[00:00:01] Nick: On this episode of “In The RACK” podcast.
[00:00:04] Hayden Gray: And you're right, those chain clinics, the ones that are kind of every you see him on every corner and almost they're like a Dunkin Donuts, they breed mediocrity and the mediocrity comes in the form of for the patient's care. And then sometimes like you said, some people need that. But also at some point, you could be the best.
[00:00:29] PODCAST INTRO: Welcome to “In The RACK” podcast, where we provide you with the practical framework for breaking PRs in all facets of health and wellness. We are just a couple of bros giving you the simple house in a world of complex wants. No filters, no scripts, no rules, just straight talk. Now, let's get into the rack with your hosts, Dr. Chad and Dr. Nick.
[00:00:55] Chad: Alright, everyone. Welcome to “In The RACK” podcast. I'm your host, Chad and with me is my co-host, and fellow physical therapist, Nick. I've been looking at other ways to kind of preface this, we're going to probably have to change it anyways, soon. But Nick may not be the co-host for much longer. I'm just saying. I'm just saying. And I'm only saying this for two reasons. One is, I'm being shaded by my employees. The second reason is, the second reason is everybody needs to go read Nick's latest blog post. Because if you haven't read Nick's latest blog post, he clearly states that he is now not only the face of ProForm. But Taylor runs the show. Karissa is the fan favorite. And just the other day, Taylor got busted, and said that Nick is the biggest asset did say biggest asset in the company. She did say that. She did say that.
[00:01:58] Nick: So welcome to my podcast.
[00:01:59] Chad: So welcome to Nick's podcast. So basically, all I'm saying is, I can see the writing on the wall. But no, I joke about this. I know Nick's been here for a while. And I think it's a great testament to the employees that we have here. I think it's a good thing means I hired the right people. I think everybody's enjoying themselves. And I'm getting replaced. And I'm cool with that. I'm cool with that.
[00:02:22] Nick: No, you can't be replaced. You can't be replaced.
[00:02:25] Chad: And Nick said, I just own the place which is true.
[00:02:29] Nick: Which is a big deal. So big deal. But seriously, check that, I'm pointing to the camera. You gotta check that blog. It's actually some good stuff that we're getting into it at ProForm. So check it out. And then if you're like, “Man, this is really cool. Give us a call.”
[00:02:48] Chad: And speaking of hiring the right people, we've got our new PT here, Hayden Gray. And he's new PT. And we just hired him this week. And he's actually going to be starting next week. So it's gonna be sweet. We're looking forward to that. And we have him on the podcast today to not only welcome him to the team, but to the podcast. But we want to kind of pick Hayden's brain because he just graduated from PT school. So we want to talk a little bit about that we want to talk about a little bit about his clinical experience as well as his experience through PT School and how PT School has maybe changed since we've been PT School. So Hayden, why don’t you tell us a little bit about yourself?
[00:03:30] Hayden Gray: First of all, thanks for having me on. And thanks for having me on the team. I'm super excited and can't wait to get going. So I graduated from undergrad in 2020 from UMass Amherst, I was on the “Track and Field” team as a sprinter. Following undergrad, I went right into PT School at MCPHS University, where I started in kind of a hybrid model because of COVID. So our labs were in person, but the majority of our classes were online. In my second year, we switched to fully in person, which was great, because then we kind of got to meet more people and get more involved. And then this last year was on my clinical rotations, and was able to move through those. And it was a great experience for me, and I'm looking forward to moving on and graduated in May.
[00:04:12] Nick: Nice, man. That's awesome. That's awesome. So let's go back that I want to start at the beginning then. So only in person for labs, that's kind of interesting. That is interesting.
[00:04:23] Hayden Gray: Only in person for lab just because of COVID, when I started, it was when COVID was heading. So they wanted to kind of keep us in small groups, and they split us into people who lived on campus. And then also people who are commuting. So I was in the commuter groups, I was living at home. So there was just a group of four of us, and we would just meet for labs, and we would just stay within that group of four, which was good just to kind of minimize the risk at the time. But it was nice because one I got to know those people really well. And they ended up being some of my close friends but to you kind of get to know them and how they work. So it was like a good kind of team environment. So it was good.
[00:04:52] Nick: Interesting. How did they do, this is just random. How do they do tests and stuff like that? Did you have to go in for tests?
[00:05:01] Hayden Gray: Not in my first year. We were online. No, it wasn't Zoom. It's called exam soft. So it actually locks your screen and film, it designed to like be eye tracking and you can't ignore the browser or anything like that.
[00:05:14] Chad: I'm actually kind of glad I'm not in school now.
[00:05:17] Hayden Gray: think that would have stressed me out more than it was tough. Because I had two dogs who had just like, exam and like it had like tract noise. So you get a flag if there was too much noise. Or if you were like, moving.
[00:05:32] Chad: Interesting. That's crazy.
[00:05:34] Hayden Gray: That's why it's way more stressful. I feel it was kind of brutal. Honestly, sometimes obviously, with Wi-Fi with people walking in and out. Things go out and like things. Like, you'd have to email a professor and like, get a new code to login. And it was just kind of it was tough. , it's way more stressful.
[00:05:52] Chad: So how many kids you have in your class?
[00:05:54] Hayden Gray: There's 40 of us.
[00:05:55] Chad: So how many kids did you start with in your first year and how many kids are you finishing with?
[00:06:00] Hayden Gray: So we started with 40. And I think we have about 34.
[00:06:05] Chad: That’s pretty good.
[00:04:23] Hayden Gray: Actually, I think we started at like, 32 or 35. And I think we finished with 18.
[00:06:14] Nick: Well, I think we started at 40. I know, we started at 45. And I think we graduate. I think it was 39. But I can't remember the exact number like the six.
[00:06:24] Chad: How did you feel that PT School prepared you for? And I know you really haven't kind of like been out “Yet”. But in terms of like your clinical? How do you feel like PT School prepared you to kind of go out and start treating patients and your clinical?
[00:06:41] Hayden Gray: I actually had this conversation with somebody, I think yesterday, maybe. I think PT school actually prepared me fairly well, like I actually felt confident within, we had a pro bono clinic at school. So we kind of got we're able to get like hands on experience right away. So that was kind of like a benefit, like where we could apply their knowledge in there, like right after we learned it, which is cool. So I think that kind of model of being able to apply the learned knowledge, like immediately throughout your first, second and third year, kind of help flex information. So I would say it prepared me pretty well.
[00:07:13] Chad: But did you find that your program prepared you better for one type of setting versus another?
[00:07:18] Hayden Gray: Yeah, absolutely, outpatient.
[00:07:22] Chad: Outpatient, that's interesting, because I had the exact opposite experiences that and, and I think that really all depends on who the director of your program is personally, the director of my program was very much into inpatient. And so anytime that we had a bunch of clinical rotations on our sheet, there were minimal outpatient orthopedics and a ton of impatience.
[00:07:45] Nick: I think a lot of times too, it depends on the recent history of the licensure exam as well, because I remember, when we were going through it, they just kept harping on the past. However, many years had been very, like inpatient oriented. So when I was in school, there was this big change, where now the PCs were getting into the ER at the time prior to that they weren't really there. So there was this influx of that, and with that whole thing coming up, I think they shifted gears on the licensure exam to say, let's include more of this because now it's a thing. So they were getting more into like red flags, where it's like, why do I need to know this, but they do spend some time in the ER, where you're in there with trauma people and all that kind of stuff. So that was a big focus then. So I wonder if the exam has shifted to more outpatient.
[00:08:38] Hayden Gray: I think it based off of the material I'm seeing, he kind of has, I think we just kind of felt like where we were taught with acute care and like all like cardio, palm and all that type of stuff. I feel like it kind of lacked a little bit. It gave us all the necessary information we need to know. But I felt like there was no practical application of it until we finally moved into our like inpatient rotation. I was in a hospital for my inpatient rotation where we were actually like, in the ER in the ICU on the med surg floor, on the cardiac floor. So it was kind of allover that hospital. So I feel like with that experience, that kind of solidified more of the knowledge for me because I was charting and reviewing all day long, and like monitoring their lab values, so that way, I can kind of know them for saw them. And that kind of solidified it for me.
[00:09:26] Nick: I kind of liked that they shifted more towards outpatient honestly, because I know PT in general started as a profession more so in the hospital. So it was more of an acute care, inpatient type of thing. But now we're seeing obviously a huge influx of people dealing with outpatient related issues, or issues where they will be referred to outpatient physical therapy. So I think that's a huge thing. And the other thing is like when you go inpatient, I don't want to call it simple, but in general the physical therapist is there to get you moving. Obviously, make sure you're safe doing that but just get you up and moving because most people in that instance aren't getting adequate enough movement. So the rehab in those instances is a little bit less. There might be complex comorbidities at play. But in terms of what you're doing from a rehab standpoint, it's a little bit more simplified than outpatient can be sometimes you're trying to balance oh, this person wants to get a better golf swing, but they also want to hike and they also want to do this. And now you're trying to kind of loop all that stuff in and get them back into those types of activities, as opposed to like, we just need to walk. We need to get the move.
[00:10:32] Chad: I feel like when you say simple, or simplified, I feel like there's less differential diagnosis kind of going on your know why they're there. It's already been determined.
[00:10:43] Nick: Simple is a tricky word. Like, you say my say everyone. It's simple.
[00:10:48] Chad: That's also the beauty of physical therapy. Like, it's nice that we have a million different sub specialties within the profession, so that it gives people multiple different options. Again, we're not saying that one is easier. One is harder. But they all are necessary in the grand scheme of things. But I will say that I've been in most of the settings. And I will say that outpatient, I think, is the most challenging in terms of differential diagnosis not challenging working with certain patients, I know that that some patients can be very hard to deal with in the hospital setting as well.
[00:11:22] Nick: Just think about too impatient. Yes, all of us spend time there, your meeting, typically with the nurses, doctors, like at some point about this person's plan of care. So everyone's kind of on the same page. So you have all these other providers that have a different lens and how they look at it. So you're getting all this information about this one person. So the amount of information you get about that person is insane in the hospital. It's so much like you take so much time looking through all that stuff. Outpatient, we know all the time people leave stuff out, like they they're like, actually, I forgot to tell you like, I'm also had this crazy major surgery last year, I totally forgot people just totally, absolutely admit stuff.
[00:12:00] Hayden Gray: It's like with direct access changing now to like, where people can just come in and see, but you really kind of have to know what you're dealing with and how to assess and treat.
[00:12:06] Chad: Do they talk about direct access? And did they talk about, like, the professional physical therapy besides what you need to know, for the boards when you're in school?
[00:12:17] Hayden Gray: Actually, it was more of like open conversation stuff. I feel like that would maybe branch off of what we were talking about in a lot of our professors, they really drill something home because you guys need to know this, because Direct Access is a big thing. Now people are coming into the clinic with no referral, like you need to kind of know what you're doing. So I guess kind of in that sense, they talked about that. But there was also like other things unrelated to, let's say burnout, for example. Like we'd go off on tangent about burnout, we've talked about other things like related in the clinic that just aren't related to the board exam, which I thought was like, that's awesome for in some senses.
[00:12:51] Chad: I definitely didn't get that when I graduated like 15 years ago. So I know that lots have changed since then. But we had this one professor, I remember. And it was in Rhode Island. That's where I went to school. And he was on the board of physical therapy at Rhode Island, and on the Rhode Island chapter of APTA, and he’d spend 15 minutes before we went into the actual curriculum, and talk about what the last meeting was about, because all that stuff affects us and my director did not like that. And he ended up losing his job, like, within probably two years after that, and he was well established, he was a PT for over 30 years at that point in time. So I'm glad that they're doing that because it needs to happen, number one. But number two, it's also nice when they can take other. So for example, if they take like an adjunct faculty, so somebody that's actually out in the field doing it, bring them in, so they can show people hey, this is what's actually going on out there. That's always nice too. And not because in my experience, all of the professor's maybe minus one had not been practicing for about at least 15 years, out of the loop, completely zero idea which helped us no way like they were just by the book and I'm glad that things have changed like that, because things are changing with physical therapy. It's not what it used to be, it's not even close. And you're seeing it just now just from being here. But it's going to become more of a movement going forward where physical therapy is just not physical therapy anymore. Like, Nick, diving into functional medicine. We do nutrition training, like it's all just under this big umbrella holistic.
[00:14:34] Nick: In school, did they talk about cash based clinics at all with you guys?
[00:14:30] Hayden Gray: Not like in depth. We did take a course that kind of covered I think it was more of I want to call it like an insurer. It was almost like an insurance course I forget the actual course we went over all of let's say like billing and coding guys what the course was. We dove into it a little bit. In that class, but not to an extent where I knew 100% about it when I was leaving that class, but they talked they touch base on it, which was nice. It was interesting. We had a couple guys. And so my buddy Mike, he kind of always knew he wanted to be in a cash base any he didn't want to work at all and insurance base. So right out of school, he kind of had a job lined up that was in a gym. So it was a cash base opportunity. So he was always asking questions related to that. And the professors were always so determined. They were like, “No, that's not that's not a thing that doesn't make sense, it's not going to work, basically, is the way they would kind of shut it down.” And he was just like, it works. Like there's plenty of people I know, that I've talked to, and there was another person who was in my class that was in the same kind of the same mindset. So they would constantly ask questions about it. And at a certain point, I kind of got annoyed and I was like, “Guys, they've given you the same answer every time just stop asking the question, that's where my head went.” But they were ahead of their time, for sure. And at that time, the professors would just try to shut it down, kind of sway you against, and I think it was more, so they just didn't know, which they didn't know, whatever. But they could also said that, so that won't happen, it won't happen.
[00:16:16] Chad: For sure, totally. And that was not a thing when I was in school, either. In fact, I was actually just talking to my first boss that I had when I graduated, because he knows that we've transitioned our model completely. And he's like, man, we got to talk. So I talked to him, and he's like, but it's just not gonna work my area. You just don't understand my hair. And I was like, “No, I do understand your area. And I have three colleagues that are also in your area that are doing it.” And I know, they're crushing it. And it's like, I don't know, you're not ready, you're just not ready, like you've been out for too long. And not just saying that you can't do it, but you're so comfortable in the situation that you're in, it's going to be hard for you to make that transition because you don't know any other way. And I think it's just one of those things where there just needs to be more like social proof of people doing it, which is becoming more and more of that. And as more and more proof comes out that more and more people are going to start believing in the model.
[00:17:10] Nick: Same idea in March Madness, it's just pertinent in my brain. But the upsets always kind of happen, but never did a high seed go on that far. And then it did happen. And once it happened, all the other seats were like, we can actually go to the NBA. That's pretty cool. We can go to the Final Four. And now we see it all the time. We see these double digit seats going on for and it's like as soon as it happened once there's the belief room now, so that mental component is huge, it could make or break where the future your business goes. That's why we need you as the owner, Chad. Now I know. It's why I'm here. I'm not gonna be here. You got that growth mindset. You might be in the office or something wherever the business that's fair. That's fair. Let me go within.
[00:18:06] Chad: So we kind of touched on your college background, your experience in PT school, let's talk a little bit about the clinical experiences that you've had. So dive in a little bit in terms of the different and what do you have to do three clinical. So in those three clinical, what different settings were you in? Like? What were your experiences whether it be with your CI, whether it be in the environment, culture, that kind of stuff?
[00:18:30] Hayden Gray: Like you said, I do three clinical rotations. My first rotation was just an outpatient clinic in another town around here. My second was in a hospital setting, a very small hospital called Haywood hospital and Gardiner mass. And then my third was in South Carolina at Carolina, Sports, medicine and PT. All of them I took away like a lot of information from like, I think starting out at a general outpatient clinic was a great introduction to like what physical therapists in that field do. It kind of also opened my eyes into, how that setting can get super busy and super crazy, and you have patients every half hour. And it takes a lot of planning and like moving around to get people in and out of the door there. You kind of have to be efficient with your plan of care, which I think is great, but it felt like I was rushing almost to get my patients in and out. Which I just didn't appreciate. And that was like a good takeaway for me because I knew immediately after that rotation that that was just not what I wanted to do. I knew I want to work one on one with people for longer durations. My second clinical rotation was cool like it was in a small hospital acute care like I said earlier, I was on the like almost all the floors in the hospital, which was a great experience but I also knew that that wasn't the setting I truly want to go into just because it's a lot like they don't teach you like that when you go into those places and PT School that was one of the things I felt unprepared with was like the people who are in there like very sick like they That sickest they've ever been most likely. And having to deal with that is difficult. Like, it takes a toll on you kinda. So I knew immediately after that when I was like, this is not setting for me. And then my third was in a private practice, it was a great experience, like my CI was great. She was very knowledgeable, probably one of the most knowledgeable instructors I had, which was great. She taught me like, taught me a lot. But like I said, a couple of times, like threw me to the wolves which was a good learning experience, but it kind of makes you uncomfortable, it makes you uncomfortable sometimes. And like, when you go into something, and you don't know about it, like you feel like, al, what I'm doing isn't effective. But at the same time, like you're learning, you need to realize that.
[00:20:47] Chad: So I think there's like pros and cons to that type of situation. And I think that the pro is, you need to know what it feels like to be uncomfortable, because you're gonna be in those situations. So you don't want it to ever be your first time like, for example, here you're not going to ever feel uncomfortable, because you already know what that feels like. But I also say shame on the CI for doing that, because I know a lot of students in the past and even myself, I've had one bad experience. I had one great mentor, that was an amazing CI and I'll never forget his value, but it's one of those deals where they utilize you as an extra pair of hands. And that should not even be fucking allowed. That's just shit. And I think that needs to stop, and I think that whoever's doing that, and the program starts to realize that they need to take that shit off the list because that does nothing for the profession. It does nothing for the students going through the process is that for just utilizes you, and an already busy PT mill, and they're just trying to get a little extra money out here and I think that's crap. So free work are totally right. And for any CI that's doing that, either stop or just stop taking students. That's just not.
[00:22:00] Hayden Gray: There were some times where you definitely feel like that that's going on, luckily, is going on. I feel like luckily for me, like I don't, it doesn't like I can, like I don't care. Like it doesn't bother me that much. I also understand and I never like would probably never vocalize it like if I felt I was being taken advantage of like, especially they're like I'm there to my job, and, and out of there and get my clinical rotations over with. But at the same time, you do realize it and you recognize it. And it's just kind of like one of those things, I'm sure I'm not the only person who's ever had to deal with that.
[00:22:32] Chad: And you won't be the last, fortunately, but I also liked the fact that you were in a busy place, because it does give you appreciation for the other side. Because you know what it's like to see all these patients and you're like, what did I even go to school for? You can't even utilize your skills, because you don't have the time to do that. So it's good thing and a bad thing, like you said, take care of your lessons learned and be able to apply them going forward.
[00:23:01] Hayden Gray: I had a conversation with one of my friends the other day about just, like I said, there's an absolute need for those outpatient clinics. Like there's 100, because 100% people, like some people need that some people just need to move and some people need a plan of care that's consistent is not going to change much. I think it's super important. But for me, I felt like I almost fell into that trap of doing the same thing over and over and over and over again, without any type of appropriate progression or without changing the overload or anything like that. Because in my mind, I know that those things like are scientifically backed, and they're gonna help my patient get better. But at the same time, I fell into that like almost like a black hole. That's what we call it like the black hole of like, just going over and over and over. But I physically couldn't stay on top of everything if I didn't do that. But once again, I think it's super important.
[00:23:49] Nick: And you're right, those chain clinics, they are the ones that are kind of you see him on every corner and almost there like a Dunkin Donuts. They breed. Actually they breed mediocrity and the mediocrity comes in the form of for the patient's care. And then sometimes, like you said, some people need that. But also at some point, you could be the best hands on the most that kind of quickest thinker, physical therapist. But at some point, it's going to breed mediocrity for you because you're just too busy. And we see that all the time. And it works for some people, like I had some people in my class that that you could tell. That's just what they wanted. They had no aspirations to be better. They just wanted to be sufficient. I don't want to hurt anybody. And I just want to kind of do my nine to five and then go home and they had other aspirations in life, which is great. That's for that's for certain people, but they had no extra drive to then be above mediocre, and they just were fine being average and that's totally fine. You're right, that's what it's going to drive is going to drive that mediocrity. So I think it's important for patients to understand that too, because if that's where you're going, just know that you're probably going to get better. It might take a little bit longer. But you're going to get ideally at least the minimum effective dose or something that is effective, sometimes you won't, unfortunately. But you are going to get usually the bare minimum, because that's all people have time for in that setting, unfortunately, but the other thing I love that you were talking about, you knew you didn't want to be inpatient acute care, but you still love that rotation. And I kind of had the same experience, I was dreading it going into it, but ended up loving it. And one of the biggest things was the communication piece in terms of interacting with so many different providers, even just going up to. We all in the US, especially we put the doctors and the surgeons on a pedestal and part of that is because you can't get face to face time with them. But in that setting, it's like everyone wants to talk to the doctor. And that doctors like in and out. And then they got all these questions for the PA for the nurse, whatever. And it's because they're so busy too, and whatever. We've talked about that on numerous podcasts, but in that setting with as a PT sometimes the doctor comes up to you, and you're like, “Whoa, they actually know who I am.” And so that communication piece in developing those skills. I think it's super beneficial for young PTs without it.
[00:26:19] Hayden Gray: I definitely do. Like you just said, the communication piece was huge. Like we actually were such a small hospital where we go to rounds with the docs every single day. So we actually saw them face to face. And if they wanted us to see somebody, like we'd have a referral, we'd have an order, when we walked in to our office after that. And it was cool. It's just like that relationship was really nice. And like you also learned a ton. I learned a ton on that rotation. That helped me out like in any type of setting. I feel like just like moving around helped like getting patients up and everything being safe, I think just helped me a ton. Without a doubt, for sure.
[00:26:52] Chad: I think I had one impatient experience. And it was only because I took it in the end, I probably shouldn't have taken it. And it was it was only because nobody else wanted to take it there was at Beth Israel. And my boy, they call it ACCE or something. The one that pretty much sets up all the clinicals. She was like, “Hey, we just established it. Somebody has to take it. Nobody's taking it.” And I'm like, I'll take it. So I took it and only because I could take the train and whatever it was. I lived at home for that and it was very difficult to kind of work in a huge hospital like that. And it's like you have a West and an east and the south and the north. And I'm like, and then you've got patients, like you said, it's not even the sickness. It's like, nobody taught me how to like, disconnect this. Where do I put this line? What do I put that line? I'm like, “How do I walk with this patient with all this shit?” And you get there and with a bunch of Northeastern kids and Simmons kids, and they're in these coops, they've been there for months, and they're just like, “You don't even know what to do.” I'm like, “No, I have no fucking clue”.
[00:28:02] Hayden Gray: When all was said and done, my CI was like, “You really haven't been in a setting like this before”. I'm like, “No”. And I'm like, nobody prepared me for this. So I don't know if we still have I don't even know if you are I still has that connection. But probably after me.
[00:28:13] Nick: They replicate it in school, you just can't replicate it. Like we got somebody up and out of bed in the ICU. And they were fully vented, like intubated, which was the craziest thing ever. Like, they can't talk to you. They can't do it. They their soul. There's so many wires, like we had the respiratory therapist, and we had the nurses. And then I was like, why was in there with the other PT. So there was four of us just like getting this patient up and out of bed. Like just because like, that's what the doctor ordered. So like, it was really cool. But like, in terms of like organizing everything, it takes 10 minutes just to get everything on the right side of the bed before you even move them. Which is just crazy. You told him that in school 1,000% can't do it speaks volumes to the nurses in our world there. And you're like, wait, what? It's kind of crazy. Some of the capabilities they have from their experiences, it's wild.
[00:29:05] Chad: And it's great. So you saw all your experiences there. And you've come here, what was the defining moment for you being like, you know what, ProForm looks like a really cool spot. I want to go further my experience here, what sold you on that?
[00:29:24] Hayden Gray: So I reached out to, just because I knew I knew of you guys from family and stuff like that. So I reached out to, Nick. And Nick and I were about to set up a conversation. I think Nick it actually told me that you guys were looking to hire. But when I talked to Nick and Nick and I had that conversation about what ProForm does sure what you guys stand for your values and everything I felt it really aligned with what I also value. So I feel the culture was just like a perfect match. And then even coming in here and seeing you guys work seeing the work you guys do. Like how you guys design and structure a plan of care. I just think that it's really great. I think you guys care a lot. I think I want to be in a place where people care about their patients and want to provide high quality care. But like I said before, especially it was the culture and the values that you guys both have. I was set sold after I had talked to people that that was where I was sure.
[00:30:16] Chad: The culture is huge, man. It's huge. It should be huge everywhere. But like, not everybody focuses the attention on that. And it's funny. We interviewed a few people. And I was a kid, because they were every kid that came in, it was like, some would just stand there someone even socialize, some would socialize, but then just stand there. And I remember I pulled you in at the interview, and I said, do you know what moment actually sealed the deal for me for you? And you're like, I don't know, man, just kind of trying to help out. And I'm like, “Dude, you fucking helped out, like, you literally, were helping by cleaning the tools and cleaning the tables.” It's like, I know, that's not like a big deal to some people. But for me, that's a huge deal. Because it means that you're willing to do anything to help out the team. And meanwhile, all the other interviewees that we had, they were just standing there. One kid was like, I gotta leave early. And I'm like, one kid didn't even get back to us because he was too busy getting stuck at the final four. So I feel like, if you want it bad enough, show me you want it.
[00:31:17] Nick: 100%.
[00:31:18] Chad: And for you, it was effortless. It was just came natural. I just got a clean table, because it looked like it was dirty. And that's what we need a team player and it's so hard to come by. And when you find it, you're like, “This is the guy.” So for anybody that's listening to this, and you go on any interviews, this keep this in mind. It's a little things that matter.
[00:31:39] Hayden Gray: And those type of things too. It's just people shouldn't want to do those things. So if it's not like, it just you say that it's true. It's just one of those things. Like, you just have to, like you have to want to do that shouldn't even be it's not sure. Like, it's not that you should like have to think about doing just go ahead and do it.
[00:31:57] Nick: Like that's kind of the essence of being a nice person. And that's step one, whenever you're in a position like a physical therapist, or anyone in healthcare, that's your goal is to help people just be genuinely care. Like, that's number one. And a lot of times, things will work themselves out over time. You troubleshoot things and all that kind of stuff on the way but you got to be genuine and care. And that's one of the biggest reasons like Chad was saying that we went with you because it was just like this person cares. And that's important for any of our patients or prospective patients, clients that may listen that we had this problem in the past one when Chad first hired me six years ago, people new chat in the area, so they'd call and they'd be like, I heard about chat, I was chatting, I want to see this kid, Nick, he doesn't know what he's doing. But as much as I didn't have as much experience as Chad, the care was there, I wanted to help people. And I was genuine about that, at least I think it was. So that's the most important part. So anyone listening Hayden's graduating in May. But just because you didn't have as much hands on experience as us like to do genuinely cares about you and you getting better. So it's gonna work out, we promise you and he's gonna be able to bounce things off Chad and I all the time. So if he is maybe struggling with where to go next into rehab, we're all here to help. So it's not the type of thing, I don't know, if I want to go with. Hayden is so young, you're in high school, he had these weird clinical experiences that don't make sense to me. Now, it's all gonna be good. So people shouldn't worry about that.
[00:33:38] Chad: And we wouldn't hire anybody that we didn't think wasn't gonna be not only a good clinician, but a good fit culturally, because I always tell people, and I told you this too when I started the other day. I said, we can always make you a better clinician, but I can't make you a better person. That's just genuine. And there's just so many good clinicians out there that are just bad people. And it's unfortunate too, because they can help so many more people. And it goes beyond the fact that you're just nice, it's like you were saying, Nick, it's like the genuinely I care. You could say, well to go and treat it as shields what we do, it's like nobody cares, But if you can relate to the patient, and the patient can have a part in the care, then it works even that much better. But if you can't relay that information, you're just so damn smart. But you could care less about the patient. You just want to do your job and just be known for getting people better than you. It's not gonna work. And I feel like, I don't know, maybe it's shifting I hope it is because I know when I graduated the whole DPT thing was just coming out. And I think I was in the third graduating class at URI and I think even like some schools were still offering masters at the time. So when people got that it was like this big ego trip. And even now we get people like Do you want me to call you it's like just call me, Chad, is cool. And some people will just like, I'm still gonna call you that, some people still shop chat, it's fine, you can do that. But I feel like people kind of get this ego trip. And I think it's been a blessing and a curse. I know the profession has to move forward that way. But it's also really kind of demonizing their bastardizing somebody's kids being like, I think I'm just all that shit. And it's like, you're not though, you're fucking not. So I think we all kind of need to get a reality check and just realize that, “Hey, we're just here to help you, and it's paid Chad, Nick”. And if you want to fill the doctor in there, go for it.
[00:35:35] Hayden Gray: And like he said earlier, people need to know how much you care, they don't give shit how much care at all now, they need to know that you care about them. And not even people's like also say the seminar last week. And he was just saying, some people keep coming to me. I can tell you, they're not getting better. That's why they just know I care about them. I'm trying my best, and they're gonna keep coming see me. That's not obviously, ideally, we want to make our patients better. But they just know how much people if they appreciate you, and how much he cares. And like, they're gonna keep coming back to you.
[00:36:09] Chad: Do you know how many people come to us, and they were better months ago. They still come because they just like the environment. And it's like preventative at that point. And we can do that. But I think that that's all part of the “Customer Experience”. And to say that, it's health care. But it's also a business like to say that, it's health care. But it's also sales. It's just what it is and at the end of the day, we have to be able to show patients not sell them, but convince them this, “Hey, listen, this is how we can help you, show them the value that we're providing.” And I think that kind of gets missed in the whole grand scheme of things, and that's why it just what it is.
[00:36:45] Nick: They leave here feeling better. And that's one of my big qualms with the health care system is we put all these the eggs in the objective basket, did this scale improved this assessment improve? And it's like, “Hold up, let's just take a step back for a second. Do they feel better? Like to do they feel like they're doing better?” Because that's huge in my book, that's number one. Like, that's gonna be the first question. And if it's okay, it's like, “Alright, cool.” And they're like, did my knee range improve? I'm like, “I'll check it.” But he just said, we'll keep doing what we're doing.
[00:37:20] Chad: And I think that you'll keep him. That's one of the biggest reasons why we went to this model with insurance, you have to do your LTFS in you. Now, Chad, let's make this quicker. So we have all these in place yet. They don't mean shit to us. And the patient could care less and sometimes the patients don't even know how to say, how are you feeling? It's all subjective and it's a waste of time.
[00:37:46] Nick: My favorite is LTFS. When people are like, “Oh no, it hurts to walk from one room to the other but I can run. No pain at all clearly.”
[00:38:00] Chad: We could go on a tangent for hours about that.
[00:38:02] Hayden Gray: I literally didn't read it.
[00:38:04] Nick: We did so many of them on my last rotation, and they hated filling them out. But it's just one of those things. I really have to fill this out to them like so.
[00:38:11] Chad: Now they're trying to make it all electronic. Like, nobody cares. It's the same shit, man. And at the end of the day like Nick said, that's not scalable us anymore. It's really not. Do you feel better? Great. See you next week. We don't need to have you fill out all this crap. Because we're not required to, we don't have to say, “You scored five points more.” So hopefully, we can justify two more visits for that. We don't have to play that stupid game no more and that's the best part. At the end of the day, we just made it all up. Like, in all reality all those scales, there's studied but we still just made it all up. So the goal is to help people feel but when did those studies come out, Nick? This research is in 70s maybe.
[00:38:54] Nick: It has been studied again but in general. I was actually telling this to a student last summer. It's kind of funny, because he was kind of stressing out about like, how do I know that this is right? And I'm like, at the end, I see you this is all stressing out. You want to do the exact right thing. But hey, we made it all up, man. We made up exercises. Like as humans, we used to move. And we used to technically do the movements that are involved in exercise, but exercises made we made it up. So as much as we're studying this stuff and seeing this is beneficial. This is beneficial at the end of the day. We just made it. We made up our society, the structure of our society, it's all made up. We invented all that. So just always take a step back from things and just look at.
[00:39:40] Chad: Carissa just showed me the LTFS 1999. That's not that far. I think about it actually is 25 years, I suppose 30 years. And this is probably new. This is probably the newer version. So look at look at these things.
[00:39:57] Hayden Gray: There's so many more factors. Just like how does your patient walk into the room? How do they look when they come in?
[00:38:04] Nick: Guys no one no one carries groceries anymore lifting an object like a bag of groceries, you can get it delivered and then someone brings it in for you. So a robot does that for you. Who squats anymore? Jeez, come on, you don't have to put your own socks and shoes on. You could train your dog to do it, so it's ridiculous.
[00:40:23] Chad: It is ridiculous. But in a nutshell, that is the bonus of coming to a model like ours for sure. We don't play those games.
[00:40:32] Nick: And clearly we have some fun.
[00:40:38] Chad: Anything you want to add Hayden in terms of your experience previous to coming here, whether it was through your clinical or your PT college experience?
[00:40:48] Hayden Gray: For sure. I'll touch on too. So I think one of the biggest experiences I had a great, I want to call a mentor throughout Canadian for throughout my program at UMass. And he told me about Mike Boyles, he was like hey, they do a summer internship, you should see if you can get a summer internship. So I applied if to make it, you had to make a video, you had to submit some stuff. So I did it got the internship. And then I had the privilege of working under Mike for a couple of groups. I've been working with some other really great coaches who are either still there aren't there anymore. And then the next time I went back, and I was a full time coach on the summer staff, which is great. I learned so much from those guys, we got to go to perform better seminar and teach and everything. And I really dove into what they were practicing there and what they were like doing with other athletes. And I think it helped me in terms of identifying certain movement impairments and implementing progressions and regressions. And just being a good coach. And like knowing how to have knowing how to watch for things, and knowing when something doesn't look okay, and how to modify it. I think that really helped me out, like throughout physical therapy school and even currently, but prior to that I just wanted, I think my athletic endeavors and UMass on the track and field team also helps kind of really shaped me, my junior and senior year as a captain on the team. So had a ton of responsibility managing 50, or we had 50 guys on the team. So there was a ton of us. And just talking to the coaches, the directors, getting us all organized. I think that kind of played a huge role as well. Like, just from a discipline standpoint, and just how to work effectively and time managers as well.
[00:42:25] Chad: I love that. And I agree with you. We've been to a few of his events, but we did his winter seminar a little while ago too, as well. And we definitely will Jive better with that group. We've hung out with Kevin and all them for years and anytime we go to a conference 90% of the time, it's usually training related. No just so much PT related and that's just what it is because it just jive more with our model. And we feel more at home in that environment versus like going to a PT conference, even though APTA CSM is going to be in Boston this year, so I did crash that.
[00:43:12] Nick: We'll see what happens because we're usually underdressed for the PT ones.
[00:43:15] Chad: But we'll see what happens. I'm excited. They're changing things a little bit. But I think the more like, like people like us go there, and let them know that shit, he's a change, then shit will change. Because otherwise, if we don't, then it's just going to keep going the way it's going. So hopefully, hopefully, that'll be better. But I agree with you. I think that I think that's great. I think that it does make you I believe it makes you a better PT in the way that PT is going. Just because PT and training is becoming more like, united, versus PT over here and training over here.
[00:43:51] Hayden Gray: I would agree with that, for sure. I feel it just helps, kind of just identify and work with people. I was supervising groups of anywhere from 11 to 15 kids at some point. So it's really have to be on the ball at all times. And it's one of those things where you need to be able to deliver what you want done kind of in an effective way. I think that also just kind of helped me communicate with my patients like not even aside from just training program looks like, as well do with one of my patients here. Just the communication piece of like learning how to like, simplify things and tell them how to do things. Like that was night and day for me.
[00:44:27] Chad: As a PT, you're like a coach. So it doesn't really change. The labels may be different. That's about it.
[00:44:35] Hayden Gray: I wouldn't even say you're like a coach.
[00:44:37] Chad: You are your coach. And you're a coach in many aspects. You could be a health coach, you could be a nutrition coach or you could be a strength coach. That’s the beauty of it.
[00:44:47] Hayden Gray: I think that's honestly one of my favorite things about PT is like you have so many different avenues that you can go and like you can bring in so many different resources to help your patients out. There are some limits, but at least in our scope, there's really not a term but we can't really wrap it in.
[00:45:02] Chad: It's wild. We were talking about the functional medicine stuff, you're like, “This isn't our scope. It definitely isn't in our scope.” Dry needling. That's in our scope. We didn't take that away. But that was something that we earned. So it's slowly getting more and more diverse, which is amazing. I think that was good conversation. I think it was good introduction for forgetting hated in here. I learned definitely a few things about him that I didn't know on the interviews.
[00:45:30] Nick: One of the cool things about Hayden comes from he's a sprinter. He was sprinter in college, so everyone knows, or a lot of people know that. If you train with me, you're probably going to sprint in the nicer weather. And while I was a basketball player, and you never get to it. Science is pretty clear on it, the courts way too small, you never touch 100% speed. So I only started sprinting, the last couple of years. Hayden's gonna make me faster now that he's here, so I'm gonna hold him to it. He's gonna make me less killable in this world. Hayden is gonna make me faster. But now you guys have a real sprinter to make you sprint ProFform. So if you're gonna work with Hayden watch out, because his sprinting is probably way more intensive.
[00:46:12] Chad: Or maybe he'll help make you bigger. , you guys are wearing the same size shirt I'm just saying.
[00:46:19] Nick: My goal is to be less killable. So I need a good combination of muscle mass, plus the speed, plus the agility, all I need to climb well. So we need a climber in here. So we got you. I'm a terrible climber. So I got no help there. So we need to get someone to help us. So we all need to be less killed. But we all know Chad's the most killable right now. Totally too dense. He would sink if we were in the water. So he's catch me even though he looks like he's less killed. Well, he's actually a mod killable in here. So if we were living it's basically a store game defense. It depends. Bu he's saber toothed Tigers after us. He's caught because he can't move fast enough. He might be able to have a nice little hand but hands on comprehend and combat with it or hand the claw, hand to paw, I don't know. Combat with it. But he's still probably getting got by those buttons. Large teeth quick enough to avoid getting sick, though. I'm just saying. I'm telling you. If you are the faster you are, the less sick you get. It's science. It's true. The science is moving so fast that you can't read it. It's out there. The fast you are viruses can't catch you. So everyone's worried about this particular virus to be faster in this world to get sick as much. I'm excited to get faster try to catch this dude. It's gonna be fun.
[00:47:39] Chad: It's gonna be fun. It's gonna be fun for Kate. We'll get in Taylor, we will get Chad.
[00:47:44] Hayden Gray: I don't remember the last time I'm sprint. We're gonna transition to long delays after college.
[00:47:52] Nick: Taylor and I when the weather's nice. Try to sprint twice a week right out front. So you're in man. It’s gonna be fun. We'll try to catch it. It'd be great.
[00:47:58] Chad: I'll see you guys at two.
[00:48:01] PODCAST OUTRO: Thank you for joining us “In The RACK” this week. Make sure to subscribe so you don't miss out on any future episodes. You can also find us online at proformptma.com, or on social media at ProForm PTMA. And remember;
“If you train inside the rack, you better be thinking outside the rack”.
