WEBVTT 00:00:01.225 --> 00:00:01.506 All right, 00:00:01.526 --> 00:00:03.746 today we've got a legend in the house, 00:00:03.867 --> 00:00:05.746 someone who spent his career standing at 00:00:05.767 --> 00:00:07.147 the crossroads of science, 00:00:07.248 --> 00:00:09.928 clinical mastery, and military precision. 00:00:10.169 --> 00:00:10.249 Dr. 00:00:10.269 --> 00:00:12.849 Gail Dow is the clinician scientist who 00:00:12.868 --> 00:00:14.009 doesn't just talk evidence, 00:00:14.369 --> 00:00:15.009 he generates it. 00:00:15.750 --> 00:00:17.591 He's mentored generations of residents and 00:00:17.951 --> 00:00:18.291 fellows 00:00:18.870 --> 00:00:21.832 pushed PT diagnostic competency forward 00:00:21.931 --> 00:00:23.591 and published clinical trials that have 00:00:23.632 --> 00:00:25.393 shaped how we treat chronic 00:00:25.472 --> 00:00:27.073 musculoskeletal conditions. 00:00:27.553 --> 00:00:28.853 If you care about advanced clinical 00:00:28.893 --> 00:00:30.134 reasoning, fellowship training, 00:00:30.173 --> 00:00:31.795 or the future of PT's role in global 00:00:31.835 --> 00:00:33.354 health, buckle up. 00:00:33.634 --> 00:00:34.655 This is going to be a good one. 00:00:35.295 --> 00:00:35.975 Let's get into it. 00:00:36.036 --> 00:00:37.277 Gail, welcome back to the show. 00:00:37.837 --> 00:00:38.377 Well, 00:00:38.417 --> 00:00:39.296 thank you very much for allowing me to 00:00:39.317 --> 00:00:41.338 sit here with you today. 00:00:43.280 --> 00:00:45.161 Last time we recorded, we were in person. 00:00:45.201 --> 00:00:48.704 We were at the AOMT conference in Reno. 00:00:48.783 --> 00:00:49.984 So my first question is, 00:00:50.564 --> 00:00:51.585 did you make it out of there with 00:00:51.604 --> 00:00:52.886 all your money or did you lose? 00:00:52.945 --> 00:00:54.707 Did you leave some in the machines or 00:00:54.726 --> 00:00:55.387 on the tables? 00:00:55.786 --> 00:00:59.668 No, I escaped there relatively unscathed. 00:00:59.689 --> 00:01:01.270 My problem was I was up twenty five 00:01:01.310 --> 00:01:02.990 bucks in the first day and then down 00:01:03.011 --> 00:01:03.951 one hundred twenty five bucks. 00:01:04.712 --> 00:01:06.393 That's how that's how the law of averages 00:01:06.433 --> 00:01:06.813 gets you. 00:01:07.323 --> 00:01:10.266 Yes, yes, yes. 00:01:10.326 --> 00:01:11.007 I didn't go through that. 00:01:11.027 --> 00:01:12.048 That's because you're smarter than me. 00:01:12.067 --> 00:01:13.448 That's why you're the guest and I'm just 00:01:13.468 --> 00:01:14.150 the silly host. 00:01:14.769 --> 00:01:15.891 All right, so let's start with this. 00:01:15.911 --> 00:01:17.953 You've mentored physical therapists across 00:01:18.673 --> 00:01:20.015 every level of training, 00:01:20.635 --> 00:01:21.596 but I want to know this. 00:01:21.756 --> 00:01:24.677 What's one trait you see in the clinicians 00:01:25.099 --> 00:01:27.600 who really take off after fellowship? 00:01:28.001 --> 00:01:29.682 Is there one trait or many that you 00:01:29.721 --> 00:01:32.224 probably can see in people and when you 00:01:32.284 --> 00:01:32.584 see it, 00:01:32.605 --> 00:01:35.406 you know this person's going to take off? 00:01:35.447 --> 00:01:35.947 Well... 00:01:37.245 --> 00:01:41.388 I think it is the clinician that realizes 00:01:41.509 --> 00:01:42.909 patients are complicated. 00:01:43.430 --> 00:01:45.471 And with that, 00:01:45.632 --> 00:01:48.013 there comes a certain humility you have to 00:01:48.073 --> 00:01:50.575 have to think that no matter how much 00:01:50.635 --> 00:01:52.537 effort I put into this or how hard 00:01:52.597 --> 00:01:53.198 I've worked, 00:01:53.759 --> 00:01:57.022 I'm still relatively unprepared to take 00:01:57.042 --> 00:01:59.263 care of the complexities that I'm likely 00:01:59.284 --> 00:02:01.245 to encounter on a day-to-day basis. 00:02:02.585 --> 00:02:05.509 And I think that the more hungry that 00:02:06.575 --> 00:02:08.736 either residents or fellows when they go 00:02:08.796 --> 00:02:11.396 into training are, you know, 00:02:11.497 --> 00:02:13.497 the more they really want to be able 00:02:14.217 --> 00:02:17.199 to offer their patients that's uniquely 00:02:17.258 --> 00:02:17.838 skillful. 00:02:18.399 --> 00:02:19.659 You know, they just, 00:02:20.020 --> 00:02:24.381 they bloom in the training and their 00:02:24.420 --> 00:02:27.942 trajectory for their post-training growth 00:02:28.882 --> 00:02:31.222 is really more sharply elevated and they 00:02:31.282 --> 00:02:33.122 just, they continue on that pathway. 00:02:33.808 --> 00:02:34.568 Yeah. 00:02:34.588 --> 00:02:35.669 And you've been doing this for a long 00:02:35.710 --> 00:02:35.930 time. 00:02:35.949 --> 00:02:37.411 Is it fun, I imagine, 00:02:37.431 --> 00:02:39.711 to run into people you mentored five, ten, 00:02:39.752 --> 00:02:41.532 fifteen years ago and kind of listen to 00:02:41.552 --> 00:02:43.593 the stories of where they've gone since 00:02:43.614 --> 00:02:43.753 then? 00:02:44.594 --> 00:02:45.414 Oh, yes. 00:02:45.694 --> 00:02:47.977 And at times it's almost like the 00:02:48.076 --> 00:02:49.518 mentoring role has changed. 00:02:49.657 --> 00:02:50.057 You know, 00:02:50.937 --> 00:02:52.699 I can go to them and talk to 00:02:52.718 --> 00:02:54.419 them or ask them questions. 00:02:54.539 --> 00:02:55.420 And, you know, 00:02:55.441 --> 00:02:57.622 they've been able to specialize in things 00:02:57.641 --> 00:02:59.443 that I have not or they've gained 00:02:59.502 --> 00:03:01.304 experiences that I don't have. 00:03:01.364 --> 00:03:01.443 And, 00:03:02.027 --> 00:03:05.069 So it just kind of flips the mentor-mentee 00:03:05.090 --> 00:03:05.371 thing. 00:03:05.411 --> 00:03:08.152 But that's one of the most rewarding 00:03:08.193 --> 00:03:09.174 things, I think, 00:03:09.213 --> 00:03:11.716 of someone who has been in my position 00:03:11.776 --> 00:03:14.997 and had some opportunity to work with and 00:03:15.299 --> 00:03:18.121 help the growth of some of these 00:03:18.181 --> 00:03:18.760 clinicians. 00:03:19.122 --> 00:03:19.542 Yeah. 00:03:19.602 --> 00:03:20.603 Well, let me flip it then. 00:03:21.503 --> 00:03:24.325 You've worked as a mentor with mentees. 00:03:25.247 --> 00:03:26.388 Not everybody probably... 00:03:27.566 --> 00:03:28.646 should be a mentor. 00:03:29.046 --> 00:03:30.788 I just mean like, what, what are, what, 00:03:30.829 --> 00:03:31.930 what makes a good mentor? 00:03:32.189 --> 00:03:34.652 How did you know that mentoring, um, it's, 00:03:34.712 --> 00:03:36.174 it's one thing to be a good clinician, 00:03:36.213 --> 00:03:38.056 but I'm guessing vastly different to be a 00:03:38.135 --> 00:03:39.997 mentor to someone else to do that. 00:03:41.239 --> 00:03:42.039 Yeah, I think, 00:03:42.259 --> 00:03:43.441 I think you have to be, 00:03:44.042 --> 00:03:45.883 be willing to, um, 00:03:46.403 --> 00:03:49.366 be a role model and to, 00:03:49.387 --> 00:03:50.888 to be exemplary. 00:03:50.948 --> 00:03:52.610 And, and there's times when 00:03:53.776 --> 00:03:56.016 You have to break down what you're doing 00:03:56.076 --> 00:03:57.516 so it's consumable, 00:03:58.937 --> 00:04:01.677 so they can see exactly what that is. 00:04:01.737 --> 00:04:03.598 And then, you know, 00:04:03.618 --> 00:04:06.139 there's just times when the ethics of 00:04:06.179 --> 00:04:09.379 certain situations, you know, 00:04:10.039 --> 00:04:11.681 will challenge a mentor. 00:04:12.001 --> 00:04:13.561 And, you know, 00:04:14.221 --> 00:04:15.741 you have to be willing to show your 00:04:15.762 --> 00:04:16.302 cards. 00:04:16.382 --> 00:04:17.641 And I think, you know, 00:04:18.041 --> 00:04:19.523 you want to make sure you stay on 00:04:19.543 --> 00:04:20.483 the high ground and 00:04:22.269 --> 00:04:25.192 so that the mentee can see the complexity 00:04:25.233 --> 00:04:26.853 of the decisions you had to make, 00:04:27.415 --> 00:04:28.375 how you got there, 00:04:28.875 --> 00:04:32.038 and why you did what you did. 00:04:32.059 --> 00:04:32.399 Now, Gail, 00:04:32.418 --> 00:04:34.321 you're a strong advocate for physical 00:04:34.360 --> 00:04:37.004 therapists as frontline diagnosticians. 00:04:37.644 --> 00:04:39.425 Is there a story that you've got, 00:04:39.586 --> 00:04:42.689 a moment when a PT's diagnostic skill 00:04:42.928 --> 00:04:46.012 really changed a patient's medical path? 00:04:46.052 --> 00:04:46.952 Anything come to mind? 00:04:48.612 --> 00:04:48.692 Well, 00:04:48.711 --> 00:04:51.173 I guess I've seen it so many times 00:04:51.314 --> 00:04:53.134 where, um, we've had, um, 00:04:54.355 --> 00:04:56.235 physical therapists, you know, 00:04:56.435 --> 00:04:59.017 take patients that have been sent to us 00:04:59.038 --> 00:05:00.538 and they've been through a fair medical 00:05:00.579 --> 00:05:03.920 process and their diagnosis is such that, 00:05:04.100 --> 00:05:04.261 you know, 00:05:04.281 --> 00:05:06.521 they do not belong in physical therapy. 00:05:06.601 --> 00:05:08.223 And it's, it's hard for, 00:05:08.403 --> 00:05:11.884 for one to stand out, but these things, 00:05:12.245 --> 00:05:12.605 you know, 00:05:12.665 --> 00:05:13.505 ranging from 00:05:14.533 --> 00:05:17.516 know trainees being in a line with chest 00:05:17.557 --> 00:05:19.059 pain and they were having you know 00:05:19.119 --> 00:05:22.682 myocardial infarction to tumors growing in 00:05:23.064 --> 00:05:26.307 in young people's long bones to um you 00:05:26.487 --> 00:05:29.670 know infections and leukemia and you know 00:05:29.790 --> 00:05:32.274 it just the list keeps on and on 00:05:32.334 --> 00:05:34.976 but you know i think physical therapists 00:05:35.771 --> 00:05:36.211 you know, 00:05:36.250 --> 00:05:39.473 do really well at being able to interview 00:05:39.492 --> 00:05:40.194 their patients, 00:05:40.233 --> 00:05:41.975 particularly if they've had some advanced 00:05:42.014 --> 00:05:42.935 clinical training, 00:05:42.995 --> 00:05:44.976 residency and fellowship level training, 00:05:45.677 --> 00:05:48.158 and they can quickly determine, you know, 00:05:48.259 --> 00:05:50.940 this just does not seem to be appropriate 00:05:52.021 --> 00:05:53.242 for physical therapy. 00:05:53.281 --> 00:05:54.822 So it's, you know, 00:05:55.564 --> 00:05:57.625 I have some teaching examples sometimes 00:05:57.665 --> 00:05:59.245 that I use, but, you know, 00:05:59.286 --> 00:06:01.266 it happens frequently enough that it's 00:06:01.326 --> 00:06:04.209 really not one unique thing, 00:06:04.249 --> 00:06:05.310 but it's almost like 00:06:06.007 --> 00:06:06.447 You know, 00:06:06.528 --> 00:06:10.692 if you had oversight to all the therapists 00:06:10.711 --> 00:06:12.252 that work in most of the settings that 00:06:12.333 --> 00:06:12.994 I've been in, 00:06:13.374 --> 00:06:15.776 it's probably every other day somebody 00:06:15.836 --> 00:06:17.798 pulls some patient out of there that 00:06:17.858 --> 00:06:19.279 doesn't belong in that clinic. 00:06:20.485 --> 00:06:20.925 That's great. 00:06:20.946 --> 00:06:22.687 You mentioned advanced clinical reasoning. 00:06:23.007 --> 00:06:24.007 When you think about that, 00:06:24.028 --> 00:06:25.447 when you think about advanced clinical 00:06:25.488 --> 00:06:25.889 reasoning, 00:06:26.288 --> 00:06:29.670 what's the biggest unlock that most 00:06:29.690 --> 00:06:32.232 clinicians miss early in their careers? 00:06:32.291 --> 00:06:33.632 Is there something holding them back? 00:06:33.793 --> 00:06:35.934 You mentioned a minute ago, really, 00:06:35.973 --> 00:06:38.595 really being able to understand that the 00:06:38.634 --> 00:06:39.815 patients are complex. 00:06:39.836 --> 00:06:41.456 That's got to be one of those unlocks. 00:06:41.476 --> 00:06:42.817 Is there anything else? 00:06:42.877 --> 00:06:46.358 Well, I think for someone like me, 00:06:46.439 --> 00:06:50.261 who I was very internal 00:06:50.757 --> 00:06:52.098 with my processes. 00:06:52.377 --> 00:06:53.338 And, you know, 00:06:53.377 --> 00:06:55.238 I think that there was a lot going 00:06:55.399 --> 00:06:57.298 on and I think I'd had lots of 00:06:57.358 --> 00:06:58.980 experience and there was things that, 00:06:59.120 --> 00:06:59.279 you know, 00:06:59.360 --> 00:07:01.380 I could just kind of tell what it 00:07:01.420 --> 00:07:02.901 was when you see it walk in the 00:07:02.920 --> 00:07:03.242 door. 00:07:03.961 --> 00:07:07.302 But until you bring your reasoning out and 00:07:07.343 --> 00:07:09.704 look at it and examine it and probably 00:07:09.744 --> 00:07:11.444 have somebody help you with that, 00:07:11.985 --> 00:07:13.985 you're not, you're not going to be as, 00:07:14.725 --> 00:07:17.067 as clean and as efficient as you could 00:07:17.086 --> 00:07:17.326 be. 00:07:17.666 --> 00:07:18.127 And so, 00:07:18.814 --> 00:07:18.973 You know, 00:07:18.994 --> 00:07:21.235 if you take what's implicit and make it 00:07:21.377 --> 00:07:24.158 explicit and get it out where it can 00:07:24.199 --> 00:07:26.040 be seen and where you're, you know, 00:07:26.060 --> 00:07:27.862 you're making mistakes or you're jumping 00:07:27.882 --> 00:07:30.225 to certain things or you're not exactly 00:07:30.365 --> 00:07:32.026 asking the right thing or you've missed 00:07:32.088 --> 00:07:32.767 opportunities. 00:07:33.348 --> 00:07:35.290 Those are the kinds of things that will 00:07:35.411 --> 00:07:37.632 elude someone that probably hasn't been 00:07:37.673 --> 00:07:41.057 through some formal training in how to get 00:07:41.096 --> 00:07:42.358 better at clinical reasoning. 00:07:43.077 --> 00:07:45.079 It sounds like it's the physical therapy 00:07:45.120 --> 00:07:46.880 equivalent of you got to show your work, 00:07:46.940 --> 00:07:48.463 not just your answer in math class. 00:07:48.483 --> 00:07:50.204 It's pretty much it. 00:07:50.444 --> 00:07:51.764 And there's a certain willingness. 00:07:51.865 --> 00:07:52.146 I mean, 00:07:52.565 --> 00:07:55.048 it's a little invasive to have someone 00:07:55.108 --> 00:07:57.889 come into your space and say, well, okay. 00:07:58.430 --> 00:08:00.632 But there was some things you could have 00:08:00.673 --> 00:08:02.093 done better here. 00:08:02.394 --> 00:08:05.115 And your thoughts are personal and so on 00:08:05.235 --> 00:08:05.937 and so forth. 00:08:06.016 --> 00:08:08.699 So it really is a willingness on the 00:08:08.759 --> 00:08:10.800 mentor's side to get a little bit of 00:08:10.860 --> 00:08:10.980 the 00:08:11.552 --> 00:08:13.675 mentee on them and you know and to 00:08:13.694 --> 00:08:15.675 be a little invasive and then you know 00:08:15.716 --> 00:08:17.476 and then mentee has to be accepting of 00:08:17.497 --> 00:08:19.819 that you know if you get if you 00:08:19.838 --> 00:08:22.100 get defensive then that's where where 00:08:22.141 --> 00:08:25.023 growth stops yeah i i imagine setting good 00:08:25.103 --> 00:08:27.665 expectations early on in that process of 00:08:28.084 --> 00:08:29.245 i'm going to push you but there's a 00:08:29.346 --> 00:08:30.987 reason to it it's not me trying to 00:08:31.028 --> 00:08:33.548 step on toes or or make you defensive 00:08:33.568 --> 00:08:35.191 there's a method to it so i imagine 00:08:35.311 --> 00:08:37.532 setting good expectations is probably 00:08:37.552 --> 00:08:37.993 important 00:08:38.499 --> 00:08:39.799 Yes. 00:08:39.919 --> 00:08:42.121 I think good communication both ways there 00:08:42.142 --> 00:08:43.162 is very helpful. 00:08:43.663 --> 00:08:44.563 Yeah. 00:08:44.604 --> 00:08:46.664 You've said that physical therapists are 00:08:46.764 --> 00:08:49.706 an untapped contributor to world health. 00:08:50.327 --> 00:08:52.328 What's one global health problem you think 00:08:52.369 --> 00:08:56.172 PTs are really uniquely positioned to help 00:08:56.211 --> 00:08:56.793 and impact? 00:08:57.393 --> 00:08:58.293 I think, you know, 00:08:58.374 --> 00:09:01.956 just musculoskeletal health, you know, 00:09:01.995 --> 00:09:04.138 worldwide would really 00:09:05.272 --> 00:09:10.375 benefit from unfettered access to physical 00:09:10.395 --> 00:09:12.778 therapists and their low-risk, 00:09:12.798 --> 00:09:15.318 high-benefit strategies, you know, 00:09:15.359 --> 00:09:18.621 things that don't push patients down the 00:09:18.662 --> 00:09:23.065 pipeline of advanced imaging and invasive 00:09:23.085 --> 00:09:23.966 things, you know, 00:09:23.985 --> 00:09:27.067 whether it's diagnostic invasive things or 00:09:27.148 --> 00:09:29.929 whether it's treatment invasive things, 00:09:30.110 --> 00:09:32.812 that there's so much that physical therapy 00:09:33.270 --> 00:09:34.412 would have to offer. 00:09:34.652 --> 00:09:35.211 And, you know, 00:09:35.231 --> 00:09:38.995 and I think at times we have this 00:09:39.054 --> 00:09:41.716 wrong with third party payers thinking, 00:09:41.756 --> 00:09:42.957 well, you know, 00:09:42.977 --> 00:09:44.859 we'll save some money and we won't pay 00:09:44.899 --> 00:09:46.419 for physical therapy or, 00:09:47.000 --> 00:09:48.721 and really it's the opposite. 00:09:48.802 --> 00:09:49.042 You know, 00:09:49.081 --> 00:09:51.143 you need to open your portals up and 00:09:51.182 --> 00:09:53.404 get these patients, you know, 00:09:53.684 --> 00:09:57.587 out of probably the whole medicalized 00:09:57.628 --> 00:10:00.690 pipeline and get them into someone that 00:10:00.750 --> 00:10:01.890 can help these patients 00:10:02.491 --> 00:10:04.613 be more active and be healthier and, 00:10:04.633 --> 00:10:05.332 you know, 00:10:05.413 --> 00:10:08.313 and have things that some strategies that 00:10:08.354 --> 00:10:10.754 are, that are lower risk and less costly. 00:10:10.774 --> 00:10:13.515 All right, Gail, 00:10:13.535 --> 00:10:14.395 we're going to play red light, 00:10:14.436 --> 00:10:16.616 green light here for all the clinicians 00:10:16.697 --> 00:10:17.217 listening. 00:10:17.437 --> 00:10:19.398 What's one habit you think they should 00:10:19.457 --> 00:10:22.038 stop doing tomorrow and one habit they 00:10:22.058 --> 00:10:22.820 should start. 00:10:22.860 --> 00:10:25.019 What's a red light and a green light. 00:10:25.100 --> 00:10:27.380 If they want to become sharper, safer, 00:10:27.441 --> 00:10:28.121 more effective, 00:10:28.142 --> 00:10:31.302 what do you typically suggest? 00:10:31.442 --> 00:10:31.863 I would say, 00:10:32.360 --> 00:10:33.302 If possible, 00:10:33.621 --> 00:10:36.423 I would try to make your administrative 00:10:36.563 --> 00:10:38.725 processes as efficient as you can. 00:10:39.226 --> 00:10:39.706 Yeah. 00:10:39.807 --> 00:10:41.548 And spend more time with your patient. 00:10:41.589 --> 00:10:43.649 That would be my big green light. 00:10:43.690 --> 00:10:44.811 Get your hands on them, 00:10:45.331 --> 00:10:47.833 get your interaction to be more intensive. 00:10:48.274 --> 00:10:50.395 And, you know, 00:10:50.416 --> 00:10:54.219 I think it's very hard to replace a 00:10:54.298 --> 00:10:56.200 highly qualified and trained physical 00:10:56.240 --> 00:10:57.961 therapist in meds for our clinical 00:10:58.001 --> 00:10:58.501 settings. 00:10:58.642 --> 00:11:00.524 And so the intensity of the interaction 00:11:00.563 --> 00:11:01.945 between the physical therapist 00:11:02.534 --> 00:11:03.615 and the patient is, I think, 00:11:03.635 --> 00:11:04.817 where the true value is. 00:11:04.897 --> 00:11:07.919 So that's definitely green light. 00:11:07.980 --> 00:11:08.720 All right, excellent. 00:11:09.321 --> 00:11:10.302 Gail, this was outstanding. 00:11:10.542 --> 00:11:13.825 Nice little short burst of insight. 00:11:13.845 --> 00:11:15.745 You spent a career proving what skilled, 00:11:15.787 --> 00:11:17.587 well-trained physical therapists can do, 00:11:17.648 --> 00:11:18.729 not just for patients, 00:11:18.769 --> 00:11:20.530 but for the profession and for global 00:11:20.551 --> 00:11:20.750 health. 00:11:21.471 --> 00:11:23.432 Love your mix of curiosity, rigor, 00:11:23.513 --> 00:11:24.073 mentorship, 00:11:24.214 --> 00:11:25.875 exactly what keeps pushing together 00:11:25.934 --> 00:11:26.635 physical therapy. 00:11:26.655 --> 00:11:28.717 So thanks for doing what you do here 00:11:28.738 --> 00:11:30.158 with AOMT and for the profession. 00:11:31.427 --> 00:11:32.649 Well, thank you very much, Jimmy, 00:11:32.668 --> 00:11:33.249 for having me. 00:11:33.288 --> 00:11:35.009 And I would add one thing. 00:11:35.330 --> 00:11:38.692 A colleague sent something to me a couple 00:11:38.711 --> 00:11:41.494 of days ago and posted on Baylor, 00:11:41.533 --> 00:11:43.875 where I have a faculty appointment as a 00:11:43.934 --> 00:11:44.895 full professor. 00:11:45.436 --> 00:11:48.957 They've got my name and profile and that 00:11:49.217 --> 00:11:51.960 I am in the top two percent of 00:11:52.039 --> 00:11:54.260 cited researchers in my field, 00:11:54.441 --> 00:11:57.802 which is truly amazing for me just to 00:11:57.822 --> 00:11:57.982 think. 00:11:58.649 --> 00:12:00.049 I'm a grassroots guy. 00:12:00.330 --> 00:12:02.091 You know, I worked with colleagues. 00:12:02.312 --> 00:12:04.653 We took clinical questions that were 00:12:04.692 --> 00:12:08.316 relevant and we did studies to try to 00:12:08.495 --> 00:12:10.777 get answers to those questions and we 00:12:10.817 --> 00:12:12.619 pushed them out into quality journals. 00:12:13.298 --> 00:12:15.740 And just to see that to be in 00:12:15.760 --> 00:12:18.982 the top two percent of cited researchers 00:12:19.643 --> 00:12:20.504 is amazing. 00:12:20.903 --> 00:12:21.664 That is amazing. 00:12:22.085 --> 00:12:24.407 How what led you to tackle on 00:12:25.774 --> 00:12:27.355 big questions like that? 00:12:27.674 --> 00:12:28.475 Doing research, 00:12:28.975 --> 00:12:30.316 none of those are small questions. 00:12:30.375 --> 00:12:30.895 It's got to be big. 00:12:32.115 --> 00:12:34.017 What sort of made you feel like, yeah, 00:12:34.157 --> 00:12:37.379 I can do this and it's worthy because 00:12:37.658 --> 00:12:39.479 the effort is large? 00:12:39.499 --> 00:12:41.460 Well, I think it is. 00:12:41.559 --> 00:12:42.581 In some of these trials, 00:12:42.660 --> 00:12:45.101 it's about equivalent to raising a child. 00:12:45.201 --> 00:12:48.322 But when you take something from concept 00:12:48.682 --> 00:12:50.884 to publication, it may take a few years. 00:12:51.203 --> 00:12:51.384 And 00:12:52.219 --> 00:12:54.559 I think it's just being hungry as a 00:12:54.600 --> 00:12:57.721 clinician and you have these questions and 00:12:57.782 --> 00:13:00.962 the literature doesn't provide the answer 00:13:00.982 --> 00:13:01.322 to it. 00:13:01.443 --> 00:13:02.644 You think you see this, 00:13:02.683 --> 00:13:04.024 but you don't know. 00:13:04.664 --> 00:13:06.645 And so now it's a matter of putting 00:13:06.666 --> 00:13:08.447 it to the rigor of a clinical trial. 00:13:08.506 --> 00:13:11.408 And I think clinicians and those that 00:13:11.687 --> 00:13:14.070 indeed have some advanced training and 00:13:14.110 --> 00:13:16.291 some advanced education are in a great 00:13:16.350 --> 00:13:16.870 position 00:13:17.557 --> 00:13:19.317 to design clinical trials. 00:13:19.399 --> 00:13:19.839 And, you know, 00:13:19.879 --> 00:13:22.360 at times you may want to consult with 00:13:22.801 --> 00:13:24.462 people that are in full-time research 00:13:24.523 --> 00:13:25.844 positions and so forth. 00:13:25.923 --> 00:13:26.703 It isn't like you're, 00:13:27.164 --> 00:13:30.027 you're out there all by yourself, but, 00:13:30.346 --> 00:13:30.567 you know, 00:13:30.607 --> 00:13:34.149 I think a group of motivated clinicians, 00:13:34.630 --> 00:13:37.232 you know, working and, you know, 00:13:37.253 --> 00:13:39.073 and most of our research was, 00:13:39.234 --> 00:13:40.134 was unfunded, 00:13:40.596 --> 00:13:42.636 not connected to any big grants or 00:13:42.677 --> 00:13:43.597 anything like that. 00:13:43.778 --> 00:13:44.318 And, but, 00:13:44.438 --> 00:13:46.600 so I think it points to the power 00:13:46.700 --> 00:13:47.341 of, of, 00:13:47.628 --> 00:13:51.993 what someone who's motivated to get more 00:13:52.052 --> 00:13:52.893 information, 00:13:53.354 --> 00:13:55.176 to be able to use it in clinical 00:13:55.216 --> 00:13:55.716 practice, 00:13:55.775 --> 00:13:57.238 what you can be able to accomplish. 00:13:58.573 --> 00:13:58.654 Yeah. 00:13:58.674 --> 00:13:58.855 All right. 00:13:58.875 --> 00:13:59.835 I said last question before, 00:13:59.855 --> 00:14:01.216 but I'm going to say last question again. 00:14:01.515 --> 00:14:03.096 What would you say to that clinician out 00:14:03.136 --> 00:14:03.297 there? 00:14:03.317 --> 00:14:04.337 They're not a researcher. 00:14:04.457 --> 00:14:05.118 I'm using air quote. 00:14:05.138 --> 00:14:06.178 They're not a researcher. 00:14:06.719 --> 00:14:08.320 But what would you say to them of 00:14:08.440 --> 00:14:11.000 why it will help their career and, 00:14:11.041 --> 00:14:12.241 of course, big picture, 00:14:12.261 --> 00:14:14.363 help the profession of taking on either a 00:14:14.423 --> 00:14:16.144 large or a small research project? 00:14:16.163 --> 00:14:17.224 Because we need those clinician 00:14:17.264 --> 00:14:17.884 researchers. 00:14:18.125 --> 00:14:18.504 You do. 00:14:18.845 --> 00:14:21.486 And I think what they can really add, 00:14:21.687 --> 00:14:22.647 one, you have the patients. 00:14:22.687 --> 00:14:25.428 So you have the subjects for any clinical 00:14:25.469 --> 00:14:25.788 trial. 00:14:26.269 --> 00:14:28.010 And you may have the question, 00:14:28.110 --> 00:14:29.552 and there's nothing wrong with 00:14:29.952 --> 00:14:35.619 collaborating with a research center or an 00:14:35.778 --> 00:14:38.201 educational program of one sort or 00:14:38.241 --> 00:14:38.621 another, 00:14:38.662 --> 00:14:40.604 whether that's at the entry level or 00:14:40.644 --> 00:14:42.166 that's a graduate level program. 00:14:42.586 --> 00:14:43.908 And you might be able to look at 00:14:44.528 --> 00:14:46.350 their research question that they're about 00:14:46.389 --> 00:14:48.753 ready to embark on and say, you know, 00:14:49.596 --> 00:14:51.118 I'd do that a little differently. 00:14:51.278 --> 00:14:52.778 I don't think that question is so 00:14:52.859 --> 00:14:53.759 relevant, you know, 00:14:53.859 --> 00:14:55.759 because from what I'm seeing, 00:14:55.840 --> 00:14:57.581 if we would tweak this or do this 00:14:57.620 --> 00:14:58.520 a little bit differently, 00:14:59.042 --> 00:15:01.442 that might be a much better question. 00:15:01.462 --> 00:15:01.883 You know, 00:15:02.102 --> 00:15:04.464 maybe it would yield you something that 00:15:04.543 --> 00:15:06.664 clinicians need in order to be able to 00:15:06.705 --> 00:15:08.066 go in and do business on a, 00:15:08.466 --> 00:15:09.586 on a day-to-day basis. 00:15:09.626 --> 00:15:11.607 And I think that's what you would have 00:15:11.927 --> 00:15:13.708 the most to add, you know, and if, 00:15:13.928 --> 00:15:15.850 if you think, well, you know, in the, 00:15:16.274 --> 00:15:19.394 statistical analysis or maybe what is the 00:15:19.434 --> 00:15:22.716 most rigorous design or something like 00:15:22.755 --> 00:15:22.995 that. 00:15:23.176 --> 00:15:23.395 Yeah, 00:15:23.436 --> 00:15:25.317 there's plenty of room for collaboration 00:15:25.336 --> 00:15:27.597 with those things if you feel like that's 00:15:27.658 --> 00:15:28.857 not exactly your skill set. 00:15:28.878 --> 00:15:30.839 Yeah, and we need that, right? 00:15:31.918 --> 00:15:33.700 The researcher and the clinician, 00:15:34.480 --> 00:15:36.200 they just bring different things to the 00:15:36.240 --> 00:15:36.620 table. 00:15:36.701 --> 00:15:38.821 I imagine it's probably better than the 00:15:38.880 --> 00:15:39.741 sum of their parts. 00:15:40.282 --> 00:15:40.662 Oh, yes. 00:15:41.831 --> 00:15:42.212 Love it. 00:15:42.253 --> 00:15:42.493 All right. 00:15:42.592 --> 00:15:43.793 I promised you last question. 00:15:43.813 --> 00:15:44.095 I got it. 00:15:44.115 --> 00:15:45.115 Gail, appreciate some insight. 00:15:45.135 --> 00:15:46.057 We'll love to have you back on the 00:15:46.076 --> 00:15:46.837 show sometime soon. 00:15:46.898 --> 00:15:47.578 All right. 00:15:47.639 --> 00:15:48.460 Thank you very much.