#60 - Supercharge your Clinical Skillset, Part 2

The business, then between between the business. Hi guys, welcome to a new episode of The Factor podcast. I'm your host Jessica Riddle. If this is your first time tuning in, welcome and thanks for listening. Today we wrap up our two part training titled Supercharge your Clinical skill Set with Doctor Benjamin Fergus. Doctor Benjamin Fergus is the owner of Cornerstone Help, a clinic specializing and helping individuals overcome chronic pain and regain their quality of life through their unique approach called the Grip approach. Doctor Fergus and his team have achieved a remarkable ninety nine percent success rate in treating chronic pain. They focus on helping their clients achieve their goals through foundational fitness programs. In today's training, doctor Fergus will discuss how he asks questions about the tasks and activities the patients find challenging in order to set objective and physical goals rather than just basing their goal solely on pain. He will also discuss the importance of setting macro goals and then identifying micro barriers that prevent patients from achieving them, and walk us through his process for creating a recovery roadmap. So pull up a seat and be prepared to take notes because this episode is packed with valuable tips and practical advice. Let's get started. So let's talk about drafting or building your perfect team. Now again, if you are a solo provider, and maybe you intend to stay a solo provider, this might not be directly applicable. However, the things that are listed here are things that you can build within yourself as a skills tower. But this is really geared towards those that are part of a team or are looking to build a team to scale their impact and scale their success. At the top of the team, you need an examining individual. I put clinician on here because I run a clinical practice. The guy at the top or the lady at the top is often the highest skilled person or they hold a license that has the most privileges and allowances to make it easier for everybody to work under them. Next, we need to find that first great treating provider. The treating provider needs the top two here, one or both of the top two. First, they need to be able to deliver corrective exercises or rehabilitation, and the second skill area for the provider is being able to deploy soft tissue therapies. Finally, it's helpful to have somebody that has some specialization and a board certified treatment skill like a chiropractic, adjustment, acupuncture, nutrition. And this can also be the same person as number one, the examining clinician, until volume becomes excessive, so at top it's probably you. We have the examining clinician. Then you need your number two person, you're treating provider that is able to step into any case that you've pinpointed and effectively deploy a skill set that you train them or that they have to use, corrective exercises, tissue therapies, etc. A lot of professions can be applied here. For your tissue therapies, you might use a highly skilled massage therapist I think we've got one tuning into this message. Or you can train an athletic trainer, a chiropractor or a PT with these skills. Additionally, for the corrective exercises, you could use a highly skilled and trained personal trainer, or again at a clinical degree, with an athletic trainer, chiropractor or PT. Finally, I believe the next step should be a fitness or exercise provider. Now you might not think about using a gym or fitness in your clinic, but this is the direction. A lot of the most effective practices are moving, including my own. Any of the above providers are treating providers can also deliver fitness that can be part of their schedule. I've done it. All of my treating providers have done it for a period of time. But when you get to a point when you can hire a separate person as that personal trainer, it becomes more efficient and it gives a little different flavor to the training side of what we do. But again, number one or two can deliver number three, but number three can't deliver number two or one. So we start at the top and work down this list. Once you have your team, we need to train them well. I've looked at a lot of teams and practices that work extremely well and those that suffer. The most effective teams have a clear mission, They communicate with the same system, they meet and train regularly, and everybody knows their role. This is how you can train your team with GRIP, whether it's a new hire or somebody that's been with you for a while. First, it's observation. They join you for an exam, they join you for a treatment, they fill out the charts, they learn the language of the practice and the mission of the practice. Along the way, they're going to meet a lot of patients and everybody gets aware of the team approach that you're building. Next virtual training, your new hire can complete their Virtual GRIP coursework and practice it on their own time. A dedicated learner could learn the whole system in one to two weeks. Then they can begin to use a Virtual GRIP as their quick reference to start contributing to care any case do you have. There's some great techniques within GRIP to help you accomplish those goals. Finally, and this is a spot where I think a lot of teams struggle. You need either weekly or daily training. That is daunting, but let's break it down. I have a team skills meeting three days a week for about thirty minutes with my whole clinical team. Each of those three days we tackle one movement, limitation, or one concept. We look at it forward and backward and make sure everyone gets it and anyone could step in for that micro problem and solve it. Then eventually, your most skilled team member, your most skilled provider, can take over leading these they can begin to educate those under them. It doesn't always have to be the person at the top. Finally, when we complete a segment, we hold a little bit of a longer session one to two hours, one to three hours where we meet down in review and work out some details, or we attend a full seminar together. Team training the big thing here as you think about committing your time and resources to training, you have to remember the more skilled your team is, the more they can accomplish for you. This is a struggle for most practices that add somebody new and they want that person just to step in and add value right away. Ultimately, a lot of providers feel one of two ways. Either one they trust the person they hire they want to hand the case over and forget about it. Or two, they hire somebody yet they don't trust them, they don't trust their skill, and they don't trust they're going to take good care of the patient. And in that scenario they become deadweight financially. And it's not on that provider, it's on the person who hired them and hasn't trained them enough that they can trust them to be effective with care and communicate well. So every time I'm put an hour into training, I'm remembering, I'm freeing up my own schedule. I'm allowing more people to be trusted with the patients i'm trying to help, and that allows us to scale. So we're at a spot now where my team can pick up my chart for any case I examine and lead the entirety of the care. Without me, I can still step in occasionally and provide a skilled aspect of care or redirect, but our training has allowed me to maintain exceptional skill and success, and that's what our reputation is based on. We don't want to be known as the person who delivers X tool. We want to be known as the expert that solves problems. It doesn't matter what the skill set is, it matters how you deploy it and how you attach it to the patient's goals. So, in summary, we need to focus our intake on physical goals, not subjective pain. First, identify the macro goals and get your patients motivated. Then identify the micro limitations that need to be overcome. Take action by utilizing your entire skill set to guide the patient to their goals. Build your own clinician skill set to widen your range of treatment options. Then leverage your skills and degree and build a team. Successful teams rely on a common mission, great systems, and consistent communication. GRIP approach was designed to work in busy clinics, to be scalable and deliver consistent results based on the research. That's the end of my presentation on supercharging your skill set. Today's training is brought to you by Southeast Professional Education Group. Are you a healthcare provider interested in teaching? Have you developed content or a curriculum but have no idea how to get started in continuing education? Maybe you sit on the board for an association or group that wants to offer a virtual summit or live conference, but the logistics, planning, and marketing are just too much for your volunteer led group. If these statements have you shaking your head yes, then it sounds like you could use our help. For almost a decade now, Southeast Professional Education Group, also known as Southeast Sports Seminars, has helped individual instructors, membership organizations, higher ed institutions, and groups of all sizes create memorable virtual and live events in the healthcare continuing education space. We have the experience, the know how, and the infrastructure to help you bring your event or course offering to life. For more information, visit the link in our show notes to schedule a call with a member of our team. We can't wait to speak with you. Thank you so much, doctor Fergus. We want to open the floor now to some questions. We do have a few that have came through throughout the presentation today, so I can go ahead and start asking those, Doctor Fergus. Towards the beginning, you were talking in your assessment about the need to not catastrophize pain. Do you have some guideline for how to address patient's pain and how to give them the appropriate education about their diagnosis without catastrophizing it, or some best practices that you utilize for that. Yeah, that's a great question, and this is the mindset challenge that it's probably the one that's hardest to shift to. In fact, even when I work with a patient, I often have to remind myself to shift that language to an extent. We don't want to ignore pain. Pain is a vital essentially a vital sign that we know what the person's experience of the discomfort is, but we don't want to get in the habit of viewing it the way we view other vitals. It's hard for a heart rate to lie to us, it's hard for motor neurotesting to lie to us. But it's really easy for the pain experience to be inaccurate to actual damage or threat. So we can acknowledge. And when I acknowledge, I typically still want to go in a way that's not attributing extra value to the pain. So let me demonstrate. If you come in you say, my hip really hurts. As a provider who doesn't follow these methods, you might say, tell me about that pain. Is it sharp? Is it tingly? Is it throbby? And as you ask these questions you might get a little more info. But also the patient is now becoming more focused on the pain, and their internal dialogue is, oh, it is sharp? Is that an issue? That it's sharp? Do I need to be concerned about cancer? If it's sharp? Am I ever going to get better? These are the internal catastrophizing thoughts that people with chronic pain and even those with a cute pain are often thinking but not always saying. So we want to get detailed information about pain without letting them snowball their concern about it and without attributing any false value to it. So let's take that again. Somebody comes in and I say, why are you here today? And they said, my hip really hurts. I say, I'll I understand that is so frustrating when the hip hurts. Help me understand this more. What are some things that you are doing that you feel your hip is limited you from? So at that point, I've acknowledged the pain, and then we can start to ask the question like we might want to naturally say does your hip hurt when you flex it or when you extend it? But I'm going to ask what things do you struggle doing? And they could say a squat or I have a hard time shaving my calf or I can't tie my left shoe. At that point, you've learned some movements that are painful without asking them what movement is painful? So we're gradually acknowledging and shifting the dialogue. And in our chart that we're typing, we can still talk all about pain. I'm just advocating that we don't focus the language we communicate to our patients on pain. As a follow up to that, in that slide, the file on the side called repair ruler. If you look at that. The first page is a diagram, but the second two pages are in a printable format that you can print front and back and laminate. The front side talks about healing times, but the backside is all about transitioning your dialogue from pain focused to function focus. So that's a really good guide and tool for your attendees. Absolutely, that's wonderful. When it comes to going along this same discussion about catastrophizing pain, how have you found that this is a bit of a different conversation or is it a different conversation when you're addressing athletes who are actively playing and you want to make sure that you're not you're instructing them on how they need to change maybe their training or their even play schedule, but then at the same time without catastrophizing so that they have really bad fear avoidance behaviors. Yeah, these are some great questions. So just in this question, are we assuming that the athlete is presenting to us with an acute, painful injury or any presentation? I would say, if maybe we can address it from an acute presentation and then any presentation, if there's a difference between how you would address it in each of those scenarios. Yeah, So let's use an example. I was working with a football player who was trying to get drafted in the draft this year, and leading up to training, somebody, a different player dropped a stack of weights directly on his foot two weeks before he had to run his forty yard dash for his pro day. So that's an acute injury, a painful acute injury, and he has some really specific things he has to do. He wants to run a forty yard dash in two weeks and get drafted in the NFL. So we need to know both factors. And I think it's that second group of factors that gets often ignored, which is those physical goals. If I sit down with him and all I'm focused on is the plates that dropped on his foot, what hurts, and what's going on, we're never quite getting to his clear goals, which are what he wants to do two weeks from now. Now. Two weeks is an absurd time frame to come back from a lot of injury things like this, But there's consequences if he chooses to run his forty yard dash. He has the two consequences. One he might not be fast enough, and two he might do more damage to his foot. Neither of them are good. On the flip side, if he chooses not to run his forty time, he might not have enough data points to get selected for the draft, and he might feel like he misses out on a big opportunity. So we need to know the consequences even as we do the exam, because it might change the way we do things. So when I see this person, I'm going to be talking to them some about their pain, and it's primarily a locating thing. I need to know where the weight was dropped, and I still need to know what's limited, so I can ask him what movements are limited, what tasks he can't do, and why. I'm not going to ask him any of those questions with the P word with pain. I'm simply going to say, what happened, where did it hit your foot? What can't you do? And can you show me what's not working? Now? He can tell me all he wants about pain. I can acknowledge his pain, but I try not to repeat and build up any question about pain, because that again builds concern for the individual. He's going to tell me anyways, because it hurts and it gets in the way of his goals. But by asking it directly and getting way too in detail about the pain, I don't necessarily lead myself to more actionable steps. He just builds up a lot of information in his head about the quality of pain. So in this case, I still need to know, essentially, is it safe to proceed with treatment, and do I need extra imaging? Based on the type of injury and what he wants to do, I know I need imaging, so I do an initial exam, I determine what errors need to be imaged, and I send him off and I get those findings, and when he comes back, we sit down and say, here's the situation. The imaging is showing us what kind of injury it is, and fortunately it's not the most severe type. So we can train and we can get better, and we ideally get you ready for the NFL. But we need to know the consequences. If we train really hard right now and you get back to running your forty, we do have a risk of doing too much and causing a slowed healing time. Also, you might not run your best time. Now, I'm not going to advise you whether or not to run your forty, but you should have that conversation with your agent now. Conversely, if you choose today that you're not going to run that forty and you're going to go into the draft without it, then we can start to build up slowly and gradually on everything we need to do to get you ready for after you sign with the team. So I'm talking about all the things he wants to hear. I'm getting the information he needs, but I'm trying not to build up a lot of doubt and a lot of concern around pain discussion. Does that answer the question? Yes, that was a very very thorough question. Thank you for that. Shifting now to building your team, you mentioned a lot about how it really is important not only to develop a team that has different skill sets that can compliment yours and essentially help you accomplish more with your patients. What have you found are some best practices that you've utilized in your clinic for sourcing these team members? Where are you finding them? Where do you feel like are the best places for practitioners who are looking to build a team to really start finding that talent. And I think it's probably different for each regionality and country. For two reasons. One, people look at different sites in each region, but also depending on the state or country you're in, the provider that you hire may have different allowances to them. For example, I can use an athletic trainer as a clinical extender for ninety percent of the things that I do legally and bill for it, but in some states that's not available at all. So there is some regional variants to this. But I always start with the problem, So the best thing to do before you make a higher is clearly identify what problem you're trying to solve with that higher. Right now, I'm not going out looking for another examining provider because if I see six or eight exams a week myself and that's my role, that's enough new exams to keep my practice really popping. So I don't need another examining provider right now. But I do have a need for more treating providers, and specifically, right now, I have a team that's really good at delivering effective corrective exercise, but I need more team members that can deliver tissue therapy and other soft tissue therapies. So I've narrowed my need down to the essentially the specific things that we can't do enough of right now, and at that point you try to determine what the best profession is to fill that role. And another thing I like to do is do a little calculation of essentially how many hours I think this person would have on a weekly basis. I try not to hire part time. I do have some trainers at a part time, but I try to envision every higher being a big part of the team where they can quickly progress to full time. So once I have all that data, I write a job description that tries to specifically find the person I'm looking for, and that's story. Branding is a common way to do that. So we can say something like, if you want to enhance your skill set as part of a team and spend your day helping patients overcome chronic pain, I've had a perfect job for you. Learn and grow with us in Evanston, YadA, YadA, YadA. We try to highlight what somebody that we want is looking for in that job posting, and for actual locations, I do a broad initial search. I push that out to schools and profession boards of the profession I'm trying to hire, and I've had great success finding good people on indeed dot Com as well, and then we have a few layers of screening to get the right person in. Because we've built a team, I'm actually the last person that any applicant sees. First, my team has to approve them as an individual that they want to work with and train with, and then they'll send them to me and I make the final decision. Wonderful. So, kind of diving a bit deeper into the interview process, do you have like a set list of standards that you want to ensure that you're so that every staff member's kind of on the same page in terms of making sure that they fit the criteria that's needed before they come and meet with you. Does each individual staff member have a different role in the interview process dependent upon the type of role that you're looking to fulfill or the type of role that that existing staff member fulfills. What does that interview process look like? Yeah, I think the answers yes to all the above. We do have the process systematies that works well for us. Now. Ultimately, no matter which position we're trying to fill, every possible hire has to fit the following few things. One, they have to have a energy and be enjoyable to talk with, because ultimately, when you work in healthcare, it's a talking profession. If you don't connect well with individuals on the team, you won't learn well. If you don't, we don't think you connect well with individuals of various backgrounds. That can be a barrier to therapeutic success. So we would just want to have fun talking to the person that's got to be there right away in a clear communication style. Next, this is key, no matter who it is, what professional want age, they have to be eager to learn. They have to value education and learning because our jobs aren't easy. And for me, I've been doing it for a while, I study a lot. I want to get better every day, and I don't want to be slowed down by team members that don't also want to get better every day. In fact, right now, the next room over my head athletic trainer who's been with me a little over three years, is leading a seminar to the rest of our staff and some local referral people, and he's teaching them more about what we do and he's honing their skill because he wants to learn every day and the whole team does as well. So fun to talk to eager to learn, and then they have to contribute some unique skill to what our needs are, whether that's soft tissue or exercise. They have to have enough of a background to not cause harm, and then we train them up to be able to achieve success. Now on that interview process, another really important thing for us is being reliable. So we have a few ways to screen people coming in. We make sure they send us an email resume, and we put a couple of things that they have to fill out in a title page because often when you put these job postings, people are just looking and they're sending you a resume and they don't even know who they sent it to. And we at least want enough attention to detail and reliability that they read the whole post and they fill out a couple things and send it to us. So that's screening. On next, we schedule a specific time for them to have a call with our receptionist and that's just fifteen minutes of getting to know them and seeing if they're fun to talk to. And I'll tell you what, eighty percent of the time we schedule somebody for that meeting and they're late or they don't show up and then the twenty percent that do show up right away, Our receptionist says, Okay, I've narrowed it down to three that are the most fun to talk to, and then we start to bring those three in and we move them on to the next step about skills, and it's not just fun, but engrossing, engaging, good conversationalist. Absolutely, and I think across the board, what we've seen throughout several discussion boards that we've found in Factor even is that those soft skills are so important, that interpersonal skills are so important being a great team member, being reliable, but then also having a great bedside manner with patients as well and being able to compact with them in an engaging way. We're in a role where we're often guiding people through some of the hardest time of their life, and there is a skill set that needs to be somewhat natural but also built upon to be able to have tough conversations with people in pain and to still guide them away from pain into success. So that's something we try to identify, at least a basic skill set and eagerness to learn. Absolutely. Do you find that your team approach to treatment is something that really drives a lot of your local marketing in order to bring new patients in the door. Do you really emphasize the fact that you do have a multifaceted team approach to care. I've had this conversation with another really good marketer, doctor Kevin Christie, who focuses a lot of education on marketing for chiropractic offices. I initially told him that I don't market at all, and he looked at everything I do and says, no, You're actually really good at marketing. So I think there's some It depends on the perspective. We don't do a whole lot of advertising, but we do a lot of educating what we do, how it's different, and essentially that we help people get back to things like Tom's golf trip, for example, And when somebody comes in they see some videos in our lobby that shows our whole team working with people. And I will often make sure that anytime a new patient is in the office that our individual team members see them say hello, say I'm doctor so and so, I'm part of the team here. We look forward to helping you achieve great things. So we're always introducing the team so that it's not a surprise when somebody other than the examining physician picks it up and runs with it. Also, when we meet with other practices, I always emphasize that we have a lot of different skills in our practice, that we have a team approach, and we like to go and help to share our knowledge base with other practices. But I don't think we do anything that directly markets to patients that hinges on the idea idea of us being a team. But it's pretty evident when you're here that different people can add something really unique to care and that there's a benefit for them to be able to schedule whenever they want because they're not trying to only get on my schedule, which is booked out. They know they can work with anybody and have really good results. Absolutely, and I think that's a really important component that a lot of practitioners sometimes lose sight of in terms of building their business, is making sure that it's built with the ability to have an exit strategy in mind, and not even from a I want to leave or sell my practice one day, but in the case of something happening to me and I'm hospitalized and are injured or Lord forbid, that the worst happens and I'm no longer here. Can my practice carry on without me? Do those patients still have the same high level of care if I'm there or if I'm incapacitated for a certain period of time, And then, of course it's nice to be able to take things like vacations every now and then. I'm sure you would agree as well. Yeah, I think to circle back on that, one of the biggest stressors for practices of solo providers is feeling like they can't step away because nobody's going to care for their patients. And when I think about my learning and training and this staff, I try to think about everything that I'm the only one that can do it. And when I look at that list, initially I thought, I'm the only one that can do this corrective exercise, I'm the only one that can do this tissue therapy. I'm the only one that can do this adjustment. And what I started to do at that point is change that as fast as I could and say, if I feel like I'm the only one that can do this tissue therapy, then I need to do a better job of training my hire and I train them and train them and train them until I can say everybody can do this tissue therapy, you don't need me, and I start to take away from what makes me unique as the only person that can care for them, until the team is the one that cares for them and I only have to step in for the thing that nobody else can do. And I want that only to be two things complex exams and right now the chiropractic adjustment until I have another chiropractic adjuster on the staff. Absolutely, and I think that goes even beyond a clinical setting because oftentimes we find that practices because of that doctor patient relationship. It's really hard you mentioned for practitioners to kind of put their business hat on and step outside of the thought process that I'm the only one that can provide care. The business world, we talk about things like genius zones and kind of discovering like, what is your specific contribution to this business? What is your specific contribution to patient care that no one else can do quite the way you do? Ye? Was that evolution and decision process for you and kind of deciding, okay, these are the two to three things that I absolutely want to be the person to handle versus here the other components of treatment and care that I feel very strongly about having a staff takeover. Yeah, there was nothing wrong with being a solo provider that skilled at everything, but it is pretty exhausting to operate in that way, especially when the demand for your time exceeds what you have available for them. And ultimately, I think I think initially when people are building up their skills tower, they think about separating themselves from competition by becoming the best. I think that's part of the drive to keep educating, and that's fine to motivate yourself early on. But ultimately, any of us in these health professions, we really only see a small segment of the population. I'm in an average sized town of a quarter million people that's right next to Chicago, so maybe a broader reach of three four million people in my Needd area, and there's not enough chiropractors and rehab specialists to service that whole population. And that's okay. I mean only a segment of the population seeks care for non surgical, non pharmaceutical care. I don't believe there should be a competition from provider to provider. In fact, the other chiropractors in town, I invite them in for education. If there's a patient that's a good fit for them, I send them that way. We want to be a service to those individuals, not a competition, So ultimately I don't need to distinguish myself as the most skilled individual for let's say a chiropractic adjustment. The way we distinguish our practice is we're a practice that is the best at clearly identifying what the problem is and finding a solution to get the client or the patient back solving that problem. And once we've identified it, they can seek the treatment portion care anywhere. So technically I could probably have an office filled with just exams if I was a solo provider, and all I would do is exam, write down exactly what needs to happen, and get them off to another provider. But it's helpful to have that all in the same location. That solves a lot of problems. So we had to build a team that could provide the care that I knew that person needed. So for me, I quickly understood that my unique value was in the way that I examine and diagnose a patient. And that's also where I found the most fulfillment and the most joy. If I had a day of just exams, I'd be really happy. I know some providers that don't want to examine at all, and if they had a day of just adjustments, they'd be really happy. And if they're in a position to do so, they can build a team that does the exam, they rehabing the soft tissue and they can just adjust, or they can seek a position where that's all they do. But I think knowing what leads to your own personal fulfillment is a good way to start understanding what other pieces you want to bring in and be a team. And now, because my business doesn't rely only on what I do, it's an actual business. It's not just a brand where everything's about doctor Fergus. It's a brand where Cornerstone Health solves chronic pain in Evanston and Chicago and people come here to overcome pain restorabilities, no matter who they're with. And I love that mission because it allows us to be the most flexible and the most effective with our approach. Absolutely, And I think that kind of goes back to the old adage of do you have a business or do you have a really expensive job? But yeah, that's right. Sometimes when you're the one wearing all of the hats, it can begin to feel that way. I know that within your Grip approach framework, you have a clinical track and you have an exercise track, much like we in Factor have the Factor rehab system, and then we have rehabed a fitness which is more oriented towards post rehab and going into fitness. You talked a little bit about having exercise professionals as part of your team, but then also having rehab specialists that are more clinical, such as your athletic trainers in your practice. How do you determine at what point someone can do rehab with your needs to do rehab with your rehab specialists, your athletic trainer, versus when they can work with your exercise specialist. Because nowadays there's a lot of controversy around kind of the gray area between rehab for pain versus exercise for fitness and kind of where those two converge. And I think exercise is an effective pain management tool as well, but often should be guided by a clinician if it's being used for pain management versus being guided as a personal trainer. So ultimately, fitness is a progression of forces from rehab, so they're not distinctly different things, but I think it's a good idea to use language that describes them as slightly different things in some ways. So when somebody's ready for fitness, I want them to feel like that is victory, like that success that they're no longer working with a clinician and now they get to move some weights around, work up a sweat, and feel great. Even if it's clinically minded. They need to know a distinction that they have now had enough wins that they're well on their way to their ultimate goals, and fitness is going to accelerate at that point. So when somebody starts care with us, it's rare that we drop them right into fitness from day one. We need to stabilize and if you look at that recovery roadmap file, it kind of separates our phases into phase one, two, and three. So Phase one, we're going to stabilize symptoms. We're going to begin some movement training with a clinically certified and minded individual, and we're going to start to address their specific limitations. And once we start to meet the initial goals in the box to the right of that, we're going to reevaluate and move on to Phase two. Phase two involves improving movement, control of movement, and introducing clinical exercise. So essentially, when the case is stable and we can use if you're in the pain mindset, you can view pain as being stable. But again, I think that's a pitfall when you start to view that the movement as being stable and the activities is being stable. And let me define that. If somebody comes to you and they say I can't wash dishes at the end of the day for an hour and I need to, and now they can wash dishes at the end of the day for an hour, we've now stabilized that initial complaint. So once we stabilize symptoms, then we need to say the progression for this to make everything that you're struggling with today much easier for you is to get stronger in the movements, the muscles and the joints that are used. And we're going to do that using fitness. I'm going to introduce it nice and slow with our clinical teams so that you learn how to move your body and what positive soreness can feel like. And once you get the basic foundation down, we're going to confirm that you're ready to jump into one of our foundational fitness classes. That's phase three. That's where your advanced recovery happens. And I love to use this dialogue with my patient at that final re exam, I congratulate them, I say, Tom, I'm so happy that your hip isn't bothering you anymore, that you win on your three day golf trip, and that you're about to go on this hike. You have now just created a new feu for yourself, and today you're at ground zero and you get to decide what you want to look like and feel like when you're eighty five, not just for your eightith birthday, but when you're eighty five. So let's look at what success would be like five years from now, and I can position fitness as a way to help him go from where he's at today to his wildest dreams of what his body would do. And that's when we'll start to work into more of the fitness model. Wonderful. Thank you for that really great explanation there. Thank you so much, doctor Fergus. This was a really great presentation and a wonderful discussion. I think about different ways to advance practice and to really maximize patient care and to be better practitioners, which is what we at Southeast Sports are definitely in the business of helping to support our our network with coomes. So thank you, doctor Fergus. Have a great day. Okay, thank you. That's it for today's episode. Be sure to tune in for episode sixty one, where we will kick off a new training with doctor Shay Stark. We're going to have an open conversation about being a female leader in sports chiropractic, and we'll discuss the ways that we can encourage the next generation to step up and step into more of these roles. You won't want to miss it. Episode sixty one drops in two weeks. You can subscribe to The Factor podcast on Apple, Spotify, iHeartRadio, or the podcast app that works best for you. Give us a five star rating to help us grow the show. Every little bit helps, and last, but certainly not least, be sure to visit our show notes for special promotions from our sponsors, a link to download the PDF of today's full presentation, and a link to view the recorded replay of our full webinar. We'll see you next time. Hey guys, If you like what you heard today, I encourage you to visit our website at Factor hyphenstore dot com that's spelled fak tr hyphenstore dot com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. 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