Feb. 18, 2026

Sorry Karen — Your PT Has Tattoos

Sorry Karen — Your PT Has Tattoos

Live from APTA CSM in Anaheim, Jimmy talks with Dr. Jenn Bell about redefining professionalism in physical therapy.


They discuss:

  • Where traditional professional norms came from
  • Who those norms disproportionately impact
  • Why authenticity affects burnout
  • Why recruitment without belonging fails
  • The shift from diversity → equity → inclusion → belonging
  • What PTs must let go of to evolve


If your clinic wants to recruit and retain strong clinicians, this conversation matters.


Key Takeaways

  • Professionalism has historically centered a narrow identity standard.
  • Underrepresented clinicians carry extra cognitive load when asked to “code switch.”
  • Burnout is worsened when clinicians can’t show up authentically.
  • Recruiting diversity without creating belonging is performative.
  • PT leaders must examine their own biases and expectations.


Transcript
WEBVTT

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Go.

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A little time-lapse photography.

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Oh, very nice.

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It's pretty sharp.

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Yeah.

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It's beautiful here.

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Live again from APTA CSM here at Anaheim,

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California.

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I want to say thanks to Empower EMR.

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If your clinic is stuck in an EMR

00:00:20.455 --> 00:00:21.977
that slows you down, that's your fault.

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You did that.

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You can also undo that.

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Empower EMR gives you speed,

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clean workflows,

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and features PTs actually ask for.

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Upgrade your clinic's brain with Empower

00:00:32.146 --> 00:00:34.287
EMR at empoweremr.com.

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That is empoweremr.com.

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If you've ever been told...

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To look more professional without anyone

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defining what that actually means,

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this conversation is for you.

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I'm looking at you.

00:00:47.534 --> 00:00:48.735
Our next guest has spent her career

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expanding access to care and challenging

00:00:50.576 --> 00:00:53.197
narrow definitions of who gets to belong

00:00:53.216 --> 00:00:54.637
in this profession and who doesn't.

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Live from Anaheim, Jen Bell,

00:00:56.758 --> 00:00:57.378
welcome to the show.

00:00:57.518 --> 00:00:58.679
Yeah, thanks for having me.

00:00:58.698 --> 00:01:00.619
Thanks for taking time here during the,

00:01:00.640 --> 00:01:01.320
well, it's a little busy.

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A little bit of chaos.

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So it's a little bit of an unusual

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intro, right?

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So how do most PTs define professional?

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And where does that fall short?

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Yeah, definitely.

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Well,

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I think a lot of the definition of

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professional demeanor,

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professional appearance comes from kind of

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the classic white male heteronormative

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perspective that kind of governed health

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professions forever.

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And so that's the definition that's been

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handed down to us from other healthcare

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professions that came before us.

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And it's the one that's stuck around.

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The problem with that is that it's not

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who our patients are.

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And the world's changing.

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Yeah.

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That's not who we're actually have a

00:01:42.158 --> 00:01:44.278
mission to get more of into our

00:01:44.319 --> 00:01:44.778
profession.

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And it's not having to conform to those,

00:01:48.441 --> 00:01:50.902
those normatives around professional

00:01:50.921 --> 00:01:54.524
behavior and demeanor and appearance burns

00:01:54.543 --> 00:01:55.144
people out.

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And so these are three big problems that

00:01:57.165 --> 00:01:57.965
are professional right now.

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How do we connect with patients where they

00:02:00.427 --> 00:02:01.847
are to have good patient centered care?

00:02:02.454 --> 00:02:04.897
How do we recruit and retain diverse

00:02:05.177 --> 00:02:07.340
people to enter our profession and help

00:02:07.361 --> 00:02:08.662
them to feel like they belong there?

00:02:09.263 --> 00:02:10.563
And then how do we prevent them from

00:02:10.644 --> 00:02:10.965
burning out?

00:02:10.985 --> 00:02:11.784
Yeah.

00:02:11.846 --> 00:02:12.747
It's huge.

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World changed.

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Not that long ago.

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Having a tattoo was like, I mean.

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Yeah.

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It was sacrilege.

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And now,

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I don't know if it's a two on

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a scale of one to ten,

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but sometimes people will react that way.

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Having a piercing anywhere but a standard

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location was sacrilege.

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I worked at a job in rural Alaska

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and the email comes out with a reminder

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about the dress code.

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You're only supposed to have nail polish

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that's red or pink.

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and like all of these like just archaic

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definitions of like what's acceptable and

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i'm like in the world decided pink and

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red are okay but like blue or orange

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isn't like it's just absurd and you said

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that was in rural alaska yeah i mean

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i gotta be honest when you're that far

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away from help like the rules nobody cares

00:03:01.854 --> 00:03:03.355
right like what are we what are we

00:03:03.395 --> 00:03:04.437
doing what are we dictating

00:03:04.516 --> 00:03:07.300
yeah but even as recently as this summer

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i had a student tell me that someone

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told them like you're not gonna go into

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the clinic with your tattoos showing are

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you and it's like and the student was

00:03:15.528 --> 00:03:16.469
like how would you like me to do

00:03:16.590 --> 00:03:18.532
that right and it's like that's not the

00:03:18.551 --> 00:03:20.774
world that we live in right now if

00:03:20.993 --> 00:03:22.695
we continue to maintain those narrow

00:03:22.756 --> 00:03:24.919
definitions we're really gonna run people

00:03:24.938 --> 00:03:25.139
away

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Right.

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You're going to miss treating people and

00:03:28.098 --> 00:03:29.941
you're going to miss the people that treat

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those people.

00:03:30.942 --> 00:03:31.883
Yeah, exactly.

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And that make us better SPTs.

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Who gets marginalized most by traditional,

00:03:36.748 --> 00:03:37.370
I'll use air quotes,

00:03:37.409 --> 00:03:38.812
traditional professional norms?

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Who does it affect the most?

00:03:40.933 --> 00:03:41.473
Yeah, certainly.

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Well, I mean,

00:03:42.014 --> 00:03:43.955
we're a profession that has a lot of

00:03:43.995 --> 00:03:45.314
women in, and that's great.

00:03:45.835 --> 00:03:47.616
But I see some of the biggest impacts

00:03:47.795 --> 00:03:50.156
are in people of color,

00:03:50.276 --> 00:03:52.137
women of color that are coming in,

00:03:52.217 --> 00:03:54.356
and then also our gender nonconforming

00:03:54.757 --> 00:03:55.798
members of our profession.

00:03:55.897 --> 00:03:57.638
They are the ones that are,

00:03:57.918 --> 00:04:00.679
how they show up is always appreciated or

00:04:00.718 --> 00:04:01.538
respected, right?

00:04:01.598 --> 00:04:01.878
And so

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You know,

00:04:02.960 --> 00:04:04.300
I don't want my students when they're

00:04:04.320 --> 00:04:05.901
graduating to have to worry about whether

00:04:05.921 --> 00:04:08.204
or not they should put their pronouns on

00:04:08.243 --> 00:04:09.004
their CV.

00:04:09.044 --> 00:04:10.626
It's like if it's important to you,

00:04:10.665 --> 00:04:11.967
you need to put it on your CV.

00:04:12.448 --> 00:04:12.608
Right.

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And you don't want to work for someone

00:04:13.848 --> 00:04:14.830
who isn't going to respect that.

00:04:15.830 --> 00:04:18.052
So really thinking about the

00:04:18.153 --> 00:04:20.194
underrepresented people in our profession

00:04:20.254 --> 00:04:22.115
are the ones that are getting impacted by

00:04:22.156 --> 00:04:24.257
these these older, more traditional norms.

00:04:24.278 --> 00:04:24.377
Sure.

00:04:24.398 --> 00:04:24.497
Yeah.

00:04:25.579 --> 00:04:26.500
Why does this matter now?

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Well,

00:04:28.476 --> 00:04:29.737
we're doing so much stuff to try to

00:04:29.757 --> 00:04:31.678
diversify the profession and recruit

00:04:31.699 --> 00:04:32.220
people in,

00:04:32.540 --> 00:04:35.382
but we have to accept them when they're

00:04:35.423 --> 00:04:36.624
here as they are.

00:04:36.723 --> 00:04:38.446
And then we have this huge burnout issue.

00:04:38.526 --> 00:04:40.586
And so when we're constantly telling

00:04:40.627 --> 00:04:42.829
people that you need to code switch in

00:04:42.848 --> 00:04:43.449
the workplace,

00:04:43.490 --> 00:04:44.911
that you need to not show up as

00:04:44.930 --> 00:04:45.732
your authentic self,

00:04:45.771 --> 00:04:47.834
you need to dress up to look like

00:04:47.874 --> 00:04:49.656
what we expect a PT to look like.

00:04:50.255 --> 00:04:51.956
That's adding additional cognitive load.

00:04:51.976 --> 00:04:54.036
Layers and barriers and all those things.

00:04:54.096 --> 00:04:54.637
Exactly.

00:04:54.716 --> 00:04:55.838
And so, of course,

00:04:55.937 --> 00:04:58.358
those people are going to burn out faster

00:04:58.379 --> 00:05:01.720
because they're not able to fully relax as

00:05:01.740 --> 00:05:03.399
their true selves in the workplace.

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What do students understand about

00:05:07.161 --> 00:05:07.922
authenticity,

00:05:08.081 --> 00:05:09.161
which is a word I don't think was

00:05:09.262 --> 00:05:09.382
used.

00:05:09.882 --> 00:05:10.982
It's being used a lot more now,

00:05:11.002 --> 00:05:13.663
especially when you can generate anything

00:05:13.682 --> 00:05:15.543
you want with artificial intelligence.

00:05:15.584 --> 00:05:16.744
But what do students understand about

00:05:16.824 --> 00:05:18.185
authenticity that maybe the profession

00:05:18.204 --> 00:05:18.964
doesn't?

00:05:19.288 --> 00:05:20.428
forgot.

00:05:20.569 --> 00:05:22.689
Yeah, I think the, you know,

00:05:23.230 --> 00:05:24.829
most of the students coming through are

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those younger generations.

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We have some non-traditional students

00:05:27.069 --> 00:05:27.410
coming through,

00:05:27.750 --> 00:05:31.310
but they see that they can show up

00:05:31.391 --> 00:05:33.732
in these diverse ways and be respected.

00:05:33.752 --> 00:05:35.591
They're seeing, you know,

00:05:36.052 --> 00:05:38.692
people on social media that are medical

00:05:38.732 --> 00:05:39.353
professionals,

00:05:39.372 --> 00:05:43.213
that are leaders that aren't conforming to

00:05:43.293 --> 00:05:44.752
the white male heteronormative

00:05:44.834 --> 00:05:45.713
expectations.

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And so they're seeing it as

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they're coming in and they're expecting us

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to welcome them in in that way and

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we really only have ourselves that are

00:05:54.596 --> 00:05:56.377
going to hold them back right and so

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we've got to we've got to open our

00:05:57.576 --> 00:05:59.197
eyes we need to do some self-reflection we

00:05:59.218 --> 00:06:01.278
need to stop and pause and think about

00:06:01.939 --> 00:06:04.439
what is it as for me as a

00:06:04.500 --> 00:06:06.639
white woman what are my biases that i

00:06:06.699 --> 00:06:08.221
hold i need to figure out what they

00:06:08.261 --> 00:06:10.942
are check them think about how i might

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be interacting with young people coming in

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how am i connecting with my patients to

00:06:14.583 --> 00:06:16.624
be able to really um

00:06:17.403 --> 00:06:21.245
open up and allow these diverse

00:06:21.627 --> 00:06:24.267
individuals to really fully be themselves

00:06:24.307 --> 00:06:24.887
in our profession.

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All right.

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You got a magic wand.

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Yeah.

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Which belief do PTs need to let go

00:06:29.370 --> 00:06:30.651
of first?

00:06:30.992 --> 00:06:31.791
And you get to decide.

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No pressure.

00:06:32.093 --> 00:06:32.492
No pressure.

00:06:32.512 --> 00:06:34.874
Because no matter what you say,

00:06:34.913 --> 00:06:35.995
you're going to pick the wrong one to

00:06:36.035 --> 00:06:36.795
someone.

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What do you think?

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What do you think they need to let

00:06:38.355 --> 00:06:38.916
go of first?

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Us, we, we can own it.

00:06:40.658 --> 00:06:40.858
Yeah.

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No,

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I think we need to let go of

00:06:43.678 --> 00:06:46.161
our expectations that a couple of things.

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Our expectations that PTs are always going

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to continue to look the same way.

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I'm sorry,

00:06:51.625 --> 00:06:53.086
but we've put a lot of our khakis

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and polos and sneakers away.

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Yeah, we can ban that, right?

00:06:55.572 --> 00:06:56.612
Yeah, for sure.

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Sorry to my friend Anna who has it

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on right now.

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And we need to set aside the expectation

00:07:03.795 --> 00:07:04.634
that, well,

00:07:04.915 --> 00:07:06.055
I had to do it this way.

00:07:06.237 --> 00:07:07.817
So you have to do it this way.

00:07:07.877 --> 00:07:11.701
Like luckily these younger generations are

00:07:11.721 --> 00:07:12.982
coming in and I'm forty four,

00:07:13.021 --> 00:07:13.822
so I'm not that old,

00:07:13.862 --> 00:07:14.642
but I am that old.

00:07:15.322 --> 00:07:16.204
They're coming in with different

00:07:16.244 --> 00:07:18.745
expectations of what the workplace means

00:07:18.766 --> 00:07:19.185
to them,

00:07:19.245 --> 00:07:20.687
how they show up for their patients and

00:07:20.726 --> 00:07:21.108
connect.

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And we have a ton to learn.

00:07:23.209 --> 00:07:24.189
So we need to let go of our

00:07:24.290 --> 00:07:25.951
old expectations and learn.

00:07:26.911 --> 00:07:27.851
through reflection,

00:07:28.072 --> 00:07:29.932
of being curious with people that are

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coming in that are different than us so

00:07:32.194 --> 00:07:34.134
that we can all make the profession better

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and for our patients to get better faster.

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Yeah.

00:07:36.315 --> 00:07:36.836
All right.

00:07:36.875 --> 00:07:37.817
We've got a tradition on the show.

00:07:37.857 --> 00:07:38.976
It's called the parting shot.

00:07:39.016 --> 00:07:39.237
Yeah.

00:07:40.057 --> 00:07:40.677
What's the last,

00:07:40.798 --> 00:07:41.918
we're doing fast episodes here,

00:07:41.939 --> 00:07:44.199
but what's the last idea you'd want to

00:07:44.220 --> 00:07:44.980
leave with the audience,

00:07:45.019 --> 00:07:46.680
your mic drop moment or your soapbox

00:07:46.701 --> 00:07:46.920
statement?

00:07:46.940 --> 00:07:47.360
What do you got?

00:07:47.685 --> 00:07:49.507
Oh,

00:07:49.526 --> 00:07:51.187
I think it's really important that we're

00:07:51.228 --> 00:07:54.209
continuously growing and changing as

00:07:54.290 --> 00:07:55.130
professionals,

00:07:55.230 --> 00:07:57.452
and that can include the way you look,

00:07:57.473 --> 00:07:58.713
the way you talk, the way you dress,

00:07:58.834 --> 00:08:01.576
and that there's true value in showing up

00:08:01.637 --> 00:08:03.877
authentically for our colleagues and for

00:08:03.898 --> 00:08:04.399
our patients.

00:08:04.737 --> 00:08:05.819
We're going to be better for it.

00:08:05.999 --> 00:08:06.278
Yes.

00:08:06.319 --> 00:08:06.839
Right?

00:08:06.920 --> 00:08:07.600
Absolutely.

00:08:08.261 --> 00:08:10.603
We're going to be better people just in

00:08:10.642 --> 00:08:12.843
general, but also better PTs and leaders.

00:08:13.524 --> 00:08:13.985
Absolutely.

00:08:14.045 --> 00:08:16.507
DE&I is three letters that I don't know

00:08:16.526 --> 00:08:17.908
if they were talked about that much ten

00:08:17.947 --> 00:08:18.488
years ago.

00:08:18.509 --> 00:08:19.970
And when someone's against that,

00:08:19.990 --> 00:08:22.031
I guess someone said it way better than

00:08:22.071 --> 00:08:22.110
me.

00:08:22.130 --> 00:08:22.432
They're like,

00:08:22.471 --> 00:08:25.994
so you're okay with the opposite of DE&I,

00:08:26.014 --> 00:08:28.016
which is the opposite of diverse is

00:08:28.076 --> 00:08:28.757
homogenous.

00:08:28.776 --> 00:08:29.357
Right.

00:08:29.591 --> 00:08:32.099
right, equitable, inequitable, right,

00:08:32.178 --> 00:08:33.383
diversity, equity, inclusion,

00:08:33.403 --> 00:08:34.326
you like exclusion?

00:08:34.826 --> 00:08:36.471
If anybody, when you put it like that,

00:08:36.513 --> 00:08:36.854
it sounds,

00:08:37.798 --> 00:08:37.999
Right.

00:08:38.298 --> 00:08:38.940
Not great.

00:08:39.000 --> 00:08:39.259
No.

00:08:39.580 --> 00:08:41.361
And we've got to go that step beyond

00:08:41.381 --> 00:08:42.221
that to belonging.

00:08:42.241 --> 00:08:42.643
Right.

00:08:43.023 --> 00:08:44.264
So not just make it right.

00:08:44.283 --> 00:08:45.024
Not just right.

00:08:45.085 --> 00:08:45.965
Not just, you know,

00:08:46.365 --> 00:08:47.546
bring these folks into the profession,

00:08:47.566 --> 00:08:49.447
but to help them to develop that sense

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that they belong.

00:08:50.828 --> 00:08:51.208
Sure.

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In the profession, in the clinic with us,

00:08:53.750 --> 00:08:56.192
with their patients and also making sure

00:08:56.212 --> 00:08:57.974
our patients feel like they belong with us

00:08:58.053 --> 00:09:00.035
and that we can relate and connect with

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them.

00:09:00.395 --> 00:09:00.817
Exactly.

00:09:00.836 --> 00:09:02.077
Jen Bell, where can people find you?

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Where would you send people to find you?

00:09:03.379 --> 00:09:05.961
Yeah, so my Instagram handle is JenBell,

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and I am a professor at Tufts University,

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so you can find me on the Tufts

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University DBT Phoenix website.

00:09:13.811 --> 00:09:14.150
Jen Bell,

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appreciate you stopping by here at the

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live stream at CSM.

00:09:16.714 --> 00:09:16.875
Thanks.