3 Techniques You Must Use When Treating Patients in Your Cash Practice | Aaron LeBauer

Okay, so here's my three things that you need to do to get patients better. How many of you out there have ever felt bad for doing hands on therapy because it wasn't evidence based? When I was in PT school, my professor said, oh, you guys should go check out the new EIM blog. And the post that day was a post slamming one of my mentors, John Barnes. And it was just like. And they've since taken down the post. It was funny, it was crazy. It caused a firestorm because what he was teaching wasn't evidence based. But look, here was the guy that taught me how to treat patients and do things. So my patients told me. I've been to PTS for years, and you're the first person that's touched me where I hurt. You're the first person that's done something that's helped me. Now, look, this is not a. This isn't my opportunity to go and defend someone, but it's like this was my experience as a PT student. I come out of school and that's really. That's all that's being put out there is just, you know, evidence shows this. You shouldn't do these other things. And yes, there are people that meet in the middle, but who are the loudest voices, but they're missing something and they're why I am busy because people come to see us because they haven't been touched. I've seen patients where, I've asked them. I said, there's like, oh, I think I have a meniscus tear. I know I haven't. I was like, why? Have you got an mri? No. You know, I've got knee pain here. Did your orthopedic surgeon do any hands on testing? No. No one ever touched them where they hurt? Well, yeah, the MRI shows a meniscus problem, but if I can press on them somewhere and it relieves the pain, like, don't we all know now that it doesn't mean it's a meniscus problem? You know, evidence is great, evidence is great. But if you're listening and you feel like I shouldn't be touching patients, don't listen to those people. Because people need to know, you know, where they hurt. Okay, so here's my three things that you need to do to get patients better. Listen, touch, and empower. And the fourth thing, Listen, touch, empower. But the fourth thing is you got to ask. Learn how to ask the right questions. So listen. You need to have time to spend to listen to people. It's probably one of the most valuable Things that we do. I got 45 to 60 minutes. Like we do a 45 minute treatment. If all I do is sit there and listen to people, they'll happily pay. Because guess who doesn't listen to them? The PT at the mill and Dr. Orthopedic Surgeon. They don't listen. When's the last time you went to see the orthopedic surgeon? How much time did they spend with you? Even if you weren't there, if you were there as a patient, not to market your business. Look, even if we're only going to do exercise, I got to put my hands on you. It meets your affective needs. Shout out to Bob Duvall. Sports Medicine. Atlanta taught me that one. Just gotta meet their affective needs. They need to know, you know, where they hurt. We can just talk about it, show it on a screen. Here's the other funny thing. I saw a patient. She was referred. She wasn't referred to us, no one's referred to us. But I was up by their friends. She found us and she came in to see me. She had had a double knee replacement and she was in physical therapy. I can't remember how long I'd have to look at her chart, but it was long enough that they discharged her because she was done with physical therapy. What was done with physical therapy? She wasn't going to get any more range of motion in her knees. She was at 90 degrees. And guess what she did for a living. She was a firefighter. She's actually captain. She leads a team. She's got to drag 170 pound dummy up two story ladder and 100 yards and she's got to do that to qualify. She didn't have to do that to work. But she really needs to be able to do that, you know, to be the leader. She's got to be able to, you know, lead from the front. So she comes in, I'm like, what? You know, I'm talking to her, asking her all the right questions and she's crying and just like, I'm never, you know, like, this is my job, this is my life. I need to be able to do X, Y and Z. And they told me physical therapy, they're done. You're done with physical therapy, there's nothing more we can do for you. And she's like, I just need some hope. I'm like, all right, well, let's see what's going on. I lay her down her back and she's in her shorts. I'm looking at her knees. Okay, they're A little swollen from surgery, but it's been a good two and a half, three months. She's probably, you know, she's not past five months, but she had just finished her three times a week on the bike. Ice pack, heat stim. Who knows what the hell they were doing because they certainly weren't helping her. Because I'm going to tell you why in a second why I know this. She lays down and she says, here's where. I said, where do your knees hurt? She points. She points. Let's see, can I get my kind of like back of the knee, right where the hamstrings attach. I'm like, huh. Okay, I touch her knees 90 degrees. All right, kind of stiff. All right, where does it hurt? Okay, I take my thumbs and I press into her hamstring and guess what? Her knee goes 110 degrees, 90 to 110 in like 30 seconds. I'm like, huh. Okay, let's go around to the other side. Test the other side. It didn't hurt as bad, but I didn't get 110. I got 100 degrees out of it. I got another good 10. So right, five plus or minus five is the standard. And who are these people telling her? She was never gonna get her knees to bend any further. So we did some hands on mobilization, some mfr. I did some, gave her some exercises and self treatment to do at home. And after three visits she called us to cancel her fourth. Why not? Because we weren't getting her better. Because there's fires in California and I'm going with my team out to fight fires. Look, she needed to be able to squat. Who the hell didn't actually touch her where she hurt and help her get some more range of motion? Somebody. Look, you know, I don't care what you're doing. If you can't spend three minutes touching someone, you're not doing physical therapy. Five minutes left. What? I touched her for five minutes and she got 20 extra degrees of range of motion. Remember she had a bilateral knee replacement. It's not the only time this has ever happened to me. You know, I've been doing this for long enough. I guarantee if you're listening to this, it's happened to you too. Someone else has missed something. Well, yeah, you can miss something, but it doesn't happen over and over again. If you're doing good quality physical therapy and you may be the best physical therapist and you don't have time. Look, you only have 15 minutes for people. You can touch them where they hurt all Right. We kind of went to listen. I got to have time to listen. I don't have to have that much time to touch them. What do we all do? We empower our patients. We don't want people to. I don't want someone to come and get a massage for me every month because I'm not a massage therapist anymore. I want them to come once a week. But I want them to learn to take care of themselves. I want them to learn to treat themselves, to improve themselves. And they need to come see me every once in a while to get a kickstart or get to the next level. I have no problem with that. Especially even if it's once a month for some people. I have no problem with that. And the fourth thing really is you have to learn how to ask the right questions. And these aren't the questions that you were taught in PT school. These are the questions that you ask when you get people to open up and share with you why this is so important for them to do it anyways. Because that's what's going to get them compliant. But when you know why, if you get to the point where they're about to cry because you're the first person that sat and talked to them about this ever. They give you whatever you want when you tell them you can help them. Because really all people want is to know that you heard them. To know that there's hope and they're not the worst someone's ever seen. Like, I don't know what the fuck that means. You've got the worst spine I've ever seen. Like, why would you ever tell someone that? All it does is make people feel like shit. So if there's one thing that needs to change on the medical provider side, it's stop telling my patients. You've got the worst blank I've ever seen. Makes me want to vomit every time I hear that. I mean, that's it. Look, go do whatever it is that you. Whatever kind of treatment resonates with you that helps you get results. Like, yeah, there's some treatments out there that are bs. I'd never do them. You might think they're amazing. Look, it doesn't matter as long as your patients get results. I mean, your patients get what they want. Does it matter what I do? Well, look, if you're not touching patients, they're all going to come see me. They'll eventually find their way to see me. If you're not touching your patients where they hurt and doing some kinds of hands on care because that creates connection. They know you care. They know you know. And number three, where they hurt. And that makes all the difference. Sa.