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What a chiropractic student learned about communication and care

Episode 138

69 Minutes – May 8, 2019

0:00 / 69:32

Chapters

Questions this episode answers

My MRI shows a disc herniation, do I have to stop working?
Not necessarily. Disc herniations don't cause low back pain alone, and many people have them for years before any pain starts. Find someone who shows you what you can do to control your pain right now.
How long should a first chiropractic visit take?
I book an hour and a half and usually use an hour to an hour and fifteen. The first visit is about a full history and building rapport, not rushing into treatment.
Is a $40 chiropractic exam deal worth it?
Geronimo described cheap online deals where you get an exam and an x-ray review but never get touched or treated. In his experience a large care plan often sits on the other side of that price.
Should I keep seeing a chiropractor forever for back pain?
The goal should be independence. I move people out of treatment and corrective exercise as quickly as I can and into resistance training, so they can manage on their own.
Should my chiropractor know how to lift weights?
Geronimo's take was yes. He found he couldn't coach a deadlift or even the McGill Big Three well until he had done them himself and been coached.

Communication comes first

Geronimo Bejarano is a first-quarter chiropractic student at Palmer, Florida. Before school he worked the rehab side of a chiropractic clinic, spending 30 minutes with each person. He says he got very good at one thing there: talking to people in plain words.

I agree with him. Communication is what gets buy-in. It is what gets someone to do the at-home work. If you can't explain it, they won't do it.

His advice to students is simple. Get in front of people who aren't your peers. Shadow. Sit in on a local talk about low back pain and listen to how the clinician turns jargon into everyday language. School gives you professors and classmates. It rarely gives you that.

Build independent people, not dependent ones

Geronimo's take was blunt. With big student loans, it's easy to forget who you're doing this for. Long care plans that create dependency are the trap.

He also admitted something I've learned too. Some people will keep coming back no matter how well you explain things. He'd rather they come to him, where he keeps pushing them toward independence, than go next door to three visits a week for three months and then once a month forever.

My approach is to get people out of treatment and corrective exercises as quickly as I can, then into load. After that it looks like a personal training session with someone who knows the condition. I have a few people who still come weekly. They enjoy it.

Geronimo also made the case that your clinician should know their way around a gym. He couldn't cue a deadlift he'd never done. Even the McGill Big Three felt hard to coach until he did them himself and got coached.

A back pain story that shows what's at stake

Geronimo's mom called him about a coworker, a woman around 60 who cleans houses for a living. She got adjusted, still hurt, then saw a doctor. An MRI showed disc herniations at L4 or L5. She was told to stop working, given steroids, and told surgery was next. She went on bed rest and panicked.

Geronimo explained that she had probably had those herniations for years and only recently started hurting. He told her to find someone who would show her the small things she could do to control her pain right away. He sent her Stuart McGill's Back Mechanic.

She got up that day, felt better, and felt in control. Without that call, Geronimo thinks she was headed for chronic pain and possibly surgery.

If you asked me what goes on my gravestone, it's this: disc herniations don't cause low back pain alone.

Exams, value and the cheap first visit

Geronimo described exams sold online for about $40: a quick exam plus an x-ray review. You never get touched or treated. On the other side of that $40, he says, sits a $4,000 care plan.

I book an hour and a half for a first visit and usually use an hour to an hour and fifteen. The first day is not about doing a lot. It's about building rapport, so the person trusts the plan enough to reach the end goal. Geronimo had a fellow student take his history recently. It took over an hour, and he kept remembering things he'd never thought to say.

My view on value: you are worth what you save someone from. Back pain can take away the things people care about most. With groin pain that turns out to come from the low back rather than a true sports hernia, people show up with no idea what to do, sometimes facing a surgery insurance won't cover.

Stay skeptical and keep learning

Geronimo thinks skepticism is healthy, toward professors and toward people like me. Research gets us closer to the truth, he said, but it's really about being less wrong. Ask where the information comes from.

He also pointed out that big names in this field often answer emails. Join groups. Practice skills with colleagues, because hands-on skills fade if you don't. I'm getting together with a colleague to rehearse neurodynamics for exactly that reason.

His last point was a good one. Specialty courses build confidence, but also seek out courses that show you how to put the pieces together.

Key takeaways

  • Clear, plain-language communication is what gets people to actually do their home program.
  • The goal of care is an independent person, not a lifelong visit schedule.
  • Disc herniations on an MRI are often old findings and do not explain low back pain on their own.
  • A real first exam takes time, because rapport and a full history drive the plan.
  • Be skeptical of any advice, including mine, and ask where it comes from.
  • Keep learning and practicing with others, because skills fade without use.

At a glance

Conditions and injuries
  • Low back pain
  • Lumbar disc herniation
  • Groin pain mimicking sports hernia
  • Flexion intolerant back
Anatomy involved
  • Lumbar discs at L4-L5
  • Upper lumbar nerve roots
  • Groin
Symptoms described
  • Low back pain after an MRI diagnosis
  • Groin pain
  • Hamstring tightness
Treatments and exercises
  • Plain-language education and self-management
  • Resistance training as an exit plan from care
  • McGill Big Three
  • Thorough history and rapport-building exam
Episode Transcript

This transcript was generated automatically (whisper.cpp large-v3-turbo) and may contain errors.

And every single one, you're going to take some nuggets. But I think more importantly, what I got in from this is, here's this doctor who's been out 10 years, who what seems like runs a very successful practice, who gets to talk to all of these big names, we'll call them, and he is still learning at all times. You can be, you know, Sebastian. Oh, interesting. I wouldn't have thought you would have said that. You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. And now, your host, Dr. Sebastian Gonzales.

Hey, guys. It's Dr. Sebastian Gonzales, your host for the Restoring Human Movement podcast. Thanks for joining the movement. Movement. We're going to have an extra special guest on today. This is going to be a student. I'll let him tell you all about himself. But I'm going to have a student on today, and this is somebody who has been listening to roughly about 90% of the podcasts that I've released. So, I've released almost 140 podcasts. He's listened to a ton of them. And so, what I'm interested in is, has this improved his schooling experience or how he's going to practice in any way, shape, or fashion?

My goal is to get people to improve how they practice sooner than I did. I didn't really improve my practice in regards to improving my patient outcome really significantly until about five years out of practice. And there's a lot of things that I wish I would have known now that I wish I would have known in school. And so, I'm hoping to share all that kind of stuff. And if you listen to a lot of the podcasts, I've shared a ton already. And so, now I kind of want to see how things are going. It hasn't been improving things on the other side. And so, I'm going to have a series where I'm going to start interviewing some students, some chiropractics, some PT, some athletic training students, and just see how things go.

And see if I can improve my services to you guys and see where I need to improve my content as it gets to you guys in the next coming episodes. So, I'm going to have on, I think, one every month. Roughly every second week of the month on a Wednesday is going to release. And so, I already have a few lined up, by the way. Also, too, and this is, I'm going to pitch this again just because I know it will change your practice career. If you're a student and if you've wondered about how to use corrective exercise or how to use loading or how to use resistance training or where to patch things in in people's care, when do they need tissue work, when do they need adjustments, when do they need pain trigger reduction, when do they need first aid?

I'm going to go through all this kind of stuff that I've learned, at least through the people that I've interviewed as well as all the workshops that I've been to. I'm going to do a workshop on my own. It's the very first one. It's in June 8th and 9th in Huntington Beach. It's in my own clinic. There's only like 20 spots, and I think as of right now, there's probably one left. I don't do really good bookkeeping on this, but for the most part, there's not a lot left. So, if you're interested in that, direct message me on Instagram, that's performancehb, or just email me, sub at p2sportscare.com.

To be honest with you, that whole workshop was not my idea. I had some students, or not students, but my classmates mentioned something about, hey, let's all get together and do some CEs. By the way, why don't you put them on? And so, I said, hey, that's a good idea. They're like, hey, why don't we do it at draft picks over in Whittier, where we used to all go to the bar after going to school. And I said, well, we can't do it at a bar, but we can do it at my office, and we can have steaks and beer after. So, I put it all together, and I only had a handful of my classmates actually sign up, and I realized, you know what, Mike, you know what, I think the listeners would like it.

And so, this is how this thing really started, and there was scaled pricing in there, and there was early bird, I guess, extra early bird and so on. And I realized that the top level was $500 at the door. I just wanted to be a party, honestly. I just wanted to hang out and learn from all you as well. So, I didn't really want to charge much at all, but when I started doing all of the learning what CE costs to actually put on, it ended up becoming a thing, and I had to present also what I was going to present to you guys. And becoming work is the point. So, if I do this workshop again, and I don't know if I'll do it again, it's going to cost more.

So, if you're looking to save some money and learn shit that's going to change your way of practicing from me, and all the stuff I've learned from all the people on the podcast, please attend, all right? I really want to shape the profession. This is probably the easiest way. And honestly, from the people who I've shadowed, a lot of students have shadowed me. They want to learn all of these things, but they're learning it in bits and chunks through like a four-hour shadowing session. If you want crash course, just go. Just come. I would love more students than clinicians to honestly come to this.

So, it's going to be a good time. Everyone wants to have tomahawk steaks and beer or whiskey or whatever. We're going to have it all after. So, anyways, last part before we actually go into the interview is that every time I try to share a little bit about myself through a personal story or a rant. So, I'm going to share that right now. Then we're going to get right into the podcast. Please subscribe. Share this with a fellow student. And here we go. So, back in the day growing up, I didn't really have a ton of money. Like, we weren't poor or anything. And we definitely had enough money to survive.

But I never really asked my parents for a lot of money. And so, I wasn't taken care of that way. Although my dad might tell you different. He's like, they were spoiled brats. But I never really asked them for money and said, hey, dad, give me 200 bucks, you know, type of thing. So, anyways, I grew up kind of frugal. And so, one thing that I thought kind of was a waste of money was greeting cards or especially like Valentine's Day cards, birthday cards, and so on. So, there was one time that I bought a card for somebody and I took a piece of paper and I wrote on the paper and put it in the envelope and didn't seal the envelope and put it in the card.

And so, when they got the card, they read the piece of paper and the card was blank. And I said, here's the gift that keeps on giving. You can just return that and get about five bucks back. So, it was kind of like, you know, it served its purpose, but you don't really need to write on the card. I wasn't going to keep the card. They weren't going to keep the card. It was just going to be a toss and throw away. And also, too, back in the day, I used to draw cards. Me and a friend used to actually, for his, I think it was his birthday, maybe it was Christmas, I forget. But you'd do a wrap in the card.

And I would draw my own card. Again, I'd just do it on paper because I like drawing, as you've seen, probably. But anyways, so we do these wraps. So, if I can find one, I'll actually do one on air. He might have some, but I thought they were pretty clever. They're probably about, like, 30-second wraps. Real cool. All right. Now, on to the content. How's it going? Good, good. How are you? Just came from wet lab, so cadavers. Oh, I was going to say, I was wondering, when you said wet lab, I was like, it sounds messy. Yeah, yeah, yeah, cadavers. Yeah. Like, dry lab and wet lab. Are you still wearing your smock, your jacket, too?

Yeah, it's like a white coat sort of thing, but we didn't touch anything today. I'm only in the third week, so it was just him showing us, or the professor. Oh, really? But it just, I remember just reeking, like, formalgahide. Like, we just... Yeah, it does. It does smell. It smells in here. Yeah. Are you... Oh, you're at school, so you're in a little room over there? Yeah, I'm in a study room. Mm, got it. I think that's the best way to keep quiet in a school. Probably. So, what's up? Nothing. I'm excited. I'm really excited. It's good to see you and meet you, actually. Yeah, good to meet you, too.

It's an impressive number, 90% listen. I don't think I've heard 90% of my own. Yeah, I've definitely gone through everything in 2018, 2019, and I'm, like, in 2017, and then I haven't listened to those mornings yet. Oh, really? Yeah, I mean, you didn't put it out early enough, you know? Oh, what time? I think it goes 4 o'clock Pacific, I think, so that's... 7.30, yeah. So, school for me starts at 7.30, and I live an hour away from the school, so that gives me a good enough time to listen to a lot of podcasts. Well, I'll tell you, maybe I should start doing it at 3 o'clock. Oh, you're good. I mean, I listen to a lot.

That was one of the things that I wanted to mention on the podcast was just the communication stuff just with you. I like your podcast so much just because when you start off with the stories and stuff like that, it just makes you feel like I know you, and that automatically makes a podcast just almost, like, mean more. Same thing with, like, patience and stuff like that. Yeah. I think... Well, thanks. I've wondered, as you've probably heard over the course of the years, I've done them in a different style, but I remember in one of the interviews, I sent them for review, and they're like, they're like, why did you put that in?

No one cares about that. I said, I'm like, I don't know. It feels right. I don't know what to tell you. Yeah, it's really cool. I mean, don't get me wrong. There's one where, like, you're singing in one of them, and stuff like that. Don't get me wrong. That one was an old one. Yeah, it is. I actually heard it the other day. It is. But, like, usually I'll skip. Like, if I know it's coming, like, and I listen to other podcasts, I'll have, like, an ad read or whatever, and I'll usually just, like, because you can do the 30-second skip. But with yours, I don't do that, and, like, I didn't think about it until we said we're going to do this podcast, and so I started thinking about, like, the different things about it, and I was like, hey, like, I think I like it because it's, like, almost like I'm listening to a conversation instead of, like, somebody just speaking to me, I guess.

It's a little different than, like, an audio book or something like that. Well, nice. That's how I, like, your audio book, too, is it felt like just a five-hour-long podcast or whatever it was. Man, that, I tell you, that audio book was, I think, was the hardest thing I've ever done in my life. How many times did you, did you have the, was it just one take or? No, there was a, actually, so, so with these, with the, with these podcasts, like, I, I don't, I don't really edit much unless there was, like, there was a couple that I, one I bleeped, and there was a couple that I clipped out a little bit just because it wasn't, it was like an ongoing something else.

But that one, it's because there's, you remember Popcorn is Cool? Did you have Popcorn? Yeah, yeah. And so you have to kind of go, like, you can't change the story at will, so it was kind of like, it had to kind of follow, so as I started to read it, I started realizing that I could have probably written that better because it doesn't flow off my tongue, and so I started ad-libbing a little bit and so on, but they chopped up. And so that one I had to send, actually, to a professional audio person, and he took out the clips that sounded like, or the clip points, you know, but he did a good job.

It was cheap, too, by the way, so. Yeah, well, far away from doing anything like that, but still. Well, in case you ever want to. Yeah. So, actually, I didn't tell you, we're actually recording already, and I found that in the past, when I'm speaking with people like you, like, some of the really good stuff is in the recording before, or pre-recording, and so I was going to give you the opportunity to cut it out, but I think the communication was good, so I'm going to leave it, if you're good. Yeah, no, definitely, that was one of the things I wanted to talk about anyway. I just think that's probably, if not the most important thing that we do, is being able to communicate right, because that can lead to so much buy-in, and it can lead to the patient wanting to do it, especially the at-home stuff.

If you don't communicate correctly, then it's just, it's so hard. That's why I always, I heard the recommendation from when I was an undergrad to not going straight into grad school and go and work at a clinic. A, because you're about to put in $100,000 minimum in student loans, possibly, and so make sure you like it, and B, just to kind of feel more comfortable. So, I definitely, I think the biggest thing that I got ahead of it was just that I was dealing, I was doing the rehab portion of the, when the patients came into clinic, so I was spending 30 minutes with them, and I got so good at communicating whether, how good I was at doing the actual rehab stuff is iffy, but the communication with me, I have no problem talking to somebody and explaining to them.

And especially since I wasn't yet through the graduate school stuff, it's not like I had this big terminology of all the medical stuff. It was just, I was technically speaking in my own terms, and they were layman's terms, and I learned them, and I think that was the best part about it, and that's what I would really recommend to students. Or even if you're in grad school, go shadow and try to get as much time in front of people that aren't your peers. And then, or if you're out of work, go and do a case where, like, you're bringing people in, telling them you're going to speak about low back pain.

I go to a person, a PT that does it, that works out of a CrossFit gym. He's got a room at a CrossFit gym, and I read the first of every Saturday, he does either low back pain or whatever, and it's usually people in his CrossFit, but I sign up, it's $10, and I go, and I learn, and I know the FMS and the SFMA and all that stuff that he's saying, but he's speaking it in layman's terms, and I think that's so important to practice that. It's something that you don't get in school, because it's always peers or professors, so it's a lot different. I think that's one of the hardest things about getting from school to getting out.

Yeah, I do too, actually. Actually, you know what? I'll come back to this in one sec. Tell everyone your name and a little bit about yourself, because we've gone this far. I'm confusing myself. My name is Geronimo Bejarano. I'm a quarter one student at Palmer, Florida. I initially was going to do PT, and then I was told to get a job before I make sure that I go and invest all this money, and I ended up getting hired by a chiropractic clinic that was doing, let's say, a lot of rehab, but it was a lot of cookie-cutter rehab. Fortunately for me, unfortunately for the patients, I didn't get a lot of tutoring or showing what to do or anything like that, but fortunately for me, I got in.

I joined a bunch of clubs on Facebook. I listened to your podcast. I read Miguel's books, I read a lot of stuff, and I just got better, and I think that was one of the biggest things for me was how much better I saw myself get with patients and speaking to them. So that's kind of what sets me apart at school and why I'm a little more advanced with certain things, and I'll have a little more biases with certain things, especially when you're in chiropractic school and how much straight and mixer and subluxations and professor biases you can get. So it's a little different, as you probably remember.

Yeah. That was, it seems like, it doesn't seem like that long ago. That was 10 years ago for me, I think. So you read all that stuff, and you started doing all this before you actually schooled then. Yeah, I mean, I was doing it probably a month or two, and I started just, the more you listen and the more, especially with your podcast, you had so many people on. I mean, I don't remember if I heard of Stu McGill from you or if I heard it prior, and this is what led me to it, because I essentially went and just searched Stu McGill on the podcast app, and I just listened to every podcast that he has been on, and then I essentially did that, and I don't know if that's how I found this podcast or somewhere else.

It's been over a year now, but I did that for Stu McGill. I've done that for Craig Liebenson, and then lately I've been doing a lot of the pain science guys, so like Peter O'Sullivan and Greg Lehman and stuff like that. I think that part is fascinating to me as well as the pain science guys. I think it's, I've always been interested how, I mean, people, like Stu does a really good job of, like he interviews really well, and in a lot of them, I know he asked me this, he said, you know, like, oh, Sebastian, what would you like me to call you, you know, and so, and then he'll call you by whatever he asks, and he'll call you by name frequently throughout.

And so, I think there's a bit of, I don't want to say coaching with that, but it's like, like, just for working with people, like, they resonate well when you say their name a lot, you know, and so I think those people on those podcasts, the ones that are the more noteworthy ones, whether they're good or bad, they're really good at communication, you know. Yeah, that was one thing that I heard, like, I just recently listened to your Dan John one, so it was 61, I listened to that one, and you guys spent the first 30 minutes talking about communication, and almost every single one of them, whether it's McGill or any of them, you guys at some point talk on communication, and I think that's so important, especially with all the, I would say, lies being told, or things that, I guess it's not a lie that if the doctor doesn't know any better, but, and just trying to create this dependency, and I think that's the hardest part, especially when you come out and you have all these loans, and it's hard to remember that, and you wrote this on the checklist sort of thing that you said, the things that you wish you knew in school is just, with all these loans, don't forget that you're doing this for the patient, and don't try to, you know, do these long care plans, and different things like that, and that's a big part of the communication part, is making sure that they understand that something that they can buy into, something that they can do for themselves, and create independent people and independent patients, and I think that that's the hardest part, especially coming out of school, is knowing the communication, because everything else is just stuff you'll learn.

Yeah. I don't know if you've experienced it yet, but I know that just as you were speaking about that, it reminded me that, I feel like there, I don't know when this became a thing, but I feel like people started to distrust their doctor in the recommendations, and I don't know if it's just chiropractic or PT or whatever, like MDs, but it's like, they, like, whatever you're recommending, there's this unsaid thing in their head where they're like, hmm, I don't know, my mom told me that, that this guy's gonna say that, and I shouldn't do that, you know? But your recommendation should be so pure that it's like, why is this person not, like, complying?

I'd actually, I actually think that's a good thing for people to be skeptical, though, both as students, to your professors, and to the doctors that you're listening to, and I don't think you should take anybody's word at 100%, especially with the way that research works, is we're getting closer to the truth, but we're never gonna get to the truth, so it's just about being less wrong. So, like, the stuff that you put out is great now, but if we look back at five years ago, you're probably gonna look back at some of the stuff you've said, and it's like, oh, this is completely wrong now, but as long as it's the truth for you now, and you're staying up to date with things, I think that's the perfect way, but I think people should be skeptical of anything. I think that's the best way to learn, and the best way to make sure that you're hearing the correct information. I am so skeptical with some of the stuff that I'm learning now, and it's just, I don't try to make a fool out of myself in school, but I also try to ask questions like, where do you get this research from? Like, where are you getting this stuff from? Especially at Cairo school, there's a lot of stuff that is great, and there's a lot of stuff that's kind of just, it's been a while. It's been a while since we thought like that, and so, and that's one of those things that I've just managed to know so much by podcast and by reading before coming into school, so that kind of lets me have a source of skeptical, but also a little bit of bias, I guess I'll say, towards maybe the rehab portion or the independence portion, things like that. Well, so is there anything in school yet that kind of changed your mind about, like, what your preconceived notion was about that one topic? Not really. It's just a lot of it right now is, the only thing that I did find is that there are people that are just going to come to you a lot, and they're going to need you, and I don't think that, I think that those people also need help. I don't think it's wrong for people that just need you to need, they won't do things outside of the office, and it's, sometimes you're, no matter how much you communicate it, and as, and I would rather them come to me, and me continue to try to grow that independence, and go, you know, next door to the guy that's going to sell them three times a week for the next three months, and then one time a month for the rest of your life, sort of ordeal. Yeah, I would, I would agree with that.

It's, I think in the past, I give patients or lay public a little bit more, I gave more credit to be able to do what's asked of them, but they, I think at least the people that come in and see us, sometimes they get that way for a reason, and so, I mean, there's people, I have people that come back to me weekly. I don't have a ton of them, but they just, they're, I think the last podcast that came out was on resistance training as an exit plan to care, or at least was one of the last two, and so, like, I tend to get them out of, like, the treatment and corrective exercises as quick as I can, and then get them into load, and then it just looks like a personal training session with someone who knows your condition, or what the condition was, but they enjoy it, you know, and I, like, I've attempted to take, tell some of these people to go to a different gym, and then, like, my personal experience was that it's some of the, some of the coaches or trainers know what I'm asking for, or the program that I would like for them, and other ones don't, and it's, it's kind of like, I, I can choose to keep this person in office to help them go through the plan that I have laid out for them, or I can choose to educate the other person, which then, this is, like, do I want to do that? It might take longer than it's worth, you know, so, but I guess that's going with your, like, the referral sources of knowing who's going to do the job that you want to be done, you know?

Exactly, and I, and I've heard a lot about this, and it's funny, because I used to not think like this about two years ago, was that all of your doctors, whether it's chiro, PT, or anything like that, that you're going to, they shouldn't be, it's not that they should be gym rats, but they should at least know their way around a gym, and I, I actually, when I first heard it, I was, and I wasn't huge into going to the gym, I played soccer, but it was, I was more of good at the skill, and not so much a good athlete, I just managed, I played a lot of it, so it was, it wasn't, I never needed to hit the gym, it wasn't anything like that, so it was, I, I didn't know my way around the gym, so I had this bias, so I was like, are you serious, I can't be a good, uh, chiropractor, or physical therapist without ever doing, you know, a deadlift, and then I got into the work, into the job, and I wanted to get them to load, and I was like, how am I going to teach a deadlift if I'd never done one myself, or cue all of these things, um, even down to like the McGill Big Three, which is such simple movements, but if you don't know what to do, or how you've never done them, it's really hard to cue them, so I started doing them myself, and I realized, hey, I'm not so good at something so simple as doing, you know, a, the McGill Big Three, or anything like that, um, and it was, I had the ghost somewhere to, for somebody to cue me, sometimes you just need to, to be cued your way through it, just like you said with, you went to Cody when you had the, the low back pain, and stuff like that, sometimes you just need somebody there to, to tell you, and you just need to listen, and you learn so much from working out, and working on your own body, that you don't, you learn all of that, and it's stuff that you just don't see in school, at least not in Cairo school, is, is, hey, you should be going to the rehab center, it's free here, and we have a great rehab center, and there's a lot of students that are going to go through the whole entire school, and never even go to the rehab center, or never, you know, get adjusted, or anything like that, and I think you can learn so much by being treated, hmm, that's a good point, actually, like, so when we went through school, like, we didn't, we, we would go to the clinic to help out the clinician that you were kind of assigned to, you know, to get their credits, but it really wasn't about us, and that's a good point, though, is that the experience, if you go to the clinic at school, you're not only giving them some credits, but also you're learning the patient experience, and I know, so your, your, your school has a, has a rehab area and a weightlifting center, too, now, or?

Yeah, so, so what happens is, the clinic itself is the, what everybody has to go through towards those, like, last nine or ten quarters, for us, it's 13 quarters total, that last, um, 10, 11, and 12 quarters, you're in the clinic, um, treating patients for what I imagine is very low cost, um, around here, around in Port Orange, um, people can come in, and you get, you just know that you're getting a student doctor, so I imagine it's very low cost, I don't know what the actual price is, but the, the students that go to, go here, and the faculty, and your significant others, and stuff like that, all go in for free, um, if you want to be treated, that's how it works here, and then there's a whole rehab side, and you have a rehab doctor who's actually great here, I met him on the FDCA Facebook page, and stuff like that, and he is an SFMA trainer, and he does, and he's, it's one of those things that, with, just like with you, and with him, is you're always learning, I always see that you're always going to either, uh, fix your own bag seminar, or you're, I've seen you're doing a lot of stuff now with neurodynamics, stuff, and you're 10 years out of practice, and you're still learning, I think that's a lot of, a lot of people get so caught up in opening up their own business, they forget that they need to continue learning at all times.

Yeah, it's, it's hard to juggle both, I know, are you trying to, are you gonna open your own clinic, you think, or are you gonna? It's funny, because I, at first, I was, I was like, no way, this is so much work, and then I realized that it was one of those things where it just seems like a lot of work, so you don't do it, it's, you get scared of doing it, and it, and with us, it's just the way that I want to treat, um, which is a lot of how you do it, you know, you spend one-on-one time, I just feel like if you're gonna ask somebody to pay for something, you need to be the one doing it, I don't like the idea of a CA, even though I was one doing that stuff, you paying X amount of money, and you don't even get to see the doctor, um, for the adjustment or something like that, um, so I want, yeah, the idea is to open up your own, and with, uh, a lot, you've talked about a lot, is the renting a room, I mean, I didn't, honestly, I didn't even know that was a thing, until I said it, um, and then, it's just, it's not, I don't know, there's stuff they don't tell us in school. Damn, I feel like that was, like, the simple, not, not, like, um, I feel like it's the simplest thing, like, that would make the best sense to me, and I know that with, I don't know if I wrote it in that little manual or not, or talked about it, but, yeah, but, that some, some docs, though, like, they, like, they want a piece of your pie, you know, like, they'll, like, I'm of the thought that it's, like, you just rent a flat rate room, don't touch my business, don't, don't screw with me, like, type of thing, um, and if you're aware with an established doc, like, and if your buddies just, like, just allow the guidance of the business to occur that way, you know, but, um, some of them are, like, no, I'm not going to do flat rate, you know, like, I'm going to, like, I want, I want a percentage of your income style thing, thing, and I would just steer clear of those, just, there's some dude around who just has a room sitting around, you know, 100%, or a lot of, a lot of, a lot of CrossFit, or out of, um, out of gyms, I've seen a, I follow a couple of the, the Instagram, famous, we'll call them PTs, but he's out of a gym, um, he's out of a gym, and he's got his own little space out of, like, a regular LA fitness, and then there's a guy that I go to here in Winter Park, he's out of a CrossFit gym, and he just has his own little space, his own table, and then he has access to everything, and it's a flat rate, and eventually, I imagine that he's, the plan is to open up your own little business, or whatever, um, and then, I know a lot of people have, especially in the chiropractic, which gives you so much business side, I feel like we get a lot of entrepreneurs on this side, uh, between chiro and PT, just because it's so hard to get a good associate job, a lot of the people are, we kind of tend to eat our young, is what they say, um, and it's just really low paying, so it just forces you to be an entrepreneur, compared to PTs, or just, they, they come out making almost double as much, and they have such secure jobs, especially in, like, hospitals, or big stuff like that, so I, I think it's really important to, to understand that side of it, and I think it's, that's not something we get in school at all. I, I agree, I agree on all points, actually, I think the PTs, they, they have more availability to them, um, and they're, I think they're more accepted, they have, you know, probably still insurance covers, clinics like that, and so on, but, but, yeah, I don't know, if the listeners don't, don't know the reality yet, if you get out of school, chiropractic school, and you think you're going to make a living, and you think you're going to get a job, you better, you better think twice, because, like, I know, like, say, people that practice like me, I ain't hiring anybody. Like, I tell interns that, I'm not, I'm not going to hire you, you can rent a room if you want, but I'm not going to hire you, and, and the high volume clinics, like, they're probably the ones that will do it, but then, like, is that your style of practice or not?

Um, but, yeah, you're kind of forced into it, and if you're not learning how to run your own business, or at least, like, market yourself, it's, it's really challenging, um, and I don't know if you guys, you guys probably have it there, I know we had it at SU, but, so, I think, I think the school's, like, rough style of, like, getting you to realize that you've got to bring people in, is they would tell you, you've got to bring two patients in the clinic, so you'd pay your mom to do it, you know, or your sister, but I was actually thinking with any of the people that shadowed to come see me, I'm, and, and this is not, like, I, I don't want, I don't, I don't want them to think that I'm trying to generate money off them, but in order for them to come see me, I want them to refer somebody, you know, I want to see that they're willing to work, um, because that's the hardest part, getting someone to get, to come into your office with your communication and how much trust you have, and then, and then collecting money from them on top of that.

It's very hard, and it's so different, um, because it's taking money for something that you deserve, and that's the hard part, but at the same time, it's like, oh, I'm not, you know, I'm not a salesman, I don't want to do this, blah, blah, blah, and it, it, after a while, though, you have to, you have to pay the bills, you have to live, and you deserve money for your expertise, exactly, but it's something that it's learned, I, and I, what I was, I, what I did learn is Toastmasters, go to Toastmasters, communicate, and then from there on, outside, just go and get in front of as many people as possible, and make sure, especially in your community, make sure that your name is known, and your, and your community, depending on how big your city is, that might be easier, that might be really hard, like in Orlando, it's, there's a lot of things going on, but you're competing with a lot of people, a lot of people in Orlando, um, so that, that is one of the hardest things, is just getting people to, to believe in you, especially coming right out of school, they'll see you look, you know, fresh-faced, 27, 28 years old, and, yeah, you just got to grow a massive beard, or put grain in your hair, yeah, that is, I guess that's one thing that you can do, yeah, so do you, um, damn, I had a question on top of my head, but I don't, I don't have it anymore, you took it away from me, damn it, um, yeah, so are you, you're gonna, you're thinking about doing your own business then, is that what, is that what I'm hearing? Yeah, 100%, I think I, the plan is to talk to as many people as possible, honestly, the, the big associate job coming out of, at least Palmer, I'm not sure if it's anything else, is though, they work a lot with the VA, um, so that's in a hospital, and that is very well paid, coming out of school, and if you work with the VA long enough, they pay for, you get all the federal benefits, so they pay for your student loans, um, but those are extremely hard to get, um, so, I think I'm gonna work my way towards that, but if that doesn't happen, um, it would definitely be immediately into, um, renting a room, I think, for myself, that, I mean, it just really depends on what options I have coming out of school, but that's what it's looking like, is if I could get that VA job, that would be awesome, um, but besides that, uh, I just, I, there's no reason for you to go and make, like, 20% of what you can make in one, you know, in one visit and make it all day, um, especially with how little associate jobs are, are paid here.

Yeah, yeah, I, um, I, I've had, I've had some friends that they, they were associates for, like, three, four years, and, uh, you know, they just, I feel like after they finally ventured out of that, they started business, and they were kind of like where I was at square one, you know, it was just a delayed process for the safety net of having a little bit of income, um, but, and then you got to practice with the style that your doc wants, you know, and you, there's not the freedom with it, uh, oh, I know my question was, at this point in time, how much would you pay for a session with yourself if you had, if you had sciatica? Oh, wow, that's, uh, I just don't, I, I know, I mean, I, it's funny because people were paying technically to see me, and I don't know if I felt that I was worth it. I definitely would say I am worth coming to see in the first, at first, in that first initial consult because I can talk someone through what they should expect. Like last night, I got a call from my mom, and her coworker has low back pain, and she went to a chiropractor, got adjusted, she kept having low back pain, then she went to an MD, and he read an MRI on her, and she has L4 or L5 disc herniations, and, um, she, he was told, she was, she told, or the MD was told her that she should stop working because my parents clean houses for a living, so she, she should stop working because she has disc herniations, and that, that job is too labor intensive for her age, or whatever, and she freaked out, did bed rest, all that stuff, and my mom called me to ask me, and I, and I had to explain to my, my parents don't know anything about low back pain, or anything like that, so, uh, I told her I'd call her, and then not only did I have to explain to her that she probably had those disc herniations for years, and she just now started getting low back pain, but I also explained to her the, the stuff about being independent, and finding somebody that's going to get her to find the different little things that she can do to get out of that pain immediately, um, and that she can control her pain immediately, and then, uh, explain to her, I liked what Dan John said in his book was that, and his last day alive, he wants to be able to go to the mailbox, um, and I, I took it a little bit further, and I said, I want to be able to go to the grocery store, get my groceries, and carry them inside, and put them away on whatever my last day is, and she, I feel like everybody, that should be everybody's end goal, whether they have short-term goals or not, um, and that can be a little more aesthetic, but I think your, um, your end goal should be that, uh, you should be, want to be independent of anybody else taking care of you for as long as possible, and you can't do that without exercise, nutrition, and proper sleep stuff, I think that I could do, I could talk to the, uh, an initial consult and explain to them and communicate all of those things, um, but add to actual treatment, I don't think I can decide what's it worth, I don't know, maybe a hundred dollars.

Well, so, let's just go down a little bit on this track a little bit with, uh, because you might change your mind, uh, what is your mom doing now? Did she listen to you, or is she, did she do what, uh, she was advised? So, she got up that day, this was not my mom, this was my mom's co-worker, but she got up, she went, and she felt better, and she felt more in control, and she told me that, she thanked me, I sent her Back Mechanic, um, by the, the link to Buy Back Mechanic by McGill, and I told her that whatever, whoever she went to see, um, let me know how that first console was, and then I'd tell her if she's headed in the right direction or not, um, whether, depending on what different things they, that they did in that first console, in that first console, um, does she feel better? I think so, but, um, whether or not, I think she still needs to go out and see somebody.

Does she have a plan of attack, do you think? Do you feel like she, she knows what to do? Yes, definitely. Okay, and do you feel like she, do you feel like she's going to do it? I do. Well, she told me, she, she told me herself that if I was in Palm, my parents are about two hours away, that if I was there, she's out, but I'd pay you to work on me right now, and I was like, I don't know. You're like, well, I can't do that, I'm in school, but, um, yeah, well, so then, yeah, I'm, I'm going to get to a point in this in, in a couple of minutes, but, um, what do you think would have happened to her if you didn't, you didn't get to speak with her?

I think she would have ended up at chronic pain, potentially, uh, they gave her steroids and then told her the next option was surgery, so potentially surgery. So, and how, how old, roughly how old is she? Uh, right, it's my mom's 60, so around that, at that age. Okay, and so, um, we talked about Dan John with going to the mailbox during last, last day, so, uh, if that were to happen, and I know, I know this is just speculating, let's just say, how long, how many more years would she have with, um, being able to go to her mailbox, you know? Probably not long at all. And then how long will she live, you know?

And so, the... Yeah, probably like actually live and not just be alive. Right. So, the reason I'm kind of going down this rabbit hole is, is, um, is I had a, uh, uh, my, my intern, Jeremy, or my past intern, now he's a doctor, Dr. Jeremy Dinkins. Yeah, I actually messaged him, and he's, he's awesome. Yeah, Jeremy's, he's, he's fun. I gotta keep, sometimes I gotta talk him off the ledge with, with things. I'm sure he's listening, so, uh, I do this just to help everyone else out, Jeremy. But, so, we were, we were texting a little bit about, like, insurance or no insurance, and so on, and I was like, dude, it's, it's all about value, you know?

And, uh, and he was talking about someone that had, uh, I think it was about a back condition, or at least maybe I thought it was a back condition. I'm like, dude, I'm like, dude, sometimes they literally cannot have sex with back pain. You know, like, they can't do so, so many things that they value in life, and you, you want to, like, you want to, like, price is not a barrier anymore. Like, I don't think, like, for, for my expertise, anyways, with, the one that came out today was actually, uh, the podcast, which was, uh, sports hernias. And so, I talk about spinal hinge versus hip hinge and, uh, L, uh, L, L2, L3, uh, basically radiculopathy into the groin area, simulation of groin pain or sports hernia.

And so, I've had such good success with these types of cases that, and, and they come in literally not knowing what the hell to do. And they go through the, the route of the sports hernia, and they're like, huh, there's nothing to do, right? And so, and there's like, and then surprisingly on that side too, so there's the surgical, which, which they claim is the way to go for a lot of cases. The surgery is actually not covered by insurance. And so, it's like, this one guy emailed me and he's like, dude, I'm a teacher. I don't have 10 grand, right? And so, that rabbit hole of like, crap that they got to go through, dude, I'd easily pay my, I'd easily, if I was them, if I knew it was on the other side, I'd pay myself $500,000 easily for like an hour of my time, you know?

Oh, 100%. And so, um, if I go down that rabbit hole to make sure that everyone's listening for pricing for business, it's like, you are worth what you're saving that person from. Oh, 100%. I think that that's the main thing is I don't, and it's easier said than done, but I don't just go out of network. Everybody ends up doing it, try to start off out of network, but it's so much, when you're looking at how much your rent might be, or when you're looking at all these things and you have zero patients because you just started, it's so much easier to just be like, I have to do insurance. But I think that's the same thing as, oh, I have to be an associate coming out.

You just have to face your fears. And if you really believe in yourself and you should, then you can charge what you feel that you are worth. And it's usually even, you are usually worth higher than you charge in our profession. Probably. I know. I would strongly agree. What's the average chiropractic exam over there, by the way? Like, what's a new patient exam in Florida? You tell me, are we talking about the chiropractor that's going to take an x-ray the first time and then it's going to, you know, you have your day one, day two type of chiropractor where you come? Well, I think we have to consider the, what does the patient see?

When you say go to a chiropractor and they say, oh, the exam is, right? So then that is, that's then their perception of, of what is the norm? So I guess, so I guess my, refine my question is, what does the, what does the patient think an exam should be or typically is? I, I, the problem now I think is with a lot of like the, what I call this Groupon doctors, where you can actually go and go on Groupon and you can get a, what they would call an exam and it looks at an exam x-rays and read the review of your x-rays for $40 here on Groupon. 40 bucks. 40 bucks on Groupon. You get those three, but you never get touched.

Damn. You never get treated. And what, what they don't know is on the other side of those $40 is a $4,000 care plan. Yeah. They're good salesmen, aren't they? Yeah. Oh yeah, definitely. Yeah. I think that, um, I, I don't know what they, what they have people do in school in regards to histories anyways, but like timeframe, I, I, I book an hour and a half, but I take an hour and 15 or, or an, or an hour based upon the person's questions. And I was talking, I've had Justin Dean on before and, and we were talking the other day and he's like, what the hell do you do for an hour and a half? You know, like, why do you take so long?

And, uh, I'm like, I'm building rapport. It's like the first day is not about like implementation. Really that much. I'm building rapport. So I want the chance to get them to the end goal. I don't want them to feel I didn't take the time. So I allocate the time, but in school, how quick are your exams supposed to be? So I am pretty sure the actual, now there is a, the fourth test that you have to pass to actually get your license. I don't know if you had to do this. It's supposed to be 12 minutes. 12 minutes. Oh, just for a, uh, for a regional. Yeah. So no, they, I, I haven't, I mean, I obviously haven't taken it yet, but in order to get your last, um, your license, it's an OSCE.

Um, and you're supposed to be able to do the history and everything within 12 minutes. Oh man. But you don't have to write it. I'm not sure if you have to do like actual notes. I'm not sure, but that'd be a whole different like test. Yeah, no, a hundred percent. Um, so, but like, yeah, I went to the clinic and I am friends with an upper quarter that's in the clinic and he is completely patient centered and stuff like that. And he, um, so he's somebody that I really look up to. And I went to the clinic and he's, he had to do a whole history on me and I wasn't there a good hour and 15 minutes. And I would say that I'm fairly not in pain ever an hour and 15 minutes.

I just started just blurting out stuff that I didn't even think about when I was driving, but I didn't even think about ever telling him and that he was just really good at listening. And I don't know where now I like, I was talking about this back pain and next thing I know, 30 minutes had passed by and he figured it out immediately. I kind of already knew, um, what it was and stuff like that, but he immediately figured it out. But I mean, it took, it took a good hour. Yeah. That's funny. We had a, um, there was a couple instances where I had a later shift at the clinic at the student clinic.

And so, uh, you had to, if someone talks about like they're in for a foot problem, but they talk about their thyroid. Now all of a sudden you got to chase that credit for a little bit. And so there was a couple of people where like they have about 10 carats to chase. They really took a lot of diligence on that, uh, on that family history and personal history. Holy shit. I think I was there for three hours. Yeah. And that's the thing is sometimes people just, you just need to listen and people will feel better, especially when you get into the psychosocial aspect. A lot of the problems now that you'll, you'll see is, it's just listening to some people just need to be able to be listened to.

And it's funny. Um, I just saw because of Tyra Woods winning the masters or whatever. And he's talking about the four back surgeries. He had four back to back years. And he said that he, uh, he actually wishes he didn't have them, even though he's playing well now. And I saw one of the doctors comment on some of the, it was like, it's funny after all of these years and nobody noticed that his back problems kind of started right around the time that his life was falling apart. You know, he had the whole cheating scandal and everything like that. Like, yes, of course he had all these things, but does anybody else, nobody else ever talks about like, Hey, what if his, a lot of the stuff was just, he needed somebody to talk to him like a human being.

And now like Tyra Woods, the cheater, everything else like that. Like maybe some of these surgeries were unwarranted. I mean, he had four back to back years. So, yeah. Yeah. I'm sure that was a challenging time. So I hope he had a therapist at least too. Never know. Some of these guys are just, they're so big. It's, it's hard. Yeah, man. I would put that therapist on lockdown, like gag order. I grew up in Palm beach, which is where Tiger woods and the PGA and all that stuff is at. And where, when he got arrested, I couldn't believe, um, a year ago or whatever for being on what they first said was DUI, but then later came out that he was on pain medication from his back surgery.

Um, I couldn't believe that the, the, the police actually took him in and, and arrested him, especially in such a small beach town. And I was like, why don't you just drop him back off? I guess. And then, but I guess, I guess not everybody is like the whole lockdown is just like, he's a normal person. I was like, that's crazy. Yeah. Right. Um, I'm not going to, we're not going to close just yet by the way, but I did, there was a couple of things I did want to ask you and I'll make sure I fit them in here. Um, number one is with, um, the, my, my, the reason I wanted to do the interviews with students and I'm gonna do a whole little series here is that I want to see how, um, my purpose is with the podcast and, and I'm not intending stopping anytime soon, but also I need validation that something is occurring.

Um, and so that I wanted to see from listening to this many podcasts, is there anything that actually was helpful to you as you're going through school? Um, and, uh, and tell me what it is and the effect, if there was anything at all. I think the biggest thing I do definitely get is that communication part of how you make it seem like I'm just sitting in front of you talking when I'm listening to you or I'm listening to you and whoever the interviewer is talking the fact that I want to listen to so much. And when I don't want to listen to an audio book because I'm tired after school, I go to your podcast instead of music, um, because I can, I don't, I can just hang out essentially with, with you listening and learning at the same time.

Um, and there's hundreds of nuggets that I've gotten from it. Um, recently off the top of my head is the Dan John one. Another one that I've gotten from you is the Tom Michaud, um, interview where it's anterior fall, um, envelope and all those different things. There's an every single one, you're going to take some nuggets, but I think more importantly, um, what I got in from this is here's this doctor who's been out 10 years, who, what seems like runs a very successful practice, who gets to talk to all of these big names, we'll call them. And he is still learning at all times. You can be, you know, Sebastian.

Oh, interesting. I wouldn't have thought you would have said that. You just have to, uh, you, you just have to continue to learn and, and be just like you. So I listened to you and I, you can't from the hour, hour and a half interview that you'll do with somebody like Tom, Sean or Dan John, you're going to get a nugget or two, but you're also going to be like, I would have never even read Dan John if I didn't listen to this podcast. And I would have never, uh, maybe even met, or eventually met, uh, been introduced to Stuart McGill or so many different people that you can just, after that, I'll go and I'll read their books or listen to all of their podcasts.

But you just give me this hour and a half, almost summary of what, what they're, what they're doing and then how you use it. And then I can go and explore everything that they have to offer. And I think that's the biggest thing is just taking something from everybody and then creating it your own. And, uh, I, like Bobby Mabio says, I think he actually took this from Stuart McGill is mastery as a journey. It's not a destination, but you should be on this journey to mastery. And the only way to do that is to fall in love with the process and fall in love with knowing more about the things that you offer, whether it's just solely low back pain or it's anything else, I, I can tell that you have fallen in love with the human body in order and you love learning more and I'm the same way.

So I just use this as a, Hey, this is what he's talking about now in his podcast, or this is what he's learned. And I'm going to go explore and it just, it's a good gateway to be able to, to understand and to, um, learn a lot more. And I, I love it. I hope you never stop. Well, I think one of my favorite shows was Mary with children. And I think they went 15 years and they stopped and I was depressed, but I guess there is a stopping point. Um, I don't feel like eventually you might, you might a little retire, stay at Huntington Beach though. Yeah. I don't know. Yeah. I don't know where I go. The, uh, I, I, I, I think I would like, I know one of my goals at least for, uh, travel would be to make enough in life to where I feel like I can, I can fly five hours or less and stay there for like three, four days and then continue.

Not only because I don't like long flights, but also because I want to acclimate to the time zones. Fair enough. So, uh, I don't know if you've read, uh, why we sleep, but that, that, I think between that and Dan John's book is the biggest two life changing books that I've read. Um, yeah, I, uh, I, I have, I have to get eight hours of sleep now. Um, if, if anybody's listening to this and wants to read the book and doesn't want to spend the 15 hours on audio, um, uh, Joe Rogan has a podcast with, uh, with the guy that wrote while we sleep, he's a, uh, sleep doctor out of, I think he teaches at UC Berkeley now, but out of Harvard and it's a two hour long podcast pretty much summarizes everything.

But after reading it, you honestly will not, not sleep eight hours every night. I just, it's so important. I'll have to listen to the 15 hour book on tape. Well, nice. Yeah. Good feedback. Actually, that's, that's not what I would expect you to say at all. So that it's, it's helpful. Um, the, uh, the next question is that, uh, if I were to change or improve or add anything to the podcast, the next coming 50 episodes, what do you, what do you think I should do? Oh, wow. I don't, I don't know if I would change anything. If anything, I would say, uh, release them a little faster. Maybe not once a week.

That'd be, that'd be horrible for me. It's crazy how, I mean, especially cause these are like an hour long. So I'm sure this takes up a lot of your days. Oh, it'd be, Hey, I, I do them in bulk actually there. Um, I'm about, this one's actually, I'm going to slide it right in the middle of, of, of one that's already a bunch that already produced. So it's going to release on May 8th. Um, but I'm about six to eight weeks ahead on most things. And so, um, I think to like, I, it makes me feel very good knowing that I can just take my time and set up a good time to, to work with people and, or sorry, interview people and so on.

But, um, I honestly, I'm, I feel like I'm running out of things to share. I don't, it's just, it's, you're always learning more things though. I think that's another thing is that, um, there's more people to interview. There's more things to talk about at all times. I, I mean, I, that's what I, I mean, I'm not the one talking for an hour every week, I guess. So that's just me, but I feel like you're always coming up with some, some other things. Yeah. And all the people to interview. Yeah. Hmm. All right. Well, I'll, I'll think of some things. Someone, someone said, or did, who suggested this?

I think did, I, it wasn't you. You didn't, you didn't suggest the student interviews, right? I, it was not me. Okay. So I think someone, someone else did. I'm like, oh, that's a great idea. Let's do student interviews. You guys are going to chew up a good one week a month. What about, what about patient interviews? I, I've, I've thought about, I've, I've done some, um, uh, just here and there, but they were, uh, honestly, this will feel bad is that, or this will sound bad. But if I interviewed the pace and I'm working with patients that I'm working with currently, I feel like I'm going to like, I'm not going to be able to relay all the details of their case accurately.

Cause I'm going to forget something. Cause I tend to not read the notes and I just go off of what I recall. And so there, I might forget all the details of like this, this lady, she actually, uh, she comes in and, uh, so she was gone for two weeks and, uh, she tends to come in for, for resistance training and so on. And, um, so she went out of town. I know she went out of town and we were talking about where, and it was Portugal. And so she came back the other day and I'm like, oh, well you must be rested. You're like, we're like almost the same time zone. And she's like, that's eight hours away.

I'm like, oh, wait, you wait, what? Where's Portugal at? You know? And so I feel like an idiot sometimes if I don't have all the details. So I, I feel like if there's a new person to interview, uh, new, uh, a new patient, uh, I would probably, it'd probably be more popular or probably easier done for me. Um, but I stand screwed up when like, if, if interns come in, they're like, Hey, what's history of this case? I'm like, I don't, I don't remember anything. I think one of the, maybe the markets you haven't tapped into is the pain science people. I think I haven't heard a lot of like, um, of course a lot of them are in Australia, so that's harder, but maybe even like Greg Lehman or any O'Connor around here, I've heard some of their stuff on mechanical care forum podcast.

Um, yeah, the, uh, I'm, I'm supposed to link up with mechanical care pretty soon here, I think. And also, uh, Greg Lehman is scheduled. We didn't do it yet, but he's scheduled for release in about a month and a half. Oh, cool. That's awesome. Um, I, I enjoy hearing him talk. I don't know if you follow him on Twitter, but he definitely likes. He likes, you know, putting stuff out there and really being the devil's advocate for a lot of stuff. So it's, it's entertaining to see. Yeah. I'll probably let him lead the conversation a little bit on that. We, uh, he's actually, he's part of the, um, our, I did, I don't remember if I've mentioned it before.

We have a, we have an online, uh, con ed program coming on. Um, so the next five weeks, I think right after you, it depends where we're going through the accreditation on stuff and California is being really challenging, but, uh, Greg's in there. And so he does two hours of, uh, pain science within that, within that whole module on flexion and tolerant backs. Oh, wow. That's awesome. Yeah. I, I, you mentioned it to me, but I wasn't sure when, when I emailed you, if you were talking about the low back pain, um, book that you put out, um, the, the, the part two, which is like the online little videos and stuff like that, that you can purchase.

I wasn't sure if that's what you were talking about or you were talking about something else. So I'm guessing now that it's something else. Yeah. There's like, we've, we've divvied into a couple of things. Like, so there's the, the book was, I mean, you know, a whole history of the book. Um, but this one is because like, so we created this online course, which was, so you haven't had to experience it yet, but it, when students get out, you have to, you end up going to like say, um, uh, say Michael Shacklock, like neurodynamics is, is not, there, there is no CEs, right. And so you spend like 12, $1,200 going to a four day course and then you don't get your credentialing.

So, but you got to have most states for about 24 hours a year. And so you can get half of them online and half in person, but the ones online are just, they're just not very good. They're old stuff. And so anyways, we, we created a better one. That was the goal on that one. But yeah, that's awesome. Um, at this point I am, I'm a, I'm pro line students will be, and doctors will be on both sides of this, but I am totally for the moment that you get into school. Taking as much as continuing education as you feel like possible with still doing your school load. Um, some people will say, wait until the later years, until you see, I've told you like, I will be at Philip Snell's fix your own back pain this summer.

Oh, you're going to love it. You're going to love it. It's great. Yeah. I'm excited. And, but there's a lot of free information out there too. That's another thing is if anybody's listening, um, they can message me if they need guidance on where to go. Look, I have tons and tons of just free information. Um, whether it's like, let's say your YouTube videos, I have Greg Lehman stuff is almost all free. All his blog stuff. I feel like you should read everything that he puts out. He puts out so much stuff that, um, there's just so much free stuff out there. So that's what I like to do is just get through all the free stuff, but also don't worry so much about the price.

You're just investing in yourself. Right. Um, whether there's CEs or there's not CEs, um, I'm definitely going to take neurodynamics, whether I take that with CEs or not CEs, uh, that, that doesn't really matter to me. It's just, it's part of being a better clinician and knowing more. There's always more to know. What's your, what's your, uh, you want people to email you or Instagram? They can, they can Instagram me. Um, uh, just message me Geronimo 10 on there, G E R O N I M O 1 0. Just if you have any questions, if you're a student and you want to know more, I can definitely lead you the way.

Um, another thing that I've really found out is all these doctors that you think are these big names and stuff like that. Like there are some celebrities that you're, they all are awesome. They all email back whether in some, some, an hour, some, it'll take a couple of days, but I have messaged you for instance, and you messaged me back and give me all of your information. Um, Greg Lehman emails back same day. And, and you, I've heard that Stu McGill is, is awesome at replying and stuff like that. It's just send an email. Worst case scenario, people don't reply, but ask all the questions you can.

Most people love talking about this and don't get a chance to, I, I love talking about all of these things and in school you get to talk about it, but everybody kind of has their own biases. And my friends don't want to hear me talk about low back pain. Um, my girlfriend doesn't want to hear me talk about low back pain. You, you, you, you have a very good point. I think a lot of people, um, you need to be able to bounce ideas off each other. Just like you said that you go with, with Cody was living over there and you guys would just hang out and talk about that stuff. Some people don't have that.

Some people aren't, aren't an Island, um, with the different clinicians around them. Join clubs, email these, all of these doctors that you, you want to know more about. Worst case scenario, they don't reply. But most of them do. I, I, I agree. I think most of them do apply, reply. And actually, uh, so Dan Jones, he, uh, at presentations, he gives out his cell phone number, you know, I'm like, so you call him, he'll pick up. Um, but I think a lot of them are very humble about that kind of stuff, you know? And, uh, you're, you're right about getting together with, so actually, I mean, do you know, you know, Ben, Ben Ramos?

Yes. Well, I don't know him, but I've heard of him, especially from your podcast. Okay. So Ben is, uh, so he's about an hour and a half away from me. And so we, we took neurodynamics together and, uh, there's no one around here. There's no one around for about an hour that knows it. And, uh, I've forgotten some. And so we're going to get together like next week and like, we're going to hang out, eat, eat a tomahawk, you know, practice. And so like you guys got to get together and practice with each other because this, the skills go away, you know, and you don't get to, um, really break down all of the technical aspects of it to get better if you're with patients.

Cause no one likes to pull out a book when they're working with a patient, you know? Yeah. I would say, yeah, join clubs, um, join like the Facebook groups and stuff like that. There's more people around than, you know, um, from your podcast. Actually, I, I saw Garrett Elliott rehab fix on Instagram. He was on here talking about Instagram and stuff like that. And he ended up posting on his Instagram that he's moving to Tampa. So I messaged him. Tampa is only about an hour away and we were going to get together once he gets, you know, all settled into his job as an associate down here. And I'm just, I'm going to soak up all the information I can from him, especially because there's no rehab to performance club here at Palmer, Florida.

And he was the president of rehab to performance. I think the whole entire thing actually. Um, and I mean, he's just got so much information and Hey, practice on me. Let's talk, let's hang out. And he was totally forward. He's like, yeah, anytime let's do this. Like, especially because he's not going to know anybody in Tampa besides the people that he works for. So that's another thing is don't be, and that's an hour drive for me. Don't, don't let an hour drive or, um, being scared to send an email or maybe spending a little more on different continuing education. I mean, I see people not wanting to spend this money for a seminar and then going and taking out some more student loans to, you know, buy a car or something like that.

I'm like, really? Did you need that new car or, you know, I don't know. It just depends. I guess everybody's a little different, but you look good. You look good with the top down. Yeah. Why not? Um, yeah, I, yeah, I know Grant's moving over there. He, uh, he's great. So, uh, by the way, if you know, if people don't follow rehab fix, please follow rehab fix. Like when we, when we're circling back again, um, he's, Grant's really good at communication and he's, he's been so successful on Instagram because if you look at how he presents ideas that are, that can be complex, uh, he makes them simple and very actionable for people.

And, uh, so, uh, I, I don't know if you've heard the term already, the money's where the eyes are. And so he has currently like 50,000 eyes. And so he's going to have a very successful practice once he's not an associate doctor and he'll be perfectly fine. But, uh, if you don't learn to communicate, then you'll never get the chance. Not at all. So, um, anything you want to ask me before we close up or you want to take the mic? You want to, you want to do, this is a Geronimo podcast now. We've, uh, we've, we've talked a lot. I mean, I've just gotten to know you and I just, I, I guess I'd like to just thank you for the opportunity and thank you for this podcast.

It's awesome. Um, and I hope to be able to get out to the next time you do this, uh, to, you said June 8th, I think as you're, you're doing something at your office. Um, yeah, that's mid, um, mid exam week for me. So I'm definitely not going to be out there, but, um, but I, that's another thing is if you're in school, I would definitely say plan your vacations around different things that you can do. So let's say if I was able to, I, like, I'm going to fix your own back pain. It's in Portland and I'm in Florida. I'm going to do an extra day and an extra day and see Portland, but I'm also going to spend most of the time just learning.

And then that night I can go see all, all this Portland, anything that I plan on doing vacation wise, well, next three years is all going to be centered around that stuff. So the next time you do it, I will probably be going to see a Southern California. I've never seen it. Well, well, thanks. Thanks for, I don't know if I'll do it again. We'll, we'll see what happens. But, uh, as I'm finding writing, it is taking more work than I thought. I don't know how I'm going to speak for 12 hours. Um, the, just so I, you have hit a couple things in here, I guess I'll, um, reference. Uh, so number one, you, you mentioned the, the writeup.

Uh, I forget where was that writeup? There was a, or the, the, uh, the things I wish I knew in school. It was, I know it's on the website somewhere. It's on your website. Just, just type up, uh, wish I would have known in school or something on the search bar. Um, and then it's on the show notes of one of your podcasts, but I really can't remember. Okay. Uh, everybody should get that. It's free. Just, just go in. Um, I was drunk on a plane and wrote it. Um, if you find any spelling errors, tell me. Uh, uh, in, in addition to like, you mentioned fix your own back as well. I don't get any money for mentioning this, but if, if you literally want to have the, the best or the, the best confidence, like you can communicate really well with patients when you're confident, you know what the hell you're talking about.

And so when you go to fix your own back, like all those centered around one certain type of pathology, you're really damn good at it. And you'd be surprised how far a flexion intolerant back can create a symptom like, uh, hamstring tightness or IT band issues, or even some of that flank pain, or even like sports hernias is a correlation in there with the spinal hinge. So if you want to be really good at that kind of stuff, which probably people are going to look for you in a car as a chiropractor for just go to that. It's, it's cheap. It's cheaper than, than most seminars or go to. And it's really damn good.

Um, the other half, I know that you haven't gone to neurodynamics yet. Uh, Michael Shacklocks, it's the other part basically. Um, it will change your, your, your, your damn practice. Um, so much confidence will come from both those. Uh, yeah, I think the only thing that would add to that is don't forget to go to the ones that don't have this cool, like neurodynamics, McKenzie, all these that are, that's really good to know, but you go to the ones where they kind of put it all together. I think that that's something that is, um, like Greg Layman's course from what I haven't been to it, but from what I understand, it's, it's not so much learning.

It's learning how to put all of these different things together. I think that's really important because I know that a lot of people say that they come out of a McKenzie course and all they can do is in McKenzie or dynamics and all they want to do is neurodynamics. Um, go to courses that kind of put it all together and just talk to people. I would agree. That's actually why the, that's one reason the workshop is happening. The one that I'm doing on, it's just putting things together. So cool. Cool. Um, go to Sebastian Gonzales's, uh, I, yeah, I will, we'll, we'll see how far this goes. I don't guarantee anything.

I just know that people like going to seminars cause their friends go and they like hanging out after that's where you learn everything. Um, uh, okay. I think, I think that's all I have the questions I have, unless you have anything else you want to say at the end. Yeah, that's it for me. What would be on your gravestone? What would be on my gravestone? Uh, I don't know. Um, disherniations don't cause low back pain alone. Wow. They're, they're going to, they're going to be like, wow, this guy was a orthopedic. Um, what about you? What would be on your gravestone? Hmm. Under promise over deliver.

Uh-huh. So you've thought about this. That's not fair. You already know, I didn't. I didn't think about it. I didn't have anything great like that. I didn't. Yeah. I don't really have, I think, but after, after doing as many rants as I've done for the podcast, I, I, I have a couple of default stories just hidden in the chamber. Well, right on. Um, then I'll close it up and just pause right there. One sec. Okay. Thank you for being on. Thank you. Okay, everyone. That was Geronimo. Thanks so much for being on. Uh, reach out to him. Like he said, um, you'd be surprised how many people actually respond back.

So if you're looking to improve yourself as a student clinician, uh, he sounds like he's got a lot of stuff figured out, a lot of free stuff. So, um, go ahead and check him out. Uh, I will put a link in the show notes to his Instagram handle. Uh, I guess lastly, I don't really have too much. But, um, if you're a student who thinks you have a unique thing to share, uh, about your experience, about how the podcast has changed, uh, your, uh, your influence in school or the way you might practice out. I'd love to hear about it. Uh, and I'd love to hear feedback about how I'm doing. I, uh, uh, like I, I don't know how many times I'll do student interviews, uh, if there's a popular response, I'll probably do them a lot more.

But, uh, I learn more all the time, uh, especially when I didn't like, I had no idea who was going to say that. But, uh, for the most part, uh, whatever you say, I will take it to heart. Uh, and let's see if we can improve this podcast together. And, uh, if you're dating, dating Eagle Scout, leave people better than how you found them. See you next week.