thousand fourteen from the University of Central Arkansas with my clinical doctorate and then my Ph.D.

2:30 years later while working in a hospital system, I attained that as well. But I've been practicing for about ten years now, a little over ten years. Love it. And you believe this physical therapists should be the leaders in musculoskeletal care. Logan, why do you think that? I think physical therapists need to step to the plate and be able to do that and have our position in there. Not as a competitor, but definitely as a collaborator, right? We need to go in, healthcare as a whole needs collaboration. For a patient to have true healthcare, to have like true path into improving their life, improving their functional mobility, we need to have a collaborative approach in that sense.

3:15 But the way our traditional model is set up, it makes it pretty difficult. But I do think PTs need to be the leader in neuromusculoskeletal care. We graduated around the same time. I was twenty sixteen. We've been hearing this a lot. What are we doing wrong that this isn't the case? Because I feel like even when we were students back in the day, we were saying this. Are we getting better? And if so, what do we need to do more of to speed that up or to sort of cement that idea? I think it's very layered, right? Just with everything. Everything is very layered into how we approach it, the problems that are there, the speed bumps that might be that are there now and that are definitely coming later. All those things kind of apply and kind of slow the progressions.

3:56 Plus healthcare in general just takes time. right consistency and messaging consistency in the education and even building leaders to be able to take the path forward so i think one of the biggest things we need are leaders to step up to the plate for um people like me and and other leaders in the field to to try to push and advocate for our path in a neuromusculoskeletal approach and be the primary path not an ancillary service You need noise makers, man. You need people who know how to say something in fifty five seconds, ten seconds, five seconds or two seconds. You need people who can do that and that their job is to do that on a regular basis.

4:38 And I think, too, that people are inside the clinic and that see this on a day to day basis. We hear our patients. I spend hours with patients weekly that come in that tell me what their limitations are, what they're struggling with, the past in life that have become difficult for them. And we're in a unique position, both in our skill sets, our education, and how our practices are set up, that we can impact people's lives in a great way. We are in a unique position to then be a primary source for them in musculoskeletal care, and that's in movement disorders, that's in day-to-day, whether it's someone trying to train for a race or someone that is trying to lift heavier weight because they enjoy doing it inside the gym, or is it Miss Betty that's seventy-three that just wants time with their grandkids and not feel limited in that aspect?

5:29 We are skilled in a way and trained in a way that allows us to be a good impact in their lives. But again, this is more in a collaborative approach. We are definitely not trying to step into a realm that we're not supposed to necessarily be in. Based on our practice stack, our rules and regs, we are positioned to be able to do that, but we need to go at it as a collaborative approach so we can solve the issues in healthcare and not create new ones. All right. Well, you mentioned runners. You are a runner. And you've said that most runners aren't actually injured from running, but from everything else. Help me understand that. And what are some of the everything else's?

6:12 Yeah, it's so many things. Like I said, everything's layered in life. Everything is layered. And so with running, in a sense, people always talk and I hear it all the time that running is bad for your knees. It's bad for your joints, the compression that's there. But I don't necessarily I don't subscribe to that. I don't think that's necessarily the case. I think what gets people in trouble the most that that might tend to make someone maybe more injury prone, if we can use that term, is lack of strength, lack of biomechanics, functional and correct biomechanics. I would say poor sleep, poor diet, not having the right resources to then be able to create a great environment to then succeed into running.

6:52 And whenever I talk about succeed into running, I mean, be able to accomplish what you want running to do for you whether it's to win races to run faster to challenge yourself to lose weight to be more healthy to make your body move to learn discipline whatever it is it needs to serve that purpose but be able to do that you have to have everything else work together and so running's not the not the enemy it's everything about life that interrupts that path or does it support that path in your goals Yeah, causation correlation. We see someone run and get injured, but there's other things, and you've mentioned before, terrain, sleep, stress, load, shoes. Yep. Lots of other things in that everything else that sometimes we don't see or a clinician might not be thinking of or a runner might not be thinking of, but all those things play a part.

7:41 A hundred percent. Yep. A hundred percent. It's a taboo subject if you're wearing the wrong shoes. that that can lead to injuries that is true in a sense of let's say someone gets in a shoe that drives them into more pronation that drives this medial calcaneal to to midfoot collapse that then works its way up the chain that causes a problem right and if you do that over stress and then you add terrain to it whether it's the the the natural slant that happens to pull off rain from the road or you're running on trails that you never ran on trails before you're you've got to balance all those factors and low preparation, right?

8:21 And even low tolerance to as you increase the load. So having the resources to be able to do that is huge, both in a performance aspect, as well as just, I just want to get out and be healthier and happier. Yeah. Well, besides your clinical background and your education, you are a runner. How has your experience lacing them up as a runner shaped how you treat runners? Yeah, I think the biggest thing is I can speak the language. I know the terminology. And I was injured quite a bit whenever I ran collegiately. Maybe don't leave with that, though. I just didn't know the knowledge. Back then, I just didn't. I wasn't trained to know what's good, what's bad.

9:04 And through experience, and this happens with all of us, right? Through experience, I was able to find what works, what doesn't. And then even retrospectively, like, now that I have the knowledge that I have, I can now look back and say it's because of A, B and C, right? And this happened because I think this happened, whatever the case is. But now whenever someone comes and approaches me at the clinic or my team, They'll say, I feel this and they'll use some obscure term. It's rarely like I hurt here very much like this with burning pain. And like, it's not this traditional what we learn in school. It's I have this obscure pain and I describe it this way based on my experiences.

9:44 But because I ran and I felt that pain, I usually can navigate where they are. And then first visit, I can have them to buy in what I'm talking about and they trust what I'm saying and doing. That's bigger than almost anything. Having buy-in and trust from a person that comes in to help, they're seeking your help. If they trust me from visit one, our outcomes are going to be drastically better, especially if I have the right path early and not five visits down the road. I think the biggest thing is terminology. Plus, I go out and I run with them. We heavily support the clubs around the area. I go and I run with them. I spend time with them. They see me outside of a clinical setting.

10:26 We have conversations that are not always clinical. We're talking about life and everything. I think that, again, just feeds the narrative of I'm here for them. I'm here to care for them. My team is there to care for them. I think that's a big thing that misses in healthcare. I wasn't planning on going this direction, but you said we support the local running clubs or running community. Yeah. How do you do that? Because I know a lot of people who either open clinics or saying we want to we want to do this. But how do you tactically do that? My guess is it's something terribly simple and basic that has a really great like you don't need to drop fifty grand. You don't need to put on your own race. You might, but you don't need to. So what does it actually look like to support a local running community so other clinicians around the country can learn?

11:11 I think you just get involved. You reach out to the club. We have multiple running clubs around the area. We do a lot of things, but specifically, I talk to every single club here, me personally and my team. We make it known that we just want to help. We're not replacing. We're not trying to get in it's not a turf war it is literally we have the same path that we want to do for our runners and for our community and that's to get people to love running walk around whatever their case is and to be healthier right and so if we can join as that team and i just reach out to them i go to running events i do sponsor multiple races that are around through here we put our own race on the soma main street mile Like we're deep entrenched in that community.

11:55 And then we hold our club run. So every Sunday we have a club run. We go to Track Tuesdays, which is a club run that's put on by the local clubs. Same thing for like Thursday runs. We hold Wednesday in Conway. Like we're just entrenched, but it's because we care. And I think if you truly care for the community, you'll find the paths that go on and you just have to convey that. You paid attention. You paid attention enough to what they were doing and where a gap might be. And it sounds like you approached them not from a place of how do I sell them on something? How do I insert myself here? It sounds like you spoke to learn.

12:37 You led to listen. And we lead to serve, right? I think that's the biggest path. We lead to serve. We're not selling stuff. I mean, I can make an argument, we're always selling. Whether I'm speaking to somebody or whatever the case is, we're selling ourself, we're selling our path, our vision, our service, whatever the case is. But it needs to be led through true servitude. True, like I want to improve somebody's life because I want their life to be better. And if you hear that from me and you see my authenticity, Then that's that's way better than me saying this is for low back pain. I can help your knee pain. There's no buy into that. There's no trust built into that. And so lead with servitude, show authenticity and be part of the community, not as a secondary benefit, but as a primary driver.

13:27 Let me ask you this, though. And then we have to get businessy for a second. And that feels icky for some clinicians because we're blue. All we do is want love, want to give it away. How long did it take for you to see a return on investment? As in, now we can do money, we can measure, right? Because business goals are goals too. And if you don't measure, you don't grow. Yeah. Let's do a business KPI like, hey, we broke even. We made money on this and now we're able to reinvest. Or let's do the warm and fuzzy. When did you start to feel like this is a thing? Let's do both of those. When did it start to break even or make ROI positive?

14:10 I think that is a variable thing. There's some months and even quarters that we make more than others. There's times that we lose. Welcome to life, baby. Yeah. It's a give and take. I think if you look solely, and I've only owned Blue Rose and Blue Rose Running for... Four years, a little over four years. So I'm I'm a novice in all sense of the form of running a business. Right. What I do well, I think I do well is communicate well and I show authenticity and I'm OK going through the ebbs and flows of what's going to happen. Right. And so everything's not a return on investment for me. It's a return on impact.

14:51 Right. We make the money like that. Yep, we make the money work. You still have to look at the bottom line. I am still responsible to pay for my employees lives. They still have to raise their kids. They still have to go and live their life. I still have to support that path. But in the same notion, if everything is a transaction, that's how healthcare is built right now. And I do not agree with it. If everything is a transaction, like I do this, you do this. That is not how life is in any form of aspect. That's not how life needs to be. And so I go look on a return on impact. What's our impact? What's happening on the basis of what we're trying to do? And then is the money supporting that?

15:32 And then how can we create a system that both is we have to make money in a sense to have an impact? That's that's the fuel of what we need to do. If we don't take into that, I'll be out of business and then I can't make any impact. Right. But if we can focus on the impact, make the money work and then create the system to cultivate, I think in years we win both on a business standpoint and an impact standpoint. I didn't think we were going to get that deep at that. I thought the question was all right, but you made it great. That's a new KPI. People are going to be writing. I can hear the audience scribbling out there. ROI, return on impact. That's great. Yeah, that's just something that feeds me, so I'm excited about it. That's great. That's awesome.

16:15 Yeah. Quick break. Looking for an EMR that won't make you want to throw your laptop across the room? Check out Empower EMR. Simple, smart, and built just for PTs. Learn more at empoweremr.com. I can already hear the title of the episode, Logan. ROI, return on impact. I don't know. It's a leader in the clubhouse right now for the name of the episode. Let's take a little bit of a detour. You talk a lot about high value, low cost care. But what does that look like? I feel like that's a term we've talked about since it's been on Twitter or LinkedIn, wherever you're on there, thrown around our profession a lot. But what does that look like at Blue Rose? What does that look like in your clinic model?

16:56 High value, low cost. So I think at a micro level, like our clinic, it's difficult to have a low cost with high value with how our current model is set up, right? We're trying things that are unique to the space that are against traditional modeling of insurance, but that does become difficult. I think that's a macro problem. I think that's a macro path that needs to happen. And so in that sense, i think pts are in a unique position both in our skill set and in um how we are set up inside of healthcare we're in a unique position to help that high value at low cost right we can help save money throughout the system we can provide excellent care because that's how we're trained to do in neuromuscular skeletal care We are trained specifically into that, both on special tests, both on treatment, diagnosis and pushing red flags out and any concerns that we need to refer out.

18:03 We are able to do that. And so we can do that and save the health care community. costs of everything going on. And they've shown in the military aspect. PTs are lead providers for musculoskeletal care in the military, right? And there's studies and models that show we save the system money, which is great. If we can provide great care, great outcomes, get people back faster, and we can help them through their continuum of life, while saving the system money i think that is at least part of a solution that is there um and we just got to keep voicing that and again this is through collaboration uh not through replacement i think that if we can find our path in the system we can help the system and the people that are in it love that uh talking right to the new pt think back to uh twenty fourteen logan pts who aren't sure what kind of clinician they want to be yet I asked this question just a couple days ago on LinkedIn and got some great responses, also some trash responses like, don't join the profession.

19:08 I'm like, all right, that's valid. But what advice would you give to a new PT who isn't sure yet what kind of clinician they want to be? Yeah, I think get as involved as possible, right? Have as many experiences within the profession as possible. You don't know what you love until you experience it. And what gives you the warm and fuzzies? What's gonna lead you into having passion towards that subject? Not a paycheck, we have to make money, but what leads you to a passion? What leads you to something that gets you fired up, that fills you up and that you wanna give to others? Once you find that and then you can make money in that, You're living the dream, right? And then whether you're a key player in the clinic or you're a leader in the field, it doesn't necessarily matter.

19:53 All of it needs it. You just got to find what works best for your life, your path, and then what fuels you. And now that has to still balance with the rest of your life. So it's all very individualistic. But my main goal would be find your passions, create something around that in the PT field, and then experience as much as you can because you might be surprised with what you actually really love and enjoy. Yeah, this is the, have you heard of the, you're sort of reiterating this thing, maybe you've never heard of it, but have you ever heard of the Japanese Aiki guy? I'm probably saying it wrong one way, not the other. So essentially, and I bring this graphic up, not because I was ready, but because I have the graphic so ready because I talk about it with people that I help communicate, and it looks like this.

20:35 So it's just four circles that connect for the podcast audience, and they really just are what you love, what the world needs, what you're good at, and what you can get paid for. And that last one, for some reason, bothers people in health care. Well, you know, we can't make sure. But at the same token, they'll say we're underpaid. And I'm saying then those things need to be met, because if you can't get paid for it, but the other three are hit, you have a really, really great hobby that you're investing in but if this is going to be something you can dedicate your life to it's got to bring some return on investment so you can support yourself for summary i'm trying really hard to beat that out of the profession which is you can do great stuff and make money and reinvest some of that money into doing more great stuff and support your family because that's what we're all here for Yep.

21:21 I couldn't agree more. Sounds like you understand Ikigai without ever actually seeing it. I'm going to look it up. Those four things. And where they cross in the middle, that's what Ikigai is. It's reason for being. That's what the actual term means. When you've found that, you can sort of see it in a person's face, whether they're a plumber, an electrician, a physical therapist. It doesn't matter. When you can see it, they're totally at peace because they're in the middle of those four things. And it gets real unique there. Yeah, I love it. Yeah, I'm going to look it up after this, too. I haven't heard of that. I like the concept. All right. So let's do a hot take moment. All right.

22:02 So I want you to break down how you talk to someone who sits in front of you and says, I'm hurt from running. We talked about before that... You know, running, you're actually injured from other things. But how do you actually tactically communicate that? Because it sounds like you might have to do some unlearning or guiding towards a different idea to get that person to at least be opening open to hear your different point of view. How do you do that with someone? It's tough. Yeah. But to me, it's on the basis of do they trust you? Everything is under the basis. I go back to it often. But if they trust you and they see and they feel what you're saying, I do believe they're more open and receptive.

22:49 If I sound like every other person that they've come in contact with, they're not going to trust me. If I go through the same script of like, well, Tell me what's hurting you, okay? Can you move your knee like this, okay? Well, I think blah, blah, blah, right? I have to build a rapport. I have to understand what their driver is, both at a musculoskeletal level as well as their life, right? They're not this person with knee pain. They're this person that has their life, their reason for running, or let's say it's someone's back pain and they're not able to do things that make them feel valuable, right? And they're led through value and they want to be able to lift their kids up or they want to be able to do this job at work.

23:31 Whatever the case is, I have to find out that first. Once I find that out, once I understand them as a whole, not as an injury, but as a whole, and then I start plucking away like, hey, Running, it actually increases the conjoined in your knee. That's not necessarily the detriments, the biomechanics around it. It's this collapse that could be happening. Whatever the case is, it's all very individualistic. But first, I have to dig into them first, find what their driver is at whatever aspect they're coming in for. Then the musculoskeletal driver, find the problem. and then marry those together and create this story. And then if you create the story, then you can, I think you can actually change their perception.

24:14 It's almost as if the body and the mind are connected, Logan. It's crazy. It's a crazy concept. Which is amazing. People always advocate on LinkedIn or Twitter for changing the syllabus in PT school. It is amazing that we have essentially one prerequisite for psychology, except every single human we talk about. We're really in the behavior change business. I'm not saying throw out anatomy, physiology, ortho, neuro. Don't throw any of it out. But this whole brain thing, I think it's a thing, Logan. I think that's what you're saying. It sounds like it's a thing. At least part of it. Yeah, it's part of it. Yeah, it's a huge thing. It's a huge thing for someone that has maybe been conditioned to think a certain way, whether it's fear, fear avoidance, because someone said they had the worst back they've ever seen.

25:01 Right. Or they have that that set up to just then destroy their confidence and movement. And then you have to unbury that. And it might be fifteen years before they see a PT. Instead of seeing a PT first and be able to go and create movement patterns, find the driver, move this way. It's fifteen years down the road. They've kind of dealt with it. Well, now they are conditioned to feel that pain in certain ways, whether it's increased intensity, the times that it comes on or the fear avoidance associated with it. Whatever the case is, they're conditioned. We're all conditioned certain ways. They're conditioned that way. And then we have to unravel that. That takes time, but most importantly, it takes trust. That's relationship build.

25:42 All right, Logan, it's game time. Are you ready? I'm ready. All right, we're playing Run It or Rethink It. That's what this segment is called. I'm going to throw out some common beliefs in running, physical therapy, rehab, whatever. Your only two options. Should we run with it? Or should we rethink it? And then you can give me a little color while we're doing that. So first up on running to rethink it stretching before a run. I'm curious because I never did this. Yeah, rethink it. Yeah. And it depends. And we can go over it later. It depends if we're talking about static or dynamic. I would assume maybe in relation to whatever someone thinks stretching, they think static.

26:26 Correct. Definitely rethink it. This is me before every beer league men's hockey game watching my forty, fifty, sixty year old teammates. with the leg up on the board up to their, and I'm just like, I can tell you that that's a bad idea, but I'm going to wave. I, you know, I, where do I insert? I'm a teammate, not as PT. So, uh, by the way, I'm all for dynamic warmup. I'm the guy jumping around and getting warm and getting hot, but yeah, stretching never did it. How about this one? Running shoes past three hundred miles. Run with it or rethink it. Yeah, I think, uh, That was tough because there's so many models. You can always say, yeah, this is a physical therapy podcast. You can always pull out.

27:06 It depends. Yeah. Yeah. I would say rethink it. There's, but there's different models. There's some, I would run up into the five hundred range. Yeah. Uh, let's do two more, uh, run to rethink it. Pain means stop running. Rethink it. Hey, why? Because pain can it all depends on what their conditioning has been. Right. Sometimes people feel pain, but that's just discomfort. That's just the stresses of running. And it depends what your running cycle is. If you're a marathoner at eighty miles a week and you're six weeks into your training. You're going to hurt. Right. And a lot of times we can come in. Let's say you're just a you're a general runner that's going and running twenty miles a week just for fitness and you're having a pain.

27:53 Well, it depends where that pain is, what's causing it. And if we can make some biomechanical changes where we just shorten your stride length or we just increase your cadence or we we change the load in some way and then start you on a program. You can keep your running. We just might have to change some of the intensities. It's definitely an, it's not an all or none kind of thing. We just make some adjustments and you're guided that way. So definitely rethink it. Last one we'll do on running to rethink it. Gate analysis for every runner. Run it, rethink it. Rethink it. I think it's very useful for a lot of runners, but I don't think it's for everybody because there are people that have unique gait cycles that are very efficient and look great and they have no pain.

28:39 So there's no need to change their stress load if there is no long-term risk for that. So not everybody, but I think a good amount would benefit from it. Our professors will be excited because that was a trick. Every time you see always or never, that's usually, I shouldn't say always a red flag, but usually a red flag that the answer is not always. All right, last thing we do on the episode, Logan, is called the parting shot. Today it's brought to you by our friends at Go Baby Go. That's the crew that mods toy cars so kids with mobility challenges can tear around like absolute legends. Mobility should be fun. They make it happen. You can too. Learn more at Go Baby Go. All right.

29:20 Parting shot. Your last chance for mic drop moment. Soapbox statement. I already know which one I have, which would be ROI, return on impact. What's your parting shot for today, Logan? Let's go with that. That sounds great. So I think having a path that has the biggest impact is always the way to go. You have to balance everything else in life, both your personal life, professional life, money, all that stuff has a part. However, we're on this earth to serve and that's what we need to do. We need to go and impact as many people's lives as possible in a positive manner. The unfortunate thing with that, and we alluded to in the podcast and with some of the answers, is just that does take money. That takes effort.

30:02 That takes things that are uncomfortable. That's just part of the game. So I think think of life as how much impact can I have both on my family's life? people around me all those things how can i serve in the best way possible and then figure out how to do it right figure out what everything else entails to be able to do that and then uh don't be afraid to be a leader in the field that's that's another thing too i think we need leadership we need pass we need strong voices but also we need to uh we need to make sure we are part of the solution which i think we're positioned to do that so i'm excited for the future with it love it if someone wanted to find you this is time to be shameless uh website how do they find you Yep.

30:47 So Blue Rose Physical Therapy and Blue Rose Running. So if you go www.blueroesphysicaltherapy.com, blueroserunning.com, there's different paths for there. You have access to our clinical sites. You have access to our running, our private coaching, biomechanics, VO two max testing, all these things. You can just find our information. Plus we're on Instagram, Facebook. Look us for that. We'll put that all in the show notes. We usually share that pretty well. That'd be great. And thanks to APT Arkansas for connecting us, man. We appreciate that. Yeah, it's been great. I appreciate you having me on the show. I look forward to hopefully another time. Logan, appreciate the time, man. Thanks for coming on the show. Yeah, thank you.