E 157 Ortholive Telehealth Platform from Dr. Michael Greiwe, MD

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Episode one hundred and fifty seven Ortho. Alive Kelly Hill Platform. I’m Hosaka Justice Tressler date Michael Grievous respected. During twenty seventeen and eighteen podcast awards nominated hosts invest selling off Amazon as we get a behind the curtain. Look at all types of doctor and guess specialties. Let’s hear a doctor’s perspective. On the recently, we’ve been discussing telehealth telemedicine. How can it work for neurosurgeon? How can they work for just the everyday Dr Carr brighter physical therapist and you heard us mention another product in the past, but today. We’re GONNA. Talk about Ortho live in spring. Health live pretty much main differences. One is built for rolling muscular-skeletal people and the other one is for the other type of professionals, but it’s a hippo compliant. Compliant skype or zoom with a waiting room and all these cool features that would make it ideal as you’re going to do telehealth and you want to do it in a very appropriate way. Sin Files all kinds of things, so we’ll just dive deep into this also hear about orthopedic Shoulder Surgery, and the training and collaborations with bts in Cairo’s. In those types of things really informative. Yes, it may seem like. Like, a sales pitch, but not sponsored by that company Ortho live, but this episode is sponsored by. Swanson health they producing quality, vitamins and supplements and foods for over fifty years or twenty thousand wellness products, many are crafted in the United States of America and they have a strict quality. Standard called the Swanson Quality Code Is Park that I’ve personally used on and off during my carpet career, so we’re happy to have. have him on and if you want to try any Swanson helps great products for yourself. Use Code Doctors. Twenty Do C. T., O. R. S. Two zero for twenty percent off at Swanson Dot Com. Yeah, twenty percent off Swanson Dot Com. Okay, let’s jump right into the show. All the shows and the transcript can be found at a doctor’s perspective. Dot Net slash one five seven. Let’s go hashtag behind the curtain. Live from Germany and Cincinnati Ohio today on the show. We got a new thing. It’s telehealth. We all had telehealth before we’ve heard about it. There’s a Buzzword with cove in nineteen going on, but this has been doing it before that and we just WanNa, learn more about his company called. Ortho and spring health live while they’re not the difference between those two, but please welcome orthopedic Surgeon Dr Michael Greenway. Thanks very much appreciate it. Thanks glad to be here I think this is going to be more of a nuts and potatoes type of interview, and then you know. Why did you want to become an orthopedic surgeon and all that type of stuff? But it’s unusual because you expect. Ortho neuro, we had an oral guy just a couple of weeks ago, and he’s starting to do some virtual stuff and I was like what so now I have at least a basis of how you could do it, but what made you think from the get? Go like maybe I should do virtual consultations or post op, follow up like what is it that you use it for wide? You develop it. Thanks yeah, you know The the main thing was I. I live in Northern Kentucky, right up right outside of Cincinnati about five miles South Cincinnati, but you know my regia patients goes well down into. Rural Kentucky and so a lot of my patients were traveling like a good way as it’d be like a three or four hour drive to come see me, and you know a lot of. It was just inconvenient for them many years ago. Ago I thought. You know there’s a better win telemedicine at sort of been around, but nobody was really using it inside of Ortho, and so I was looking around and trying to find a good platform I could never find anything that was like efficient for me as a surgeon and as a physician and I know you probably would feel the same way, but it’s just hard to like. Find something that’s allows you to see patients and makes. Makes it easy for the patients to get in and be seen to, and that was a big struggle back in two thousand fifteen, so I went out and decided to build a platform myself and you know work with some of my partners we got. We got Ortho live off the ground and then so schooling. He got spring. Health live going. That was kind of the impetus for developing it by. I’ve loved it ever since it’s been great. Great and there’s a lot of opportunities to use it, but usually I use. skype were on zoom. What is the point of not just using these I mean point your camera. At whatever like we can’t. We just use this well? You know I, mean there’s this thing called hip and you know in in the US It is a big deal like you know. It’s patient, privacy, and all that and a lot of surgeons and physicians. Healthcare providers like to you know talk about hypocrites, this kind of a pain in the rear end, but it’s really a good thing for patients. It comes down to patient privacy, and so you know it’s about like keeping patients security, even their data secure making sure that.

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Everything is done in a way. That’s encrypted both you know on the one side were you and I are talking then also has its zipping across the Internet and wherever it lives. You know at the end, so having all the big thing. Yeah is the fact that technically somebody could find out that Bobby Joe had a surgery Bobby Joe was like upset about it, but now that it’s encrypted just like our cloud software just like some emails and our past for banks on our phones is just it’s encrypted, so it’s harder for somebody to just hack in I. Mean Yeah, and it could get their health information. Sometimes you know there’s some platforms. Platforms not ours in some platforms have credit card information insurance information all this. You know private stuff that you just don’t WanNa. Have people have access to? So so we built the platform in a way that like no one could hack into it was secure You know it’s two hundred fifty six bidding scripted all the things that you know you would need to make it really really good for for patients and for their security. So that was like main this, and that’s why you don’t use skype in zoom and all that stuff, so all those doctors out there that are about to roll their eyes with this hippo stuff where moving on. We covered it okay. We covered it. Yeah, thank you. Oh my gosh. Can’t we have a patient sign in sheet? I don’t know I. Guess it work as you know is unbelievable, but. Just modern people but I’m so sick of it at this. Part of it is just you know it’s the world we live, and I feel like the last like forty years. The paper continues to mount, and it’s like it is what it is we we have to deal with it, but you know the the more we can streamline, the better you know, indeed so all patients open to this virtual office situation like if my blood pressure is high I got a machine in my house. I given ten readings over the last ten days. Can I present that to the doctor and but okay? This is a natural setting way better than your office. It’s better. It’s better. You know I mean if you can do things inside your home is way better. Patients love at their home I mean I’ve seen patience kicked back on the. The couch reclining I mean they are in their element, and it’s good. It’s good for them. People get nervous. They get stressed out to the doctor’s office. They got wait for an hour. And you know with telemedicine. Most doctors are pretty much on time with it, which is great for the patient and the doctor, and then it’s It’s just that convenience. I think they really do like it. And there’s some things that you you wanna go in and see your doctor for you know obviously, but but there are certain things also that you know, it’s just a routine checkup. A you know a on incision or wound, or who knows what? Your blood pressure your diabetes, making sure like Hey, have taken my blood sugar and it’s you know Scott. It’s up through the roof. What I need to do, you know those are good. Good Telemedicine calls Okay. ’cause I was GONNA. Say obviously you think you tore your knee. Take my ACL’s broken. You might need to come in for that, but yeah, the pre opposite the post of this. Absolutely I mean and there’s things like I mean with Ortho. People like you’re crazy. What are you doing should never tell medicine orthopaedics and I was like no, that’s that’s not true. Because once I make the diagnosis I. Mean it is what it is, then then it’s a matter of getting the Mariah giving the follow up for the MRI and then if you have a surgery and you live two hours away, I like to look at your incision if I’m worried about I’ll have you come back in, but if it’s not too. Too Bad, we’ll We’ll move on and you know we’ll. We’ll just go to the next visit so I think there’s a lot of benefits and people just don’t. The diagnosis is so critical sometimes you do have to come in for that, but as you know, the history is a lot of a lot of it, too, like I could tell you ninety nine times out of one hundred, probably, if somebody toward their acl by what happened to him on the field, you know running a cut and then felt a pop and. Michael why don’t you just stand up and do this former quick? Oh, you can’t do it, There you go. I just think you four hours, but you still need to figure out what we’re. GonNa. Do about your L.. Let’s you’re even saying hey, man. You can even do it initial consultation where you can just talk. All Right! Where do you live? Yeah, that’s four hours away right? You need to come into unfortunately or or like. Let’s get an MRI. Let’s have you review that and then if you need to come in like it, you need a surgery or you need. You know whatever, but I can tell you a lot about what’s going on, but based on the history you know, but I’m not saying. Every diagnosis needs to be treated. Treated that way I mean. Don’t get me wrong, but there’s a lot that you can really do with telemedicine. It’s integrate is a great tool for US I. Think it just it helps the patient also provider a lot. How long would visit less? I mean I’ll scheduling mean probably the average telemedicine visits about seven minutes long based on what I’ve would have seen the average in person. visit is about like ten minutes but. Ours originally yeah. Exactly Yeah my office is it’s like at least an hour, so nobody really, but they loved element doc. You’re on time. Or five minutes late flow five minutes. Whatever were you did it, you know.

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It’s weird as people don’t like virtual, they don’t like we’re eating more than like two or three minutes like hey, is something wrong? We’ll be there in. You know a couple of minutes, but. You know it’s people are used awaiting. Unfortunately, longtime in the doctor’s office is terrible the way it is right now I mean a lot of physicians have such long waits, and there’s too many people just trying to get in. You know how it is. You know well when you’re with your program. Do you have a virtual radian room where people like I was waiting a couple minutes on zoom, and then you kind of locked in go. So there’s like a waiting room and you can like. Send a message. A patient’s long winded be with you. Obviously. I mean. I’ll be five minutes late. Sorry, we have I mean it’s cool. It’s just basically the platform. You basically look as the doctor. You’re looking on your screen and you just see like boom boom boom all these patients. It’s just like your normal like. Do you have any hr that used Johnson you know like you look like patient number one and then patient to go you go down the list and basically just have all these. These appointments and you know you’ll go down the list. You’ll see a green flashing light when somebody’s in there. So you know, get like this person’s in their. They’re ready to be seen. And you click on just one button, so it’s like one click entry for the provider. They’re going. They just keep going to the next one and the next one, and so just like you would go through your normal day, so there’s. There’s you know it’s. It’s nice because you just you’re in like a line. Can you send yourself a message sin? Sally these exercises are these video, or whatever and you send it through the platform, or do you one hundred percent? Yeah, so what we can do, you can upload any document into our chat so like we will chat, so you? You Upload Exercises. like a youtube video. You could. Any Link a word? Word Document PDF excel file your name. You could send it to the patient. Get it on their smartphone again. It’s encrypted. They just log in tap on. The message comes right up and they can see it. You know they can also do on the web. Tuesday can get it via the web, so there’s there’s like multiple ways people can get in. It’s. It’s really kind of A. It’s a nice thing for patients do because. Normally they just have a piece of paper which get lost, but if it’s on their phone, they’re not gonNA. Lose it right as researcher later. That sounds great, because if you’re a smart doctor with marketing a little bit and I, think our mutual connection was the insight Marketing Thompson, so? Already care about these things, not plenty plenty of episode on this stuff, but anyway the point is you can have your articles your exercises, your videos on certain landing pages and that way now. You got the site that goes. Hey, people keep kidding stage. It must be important. They’re spending a lot of time embedded on videos, and so now you’re ranking higher because you have engaged page instead of possibly just emailing a bunch of articles, you can set it up differently to where you can help yourself as well yeah I mean that’s a great way to do it and it’s But I have yeah I mean I haven’t done that in my own practice with Ortho. Live our our site like we have a lot of videos in education that people will go to so I think it does help with the education piece like if you are a physician and you’ve got your own content, and you could kind of direct people to that content. You’RE GONNA be like you know even more sought after because people will google you and they’ll find you and and you’re just gonNA continue to Your name like the rankings and things I think that’s a that’s a really great point. I hadn’t really thought about it too much that way, but I think for physicians and chiropractors physical therapists out there that are using telemedicine to good idea. Okay so as a chiropractor. Prescriptions I guess gives them supplements or whatnot, but let’s be honest prescriptions. A whole lot of red tape with that especially with opioids and everything so. How does that play out well, degree point I, mean I was asked on on the news the other day about opioids in like and I had a patient that I was interviewing and then the next question. What do you do like? He said he had more pain. Regan Prescribe opioids for forum, and I was like no. You know like we I think you still have. Have to adhere to whatever standards you have in your office, and so it could be a really challenging in sticky wicket. You know this this opiates, especially over tall noticing right, I mean somebody could say having all kinds of pain, and you really have no way of fully verifying it, and knowing for sure, so I’ve just been really careful about it or alive and. See a patient like we will not prescribe. Many opioids there probably are tele telemedicine vendors at that feel comfortable with it and I guess if you got a patient that’s been your patient for a long time, and you know them really well, then maybe it makes more sense, but you’ve got to be so careful with opioids. It’s been such a like I live in northern. Kentucky in that whole area has been. It’s been horrible so many sad stories, and just lives do other things normal things, blood pressure diabetes. Towards. Regular Medications I. Think is great because like you said earlier I. Mean they’re testing like at home, so I’ve times, they’ll have the values for their diabetes pressure, and they know like I’ve not been doing well.

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You know I’m schedule. Maybe I’m hypertensive now. I was taken is okay. We need ACCU OFF ON. times causes falls and things like that I see patients or get dizzy. Yeah. I think that’s a good point, but yeah we can. We can still prescribing do all that stuff. I’ve been really careful about the opioid stuff at any rule like scheduled three stuff. You just be row careful about I guess. I mean that’s the new protocols now. Anyway this. Hey, maybe not yeah. I. Mean, there’s these plans about musculoskeletal conditions and mental health that could probably help. Exactly. We. We need protocols right now. That’s the one thing like this song new territory. Nobody knows exactly what what the right thing is in. You know new guidelines are being made right now with everything, so it’s. It’s really it’s interesting. It’s it’s cool. It’s a new frontier. Wonder if it got to be tough to for I, think your profession. You got every every every car. Car Like Hey man. It’d be great if Dr Mike would send some referrals and you’re like I don’t know this guy was. Is this person was nice? They seem to get good results I. don’t really know exactly who I should for what condition and that’s a lot of extra work to figure out like no these people are for neath. This is the shoulder guy. And you know because you’re outside of your community when you’re doing telemedicine, I think that’s part of your point. Is you basically have the entire country? I could be the way the laws are set up now I can practice across state lines I can do consoles for anybody could be consulting in Hawaii and I. Don’t know who the right chiropractor isn’t. Hawaii you know like who do I? Send Him To? When they’ve got a neck issue, or whatever and they need some some therapy and some improvement finding out like who the experts are. The people that you trust Nisar area is really hard. If you’re treating young people that are that are far away. Know your local area really well on, so you know who patients like you know who to refer to, but it does open up a little bit of a You know more challenging. Thing I you don’t know like in. New York is the right physical therapist. I should send this patient to. NPFL tear whatever they unique kneecap location so. That does make it hard I. I agree so well. Let’s talk dollar and sincere. Can I charge the same amount for telehealth visit you had. That’s what’s crazy. I mean that is I mean seriously a writer at auto. Modified yeah, it’s the exact same as an office visit and that was the big issue. Why wasn’t taken off in the past you have? Right, pay cash or like some states. There was actually some decent laws in so you couldn’t certain states so actually. Kentucky was a good state so I was good to go even back in two thousand fifteen, but what happened is like other states started coming on board, and you had about thirty eight states where the parity laws, but not all of them. Them allowed for parody inside of Medicare for instance well, let me take that back. So not all of them allowed for parody inside of Commercial Insurance full parodies, some that weren’t Medicare you had to be in like a rural service location, though for all the older patients who is really hard. You know they couldn’t really do telemedicine because nobody wanted to. The serve like. Fifteen people in a rural area they were you know they didn’t know who to do. Telemedicine with so it just really stymied the telemedicine growth, and now I mean you get basically the same amount as an office visit. Obviously you got a document. They did the right things and everything with your physical Zaman medical decision making all the documentation and all that you still have to fill. Fill out online forms with the Classic Bat Past History and all that crap that gets you checking those boxes for an exam for a new patient. Yeah, you would You would need to like. Ask them questions about their past medical history allergies. You know social history all things to be able to check those bullet points for and then yeah, and that’s really what is. Chiropractor got any allergies yet any pastor? Say Okay you have you. Have you tried any any business yet? It’s tough I’m from Louisiana, but I’m in Germany so it’s a little bit of A. Little trickier I’ve done I’ve helped family members and stuff. I’m trying to build it, but it’s a little bit difficult. When you don’t have a base anymore, it’s tougher. I totally get it. Yeah, it’s it’s a the the bullets that you guys have still hit the bullets. Yeah, you like what six of the nine or whatever? Ben Yep, so we have to ask questions if they don’t have a forum at the ask the questions, or we create an electronic form for practices. And then we descend him it ahead of time. They it out, and then they have all the information. To us before your visit. Yeah, exactly so and we’re all using the HR anyway, so you just can’t attach it to their. Standard in and we, we actually like what we do at eleven. In Springfield live, is we? Will we integrate with the HR with the PM systems for the the practice that working with and so all that Info than will stream over and get into the charm? PM System, which is which is nice, then they don’t have to do double work double entry, and all that you’ll have like a list of vendors or major softwares that you use.

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We have like leads hundreds on the. The cool thing about what we do is like will work with those people that basically integrate everybody off Sir all that, so they they have the whole landscape covered, and we work with them, and then they help us you know to probably ought the API, the begin with you just have to tap into their API and there goes. That’s exactly right. That’s how it works. So that the is that’s the jargon word right it. Is I mean there’s so many Sdk of Api you? Jason and Before I before I had no clue about this stuff. Distorted beating surge in trying to help my patients, and then you gotta learn all that stuff you know. I want it encrypted video. Okay well, it’s not that easy. Windy a lot more. You’re like well. Can we just start with that? I mean yeah, it was You know you you start thinking about Oh. This’ll be great to do, and then you realize what is GonNa Take I. Mean anybody that’s ever started anything you know how it is you get in, and you’re like you go through this. Amaze like Oh. This is going to be amazing. Realize like wow I got a lot of work to do and he wouldn’t have done it if I known i. Is a lot a lot of work for sure, but you know we’re. We’re at a good place now. I mean I was like being on steroids with this whole Coruna, buyers just went through the roof during that time period because people needed it. You know is how they kept their offices open so daily raising. Yeah, is it only web can use your phones in Apps and all that you use your phone and everything to and just yeah, like phone. Web Pretty? Pretty much all all modes you can happen to spring live north alive, and that’s why it’s not free ladies and gentlemen because every time android and apple doesn’t update you. Get excited and everybody else’s upset because the developers now have to pay some person who know a thousand dollars to fix the program, so it works correctly it’s it’s a real pain in the butt to have an APP and yeah, just you. Are you. Hit the nail on the head there and it’s. It’s hard. You gotTA. You gotTA cover, and so we’re doing like android Apple Web. Covered all if you WANNA have a good platform, you gotta make sure that everybody’s taken care of so and I’m guessing at some point I could handle about two hundred clients. Yeah, not five hundred now. What do we do? We need to do it fast. Yeah, it’ll be set up the servers behind the scenes. The probably accommodate all those people. Yeah, we early on, you know. We had like an over a load of. Patients. I mean we’re. We were seeing You know thousands of patients. A day on the system was we were getting like up to like ACC Max capacity of our servers we. Ad Server capacity in all this stuff and I mean it was. It was a hectic first week when we realized like Oh man we we really need to like add bunches and bunches to our servers, and Google was having a field day google cloud which is. Exactly. I’m grabbing money from the Sky Yeezy. Audio podcasts. Man, but this is stuff that I. Don’t know if anybody else is interested in this, but I like this part because it’s important. I think you know you. Try Get involved in. Put Your hands in other businesses besides. The doctor stuff, and would you start building web pages and do marketing and writing books? He start to realize that there’s all this other stuff behind the scenes that people just take for granted when. Quote a little guy like you Y-. You’re not Bill Gates. You’re not this Mega Corporation. This is like no. It was just a guy that. Do something you know. I mean you know how it is i? Think you have better insight, though in you know in what’s going to help patients right like so you as a chiropractor. What’s going to work for people what’s going to help? Make their lives better and I think if we could just balance our lives better, I think the hard part for medical providers. Is You’re you’re always inundated? Ended to the Max with patients in questions, and in all these things and we love that because we love talking to people where people book persons, and so we love that but at. At the same time, if you want to reach more people and you want to help more people, you know you sometimes have to be the creator. You gotta be able to go in and create the thing. THAT’S GONNA! Make things better for people. You didn’t invent a computer, but you certainly can make processes and systems better than I think we’re gonNA. I mean ultimately hopefully help L. People and. That’s it, so is there such a thing as like a wellness orthopedic surgeon? Where all day you know eventually everybody everybody looks like a surgical case. If that’s all you do all day as some people say. Like man, there’s so much you could do their attrition. Wise or like, if you just come in. If you just do this for like six weeks, you’ll recover faster data. Yada Yada is that even have time. Have hire somebody on staff to do that? Like? How does that look like beyond Telehealth I think? It’s a great.

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It’s a great question we were to be surgeons. Don’t do a good enough job of understanding the nutrition side. You know the psychological side. You guys fit by the way. That’s the key right I mean. And good for you for being it, you know like you like it helps up here. It helps the mental game when you exercise or when you’re doing whatever, but but that part of it is sort of like ’cause you see for me. I’m a show respect. I see a rotator cuff tear and a forty five year, old guy or woman I say listen that. That needs to be fixed. We don’t think about like okay. You know might be good to have some vitamin C. to work on improving your Collagen to make sure that your your P- rehabbing so you get stronger before your surgery in a lot of it is is forgotten about because you know you’re focused on doing in your job, which the fix that rotator cuff tear. We need to do better about that type of thing. And I think part of his nutrition part of its exercise and some more research on like guests like you’d like the mental side, the grit side the resiliency side of recovery. Part of what we’re working on is like understanding like. If you’re really a resilient person, you’re GONNA. Do Better with surgery. If you don’t feel like you’re very resilient if I empire, be helpful not to have the surgery and do the therapy and just avoid that or you work on mental strength, and then like you’re ready for the surgery like a month or two, maybe that some. Psychological work that you’re doing to to get better and stronger, you know I? You hit the nail on the head. I mean. What are your thoughts on that? That’s what I was wondering because there are certain amount of nutritional supplements or a program like prefab everything you just said I just didn’t know if that’s a common thread. That’s an orthopedic surgeon offices, or if it’s a new thing where they you know, maybe they own a PT clinic just because they can make a ton of money on that. But do they really do they believe in it or if it’s just like well? No, it was just a natural extension of what we do. We’re going to send them out. We might as well send out to our clinic, so I didn’t know if how much of that’s going on, I think I mean when you’re trained. I mean that’s the good thing. Go to good training program and I think we as or those I think. Think. We have decent training across the country, but you’re always taught like you know you always start with nonsurgical methods unless like a disaster injury, right? You broke your rug Tibi our your femur broke your hip. I gotta get that fixed, but but then a at a certain point. What we hope doesn’t happen. Is that people get into their practice? Naysayer everything looks like a nail. When you have a hammer, you know so. So you, you WanNa make sure that you’re not. You know getting engaged in in doing that type of thing so I still for rotator cuff, partial thickness tears I’m always doing injection physical therapy. The the whole nine yards to see somebody gets better if they get better great, you know that’s that’s a win and it. It doesn’t have to be at the you know at your hands like you’ve done the surgery to make him. Him Make better so I think that’s where the therapy really comes in. You know bracing and all stuff because it all really factors in, but I think a lot of times people get it happens like people get misguided they they start doing more than they should. And and so we always gotTa Kinda come back and be like you know focus on what’s right for the patient, which is ultimately not having surgery. Right like we. Think yeah. I mean it’s it’s like a last resort. Thing like surgery has gotten a lot safer over the years, but ultimately putting somebody to sleep in. There’s risks so as a patient I just like this can be postponed six weeks without detriment of my shoulder yet long. that. Let’s let me give me the six weeks. Let’s try it out and if it still sucks well surgeries, don’t we tell patients that would backseat pain all the time that I should get a surgery? We’re like no. Almost all the time I. No, you should definitely try. US like a couple of weeks PD for a couple of weeks. If we don’t work, try some extra people because we’re not all built the same, and then you can finally have surgery, but it’s like you’re four. I Could not agree more I mean. especially with sponsored, RETU- because. Once, you have a spine operation in especially fusion or something like that you’re younger, you know the adjacent levels and things like that can become infected. It’s not if the faster drinker. Yeah, that’s exactly right so I. I agree with you and. You know we. We have to remember like you know why. We went into medicines to help. People get better in surgery should always be the last resort option, and so I think there’s a lot of surgeons that focus on the non operative things, and you kind of get a feel for when the non-operative stuff gonNA work one. It’s not somebody’s got terrible. Shoulder arthritis and is bone on bone I’ve found that like physical therapy hasn’t been super effective for them and I told people that I’m like you know when you do those exercises, you may help yourself from a stretching standpoint, but the paint probably going to get worse than just be aware of that and give them the option.

00:30:01 – 00:35:02

You know, but. Shared Decision Makings another thing I’m sure you agree like you know when you have a decision to make given to the patients that here’s your options. You know here’s the pros. Here’s the cons. What do you think that that’s helpful? I think that’s. I think that’s the one thing carpet missing full-blown residency type program because we’re not do surgeries, which is great, you know in a sense because it just one less thing that we have to worry about long term, but you guys do massive amounts of residency and fellowships, and you’re getting all this advice from people who’ve been doing it for thirty years so that you don’t make these rookie mistakes coming at you like you’re already been you know what I mean you. Obviously the reason why you have it, so you don’t do something and God. Thank God for my the people that taught me. You Know I. Mean I I will sit there in in a surgery to say you know I. Thank thank you. Dr Seuss ’cause you know you remember all the people in you know the way they taught you. The things that dumb got into trouble with something, and and then they’re at to get out of it and like that. That that type of training, you just don’t get the on the job stuff. That’s really important you know that’s just invaluable. Into those those teachers, the the people that we had for residency and they were incredible and then fellowship. You know so you do an extra year and kind of like Uber. Specialization and he really I. Feel like you get you get well well trained, and and then when you come out your, you’re feeling comfortable taking care of people. That’s important. so that’s a while feeling. How many years is is chiropractic? Is it Is it three four three and a third after UNI so I? Mean Yeah, so it’s like dentistry or PODIATRIST popularity because they actually are doing some serious surgeries, right? So your standard three to four years post and then. Probably clinicals and things like that too right. Yeah, like your last year is all hands on people and talking to your doctors to what even call them forgotten. Remember more to clinicians. That guides. You get like ten people per person or something. They tried to teach you what they’ve known out there in the real world. You. Don’t WANNA do. This person has headaches. It might make it worse. That’s key I mean it’s you know the real world experience is absolutely is the key and I think that’s why great here surgeons or surgeons have been around for a while. You know you tend to. Trust those surgeons a little bit more in really good reason because I think when you you know I. Come Out, even though you’ve been trained and you’ve you’ve done all the training you know having the repetition is is so critical than just anticipation of things that could go wrong. You’re not as honed in to that as you could be. In any get five years in. You’ve been through all this stress of like. You know your initial part in. In time of practice, being a surgeon, and then you start saying okay, you know now I know you know in this particular patient with this. You know set of anatomy like I’ve got to do this or this differently to to help. Make sure that we avoid any any issues in surgery, and it’s just as little like decision making things that you don’t get unless you’ve really done a lot of cases, done those fellowships and all those things so. I think in a seminar kind of looking around and I was like man. Kids are Kinda Young. Yeah finally asked right. How many people are like in school right now? And I was like. Oh, my Gosh, so many! It’s just you know it was based on where the location was, and you could definitely feel a different when they’re setting up an adjustment or something like that. You’re like. Wow, this is so uncomfortable. Please don’t trust. Their. Exactly exactly like. Where’s the doctors? Okay? I’m GonNa go practice with. Group. Groups here, I’m heading over here. We’re just learning a new technique, but it’s not like we’re like yeah. Could you imagine in the The people in the medical school that would volunteer for the physical exams and stuff I mean. Wow, there was you know some very very uncomfortable. times I think. You know you’re like. Wow, that that part of the Physical San did not go well for that particular student. And people and it is like wow, poor patient you know. So. It’s unreal, but what a wrap things up because in this podcast we like to cover a couple simple questions. How are you able to keep the love alive, and the second piece of this is always doctors. We have trouble taking vacation. So how are you keep the love alive and actually take a step away from work from. The Greek Greek question I think first of all my wife. is involved in medicine and so she she knows like you know. Sometimes there’s there’s long hours and all that, but one of the keys for me I. Think is when I I set my time up to like nothing. SORTA interrupts kind of like my dinner time with my family like we have a set time down.

00:35:02 – 00:40:03

We try to get together and that’s that’s key for for me is making sure we carve out time, and so it’s really really tried to shut out everything. Put My phone down. Do that and make sure that you know. Know we spend time together. It’s hard like today. I got done a little early. You know I I was able to take my son out and week. Did stuff together? You know sometimes like your your wife like especially. If they’re not involved in medicine, it’s hard. Your significant others is hard on him because they don’t understand the stress that you’re going through things, but I think just making sure that you you come home, and you try all that stuff. Aside you know and you you just stem you. Listen and and just try to be there for them to that I think that’s key and then. They’ll ask you how your day when you can, you can tell them about. How it was and the challenges you faced whatever, but it is just trying to block it all out and just focusing on your family and taking a one day emotionally draining of the day. Just a lot left some yet. That’s hard right because you give everything you have to your patients. That’s that’s what we do. If you’re good, you Dr Good chiropractor good physical therapist. Whatever in nurse you know, you’re given everything you, can you you? You got a bad surgery. Someone could die. GonNa deal with that and figure out. How do you wrestle with those feelings? When we’re like they didn’t get better. They still have headaches like Oh. Darn, we didn’t get like not like literally like not be able to use their shoulder. Not your fault, it’s just what it is I’m not a heart surgeon in not a brain surgeon and you know. I don’t have the life and death. Things happen every day right, but you know you’re right like you know, but when you bring it home I, think that’s that makes it hard on your spouse. You gotTA. You know you always have to think. Remember that no matter how much you give to your patients, you gotta save a little something for your family. Because if you don’t it, it makes your heart color, and so we. It’s not your kids fall. You’re grumpy. Kids and you’re the one that’s got all this bad attitude because they’re doing something that you don’t want him to. Do is like calm down right, and it’s true I mean part of it is like understanding the fact that when patients are constantly like feeding the the difficult pains that they have everything on you all day. You have to maintain a positive attitude. Sometimes as a surgeon I have to deal with complications that makes you feel worse, but ultimately it’s. Is You know you gotta find that joy? Joy In your heart? Somehow you got nine. Whether it’s you know religion, you know some spiritual or something like that or or just knowing that you know you did your very best. You know that’s what I tell. My fellows might residents like look at the end of the day you gave your best effort. And you did the very best you could for that particular patient than you should be proud of yourself, and you can go home and hug your kids and is your wife Larry? I know it’s hard. It’s hard, but that’s. That’s my take on. It lasts actually a pretty fresh perspective. For that answer. For that question, so yeah, that’s really good like the site today. What’s The web pages? WWW dot also live dot, com and www dot spring, health live dot com, and before we go, what’s the difference? Though Spring, health. Spring. We didn’t really covered. Practitioners and was for like surgeons. Yeah, that is true, so it’s worth alive is really for orthopedics, physical therapists chiropractors people in that kind of the musculoskeletal health realm and a spring health lie was released sort of were general medicine neurology pretty much an agnostic platform for everybody that might need telemedicine. We decided to kind of perfect what we’re doing inside of worth of edicts, and then we bring health. Live at help everybody else. Else that needed a good efficient platform. Well I know we probably appreciate that because I know whenever we do age. Are we looking at it and they’re like well. This is for medical doctors. And then they have like a platform that they built in for Chiropractic or dermatology, or whatever and we’re happy, because we don’t need all those other diagnosis codes. They just kind of package it for us, and we’re like. Thank you. So. Yeah, that’s good. That’s really good man all right well, that’s it I really appreciate your time and just been able to share what you’ve done and hopefully get some clients out of this. I really appreciate great talking to you, thank you. Another great interview has ended while you’re on your phone. Click that review, but right up a nice review for me five stars. 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00:40:02 – 00:42:15

The podiatrists series Dennis Acupuncture series holiday, twenty seventeen financial series how to write a review how to support the show like buying a cup of coffee getting swag like t shirts, the today’s choices tomorrow’s health book. That’s the blueprints for better health exercise picking food, correctly financial, and then of course bundle packs, which can get you the no needle acupuncture book forty common conditions, including the electric acupuncture pin at a great deal. The resources page has some of the products that I like. It’s a affiliate style, so if you buy something from them, I get a piece of that. Just like on the. The show notes page. If you buy a book from clicking that link, I got a small piece of as well so I really appreciate that things like screen CASTELL matic, pure VPN missing ladder J. labs speakers PR- alone edge or hog grips once again. If you do need any coaching on how to Improve Your bloodwork, drop weight, and the prone diet, fast mimicking Diet Five, day plan, let me know as well as if you just need some coaching whether it’s health whether it’s marketing whether you need some practice growth, etc, reach out facebook Justin Tros Clare MCC of course at a doctor’s perspective. Perspective dot net on the top right. You got all the social media icons that you can imagine. Click your favorite and reach out. Thank you so much for tuning in. Please tell a friend pass it along. You can go to dot net slash listen. It’s just that easy. It will open up right in your APP and don’t forget appreciate you listen critically think and integrate. See on the MINNESOTANS on. Thursdays and Saturdays hope you’re enjoying those. I’m definitely having fun summarizing these podcasts in less than ten minutes for you. You get the nuggets without having to waste your time every week A. A. Day. Burn to. A. Game Own!