Well, Tim, welcome to the show.
I'm super excited to talk to you.
I'm over here in North Carolina.
Tim's in Colorado.
And Tim is somebody that
I've had an opportunity to
get to know a long time now, ago.
It feels like it shouldn't
be that long ago now,
but it's exciting to have
him on the show today and
really get to talk about
some things I think that
are really important,
especially with regards to
manual therapy and education
and sort of what manual
therapy education looks
across the educational lifespan.
And I can't imagine anybody
being able to really have
this conversation better than Tim,
because he really has been
on all sides of the education adventure,
being both consumer and as
well as a deliverer of
education and various
pathways and journeys in people's lives.
And so, Tim, welcome to the show.
Well, thanks for having me.
I'm really looking forward
to the conversation today, Derek.
And yes, we go back, I guess,
a long ways now,
which is kind of wild for sure.
I still remember that it was
two thousand and eight when
Evidence in Motion was, you know,
kind of getting off the
ground and you trusted a
few of us lowly schleps to
be a part of a part of the
organization in regards to
fellowship training and such.
And I'll always value that time very well.
Well,
I think that since we are talking
about education, I mean, I look at, I,
like you,
have been super fortunate that I
was put into positions to
teach way before I thought
I was capable of doing it
by people that I were very well respected,
you know, Phil Greenman, John Bedellin,
you know, John Minnell.
You know,
I'm around these people and I'm
way too young.
And, you know,
I guess they call it
imposter syndrome now.
But, you know, you're just saying, wow.
Having said that, you know,
that's really what our role
has always been, I think, is to empower,
you know,
those around us to just do
better and to be better
than we are in terms of
both the practice of what we do, but also,
you know, teaching others going forward.
And I'm glad you brought all that up.
And I think one of the
things that I've always
respected about your
position is that you've
always maintained sort of
the foot in the door of
clinical relevance as well too.
And so I think that that's
always meaningful.
I think we all start in some
way or form with educating PTs
you know, in that clinical setting.
I remember when I first got
my first student,
I think I was only out six
months of PT school.
So talk about imposter syndrome.
I was teaching a student as
a CI from somebody who, you know,
was only going to graduate
six months before me.
And somebody asked me how that went.
And I was like, well,
I don't think I could
really teach them much,
but I could kind of help
guide them a little bit.
But I felt like there's
always been that imposter syndrome,
even for everyone,
I think is kind of refreshing to hear.
Indeed.
So the, I have a,
the topic of our conversation today is,
you know,
and it's about physical therapy
and probably more importantly, I think,
especially for our listeners here,
orthopedic manual physical therapy,
future in education and how
it starts with
the education setting and environments.
And I think we wanted to
talk about it from the
professional side of education.
So entry-level education
going through
post-professional education.
And I might even add,
little bit in there.
This wasn't part of our initial discussion,
but post-professional educational journey,
because I think a lot of us
are now starting to face
that part of our career paths.
And so I guess before we
even get into that,
let our listeners know how
you really kind of became
interested in manual
therapy specifically?
I think we all are familiar
with the work that you've
done and the research that
you've contributed to the field.
But like, where did it all start?
How did you how did you get
interested in this?
How'd you get the bug?
Well,
it's funny because I often joke my
manual therapy training.
I went to Marquette,
graduated in nineteen eighty three,
and we had a four hour
block on manual therapy.
That was the extent.
And not only was that the
extent of the block,
it was on a Friday morning.
and the thursday night
before my wife and I had
gotten engaged she was in
pt school and of course we
were provided with way too
many uh cheap shots so I
just remember that next
morning being super hung
over and that was our only
manual therapy block we got
I mean I was super excited
given my state and uh um so
that was really my initial
entry into manual therapy
but it was just a sliver
How that won you over, I don't know.
But actually, you know, I was in ROTC,
so I went into the Army
right out of PT school and
was stationed down in San
Antonio at Brook Army Medical Center.
And
I was you know life is a lot
you know people say it's
hard work but it's luck as
well I mean I could have
gotten sent somewhere
differently but at the time
it was just kind of a bevy
of super outstanding
physical therapists um
musculoskeletal imaging you
know uh but manual therapy
as well there's a couple
steve stratton was one and that just was
you know,
going to Michigan State
Osteopathic Program at the time, you know,
their continuing education
program and just saying, hey,
this is where you need to be at, you know,
this is where you got to go, et cetera.
But I was just immersed in
this muscle skeletal world
and you just were expected.
you know to to know this
material and to be good
with your hands and um so I
think I was lucky in that
regard but you know my
first exposures uh were you
know teaching you know just
extremity manipulation and
spinal manipulation people
with acute pain uh
syndromes coming in and and
then very quickly I think it was a year
two in I went to michigan
state for a five-day
principles of manual
medicine course and that
was a game changer because
it really first it was a
small group of primarily
dos couple mds and a
handful of physical
therapists but the again
the faculty was you know I
mean it was phil greenman
john minnell john bordillon
I think Carl Steele,
who was a PT but then went
on to become a DO.
It was like a student
faculty ratio about one to
six or six to one.
It was just an immersion.
I realized how little I knew,
but how, how powerful it was.
And that these folks too had,
which been orthopedic
surgeons and had given up
essentially surgery because
they just believed in manual medicine,
non-operative care, you know, back in the,
you know, this is now the mid eighties.
So,
It was very powerful,
both from the technical aspect,
but also from the
professionalization of what
manual medicine really was.
So that really launched my career.
And when I ended up going
back for my master's,
I guess it was in eighty eight to ninety,
I went to Michigan State in
the osteopathic school.
they had a biomechanics department,
which was somewhat
traditional biomechanics in
the fact that we're doing a
lot of tissue mechanics and
stress strain curves and the like.
But Phil Greenman,
Dr. Greenman was a member
of that faculty.
And I knew if I went there,
I could take more of these
courses while I was there.
And I just kept pestering
him until he said, well, Tim,
why don't you just come to
clinic with me a couple of days a week?
I'm like,
Yeah.
And so that was like, you know,
the beginning of the quote
classic kind of mentorship of, you know,
one-on-one in the clinic, you know,
you know, twelve,
sixteen hours a week just
watching a truly master clinician.
And that's when you realize
manual medicine is
described there and manual
therapy or manual physical
therapy as we now know it.
It's holistic.
And, you know, technically, yeah,
he was a skilled manipulator,
but it was all the other stuff.
His patient interaction that
we now call therapeutic
alliance was off the charts.
You just wanted this guy to be your doc.
I mean,
it was just connectivity with
people and could be very firm on,
you know, hey,
you got to do your homework,
but came from a place that, you know,
you just trusted.
And so, yeah,
you look back and those elements just,
you know,
launched my passion and career
and which goes to say how important it is,
I think, that early career therapists,
you know,
Even if it's harder yards
and not getting paid as much,
it does shift your entire
trajectory if you can have
those first couple of years
around people that actually
are doing it the right way.
and are really
patient-focused and understand,
despite the system that's really broken,
that we can still make a difference.
And that will truly launch your trajectory,
I believe.
It's interesting that one of
the things I picked up on
when you said there,
and I've heard this from a
lot of people who have gone
on to be successful in their careers,
is they pester, they beg,
they yearn for the mentorship.
They take charge in their own education.
And I've had a lot of
conversations around that with
dbt students and I'm sure
we'll get into some of that
conversation later about
some of the generational
changes and differences and
things like that but I
still think that there's
value in you know taking
charge of that and
everybody that I've met
that's done something very
well is they're basically
like just they don't stop
knocking on the door and
eventually somebody's going
to open that door and say
okay fine I'll let you in
but if you look across the
board that seems to be one of those
character traits of a, you know,
somebody that has gone on
to become a great clinician and then,
you know, have some level of impact,
wherever that impact might be defined as.
So nice and refreshing to
hear you say that.
And it just occurred to me
as we're talking that
Part of, I think,
that trait is you are vulnerable.
You're going to get told no.
You're going to be putting
yourself out there.
And I think there's an openness in that.
I think maybe it displays a
bit of openness in how you
then view science, how you view learning,
how you view growth.
And so maybe part of that is
just a trait that you kind of need.
That needs to be there in order to grow,
I think, you know?
Yeah,
it's one of the things that I
actually tell even our
students when they're learning things,
either if it's either an
entry-level PT student or
if I'm teaching fellows or
whatever it might be, I always say,
here's two things you got to do.
You have to give feedback
and then you have to crave feedback,
even if it's feedback that
you don't necessarily want to receive,
but you have to beg for
that level of feedback
because ultimately that's
going to help you grow as well too.
So I think that that's a big part of
that educational adventure.
Um, so, you know,
I know your career track
and your trajectory, um, a fair amount,
you know,
and so coming out of the military,
you know, obviously you,
you were a consumer of education,
you were taught.
And then at some point, you know, and you,
and you're always a learner.
Um,
so I'm not going to say that you're not
still learning,
but at some level you then, um, changed.
And I know that you went into sort of
almost a post-professional
focus of education and then
kind of shifted into some
entry level back again.
But talk to us a little bit about,
you know,
what I guess was the next
catalyst if I'm going to
think about phases in
educational journey.
where you started to say, Hey,
you know what we need,
we need to do something bigger.
Maybe we need to educate at
a larger scale or a larger
shift or something like that.
And that was probably the
early two thousands.
I'm sure that that happened,
but talk to us a little bit
about what kind of went into your,
your mindset around all of that.
Well, I mean,
there's a few things there
wrapped in there.
I think it has been,
I think as it relates to AOMT,
I think there is a story
there that we'll get to that.
Because I really think my
passion for manual therapy, I mean,
my PhD was not that.
I learned a lot about a
little which PhDs are.
You learn a method, you learn a lot.
And it was really in bone
stress injuries and things
that were away from manual therapy.
And this is in the nineties.
So I come out in ninety seven,
the ACPAR guidelines are saying, you know,
PTs don't do anything.
for back pain, except, you know,
this manipulation thing
seems to have a little bit of benefit.
And our own professional
association didn't jump on that and say,
well, hell yeah, that's what we do.
So we kind of fought those
guidelines as well as
everybody else that didn't
like what the answer was.
And so I came out during
that time a little like
whoa, I'm, I'm a manual therapist,
even though I've kind of
done this PhD and I was
back in the entry level teaching.
And I felt strongly that, you know,
these skills are basic
skill sets of entry level
professionals that you need
to know how to manipulate the spine.
You need to know how to
manipulate the extremities.
And that's just the basic
skill set to manage.
One of the prime largest
conditions we see is that a
spinal disorder.
So, um,
That, to me, was obvious as I entered.
I was now at Army Baylor,
and so I was teaching there.
But I also became a member of the academy.
And at that time,
I just assumed we were
pushing manipulation and
entry-level practice,
that that was just a basic skill set.
And it was,
I wasn't met with quite the
excitement that across the academy.
And again, I don't, it was well intended,
but a lot of folks felt that this was a,
you know,
a higher level post-professional skill.
And clearly you get better
and better post-professionally,
but there are a skill set
that are really all of us
need to have an entry level.
And we now do that.
But that wasn't at the time
the prevailing wisdom.
And why I was passionate
about it was because the need was there.
And I look back to my
education where my mentors,
osteopathic physicians, one in particular,
Phil Greenman,
caught hell for teaching PT
spinal manipulation because
they felt that a lot of the
osteopaths felt that, no,
that's within their realm, you know,
and that shouldn't be done.
And he was like, well, hey.
who's gonna be doing it
because he was seeing way
back in the eighties that
physician graduates of DO
schools were migrating into
traditional residencies and
really becoming more
traditional silo based
specializations and losing
their manual medicine skills.
And it was very intentional that says,
if we don't continue to teach these skills,
they will be lost and we
will not have this skill
set in US healthcare.
And so that's why I, you know,
in the back was very
passionate about having
that be a skill set of PTs
and entry-level.
But to your question now, then, you know,
scaling up post-professionally, you know,
I was just fortunate, you know, again,
you know,
somebody picks up the phone and
wants to be part of your, wants you,
them on your committee.
And the person on the other
end of the line was a guy
named John Childs.
And, you know, he wanted to do this RCT.
And I'm like, well, yeah,
I'd be happy to be on your committee.
And
And he describes it as being
a very nervous call to someone, you know,
like this expert, you know,
I was looking like, oh, this young,
eager person wants to collaborate.
That's awesome, you know.
And so, but from that, you know,
we did research together
and clearly evidence in
motion begins to formulate.
I was already doing some CD research.
production back in the day, you know,
doing a little digital Mavica, Sony,
fifteen second video clips
and smashing them on a CD.
I don't know if they have
those little discs.
They're called CDs.
They have those things anymore.
But yeah, so that was so weird.
Oh, indeed.
So.
But yeah,
so that quickly we realized the
demand for, you know,
continuing medical
education was continuing to be there.
But ultimately,
the data also was showing
that wasn't changing behaviors, right?
You just didn't change
behaviors with just one-off CEs.
You needed more ongoing
connectivity with people.
And that really...
From that stemmed really
residency and fellowship
training and certifications
and post-professional
training that was more skin in the game,
if you will.
It was longer so that you
had to commit a bit to doing that.
I look back at my career and
even though I wasn't in the
formalized system,
I was going through a
series of courses that
would be certificate-like.
But the people around you
were equally hungry.
And you'd go to class all
day learning these
techniques and then you'd
eat and then you'd grab a
table and then you spend
the next three hours practicing, you know,
with three or four of you,
like making sure you really had it,
you know, before the next day.
And that passion, you know,
I think really makes the expert, you know,
where you got it, you got to get reps,
you know, I mean, you know,
you do it one or two times.
It's now I'm learning to play golf and,
you know, man,
I can tell you that the
amount of reps to just get
minimally competent is a ton.
I mean,
that's just to get minimally competent.
And I think it's like any motor skill.
You know,
you got to be passionate about it.
You got to do the reps.
And so that really led to
more of the certification
residency fellowship kind
of training that we got involved with.
You know, it's so that's a little sidebar,
because you mentioned your PhD.
And so for our listeners out there,
I actually uncovered
unearthed some of your original PhD work,
because I personally had a
bone stress injury.
And I was like,
that can't be that Tim
Flynn on those studies, right?
Yeah.
And it ultimately was.
And I was like, wow, that's pretty cool.
I didn't know that you had
that sort of background
that obviously now I know
how it really just morphed
really quickly back to manual therapy.
But there was a brief
flirtation apparently with
bone distress injuries.
And I'm still quite interested in them.
And had I...
gone a different route,
I probably would have continued on.
But I was in the era of PhD
where you have to do something novel.
And so I was trying to
figure out if this
vibrational characteristics
of tibias would be related
prognostically to bone stress injuries,
which were very common in the military,
the tibia.
And, you know,
we got the instrument to be reliable.
And then once I got back into the Army,
we did some studies at Army Baylor,
and it just didn't pan out.
I mean, there's so many factors involved.
But I was always big, and still am,
that bone quality is a very
different measure than bone density.
Density is a contributor to quality,
but that is just...
one marker, you know,
of health and of quality.
And so, yeah, still interesting.
I read stuff here and there on it.
It was just funny to see out there.
Bone stress injury might
have been a little bit
easier to handle than
something ubiquitous like low back pain.
A little bit easier to
diagnose and have an actual
real patho-anatomical medical explanation,
really, in some regards.
So you chose something a
little bit more difficult and challenging,
which is good.
We're all happy you did.
So, yeah,
I think there's been a lot to
sort of unpack here already a little bit.
I want to take you now to
where you are at currently, you know,
providing entry level
education to manual therapists.
And as you said, you know,
when you went through PT school,
and even when I went through PT school,
even though it was, you know,
some years later,
it wasn't much different, you know,
like we, we didn't learn,
we certainly didn't learn manipulation.
We did not learn,
And then the manual therapy
that we learned was, you know,
obviously based on a lot of
theoretical models that
would just typically
confuse the heck out of
somebody not smart enough
like me to understand those things.
And so, you know,
here we are now in a whole different era.
And you're in a different
era of your educational and
teaching sort of career with that.
You know, what do you...
What do you love, I guess,
about teaching in entry level?
I mean,
I think that's where you're having
a lot of impact.
And I think, you know,
I love the topic of this
because I do think that
it's really important for
our next generation of
manual therapists to
to gain some sort of footing
in entry-level education
and we can do that now,
whereas we couldn't do it before,
yet we still were successful.
I guess, yeah,
what's your passion and what
do you see as sort of the
future of education in
manual therapy and entry-level?
Well, I mean,
I'm extremely passionate about it.
And it is what I, you know,
our health system is so bad.
And it just,
it's just crying for people
that can think,
that can have therapeutic hands,
and that can, you know,
connect with human beings.
Because that's just, to me,
part of the skill set
allows us to actually move
people to optimal health.
And but...
you have to, to me,
it's a window in to that,
despite just the basics of treating, say,
neuromuscular conditions
with hands-on care.
I think the biases,
what I like about intro level, we can,
you know, we're all biased,
but we can at least not
bias them according to even, I mean,
within the century, people, you know,
are saying, you know,
the dangers of manual therapy and
programs not teaching it
because it's dangerous, you know,
and I'm like, you know,
it's just a wild thing that
when you look back the history,
we were doing manipulation
the beginning of, you know,
in the nineteen twenties at
the beginning of our profession, you know,
I mean,
that was the basics of our
profession was hands on
manual manipulative type care.
So it's weird how things got distorted.
But I really don't want to
leave this talk or
discussion without saying
that as the academy in the
manual therapy group,
our role is that of teachers.
And I'm so excited.
There's so many fellows that
are on faculty throughout the country.
And you look and talk to
programs and everybody, you know, says,
you know,
they're excited about their
orthopedic or musculoskeletal faculty,
you know.
Well, there's a couple reasons.
Almost all these are still clinicians.
They're actually still
seeing patients in some capacity,
limited often just due to
the other responsibilities,
but are clinicians.
They have stories about real
patients right now, currently.
Right.
Their passion for what they
do exudes through.
They're not telling stories of,
''Twenty years ago when I
saw this patient.''
Students react to that.
I'm curious,
the number of fellows that are on faculty,
it has to be quite high.
What's even more exciting to
me is so many programs now
are finally shifting.
whether they're residency or
blended models that, you know, say,
you know,
those that should be teaching
clinical skills should be clinicians.
You know,
they should be expert clinicians.
You know,
I don't want my surgeon taught by
someone that doesn't do surgery.
I just don't feel that's a
good way to do business.
You know, it shouldn't be, you know,
the anatomy professor that's teaching it.
It should actually be the
surgeon that's teaching how
to do surgery.
And I think it's crazy how
distorted our profession
got away from the expertise
of the clinician really
driving the educational system.
And so that's kind of what
I'm most passionate about.
And I think that manual
therapy is really leading that charge.
in that through the
fellowship programs and
that many of those
graduates go on to be
either full-time faculty or
adjunct faculty leading, you know,
various components of the curriculum.
Yeah, you know, it's fascinating.
Like you said,
manual therapy has been a
part of what we do.
And, you know,
it's certainly a part of
orthopedic management.
You know, you're not, you know,
by putting your hands on
somebody and you establish
that relationship as well,
and you learn how to
communicate and have
empathy and all the other
components that are around it.
But it's not even just orthopedic care.
I've actually talked to a
lot of the faculty within our program who,
you know, employ orthopedic
manual interventions across
other types of settings.
And I think, you know,
and one of the things that for me,
when it was time,
when I moved from primarily
teaching post-professional
education to moving into
entry-level education, I think I remember,
I can't remember who it was
that gave me this advice.
They're like,
but you gotta be careful
because you're going to have, you know,
neuro geriatric pediatric
interest from students in these programs.
But I have found that so I
teach an advanced manual
therapy class and about
ninety percent of the
students in our program
take that advanced manual therapy class,
even if they're going into
pediatrics or neuro or some other realm,
because I think even
they're starting to
recognize the importance of
hands on care across all
different kinds of
specializations and areas.
You know,
I'm so hopeful that that is the case.
It's not a musculoskeletal skill.
Yeah,
we use it a lot in musculoskeletal care.
But, you know, I love when I see...
the predominant neurological
diagnosis patient.
I mean, again,
most of these disorders end
up affecting the movement system.
When the movement system
doesn't get to go through its range,
it has impairments that
need some hands-on care to
get them through and to ease movement.
And it makes so much sense.
I mean,
our pediatric team at Colorado Motion,
they
very hands-on focused.
They are manual therapy oriented.
They don't think anything of it.
So much have restricted movement systems.
If you're not doing some
type of manual intervention,
you really are not offering
them top-of-the-line skill set.
And again,
you can move on into Parkinson's,
another example where, again,
loss of full movements
begin to create impairments
at the joint soft tissue
levels that make it even
further difficult to move, right?
Yeah,
I just wish we'd get out of our silos.
I mean, people are,
and I just hope this new
generation just sees it as, you know,
this is just, it's not a silo.
You know,
we treat human bodies and these
skill sets cross all of our quote unquote,
you know, specialties of care.
Yeah,
I think that's something that we're
kind of seeing there.
All right,
so we're moving along in the
journey and talking about
the importance of manual
therapy education as a
professional student level.
Post-professional education
is something that you're
still involved in.
Certainly, when we think about that,
we think about orthopedic
residency or residency, I should say,
and fellowship education.
training and what are your
thoughts on that and how
important that is for our profession?
you know here I'll go up a
level here in big picture I
think you know
post-professional training
ongoing learning is just
it's the nature of being a
professional you know so
whether or not you go to
residency or fellowship uh
hopefully at a minimum some
type of certification
pathway where you you go
deeper into an area of practice I mean
Yeah,
a superficial knowledge of certain
things like, you know, a patient comes in,
they have a diagnosis I've
never heard of.
You know,
I can look up to get a basic
understanding of what this diagnosis is.
But, you know,
and I don't necessarily go
deep down into that.
specialization,
but some specializations
that are core to who I am
as a professional, I need to,
and you pick whatever that is,
but I just feel that depth
versus breadth coming out
of a professional program is necessary.
because you you got to go in
deep and sometimes you know
you go down a rabbit hole
and it you find you're
frustrated that you didn't
get as much out of it as
you wanted but actually you
did because it's the
discipline of driving
deeper into an area of practice
That allows you then to come
back out and be, frankly,
more efficient when you go
down others as well.
So I'm a big believer in
whatever your passion is to
go down a pathway.
And I think programs have
gotten better at that.
of putting into modules ways to do that,
again,
where you could maybe do such a
certification and maybe
that can build on into a residency model,
can build on into a
fellowship type model.
So I think, you know,
various post-professional
training programs,
whether they be at the
university level or
private level are getting
better at doing that.
And I think as a consumer or student,
you know, can,
has more opportunities that
that graduate has more
opportunities to find those.
So that, that's my main, I guess,
takeaway of that.
Yeah, no, and that's, you know,
so good and so great.
I know that, you know,
every student is going to
be a little bit different.
I always talk to them about, you know,
you have to self-reflect,
but at some level,
if you find yourself not
passionate or interested in, you know,
seeking more,
then it's probably a
reflection of other things
going on as well, too,
that you have to kind of think about.
But there is, you know,
I think you even said earlier,
sometimes you have to make
those those investments a
little bit different in a
way that maybe isn't what
they're quite ready and comfortable for.
But then the payout,
whether it's financial
payout or maybe it's just
professional satisfaction,
certainly comes into play
as you go through those those paths.
I don't speak to too many
people who have gone through that.
who have gone into the depths,
like you've said,
who have gone deep into the
caves of things, come back out,
maybe they come away with
some some new letters, certifications,
some fellowship training
and things like that.
They tend to be the ones
that I find to be the the happiest,
the healthiest, in a sense,
even though it seems like
they wouldn't be because of
the amount of like,
effort that it took to get there.
And it relates to, I mean,
we won't go deep into, you know,
the problems of higher education,
the costs, et cetera, but it's well known,
right?
And so part of it is, well, financially,
you know,
it just doesn't make sense to
continue to pour more in.
I clearly see the argument,
and yet sometimes we don't
talk about the fact that if
you leave the profession, you burn out,
and you leave due to dissatisfaction,
which is often because you
feel like you're not –
successful with clients.
You know, you just,
you burn out because you
don't get the hit that you
get when people are successful, right?
When you have success around
you and your patients and clients are,
you know, are
have gratitude and show
gratitude towards you,
you feed off of that.
And, you know,
it now does not become work.
It becomes passion.
It becomes truly your
professional journey.
And I do think that there's
a cost if you don't have that,
because you probably will
leave the profession early, you know,
which is a financial issue.
hit whether you have to
retrain your skill set,
which you will into something else or,
you know, some other type of thing.
And so I think that's,
it is that long game where you, you know,
you have to kind of play
and there's no right answer
for an individual, these big,
broad statements,
but I do think it's worth
looking at it that way.
The people that go in deep,
They generally come out passionate,
understanding,
and have this longer
longevity in the profession
because they just, they, they,
results improve.
And because of that, you know,
feedback from patients improves.
So I want to take us on a
little bit of a different
adventure before we conclude this show,
because I think, you know,
there was an article that
just came out in JOSPT.
It was a really good one.
It was advice to the new grad.
Right.
It was, I think, Jeremy Lewis,
Chad Cook and a few others
were on that paper.
Really nice paper.
um but here's what I want to
ask you because uh I think
a lot of our listeners
especially academy
listeners potentially are
you know a lot of our
membership is fellows um a
lot of our mentor
membership are people who
may be thinking about
fellows of course not
everybody there's also
non-fellow members but they
also have potentially have
gone down a lot of depths and and
holes in their lives as well.
So I want to go into the
post-professional
educational journeys and
get some of your thoughts on that.
So you're the seasoned person.
You have had some successes.
You do feel like you are
effective in a sense,
but you're no longer in that sort of
you know, game of trying to, you know,
build sort of this
repertoire or resume of
certain types of things.
You know, what,
what does that post
post-professional education
look like in your mind, I guess?
Curious.
Yeah, I mean,
I think that's when you enter
the phase that you truly
are a self-directed learner
that you can really continue to grow by.
You seek out new knowledge
and you get more efficient
at seeking out new knowledge.
But I think that person, you know.
It.
I don't look at it as an
obligation to teach,
whether it be being a
clinical instructor for an entry level,
whether it be a mentor for
a resident or fellow.
I think it's very selfish
that you should do it for selfish reasons,
because that to me is that next phase.
And you may have been doing it all along.
but you're doing it with a really,
you know, different intent of, you know,
I want that new learner to
challenge me on what is my
belief structure and what's
going on and this back and forth nature,
which then, you know, keeps me learning,
if you will, going on.
So, I mean, I think that's, you know,
just continuing to be engaged with,
you know,
from a teaching perspective in
whatever form,
whether it be at the university or in the
clinical environment.
The second thing I would say
is going in different directions.
And that I think is key.
I really have broadened, I mean, I've been,
I think, holistic and open to a lot of
New ideas, you know,
as we learn more about the
neuroscience of pain
mechanisms and things in
the last two decades and learning that.
But then that exposes you to the fact that,
oh, my gosh, you know,
look at the gut and the gut
microbiome and how, wow,
how this is affecting you.
you know, all these systems that I've been,
you know, teasing and using my hands with,
and I haven't really been addressing that,
you know,
the same with breath work and breathing.
I haven't been as detailed
and had a deep understanding of that,
how that interplays in what
I'm doing with my manual interventions.
And so taking those elements
that compliment my core, you know,
a clinical acumen and making
sure I'm bringing those into my skill set,
you know, and again,
the same way you got to go
deep sometimes to kind of
end up only pulling one or
two things that, oh yeah, this is my,
I always kind of do this
now with patients, you know, it's,
you know,
and I think our role obviously
is distiller, right?
You know,
we start with a wide range of
information and
which is out there,
but how do we make it
really actionable to my
patients in front of me?
So I think that's the next
phase of the
post-professional phase is
really taking newer ideas
and integrating those into
practice and then
challenging the folks
you're working with and teaching,
what do you think about this?
And this is my
mindset is that out there, this is why,
you know, watch me do this with a patient,
you know, is what do you think of that?
Is that, you know, good, bad, indifferent,
you know, again,
asking for feedback and
hopefully feedback that is not just,
you know, as I say, good job,
something that's actionable
and actually critical that allows you to,
to, to, to improve.
No, I'm glad you did that.
It was actually, I kind of,
you took the bait because I
wanted you to go down that path.
The only reason I wanted you
to go down that path is
it's something I've actually seen,
not just from you, but from other,
you know, folks who I have respected,
where it's not just rinse
and repeat after you've had
your post-professional education,
where you just
I've made it to the mountain
and now I'm just going to
kind of do what I'm going to do.
And I think that that
becomes sort of frustrating
for the post
post-professional phase of
somebody's career.
That's something that I've
always seen that I think
very healthy people start
to look at things very differently.
And you can be sort of,
focused and myopic in some
sense and still go into a
lot of depths or you can
now start to expand your
breadth like you have done and certainly,
you know,
look at things a bit differently.
But I think that that's part
of that excitement for a
lot of folks is that now you can go and
And see how everything
functions and integrates a
little bit differently there as well.
But so I wanted you to
actually say that because
that's something that I've seen you do.
I'm like, oh, what is Tim doing now?
Like this was not Tim from
two thousand two.
This is Tim from twenty twenty four.
And it's and it's got a
little it's got some Tim still,
but then it's got a lot of
other integrated things as
a component to what you do.
And I think that is that
lifeline learning.
I mean, it's thrown around all the time,
but frankly,
I do it for pure selfish reasons.
I mean, from a neurocognitive perspective,
I want to be as bright and
keep my brain as healthy as I can, right?
We know that that's do novel things,
learn new things.
I mean, and why not learn things that,
you know,
you're passionate about and can
actually make a difference, you know,
and I do a lot of these things just,
you know, and chat with people, you know,
at the,
a cocktail party or dinner party about,
Hey, I read about this.
This is pretty cool.
Or I listened to this podcast.
What do you think?
And, you know,
do you integrate this into your life,
you know, and how does that play?
And I think that's just that
natural curiosity.
You gotta,
you have to have in that
post-professional area.
And it's,
I'll say this.
It's interesting.
When I went to Fort Collins
in two thousand three,
there's Colorado has some
excellent clinicians.
I'll say that straight up.
Just really,
it was a very open state for
private practice for, you know,
from the sixties and seventies.
You know,
so it's a very open state in that regard.
You know, lots of people, you know,
hanging shingles and doing things.
And there was a good
practice in town and that was doing,
you know,
was really into the certain
technique set and that
started in the mid nineties.
And now it's already, you know,
now let's say about two
thousand five starting to
see patients coming from that.
area and an excellent clinician,
but a couple of patients would say, well,
yeah, I'd go, I was going to him,
but he's still doing the
same things he was doing back then.
And it stuck with me.
And
Doing it well, and again,
because I don't believe whatever you do,
you do it well,
you're going to get good results.
And I do think there's some
agnostic nature to the technique,
if you will.
But it stuck in my mind like, well,
I don't want to be that.
I don't want to just be
doing the same thing, you know,
ten years from now that I'm doing now,
even five years from now.
you know that I need to
continue to grow because
man the explosion of
knowledge if if I'm doing
the same thing I'm all this
stuff I've read about that
you know that I don't want
to be you know so I do
think there's a lot to be
said for that and we have
to challenge our colleagues
and friends more our friend
friendly colleagues say man
you know don't you gotta
you gotta move on and I always I'm
to the point where sometimes I'll,
I have a really good lecture and I,
I won't repeat it because I'm like, Oh,
if there's one or two
people that have heard it, um, you know,
I don't want to, you know, you know,
I want to bore them.
Right.
You know, and there's,
I think there's a fine
dance because like knowledge,
you have to get some reps at stuff and to,
to embody it both as the giver,
but also as a receiver, you know,
but you just don't want,
I just don't want to be stale.
Yeah.
You don't have those same
stories all the time coming across.
I don't think you're going to be stale.
Well, Tim,
I know that we're getting close
to the end of this,
the time that we had here.
And I just want to, you know,
thank you very much for
spending time with us today
to have this conversation.
I know that we can probably
have a lot of other
conversations about a lot
of other things that I wanted to today.
But my hope is that at least
folks can kind of see, you know,
the importance of, you know,
not just manual therapy education,
but just education in
general and how that, you know,
enhances what we can do.
And I appreciate your
spending time with us today.
Well, it's been a pleasure as always,
Derek.
It's fun to have these conversations.
And I do hope the listeners out there,
you know,
will have these conversations
amongst themselves.
And please reach out to me
if you want to chat because
this area is I'm passionate about.
Awesome.
We will do.
All right.
Well, thank you so much, Tim.
There we go.