You're listening to the PT Pinecast,
where smart people in healthcare come to
make noise.
Here's your host, Jimmy McKay.
All right.
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Let's talk about today's guest.
There's a lot of conversations happening
in our profession right now about burnout.
Words come up a lot.
productivity expectations?
How about reimbursement pressure?
How about whether the profession is even
worth staying in right now?
But if you zoom out for enough,
the conversation then changes.
Because in many parts of the world,
physical therapy isn't a stressed
profession.
It's a missing one.
There are communities where access to
rehab care is almost non-existent,
where a stroke survivor might never see a
therapist,
where a child with CP might never receive
basic mobility training.
Today's guest believes that the solution
to frustration in our profession isn't
always found in policy debates or
reimbursement reform.
Sometimes it's found in perspective.
He left a strong career in the U.S.,
packed up his family, and moved to St.
Elizabeth,
Jamaica to direct a PT clinic serving a
community with limited access to rehab
services.
Fresh off a Category Five hurricane,
he's back helping rebuild both roofs
and access to care.
Today, we're talking about purpose,
perspective,
and why physical therapists may be sitting
on one of the most globally valuable skill
sets in all of healthcare.
Today, let's welcome in Derek Landis.
Derek, welcome to the show, man.
Hey, thanks for having me, Jimmy.
Excited to chat a little bit and talk
about therapy around the world.
Love it.
All right.
So let's start here.
After that intro,
you had a stable career here in the
U S as a physical therapist,
and then made that choice to move yourself
and your family to Jamaica.
What was the moment where you just,
where that decision really became tangible
and real for you?
What was that like?
Yeah, it was exciting and really scary.
I think at the same time, you know,
when, when, uh,
They reached out to clinic down in Jamaica
we're familiar with.
My wife and I are both grads of
Arcadia,
and they have a strong relationship.
The executive director of the nonprofit
down here in Jamaica is an Arcadia grad.
She's been running the clinic for over
twenty years.
And so Arcadia students get a chance to
come down and help a couple of times
a year.
They try and have camps at the clinic
where they bring in
Patients that have had stroke mostly and
do like a week or a week and
a half long intensive camp therapy all
day, every day, which is awesome.
You see amazing gains in some of these
folks.
But that's how we got to know it.
We came as students in twenty ten and
we came back again as clinicians in twenty
thirteen.
So so we knew them.
But in the summer of twenty four,
they reached out.
and said, Hey, you know,
we need some help down here.
Would you come?
Uh,
and so we thought a lot about it,
prayed a lot about that.
Um, I came down and visited again,
you know, since, you know,
we had in the meantime,
we had had two, two girls, um,
eight years old and three years old.
So we wanted to come and visit and
see what it's like.
Um, but yeah, then we decided, yeah,
let's do it.
We feel like this is where God is
leading us.
We want to come down and help and
use our skills.
Um,
and it was just immense excitement and,
and some terror, I think in there too,
because, you know, we were leaving,
you know, our stable,
good jobs in the U S and traveling
to, you know,
where we're not going to be making a
lot of money,
not having a lot of resources.
So there was fundraising and some other
things that went along with that,
that were pretty daunting, but,
but I would say, yeah,
mostly excitement as we,
as we packed up and came and,
you know, look to,
to be able to serve in a place
that yeah,
has
very limited,
very limited access to rehab.
Now for people listening for PTs who've
only practiced in the US,
what's simple to you might not be simple
to them.
So help us understand the difference in
access to care in the US versus where
you are in Jamaica.
So yeah, the biggest problem in Jamaica,
there's a huge need,
but there's just not a lot of places
that offer therapy.
You know, across the whole island,
my wife had done some research, Stephanie,
she's a therapist as well.
Um,
and then working with me in the clinic,
you know, she had done some,
some crazy statistics about how they're,
you know, in our parish of St.
Elizabeth parishes is kind of like a
state, uh, back home, you know,
there's a hundred and fifty thousand ish,
you know,
people there's like three licensed
therapists.
Um, and then, you know, the,
the clinics that there are mostly little,
outpatient ortho think type deals.
Not a lot of places that have any
resource to handle, you know,
someone who's post CBA that can't stand or
can't walk.
You know,
so the clinic really tries to work with
people.
You know,
we try to go and pick people up
and just gain access because it's so tough
here for the folks.
There's not a lot of clinics and
transportation and getting around isn't
easy.
either.
A lot of folks don't have cars.
You know,
the taxi man's not exactly going to throw
you in the back if you're a dependent
transfer.
So families are trying to get people to
therapy.
We're trying to get access,
but it's just really hard.
You know, back home, it's funny.
You drive down the road.
You know,
if you're on a busy main road,
you're probably going to pass a few PT
clinics, you know,
every couple of miles or so because back
home,
no one's willing to go more than
a couple of miles from their home.
So we've got tons,
but here there's just not many at all.
And there's still a lot of people that
need it.
So yeah, it's just a lot different.
The amount of access they have,
the ability to access services is just so
much more limited here than back home.
So you mentioned a few of the conditions
that show up most often.
Help me understand what changes when PT
does become available.
If you've got people who have limited
resources,
if they are able to actually get to
those,
what changes for some of those people in
your parish in their daily lives because
you're there?
So the coolest ones are, I mean,
the stroke patients are kind of nearest
and dearest to my heart.
You know,
that's neurogeriatrics was my specialty
back home.
And so that's the stuff that I love
the most.
You know,
I'm brushing up on my ortho because,
you know, it's a farming community.
It's a rural farming community where we
live.
So we deal with a lot of tough
people that are dealing with.
you know, shoulder pain, back pain,
just from labor intensive type work.
Um, so I enjoy those patients, you know,
seeing someone get back to work is,
is fun, but man,
seeing someone get back to, you know,
standing up and transferring,
that's just been in bed for,
for the last year because no one even
really thought, you know, Oh,
you had a stroke and you left the
hospital and that's it.
We're going to put you in bed and
feed you and clean you.
And,
And it's just not an understanding.
There's so much education just for folks
right off the bat.
Like, no, listen, we can try.
We're going to get you up in a
harness.
We're going to do all this work.
Because if we do,
you might be able to start standing and
moving around again.
And sometimes it's just the education of,
yes, it could be possible.
It's not a definite.
We can't work miracles.
know the the education to people that you
might be able to get up and do
it again you might not walk or maybe
you can but maybe we can get you
transferring and just opening up
possibilities to people that just were
sort of written off as
you know, now we just have to,
to leave you there.
So that's the funnest, biggest difference.
Um,
but I also have a bunch of people
that I'm working on basically on return to
work.
Um, it's not as, you know,
official or regulated as it is back home,
uh, with work comp and all that nonsense.
But down here it's, it's, you're,
you're hurt.
You can't work.
Um,
So we're going to work on these things.
Yeah.
If we can get you back to work.
So that's fun too,
but I think it's the neuro folks,
the stroke folks that,
that are the most fun.
Yeah.
A lot of therapists here in the U
S are questioning whether the profession
is worth it.
I'm using air quotes there for worth it.
You've seen our profession of physical
therapy through a very different lens.
What perspective do you wish more
therapists had?
So, yeah,
I know there's a lot of talk about
the things you mentioned, you know,
salaries and reimbursements declining for
the last twenty years.
Crazy statistic that is awful for our
profession.
you know all those things and those are
valid conversations valid points i'm sure
we'll be back into it you know when
we're back in the states um but here
you just remember here how valuable our
skill is and how much it helps people
um so back home i i hope people
anyone listening will just remember like
you have a an awesome skill that people
really need um
And is really helpful to people.
So if, yeah,
if you're in a place where you don't
feel that,
I would challenge you to look around
because there's places still, even,
you know,
back home in a lot of clinics where
you can still really help people.
And yeah,
that might be helping them with their golf
swing.
And it's not maybe as dramatic and
life-changing, but that's still important.
And it's still an important thing to
remember and focus on that.
that we're hoping people live better,
live stronger.
My fox might be coming through a little
bit, but it's true.
And I think we want people to remember
that, that we are really helping people.
And I know it's frustrating that
reimbursement's gone down and you're only
making whatever, eighty,
eighty-five thousand dollars a year.
And we want to be making more because
we have all the debt and all the
work.
And those are good things to think about
and lobby for.
But I would challenge people to remember
Yeah, what this is all about,
how much this really helps people.
Sure.
So the clinic that you work at has
been serving the community,
and you mentioned before,
for over two decades.
That's not a short amount of time.
What does long-term impact actually look
like?
This isn't you coming to town,
doing some things for a week or a
month or even a year.
This is two decades.
So what does long-term impact look like in
a community like that with a clinic who's
been there for that long?
So the,
the impact becomes more missional than
like we're known and respected in the
community.
Um, you know,
the property that the clinic is on is
actually, uh,
it was previously a residential deaf
school.
Um, so there's a lot of facilities here.
There's a lot, you know,
we were able to come down and live
like right across from the clinic, um,
where the kids used to live.
Um, that went to the deaf school,
the deaf school closed down and.
Twenty eighteen.
And they were able to move their clinic
up from where it was previously.
But what that means is that they're known
in the community.
They have resources and space now to house
people.
So they're able to do a lot more
for the community than just therapy.
They're able to reach out.
You know, we host work groups.
After the hurricane, you know,
the clinic was banged up a little bit.
We had to shut that down.
But we got that repaired.
And we said, you know what,
we really want to reach out,
take some time to help others rebuild with
the resources we have.
So we partnered with some disaster relief
organizations.
God's Pit Crew was one of them and
Hope Force International was another one.
And we were kind of like a home
base, you know,
a place for them to stay.
We went out with them to do some
of the work,
a lot of debris cleanup and roof repairs.
I was reminded that physical therapy is
definitely my skill set,
trying to tarp and repair roofs.
I was a little bit of a fish
out of water,
but it was a special thing to be
able to, in that time, you know,
in that devastation, be able to go out,
um, you know,
with people who didn't know what they were
doing, uh, to help, help rebuild.
And that is what you can really do.
I think when you've been in the community
a long time, you know,
the needs
you know,
these outside groups that are coming in,
that's what they need.
They need a local partner who knows the
area and who knows where the needs really
are that can point them and their
resources in the right direction.
So yeah,
the long-term impact is great for therapy
and helping people move better and
you know,
being a resource for the doctors in the
area that they can send patients.
But I think it just becomes more of
a greater,
bigger picture impact where you can really
help and support a community and bring in
resources and point them in the right
direction.
You've said therapists should zoom out,
think bigger about how they use their
skills.
Help me understand,
what does that look like practically?
What do you wish,
what do you hope to see in the
future?
Yeah, I mean,
I know everyone's not going to pick up
and move to another country, right?
That's a tough thing,
and not everyone's in the position to do
that.
We were fortunate, you know,
that we had that connection from school
and some volunteer work, you know,
a decade ago,
and we were invited to come down,
and yeah,
not everyone's going to have that.
So, you know,
even just in your own communities,
you know, I had to really, you know,
even being down here, I challenged myself.
I'm like, man, I'm doing this, but,
you know, for the past,
ten years before we came down here i
wasn't doing anything either um even
though in pittsburgh you know my wife and
i live you know in the suburbs north
of pittsburgh like there are pro bono
clinics that you could look up you know
in downtown pittsburgh there's a catholic
the catholic charities have a clinic um
downtown i was emailing back and forth
with them a little bit just because i
was curious you know they have they have
hours all during the week um
And they're just open when therapists
actually come and volunteer.
So I think for most folks, right,
the key is look around.
There are pro bono clinics.
There are places you can go and serve,
you know,
for people who are underinsured or who
don't have insurance.
People who, you know,
there's definitely places
where there isn't a clinic every couple of
miles.
Um,
and people have a terrible time accessing
care.
And I think there is where you can
really find people who really want it,
who really benefit from it and who,
whose lives are really going to be
impacted, you know,
even just from an evaluation and even just
from education,
pointing them in the right direction,
you know, try, try these exercises or yes,
there are walkers that, you know,
have extensions and can hold you upright
and this and that, and,
and just showing people what is possible
and what's out there.
Um, so yeah,
I hope practically that that's one
listening can,
can start to be curious what's already
around me, where can I are, you know,
where can I lend a hand and, and,
you know,
clinic practice directors and owners,
you know,
how can our organization support some of
these things?
You know, how can we gather
our staff and support efforts that are
already going on or who can we support
that's gone.
There's lots of other organizations around
traveling to different countries with
rehab focuses.
Yeah.
Remote area medical is one of them that
my former professor, Sky Donovan,
volunteers for a lot.
And they go to rural America and they
say the need is great.
A few hours or maybe even not a
few hours,
just outside a lot of major U.S.
cities that you maybe wouldn't know.
Yeah.
Let's play a quick rapid fire.
I'll give you three scenarios.
And then I just want your first reaction.
This is really all around perspective
check.
So
Derek,
you can give one physical therapy student
a plane ticket to anywhere in the world
for a clinical experience.
Where would you send them?
Well, I gotta be a little selfish here.
We need help in Jamaica.
So I'm going to give them a plane
ticket to Jamaica.
I want to show them our clinic and
what you can do here.
We could,
we could have a full case of it
for you, uh, at no time.
Um,
and you would learn a ton here too.
We have a very diverse, like I said,
we got shoulder pain, back pain, you know,
A lot of the young guys riding bikes
around here, motorbikes, accidents,
surgeries,
stroke prevalence is pretty high.
You know, our director sees pediatrics,
developmental disorders.
So, yeah, I'm going to be.
I know of some others, you know,
back from our Arcadia days,
Hearts in Motion was going down to
Guatemala and things like that.
But I got to be a little selfish
and take them down here to me.
How about one physical therapy skill that
becomes unbelievably valuable in a
resource limited environment?
What's something that we're sleeping on
that we don't realize how powerful it is.
Oh man, it's gotta be transfer training.
Like it's such a basic PT one-on-one
thing, right?
Like sit pivot,
stand pivot transfers is something you
almost forget about because of how simple
it is in our education and our profession.
Um,
But man,
you get down here and you see,
you know, sons and daughters, you know,
picking mom up out of the car
And like trying to carry her over to
the wheelchair,
ten feet away and put her down in
it so they can wheel her in to
the clinic is heartbreaking, right?
But that's one of the most important
skills is just showing people, no,
there's a much better way where you're not
going to hurt her or you or anybody
else.
So it's,
I think it's those really simple things,
especially for the neuro folks.
That's one of those skills that don't
forget about.
Don't forget about educating.
Don't take for granted that caregivers
know how to do it because it's not
all that intuitive.
I think we forget about that.
Yeah, we overlook what is common to us.
We often undervalue and what is uncommon
to us, we overvalue.
So maybe don't undervalue what we actually
know.
It's pretty valuable.
Third scenario.
If every physical therapist had to
volunteer one week a year somewhere
underserved,
what would happen to the profession in
your opinion?
I think we're always talking about morale,
at least in previous employers.
That's the key to morale, I think.
I mean, yes, more money would be good.
And yes, more time off and flexibility,
all those things.
Good, good, good.
We see a lot of therapists go in
different directions to try and find those
things.
But I think
more fulfillment in the profession,
more satisfaction with your job is,
is going to come from more satisfaction
with your choice of profession as a whole.
And I think you can do that by
finding people that, that really need it.
Cause that's a different patient
population.
That's a different experience, you know,
both for you and as well as the
patient.
But I think doing that,
finding the clinic that's around,
they're everywhere.
You know, if they're not,
certainly think about starting one.
But look around.
There's going to be a clinic nearby that
you can get involved in,
really help people,
really gain that satisfaction with your
profession.
And I think that overflows into your
regular full-time job and the amount of
satisfaction you have just in general with
what you're doing.
Love it.
If people wanted to find out more about
the clinic, is there a website?
Can they learn more?
Is there a place that you'd send them
online?
yeah the website for the nonprofit is
friendsoftheredeemer.org that's the name
of the nonprofit that's sort of the
umbrella over the clinic and some of the
other ministries that are happening here
so yeah that would be the best place
to look online see what's going on my
wife is managing the social media you know
facebook friends of the redeemer united on
facebook you can follow along
And my wife and I have an Epistle
website that we put updates on more
personally about our experience and our
journey.
I can certainly send that as well.
Yeah.
Yeah, love it.
All right.
Every episode we do wraps up with the
parting shot.
I'll toss you a question for this parting
shot.
If a physical therapist listening today
feels burnt out or discouraged,
what would you want them to remember about
why this profession matters?
What's something you can give to them to
hang on to?
I think stop worrying about your salary.
I know that's important,
but try and find somewhere where you can
really go and help people.
Um,
I think you're going to be surprised to
find what that does,
not just for your job satisfaction or your
profession satisfaction,
but I think what it does for you
as a person in your life, um,
try and find, yeah,
somewhere you might not get,
you're not going to get paid for it.
You're not going to booze.
It's not a side hustle.
Um, all of those things that we're,
we're constantly looking for ways to be
more satisfied, to be more fulfilled.
I think a lot of us are looking
in the wrong places for that.
I think if you can go and serve
and help people, you'll really find it.
Derek Landis, along with his wife,
doing some great things down in Jamaica.
I appreciate you sharing this and thanks
for doing what you do and letting know
so others can learn from it and hopefully
following your footsteps.
Yeah, thank you very much, Jimmy,
for having me on.
That's it for this one,
but we're just getting warmed up.
Smash follow, send it to a friend,
or crank up the next episode.
Want to go deeper?
Hit us at pgpiecast.com or find us on
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And legally, none of this was advice.
It's for entertainment purposes only.
See you.
Bullshit.
See, Keith?
We read the script.
Happy now?