How to Know If Your Doctor Can Actually Help You (Before You Waste Time and Money)

[0:00] So, I had a patient this week, six providers that she had seen for the same hip pain. Six. She’d been to a chiropractor who told her that she had a rotated pelvis, a massage therapist who blamed her psoas, an orthopedist who wanted to do injections, and an acupuncturist who said that her chi was blocked. Let me guess, a PT who said her glutes weren’t firing. Are you psychic? Some people say. Well, then she found us. And you know what? None of them were necessarily

[0:30] wrong. They just weren’t right for her. Mhm. And she probably found every single one of those through a five-star Google review or her neighbor’s recommendation. Exactly. And so, this got us thinking, how should you pick a provider? Because the way most people do it is basically healthcare roulette. And today, we’re giving you the cheat codes. This is the PTCH. What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? But chiropractors and physical therapists don’t like each other. Oh, again. I’m Dr. Kathy Lynch, physical

[1:02] therapist who likes to help people move and get stronger. I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Welcome to the PTCH Podcast. Remember, there’s no I in PTCH. Okay, folks, we’re back at the — what is this? The — oh, we’re at the PTCH Podcast. There it is. Yes. I’m Dr. Jason Young. And I’m Dr. Kathy Lynch. And we are the PTCH Podcast. Yes, we are. So, welcome back to another week. We don’t know why you’re still here. Hey, we’re

[1:33] here. Yeah, I guess so. I guess it’s a — I guess it’s a good reason. If it’s your first time joining us, welcome and thank you, and go ahead and subscribe. Subscribe now before you hear what this is. Hey, yeah. ‘Cause then maybe you’ll forget that you just already subscribed and it’s like, perhaps you’re tired then. And it’s like, you know what? I already subscribed, maybe I’ll unsubscribe later. And you won’t. You’re still listening, subscribe. Yes, while you’re still listening, definitely subscribe. So, and we also would appreciate a like.

[2:03] Mhm. Although we’re not doing this for you to like us. Sometimes we’re giving you some hard facts and truth. Yes. A Google review would be great. No, a Google review? No, that’s what we want for our business. It’s like we want reviews on like Spotify, YouTube. YouTube. Leave a comment or whatever. Comments. We love feedback. Comments, we want feedback, but it’s also just fun, right? Like even if you disagree with us, just tell us. Love that. Yeah, or like, “Hey, we hate you.” It’s like, “Oh, thank you for listening.” We have nothing but love for you.

[2:34] Yes, you’re amazing. So, yes, so here we are again for another fine, fine episode of high-quality entertainment-based health information. Disclaimer time. 100% entertainment. This is totally entertaining. Not healthcare advice. Yeah, we’re absolutely healthcare professionals, but we do this show for fun. Talk to your own doctor. Speaking of which, we want to talk about how you find your own doctor. How you pick a doctor? It’s hard. Yeah, well, and these days I

[3:05] feel like sometimes it just gets picked for you. It does. Yeah, like your insurance company. I’ll ask patients like, “Who’s your primary?” Yeah. They just gave me somebody. My primary what? Yeah. Well, and like the local Medicaid insurance, they literally do that. They give you your card and they give you a name, and that name, that is your primary care. There you go. Yeah, it’s insane. Mhm. But hey, we also have choices in healthcare,

[3:36] ‘cause this is not Canada. No. Yes, so you get to pick the providers that you want to see, if you can get out and actually see them. You can. Yes, uh-huh. Iffing. Yeah, iffing, that is a verb. Settle down, Raul. We’re killing him over there. He’s dying. Iffing you can get out and see the and see the doctor that you want, then

[4:06] you can get in and see him. So, let’s talk about this episode — we’re going to talk about some white flags, some red flags, and every other kind of flag in between. Can you rely on your friends to give you a good referral? How do you pick the right provider for you? Okay? So, first of all, there’s no Consumer Reports for doctors, is there? No, I mean — well, there’s those health

[4:36] grades out there, but Healthgrades. That is generic and they’re not regulated. No. So, people can write whatever they want. Sure. And yeah, I don’t think I’ve ever personally gone to Healthgrades. I think the only time I might use Healthgrades — I think mostly just ‘cause I don’t want to read stuff about myself. I do not. I got to tell a real quick story. At one of the clinics I used to work at, we had a disgruntled

[5:07] intern who was asked not to come back, and he went to our Google reviews. He went to town. Ah. But his Google reviews were hilarious. I wish I would have screenshotted them. Oh, man. But the two ones that I remember were: the water is watered down there. Even the water’s watery. Is watered down. Number two,

[5:37] it smells like Arizona in there. What? Exactly. And he had a whole list. He just went through like 10 of them. He let — you have it, both barrels. Both barrels. And if you’re out there, tiger, please send me your notes. I don’t work at this clinic anymore, but let me tell you the owner of this clinic became unhinged. Oh, I believe it. And got Google on the phone. Hey, yeah, listen, if you’re if you’re accusing me

[6:07] of giving out watered-down water, we’re going to throw hands. That’s so funny. Yeah, Healthgrades, Yelp, Google reviews — unregulated. Yeah, completely. And you know, it’s interesting too, because reviews in general, you’re either going to get really, really good or really, really bad. My experience, 90% of the really, really bad — if they were writing an honest review — it’s: I didn’t want to pay my bill. So,

[6:37] let me tell you how horrible these people are. So, yeah, and I have a friend who goodness, got a terrible review, just the worst scathing, right? Like accused them of legit misconduct and everything. The poor guy — the person wrote the review for the wrong clinic. It was a clinic that had a very similar name, and

[7:07] it was just like — and they knew it, too. It was the wrong clinic. Yeah, so they got a scathing review for not them. And they know that it wasn’t them because they named the doctor, and the doctor is at this other clinic, not And so, it’s like, “Oh, shoot.” That’s a bummer. And did I ever tell you about the worst review I got? Oh, gosh. So, when you have a business, you get little notifications. You received a review on Google. And so, I got a two-star review from a patient. I knew who it was, and I

[7:38] went and I read the review because I was surprised — it’s somebody who I liked and got along well with. She was getting good results. So, I go and I read this review and she’s like, “Body of Health Chiropractic and Wellness Center is the only place where I would trust with my health care, like to take care of my back. And the massage therapists are great, and the doctor is smart, and he’s handsome.” That’s not actually But it was along those lines. It was an awesome review. Okay. Two stars. What happened? That’s a great question. So, when she

[8:09] came in next, I was like, “Hey, first of all, thanks for leaving a review. That was amazing. Thanks — it was such kind things. I do have one question, which is what would it take to get that third star? Because it sounds like we were doing pretty good. You really set the bar high. So, she’s like, “What do you mean?” And I was like, “Yeah, you gave us two stars in the review.” She’s like, “I didn’t give you two stars.” I was like, “Well, how many stars do you think you gave?” She’s like, “I didn’t see any stars.” So, she just didn’t even know stars were a thing, right? And so, she had selected

[8:41] two and just submitted the review, which was a very nice review. And so, I was like, “Well, I don’t know. Like, I don’t want to tell you what to do, but maybe you could go and change it?” Edit the stars. Yeah, she’s like, “Oh, yeah, totally.” She gets out her phone. She can’t figure out how to log into her Google account. She was just — I was stressing about it, but I was like, “Oh, wait. When people are going to go somewhere, they read the best reviews and the worst reviews. My worst review was pretty freaking awesome. That was great.” So, I was like,

[9:11] even at its worst, it’s a win. A win is a win. Yeah, right? A win is a win. So, yeah, the reviews are kind of tough. And if you’re new to an area, or you have a new problem, you need a new type of provider — like let’s say that you finally decided to trust a physical therapist. Which — can we talk about your shirt real quick? It says, “Physical Therapist: because rock star isn’t an official job.” I got this free at a con- — I got it at a

[9:42] I got this free at a con- — I got it at a I got this free at a con- — I got it at a conference. Oh, nice. But I like to rock it around the office. Working that shirt. Am I? And it’s Very good. Yes. So, yeah, if you decide, “Hey, now it’s time for me to try out XYZ,” like, what do you do to find somebody? Now, this is kind of hard to answer because we don’t have a normal path — No. anymore. Mhm. Because we have extensive networks of health care providers, and so we’re going to ask around, probably get some good advice. But what we want to talk about today is what do we tell

[10:12] patients in terms of how to select somebody. So, yeah, what do you think? Well, I thought about this in a different context, too. People will ask me for suggestions on where they should go and what to do, and I generally — and I think this will lead into our larger conversation — when somebody asks me that, I usually know the patient. I’ve known them, you know, a couple of visits at least.

[10:42] And then the people that I’m going to refer them to, I might have a couple — so if they’re asking me for a massage therapist, there are, you know, so many massage therapists in this town, and there are some I know better than others. So, when I’m trying to give the referral, I try to match the people with — Mhm. — you know, like, does this person like pseudoscience? Yes. No. Does this person like someone who’s going to

[11:12] talk them through everything they’re going to do, or does this person just want you to do it? Don’t stop talking, more working. Yeah. Kind of thing. And so, I think the important thing that we’ll talk about is you kind of have to match what kind of health care you want for yourself with the provider who’s going to provide it. Absolutely. Not all equal, and we’re all different. All different, in a good way. Yeah. Right. And it’s great. Well, and then the flip side of that is, like, just — I think last year the rules in

[11:44] Oregon changed for chiropractors where if you are going to fire a patient — meaning they can’t come back anymore — you’re now required to give them three referrals to somebody else that they could go see for their problem. By law? Yes. You could get a — By rule. By rule. Okay. Yeah. And so, yeah, basically, I have to figure out the three chiropractors that I hate the most in the area, because if I’ve got a patient who, like, I don’t know, wants to threaten staff, or, you know,

[12:14] doesn’t show up for their appointments or something. I was like, “So, who do I like the least?” Okay. I know. Yeah. All of Mel’s chiropractors, you’re on notice. Yeah, I know. So, I am so sorry if you get a referral from me, and yeah, just — hey, send me one back. We’ve all got them. Send me one back. It’s all good. Um, real quickly, though, just in general, when people are looking for health care, let’s talk about how do you find somebody who really is

[12:44] what they say they are? Ooh. Like, what’s the difference between somebody who’s licensed or certified or credentialed? Like, what are your thoughts on that? This question kind of came up in our clinic the other day because we were going to hang up our licenses. Mhm.

Jason: Yeah. And really, we don’t need to hang our licenses anymore.

Kathy: Yeah, they changed that rule for us, too.

Jason: Yeah, the rule is as long as it’s available via the internet.

Kathy: Yeah. You know, if you go to your state board—

[13:14] —the internet or AI.

If you go to your Oregon State physical therapy licensing board, you can search a person by name, Mhm. and check their licenses, and you can see if their license has any red flags on it, too. If they have had anyone complain about them that rose to the level of the board, you know, giving them a warning or—

[13:44] —which is probably a little more useful than it’s like, “Oh, look at that frame.” And you can dust the frame all you want, and it never shows you

if that person has, like, hurt a patient or something like that.

Jason: Right. Yeah, I think they changed the rule for us for that same reason. Yeah. But, yeah, it used to be a rule. In fact, I remember when I was on the state licensing board, we — I dinged more than a couple of chiropractors for not having a current license displayed. So,

[14:15] I remember when we first talked about changing that, I was like, “Are you kidding me? Like, of course you have to display it.”

Kathy: But, yeah, listening to some of the logic and reasoning behind it, it’s like, “Okay, first of all, nobody’s looking at those.”

Jason: No. Nobody, right? Um if you look at mine, mine has said Dr. Kobe Bryant

DC for years. For years. Yes, Dr. Black Mamba,

right? Uh-huh. No.

[14:46] So, sorry, go ahead.

Kathy: Yeah, you go to the licensing board in your state for the providers that you’re looking for. The medical board in Oregon will show the doctors that you’re looking for, and show their continuing education, the alphabet soup that’s after their name.

Jason: Yes. Do they really hold a fellowship in such and such? Because you can put anything on your website— Mhm. —that you want.

Kathy: Absolutely. But, your state licensing

[15:16] board will have that listed. Totally. And that is an important thing because we take for granted when people put it out there. And this is an issue these days, especially on social media, where you’ll have influencers, and you’ll have providers of different kinds, and they should be identifying what kind of provider or doctor or therapist they are. Mhm. And so, that

[15:46] is in general, and also I think it’s more specific, too, because even medical doctors, people are like, “Well, I’m a medical doctor, and blah blah blah blah blah blah blah blah.” Which is fine — that’s what they should be doing. But, if you are a gastroenterologist, I don’t know that I really want your opinion on, like, eye pain.

Jason: No. Right? And so, it’s good, I guess, if we’re getting into flags a little bit. So, providers who don’t disclose what kind of provider they are — a little bit of a flag. Mhm. And

[16:17] then, it’s also important to know the difference between a certification and a license.

Kathy: Right. So, if you have a certification, that means that you have completed a course of study. Mhm. If you have a license, that means there’s oversight and regulation. Mhm. And a certification can’t be taken away.

Jason: Right. Right. Like, I’m ART certified.

Kathy: Right. Right? It’s like, the ART people aren’t going to show up and be like, “You’re doing a bad job with patients. Give us your certification back.” No, because I paid them $2,000 to put the ART at the end of my name,

[16:49] and until that expires, I got what I paid for.

Kathy: Keep paying so you can stay on their website.

Jason: Exactly. It’s advertising. Like, that’s essentially what a certification is.

Kathy: Yes. It’s advertising that you have completed a course.

Jason: A skill. You have a skill. And a lot of these programs — I’m going to call it a hustle. It’s not a hustle. But, the hustle is, “Hey, come back and take our super expensive classes, and we’ll tell everybody that your certification’s up to date.” But, it’s just like, “Oh, wait, you’re teaching me the same thing that you already taught me again and again.” So, that’s why I don’t have a bunch of letters after my name. Early on in the career, I was chasing those letters.

Kathy: Absolutely. But, then it’s like, “Man, you guys are hitting me for like 750 bucks a year, Mhm. and I can still just do all the stuff.” So,

Jason: Yeah. And if you have a license, that means you had to pass the licensing exam. Yes. And you are held to a certain level of care Mhm.

[17:50] and rules. Yes. Laws. Yes, laws, statutes. Yeah. Right. Mhm. If you abuse a patient, your license will be taken away.

Kathy: Yes. And you no longer have the privilege to continue doing that thing. If you have a certification, that could be taken away, and you might still have the privilege of doing that because there’s no oversight.

Jason: Yeah. So, for example, common credentials that you will see after somebody’s name, which means that they’re licensed, is like, well, let’s start with the two biggest ones.

[18:21] Mhm. DC

Kathy: Yeah.

Jason: and DPT.

Kathy: That’s right.

Jason: Right? Those are probably two of the most reputable ones out there. Most reputable, most revered.

Kathy: Yeah, not far behind, you have MD, DO, right? And what do these letters mean? Okay, DC is Doctor of Chiropractic, DPT is Doctor of Physical Therapy, MD is Medical Doctor, DO is Doctor of Osteopathy. There’s LMT, Licensed Massage Therapist, which is a license. Mhm. It takes a year to get. You have to do your hours of training, but it’s a license. It’s not a certification.

[18:52] Exactly. And that is an industry where you have a lot of certifications and things like that. And so,

if you want the good stuff, go to a licensed massage therapist. ATC, which — you know what that one is.

Kathy: I know. It’s athletic trainer.

Jason: Oh, I thought that was like the four-wheel— Yeah. It’s a three-wheel ATV.

Kathy: Yeah, your athletic trainers, right? That is a post-graduate degree. Mhm. There’s internship, there’s

[19:22] certification that has to be maintained doing education. Like, well, then you get into some that are — well, there’s LAC, right? Licensed Acupuncturist. What else is there? Oh, DDS, let’s not forget our dentists.

Kathy: Favorite

Jason: Yeah, health care provider.

Kathy: Yeah, quacks.

Jason: DMD, also. Well, and the difference between a DDS and a DMD, functionally, nothing. It’s all

[19:52] about — this is what I understand, not a dentist — but it’s all about the degree that the school that you went to offers. Yeah. And these days an MD and a DO are essentially the same thing. DOs will have a little more of a musculoskeletal focus. They learn —

Kathy:

Jason: Excuse me — they learn manipulation and things like that. But they go through all the same training that an MD does. See, what else is out there?

[20:23] Like podiatrists, do they have a separate name? I don’t know. I don’t think so. But like a lot of these other specialties, they’re still MDs and DOs. Like if you’re an ophthalmologist, which is different than an optometrist, you know, you’re going to be an MD or a DO. And so looking for those things and understanding — like if you see letters after somebody’s name, Google it.

Kathy:

Jason: That you can Google, right? But

[20:54] it’s important to know because it’s not to say that somebody with a certificate is going to do a bad job, but they’re held to different standards. And like, if you’re out there and you’re putting MD after your name, somebody’s going to come after you if you’re not really an MD. You’re going to do some time.

Kathy: Yeah.

Jason: Yeah, that one’s illegal.

Kathy: That is illegal, right.

Jason: So yeah, those are important things. Make sure that who you’re working with is actually an

[21:25] expert in that field or licensed in that field. Is there a certain quantity of letters that you should be looking for after a name? I know you think at least five because you’ve got to have the PT and the DPT, right? It depends — again, it depends on what you’re looking for. If you’re looking for a specialist surgeon, you want them — like a brain surgeon, neurosurgeon — probably want them fellowship trained.

Kathy: Yeah.

[21:56] Absolutely.

Jason: Yeah. And so I don’t know what all those letters are, but — yeah, and I think that’s something you can typically find on a website. They’re going to tell you about their fellowships. Which a fellowship is just extra training.

Kathy: It is extra training.

Jason: Yeah, it’s like, I went and for a couple more years of my life, I spent it learning about how to do left wrist surgery.

Kathy:

Jason: Yeah, in the PT profession, there are fellowships and then there’s also

[22:27] certifications — like you can be an outpatient certified PT. You can be a sports certified — that’s the SCS, sports certified PT. You can get vestibular certification. The fellowship — there’s residencies and then there’s fellowships, and again like you said, there’s more training. So fellowship is —

[22:57] the way that that’s been described to me — I actually thought about going back and getting my fellowship in manual therapy because Amy McDevitt is a fellow and I said, “Well, if she did it, I want to do it.”

Jason: You’re like, “Hello, fellow.”

Kathy: Her fellow fellow.

Jason: Yes.

Kathy: Yeah, I would have been. Yeah.

Jason: Yeah, and like, do any more schooling —

Kathy: Yeah, you’re like, “No.” So it’s more — so you’re still practicing as a PT when you’re getting your fellowship, but you are doing more training, you’re doing more

[23:28] research into evidence-based practice. You’re also being mentored directly by another fellowship-trained PT.

Jason: Right. And so you’re getting a lot of hands-on mentoring, and it usually takes — I think it can be a two-year program. And so then you have to pass a lot of tests.

Kathy: Yes. You have to do a lot more testing, but then you’re fellowship trained.

Jason: Sweet.

Kathy: Yeah.

Jason: Well, and chiropractors — we’re just now dipping our toes into the fellowship

[23:58] waters. I think there’s a couple out there that exist. A lot of what you’ll see with chiropractors is diplomates. And so there’s a few associations — like national level associations — and they will come up with these diplomate programs which are like several hundred hours of training. And so I looked at like, “Oh, do I do a diplomate?” and I decided instead to do a master’s degree just because I felt like that carried more weight.

[24:31] Not a lot of people know what a diplomate is or even that they exist. And so it’s like if I get a master’s degree, everybody understands what a master’s degree is. So those are just kind of the things that you want to look for after people’s names. And yeah, more letters doesn’t necessarily mean mo’ better.

Kathy: It doesn’t. And I mean, in the PT world — — and I don’t want to rag on these certifications like sports certification or

[25:01] orthopedic certification, but in our profession, you study for and then you pass a test and you are certified.

Jason: Yeah. If you’re residency trained, that’s a different story, because the residency — you spend a year in residency with mentors and again, you’re kind of drilled into the evidence-based practice. Then you sit for your certification.

Kathy: Yeah. So you can get your OCS, you can get your SCS without having a residency. People

[25:33] that get their residency — now it’s just basically one more year where you’re working full-time, but also studying full-time and being mentored.

Jason: Yeah.

Kathy: But it can — for new PTs, it can kind of set your trajectory, give you like a three-year boost on your experience.

Jason: Cool. Yeah. So people that are residency trained — those are good PTs. I’m not residency trained, it doesn’t mean I’m a worse PT, but —

Kathy: You’re a good PT. I appreciate that.

[26:03] Good PT. Appreciate that, but —

Jason: I’m proud of you.

Kathy: Oh, thank you. I needed that today. Well, and I think one of the things that’s hard is how that translates over to patients, because it’s hard — they don’t know. I was like, “I worked my butt off for this. You know how much gray hair this cost me — or hair period?” Right?

Jason: Yeah. Well, and so with chiropractic, I will say that there is one diplomate that probably rises above all the rest in terms of significance, and that is called a DACBR. It’s a diplomate

[26:35] of radiology. So and they’ve actually studied this. They’ve they’ve measured chiropractic diplomates in radiology versus radiologists in terms of their skill in reading like X-rays and things like that. And they’re pretty darn close. They’re pretty darn close. I would say that a radiologist gets more reps and so that’s good. But these DACBRs, like it takes several years to become a DACBR and

[27:06] they work in imaging centers and things like that. So that’s pretty cool. Then you have the other end of the spectrum where we have some weird ones that are actually pretty controversial and not always really helpful. For example, there is a certification called a functional neurologist. Kathy: Oh, yeah. Jason: Yes. And so this is a little misleading because people — the public hears “functional neurologist,” you’re a neurologist. That’s amazing.

[27:36] Yes, it does not take the same level of commitment and effort to become a functional neurologist as a neurologist. Kathy: Okay. And so — Jason: An MD. Yes, exactly. So like for example, part of my master’s degree is in functional medicine and it’s a term that’s been hijacked and I think that to put it a way that kids understand, if you like — “functional dot dot dot” could seemingly be replaced by Temu. Kathy: Mhm.

[28:08] Jason: I love that analogy. I was like, “Oh, you’re a Temu neurologist, right?” So yeah, and so that’s kind of problematic because it’s like functional neurologists, they are interested in the brain, the nervous system, things like that. My opinion, they need to find another term because it is confusing to patients. I had a patient who came in — very serious concussion — went off, saw the functional neurologist, got a diagnosis that literally nobody had ever heard of. I’d never heard of it. Right?

[28:39] I’ve seen lots of concussion patients and so the state requires you to have a level of training and certification in order to return athletes to play after a concussion — if you’re a chiropractor, but if you’re anybody who is not like an MD or DO. And so I have some training in this. This diagnosis, I was like, “What is that?” Called up an MD friend of mine. I’m like, “Have you ever heard of this?” And they’re like, “No, because it doesn’t exist.” And so it’s

[29:09] like, okay. Like what is this, right? And the biggest concern is that the patient thought that she was going to a neurologist. And I’m taking my notes and everything and I was like, “Oh, okay, you’re seeing a neurologist.” And I was like, “What’s the name of your neurologist?” And I’m like, “That’s a chiropractor.” So yeah, so it’s kind of buyer beware on some of these certifications and everything, but you know, you can dig into that. Okay, well, so we talked a

[29:41] little bit about certifications. What — just to jump back to the reviews — what are some things that people should be looking for, do you think, in reviews? Like what’s okay, what’s good to look for in a review and who can you rely on in terms of not just a review but even a referral? Mhm. What do you think? Kathy: Well, again I think it goes back to what’s important to you as a patient. For me, I want

[30:13] a healthcare provider who listens. Jason: Mhm. Kathy: But is also kind of no-nonsense in the sense that they’re not going to give me fluff. Jason: Yeah. Kathy: They’re going to say — for example, my cardiologist — I beg her every year, “Can I please have some estrogen?” Jason: Mhm. Kathy: She says to me — Jason: Kathy: She said to me, she’s like, “You escaped death once. Would you like

[30:44] to try that again?” I tried to die every day with a little estrogen. You know, I highly appreciate that. Jason: Mhm. Kathy: She just broke it down for me. She didn’t try to sugarcoat it. Like, this is why — she said yes, you cannot have this unless you would like to try to die again. Jason: So I think it’s important to know what you want. Sounds like a James Bond movie. “Try to die again.” Kathy:

[31:14] Try and get you — which is James Bond. How about just a little bit of estrogen? So anyway, I think it’s important to know what you want from a healthcare provider. Do you want somebody who, you know, is going to chat you up, is going to ask about your kids, ask about your spouse, things like that? Or do you want somebody who’s just going to give you medical advice? So know that. That comes through in reviews sometimes. And you’re looking at the type of reviews — and this is not to

[31:46] bag on front desk staff or anything like that — but some people will leave a great review for a clinic or something like that because they have a great relationship with the front desk. Jason: Yes. Kathy: Which is not bad, but it doesn’t tell you anything about the type of care that you’ll be getting there from the provider. Right. And the other thing too — I think it’s a flag when you’re looking at reviews — look for evidence that somebody is out there buying reviews. Like if you see the same exact review over and over and over —

[32:16] Jason: Mhm. Kathy: I mean, I suspect that’s not a real review. Jason: Right. Also, if you see somebody left a review and they’re like, “Hey, the people at so-and-so clinic are great. Sure hope I win those basketball tickets.” Kathy: Jason: It’s like — okay. Kathy: Yeah. And if you see like five Google reviews on one day — Jason: Mhm. Kathy: Yeah. Questionable. Yes. In fact, Google will tell you it’s

[32:46] — ah, jeez. And can I just say, don’t use Yelp? Yelp is garbage. Jason: It’s old. It’s like the ’80s. It’s ’80s and they manipulate their review system and I think that they do it just so that they can get businesses to pay to advertise on Yelp. Yeah. Like it’s crazy — good reviews, bad reviews — every once in a while they’ll just be like, “Yeah, that’s not a valid review.” It’s like, wait, what? And every time I’ve gone to them they’re like, “Well, you know what? If you just advertise with us, we’ll make all of your reviews good reviews.” It’s like, okay.

[33:18] Kathy: Right. That’s shady. So okay. So let’s talk about good signs, bad signs. What are maybe some — everybody wants to hear the bad stuff. So what are some red flags when it comes to providers and what people should look for? Like what do you look for as a patient? Also, what do you look for when you’re

[33:48] thinking about referring to a provider? What’s a red flag for you? Jason: I get a lot of feedback from my patients about doctors that they see. Okay. Physicians that they see and there’s one particular that — I’ve heard it a couple of times now. They go to see this physician and — he’s the product of this system that we’re in. Kathy: Mhm. Jason: And they have said to me that they go into the visit and he doesn’t make eye contact because he is

[34:18] he is just writing down, he’s typing what they are saying. He asks them questions but doesn’t look at them as a patient. And just writes down what they’re saying. And asks follow-up questions and the only time he looks at them is when he’s saying “I’ll prescribe you this” or “this is what you should do” and that’s the end of the conversation. So that’s a bad flag. That — I think that is a red flag. I mean, that says that maybe he either

[34:50] doesn’t want to listen or isn’t comfortable with that. Kathy: Like with you as a person. Jason: Yeah. Yeah, I mean, I just don’t know what to read into it but yeah, I think that’s a bit of a red flag. Kathy: Yes. So, you know, I am taking notes while I’m at my visit with my patients because the system is I have to submit these notes to get paid. So but don’t hide behind the computer. Yes. Well, and I think before we dig any deeper into this, I think you bring up a really important

[35:20] point that there are providers and there are systems. Yeah. And all providers have to function within a system and most of the stuff that we hate about healthcare is actually the healthcare system. Yes. Right. And even in my clinic we have systems that we have to — Mhm. — that we have to follow and it dictates how things go sometimes. I really wish it didn’t but it’s definitely not the providers. Everybody loves our providers. They’re

[35:51] great. So great. Yeah, but some of the rules and everything like that it’s like — so Mhm. — let’s see. A red flag for me — I think if I hear back that a provider will not touch a patient or will not do an examination on a patient, that is a red flag for me. Especially when I have somebody who comes in and they have a problem and I’m checking

[36:23] them out for the problem and we do the exam and everything like that and then I’m explaining everything, get to the part where I’m like “do you have any questions?” And they’re like “nobody’s ever asked me all those questions, nobody’s ever — Mhm. — done all those exams. Like nobody’s ever — Yeah. — like tried to do those tests and things like that.” So I like — this is really pretty thorough. And I’m thinking back and I’m like gosh, I felt like I skipped over some stuff. You know, and I don’t do super long exams. It’s like a new patient

[36:54] appointment, it’s like 40 minutes or something like that. But it really — at that point I will look back at who they told me their providers are and I just put a little check mark next to them and I know that this provider is not doing real exams on patients. Bet you anything they’re billing for them but — Yes. — it’s — that’s an issue. That’s a red flag for me. Mhm. Yeah. Do you have any others? Yeah, well I had a professor in PT school. This is our MSK professor —

[37:25] partnered with Amy McDevitt. I just like to drop her name, you know. We love Amy. Hey, what’s up Amy? What’s up, Amy dog? Jason: Hello Amy. He announced — he announced the beginning of the semester. He said “look, I’m going to give you the answer to this exam question” and he said “when a patient says I have pain when I go up and down stairs, I’m going to ask you this question. What test should you do?”

[37:55] “If the patient comes in and says I have pain when I go upstairs, the answer will be: watch them go upstairs.” Ding ding ding. That’s the answer. It’s highly technical. Kathy: If the patient — if your provider does not see you do the thing — like “it hurts when I raise my arm up like that” — if they don’t watch you do that, that’s a red flag for me. Okay. Yes. Yeah, that’s — you got to connect the dots to where the patient lives. What the patient is actually going through. Because people do some

[38:26] funky things and it’s really easy to figure out what’s going on when you watch them do the thing that hurts. Yeah. Yeah. And I think that there’s also some obvious ones like providers who don’t take time with patients, right? Kathy: Make them feel rushed, like hurried out the door. Providers who are rude to patients. Jason: Yes. They talk down to them, demean them. I hope I’ve heard it all but I feel

[38:57] like I’ve heard it all. Like doctors who will call their patient fat. Yeah. Granted, this is coming through the filter of the patient, right? So we don’t know. Patients sometimes aren’t very reliable either. But it’s just not good when any provider makes people feel like that. And being a doctor, being a therapist, any of those kinds of things, it is stressful. There’s a lot — like I had a patient this week, really acute low back pain and

[39:29] so I’m not a rush-to-x-rays guy but this is an x-ray-first-visit guy. So we send it off, he goes and gets the x-rays. I get the x-ray report emailed back to me. And I look at it and when you get an x-ray report, it’ll tell you what’s happening at every level. All the stuff that you’d expect to see. “Hey, at L1, we saw this, this, this, this, this.” Okay? So what I was expecting to be there was there. And it was the only thing that was there, which was moderate

[39:59] decrease in disc height, meaning these two vertebrae are a little closer than they should be, which could be an indication that somebody has a herniated disc. So I was like, yes, this is what I was looking for. No other findings, okay? Then there’s a part at the bottom called the clinical impression, where they summarize all those findings and say what it means and they make some suggestions as to what’s the next step. Number one: acute fracture or dislocation. I was like, wait, what? So I go back up and I’m like, where? Where is it? Where is it? Yeah. And then

[40:29] number two was moderate disc — moderate loss of disc height. And I was like, wait, okay, so I see that one, but where’s the acute fracture dislocation? So I get on the phone right away and I call up the imaging center and I’m like, I need to speak to this radiologist. And I get on the phone and I was like, “hey, you know, you read this person’s film and I had a question.” He’s like, “hang on a second.” He looks — Kathy: No. And I was like — Jason: No? He said, yeah. He’s like, it’s a typo. I missed the word “no.” And I was like, okay, yeah, so no acute —

[41:00] Kathy: Yeah, he’s like, I understand why you freaked out. And he’s like — he’s like, I’m sorry. And then he told me the thing that shocked me. He said — he’s like, “when you called, I am on my 145th read of the day.” Kathy: Wow. Jason: Yeah, this is at 4:00 p.m. Kathy: This is the system we’re talking about. Jason: 145 films that day. And I was like, that’s incredible. That’s more people than I see in a week. Kathy: Oh, yeah. Yeah, and so I think sometimes it’s important to understand that

[41:31] especially in our healthcare system, there’s a lot of stress. There’s a lot of places that are understaffed. Jason: He had to write up 148 reports that day? Kathy: He missed two letters. Wow. Jason: Two letters. Critical. So, yeah, I don’t fault him at all and I’ve gotten many reports from this doctor. He’s really good. But, I think sometimes when you’re dealing with your provider, have a little grace. The day I found out that my mom had

[42:01] terminal cancer, I saw patients, yeah, right? I don’t know that I did my best work that day. But, you know, you got to show up and try and help people. So, you know, maybe sometimes if somebody does a really crappy job, maybe you give them another chance. Kathy: Give them grace. Jason: They do a bad job the second time, write that Google — Kathy: They’ve shown you who they are. So. Yeah. And then, what about — okay, what about this? What if somebody is good at their job? They’ve got the

[42:31] certifications and all those kinds of things, but what if they just aren’t a good fit? Like, what kind of advice would you give a patient who just — they aren’t vibing. Jason: Right. Kathy: — with the provider. Yeah. You can ask to be referred to someone else. Jason: Yeah. Mhm. Or you can just, you know, politely end your care with that provider and just say, you know, thank you, but I feel like our care here

[43:01] is done. Mhm. You don’t even have to tell them you’re moving on to another provider. Jason: No. You can leave. Yeah. Still America. Yeah. Kathy: Jason: Well, sometimes we record these episodes like a week or so in advance and we’re just not going to make any guarantees. But, as of this recording, this is still America. Okay. We’ll update you. Kathy: Yeah.

[43:31] Next week. Jason: Yeah, boy, it’s going to be funny if — this comes out and it’s like, well, who wants to tell them? Kathy: Jason: This didn’t age well. But, that’s a really good point and I think it’s so uncomfortable. It’s so uncomfortable because it is a relationship of trust and it is trust that is almost — I mean, let’s be honest, it is mostly on the part of the patient — Kathy: Yeah. — that they have to exhibit some trust, right? You go to see your doctor

[44:03] and the doctor might ask you to get in a gown. You don’t get to ask the doctor to get — Kathy: Jason: Okay? It’s like, yeah, I need you to remove your shirt. All right, you first, buddy. No, Kathy: Jason: that doesn’t happen. And if any of my patients are listening, don’t try that crap on me, okay? I invented this. Don’t try that crap on me. Don’t ask me to take off my shirt. That’ll be your last day at Body of Health. But, so patients have to put a lot of trust out there and so your trust should be rewarded. I’ll put it that way.

[44:34] Kathy: Yes. Jason: When you’re working with a provider, your trust should be rewarded. You are entitled to explanations of: what are we doing? Why are we doing it? What are we hoping to accomplish? Kathy: Yes. And so that is a big deal. So, I think it is okay to decide not to work with a provider. And I think most providers are going to understand and that’s okay, too. Mhm. Right? Mhm.

[45:04] The only ones who won’t are probably the ones who are pretty new and they don’t understand that they aren’t the doctor for everybody. Jason: Right. Right. It took me a while to figure that out. Kathy: Yeah. Maybe like a year where I was like — it felt really bad. Like, sometimes people just wouldn’t come back or they’re like, I don’t really like your style or whatever. And it’s just really easy to take that personally and I don’t think that I understood that there’s going to be other patients. Yeah.

[45:34] Jason: Patients that I like more. Kathy: Jason: I think, two — as the patient — when you go to that first visit, you can ask the questions. I like this one. Patients asked me and I should just be offering this anyway, but some of the people that will ask me like, okay, how do you see me progressing? When should I feel better? When should I notice less pain? When should I be walking better? Those kind of things are really good questions to ask and your

[46:05] provider should be able to give an educated guess. They can’t — you know, they’re not always going to be 100% correct — and Kathy: No. — and actually made a really big mistake with the patient that we shared. Mhm. And I told her — I was like, after my first exam and I was just feeling confident — I was like, you know what, I think you’re going to — you know, I just thought it was like this flare-up and it was a musculoskeletal thing that we’re going to be able to get taken care of in a month — and Jason: Kathy: that month came and went. Jason: Oh, boy. Kathy: And went. Jason: Yeah. Kathy: And went. And she — every time she would come in, you know, after two months,

[46:36] three months, she’s like, a month, huh? Jason: Yeah, how’s this month — Kathy: How’s this month going? Boy, this is a really long month. So, yeah, sometimes I’m wrong. Yeah. But, I feel like a lot of times I’ll be like, I’ve seen this before. Jason: Boy, Kathy, I’m going to be going home and replaying this over in a loop. Sometimes I’m wrong. Sometimes I’m wrong. Sometimes I’m wrong. Sometimes I’m wrong. Oh, what is it? Kathy: Yeah, so anyway, Jason: Kathy: Yep. Yeah, but it’s totally true. I mean, we — I alluded to it in the

[47:06] beginning, but we are not psychic. Jason: No. Kathy: Right? And sometimes — well, the process of healthcare is a series of educated guesses, which is why it requires so much education to get into healthcare. Jason: Yes. If you want to make uneducated guesses, you can go on the Joe Rogan show. You could have the JRE. Kathy: Jason: Yeah, a lot of shots fired at Mr. Rogan the last couple weeks. Kathy: Yeah. But yeah, that’s — I mean, it’s

[47:38] the communication is really the key and I think there’s kind of a rule of thumb — and I say rule of thumb, but there’s actually some research that supports this — but four to six visits is about when you should see some sort of appreciable change if you are barking up the right tree. And so, if you’ve been going to somebody for four to six visits, whether it’s a PT, chiropractor, orthopedic surgeon, whoever it is — in four to six visits, you should notice

[48:10] some sort of a change. And if you don’t, it’s okay to say, hey, listen, we’ve been doing this for a minute now and I’m not seeing much of a difference. And that’s not just an automatic sign that you should give up or that the doctor should give up or whatever, but it is an indicator that it’s maybe time to try a different approach, whether that is with a different provider or we’re trying a different technique or we’re seeing you less often or more often. Four to six visits is

[48:40] kind of that period where you should — I’m not saying that your problem should be totally resolved or mostly resolved, but you should see some progress by then. And I think that that’s fair. I’ve been looking at a lot of research lately and actually kind of the sweet spot — I was talking to Lily and I was like, I don’t think that we do evidence-based practice here, and she’s like, why? Jason: I was like, well, because I’ve been looking at research and the there’s the most efficacy in these studies for chiropractic treatment plans

[49:12] that are about 12 visits. Kathy: Yes. It’s 10 in PT. Jason: It’s 10. Okay, yeah. Well, that’s why I’m telling her that we’re probably not doing evidence-based practice because we’re coming in at about seven. We actually track it. So. I would be an excellent PT. Kathy: You would. Jason: We question it. But it’s an interesting thing because it’s like, oh, wow, that’s what the evidence says. It’s about 12 visits, and so I don’t know if I’m setting people’s expectations right. It’s like Kathy: Right. Man, maybe I should be telling

[49:42] people it’s going to be about 12 visits. And then how you get there is like twice a week for 6 weeks or once a week for 12 weeks. I don’t know. But Jason: Yeah. Interesting stuff. Kathy: I think it’s a legit question you can ask your physician too when they prescribe you a med. Jason: Mhm. Kathy: You know, like when am I going to feel a change — when should I feel a change from this med? Because you’re not going to see that physician Jason: Yeah. for 6 months. Kathy: Yeah. So if you keep blindly taking these meds and you’re not seeing a change, like, you should know to check back in — like they should be able to give you an answer like, yeah,

[50:13] if you don’t feel anything changing in 6 weeks — because some meds take a while. Jason: Yeah. Like antidepressants, you know, you got to take it for 6 weeks before you’re going to start to feel a change. Like that’s a legit question to ask. Kathy: Yeah. And what if they can’t give you an answer or they don’t want to give you an answer? Jason: A good answer is still “I don’t know.” If they say “I don’t know” but this is what research has said, that’s a good answer. Kathy: Yeah. If they say — you know, if they say “I don’t know” and then they don’t follow it

[50:44] up with anything — Jason: I don’t know. I don’t know. Yeah. I don’t know. Kathy: Uh-huh. Who knows? Why would I know that? And here’s some peptides to inject. Jason: Yeah, right. Let’s get you on the Wolverine stack. Yeah, and I think just in general that’s another flag that you look for is how do they respond to any questions that you ask? You know, like, is this really necessary? What are my options? Oh, that’s a big one. You have a right

[51:15] Kathy: Yes. as a patient to understand what are the risks, Jason: Mhm. Kathy: what are the benefits, Jason: Mhm. Kathy: what are the alternatives? What happens if you do nothing, right? Okay, you gave me your treatment plan for taking care of my foot fungus. What if I just decide not to do anything? Jason: Mhm. Kathy: Right? They are required to let you know that information so that you can make decisions. That’s called informed consent. So a doctor or provider that you don’t feel like is contributing

[51:45] significantly to you having informed consent — which is not just a piece of paper that you sign in the beginning. You know, if he’s like, oh, you signed the informed consent so I don’t need to tell you anything. Jason: Yeah, skip that person. Kathy: Right? And they will figure it out when they see a significant number of people leaving because everybody listens to this podcast and they will now know — Jason: Um yeah, that is not okay. That’s a huge red flag. Yeah. So I think anytime somebody — if you feel like somebody is really trying to sell you

[52:15] something, Kathy: Yeah. Jason: and by sell you something I mean like financially sell you something — Kathy: Mhm. Jason: chiropractors, like, we’re guilty of this. There’s entire seminars on how do you do an effective review of findings, which when you see that it’s like, do you mean like an actual review of findings where it’s like I’m telling you what’s wrong with you, giving informed consent, Kathy: Mhm. Jason: and we’re treating — or do you mean the review of findings where I’m trying to sell you 24 visits, which we know is not evidence-based? Kathy: No. It’s 12. Jason: Yeah, it’s just 12, guys.

[52:46] So that’s another flag. If you feel like you’re being sold something, if they’re trying to corner you into a treatment, then you probably want to see what happens when you get out of that corner. Kathy: Mhm. There’s probably some other corners in the room Jason: Mhm. Kathy: that you can be in. Now, there’s sometimes though when you’re having a serious conversation it’s like these are your options and it’s kind of limited. Like, I had a patient who came in with very high blood pressure and I was like, dude, I’m going to do

[53:16] everything that I can for you today. I am not going to adjust you. I’m not going to be able to, because I’m concerned about your safety. Your back pain, your neck pain, is not the biggest problem that you have right now. It is your blood pressure. Right? And that patient got upset and I totally get it. I understand. I did everything that I could, but I understand that he was upset. And I told him, your option is you have to go to the hospital. Right? Kathy: Yeah. Jason: So that’s not me trying to put him in a corner. That’s me trying to help him understand this is the very

[53:46] best thing that anybody could do for you right now — let’s get your blood pressure taken care of. So but that’s not me saying, listen, your blood pressure is really high, the very best thing that you can do is buy this package of 24 — Kathy: Jason: and I’ve actually got a few large bottles of supplements and I know — I mean it’s $400 for one bottle of supplements but if you buy it today you get a second one for half off. So Kathy:

[54:16] Jason: That’s what it looks like. That’s what it looks like. Kathy: That is a red flag. Yeah, or a surgeon — someone in medicine, a surgeon who tells you that your only option is surgery might be your best option. Sure. Jason: Legitimately could be your best option. But is it your only option? No, surgery’s not required. Kathy: Never. Yeah. And it’s not free. No. Yeah. So yeah, those are the things. Jason: Mhm. Can we do a couple of these? I wanted to

[54:46] do it. Kathy: And then we’ll get to the game, which I feel like is kind of similar. You see where I’m at — where it’s like the questions that you ask. Jason: Yes. It’s a green flag and a red flag. So how about this? Read the question. You give us the green flag. Okay. Kathy: I’ll give the red flag, okay? Jason: So first one — when the patient says, “What do you think is going on, and how confident are you in this assessment?” What’s the green flag? Kathy: Green flag is a nuanced answer with differential diagnosis and percentage of confidence. Yeah. So we’re like 90% sure, right? Red flag is immediate

[55:17] certainty. Like, “Oh, I know exactly what’s going on with you.” A definitive answer without an exam. Jason: Yeah. We haven’t touched — Kathy: Yeah. We haven’t looked at you. We’ve done no tests, but Jason: we don’t know. “I can already tell. I can tell when you walked in. You’ve got kidney stones.” Kathy: Jason: Your kidney stones have kidney stones. All right, what about this? When you ask, “What does progress look like? How will we measure it?” Kathy: Great question. Jason: Green flag. Kathy: Specific metrics, timelines, expectations — “By visit three or four we should see this happening.” X. Red flag is a vague, “Ah, you’ll feel better. It’ll be all right

[55:48] sometime. Give it time.” Yeah. Jason: How many visits you got on your policy? Yeah, exactly. Oh, speaking of which — Kathy: your policy first. Jason: Speaking of which, “How many visits do you think this will take?” The green flag is a range with explanation of variables. Okay, and the red flag is, “Hard to say,” and there’s no follow-up, or, “Let me sell you a 24-visit package.” And we’re not going to examine you and I’m not going to tell you when or if you’re going to feel better. It’s just

[56:19] you’re going to get those visits and you’re going to know that you’re better. Kathy: “That 24th visit you will probably be feeling much better.” Jason: Like you need to buy a new 24-visit package. Here at — Okay. What about, “Would you refer me to somebody else?” or “What would make you refer me to somebody else?” What a great question, right? Really good question. Yeah. “At what point do you think I need to be referred out?” Green flag. Kathy: Green flag — specific scenarios, seems comfortable with the idea of referring out.

[56:49] Jason: The red flag is, “Oh no, I got this.” “Trust me, I can handle everything,” right? Or they’re like, “Well, you’re talking about leaving? Yeah, don’t leave,” right? Kathy: “You won’t find anybody better than me.” All right, one more. What about, “What should I be doing in between visits?” Green flag is home exercises, activity modification, self-management education, yada yada. Yeah, and then the red flag is like, “You should be thinking about when you’re coming back next,” right? Jason: Just rest. Yeah. You should be getting a loan — only I can cover the

[57:20] cost of your care. “Only I can cure you.” Yeah, or if they tell you just rest, don’t do anything. Kathy: Mhm. Like you’re fragile. Jason: Red flag. Kathy: Yeah, you’re broken, right? Jason: So that is kind of a recipe for dependency. Kathy: Yeah. So this kind of brings us to our game. Can we play a game? I think we’re going to throw it to Raul over in the booth. Jason: Raul, what you got for us? Raul: Hello everyone. Okay, so today — basically what y’all were already kind of starting to do — I’m going to give

[57:50] you some situations. You’re going into an appointment and this is the scenario in front of you, okay? And then y’all get to discuss whether it’s a red flag, yellow flag — actually, okay — or you could even do, like, I don’t know, beige flag. Have you heard that one before? Jason: Beige flag. Yeah, beige flag. That one’s like — it’s like not wrong but just weird. Kathy: Jason: Weird flag. Kathy: Yeah. Yeah, just like weird. Yeah. Okay. Mhm. So here’s the first one. Actually, some of these y’all have

[58:20] already kind of talked about. First one is — essential oil diffuser in the treatment room. Jason: No, that’s a giant beige flag. Kathy: Jason: Giant beige flag for me. What does beige mean again? Beige is like weird but not necessarily problematic. Yeah, I’d go yellow. Yeah. Yellow-reddish. Kathy: I’ll stand by beige. Yeah. And here’s what I think — it depends upon what you’re diffusing. Jason: Yes. There’s that. Kathy: If you’re diffusing patchouli —

[58:51] like, freaking gross, first of all. Second — well, listen, you dirty hippie, no. Well, but patchouli actually is a good example because there happens to be a lot of people that are very sensitive to Jason: Yes. Common allergen. Kathy: Yes. And so that to me says a doctor who may not be thinking about who’s coming in to the room. Jason: Yes. There are some other things, though, that if they’re being diffused, it actually could be like pretty helpful. Like, so maybe if it’s flu and allergy season they’re hitting a little

[59:21] eucalyptus or something like that. But yeah. And sometimes I’ll be talking to people online and I’m like, “Oh, I’m an evidence-based chiropractor,” and then they’re like, “Let me check out your website.” They go to the website and they’re like, “Oh, they sell essential oils.” They’re like, “You’re a quack because of essential oils.” And it’s like, “All right, well, do this — go to PubMed.” Mhm. Kathy: Look up essential oils, see if there’s any evidence out there. Now, I’ll just have you know — like, the only thing I do with essential oils is I sell them. I

[59:51] don’t ever talk to patients about them, but we’ve got them and people want them, so it’s like, cool, we sell very little. But yeah, there’s evidence behind essential oils. Kathy: Sure. But I think that just from that comfort and thinking about the patient standpoint, I would agree. Jason: I’ll go yellow instead of beige. How about that? Kathy: Yellow light. Awesome. Okay, next one — this one’s kind of similar, little bit different though, I think, along with what you all are saying. Crystals on the desk.

[60:23] Well, it depends. Sometimes patients give me gifts and I leave them on the desk. So, I have a couple huge crystals in my treatment room. Those are from my mom. Yeah, she had them and so yeah, she’s she’s a part of the clinic. Jason: Yeah. Now, if it’s crystal meth, Kathy: Jason: a green flag. Green means go. Kathy: Yeah. Yeah, let’s go. All right. Is it that chili P? You know that’s right. Chili P. Jason: Yeah, it’s Breaking Bad, right? Jesse

[60:53] Pinkman’s special. The chili P. It’s got a little chili powder in it. Right? All right. Kathy: Okay. Next one, we got a skeleton model wearing a funny hat. Did you see that in our clinic? Oh, is that? Oh, yeah. I think it’s a giant green flag. Yeah. Jason: Yeah, it’s my kind of place. Kathy: Yeah, people like to have fun. Yeah, right. And I think it — I think it makes you approachable. It takes something that’s potentially intimidating and lets you know that, hey,

[61:23] we’re we’re not — we’re not too scared of the human body and everything like that. I like it. Jason: Yeah, we’re going to explain to you what’s going on. Green. I like that. Okay. Next one, we got: your provider checks their phone during your visit. Oh, that’s hot pink for me. Yeah. Kathy: It depends upon what kind of provider it is. Because if it’s somebody who could be having an emergency, then okay, that’s cool. But now, when you when you’re in the room, be in

[61:53] the room with me. Jason: Yeah, it’s pretty red. Red for me. Okay. Next one, this is in quotes. “I can crack your neck without touching it.” Oh. What are the letters after the name? PT or DC? I can’t crack your neck without touching it. I don’t — I don’t recommend that any chiropractor use that terminology.

[62:23] No. That’s red. Next. And I know that there’s a lot to disagree with me on. But when Bobby was here — Bobby Maybee — and he talked about your instruments and how you handle your instruments. I see the adjustment as one of my instruments and so I always refer to it respectfully. Yeah. If you are a member of my family and like we’re together and it’s a holiday or something like that and you’re like, “Hey Jason, can you crack my back?” I will just stare at you until you use some different

[62:53] terminology. And I’ve made some people uncomfortable because they’re like, “What’s wrong with him?” Oh, I need you to crack right here. I just — I don’t respond because Raul will crack your back. I will adjust you. Yes. No disrespect Raul, but yeah, cracking is for people that do not have the training. So. I think that’s a great explanation. Next one, also one that you all kind of talked about already. Supplements are

[63:23] for sale in the lobby. I don’t think that’s red. It’s yellow because there are some reputable supplement companies out there. And there are some supplements that are beneficial. Yeah. Totally. Yeah, I think it’s how you deploy that. Mhm. Right? If it’s — first of all, the brand matters to me. If you listened last week,

[63:53] and I think it’s a red flag if you see a clinic that is engaging in multi-level marketing Jason: Yeah. for supplements. Kathy: Yeah. Because then you’re mixing a business relationship with a doctor-patient relationship and that is — it’s hardly ethical. Jason: Yeah. So. Nice. Okay. Well, not nice. Okay. Next one, the provider says, “I’ve never seen a case like this before.”

[64:23] That’s green for me. Yeah. Yeah. Kathy: It’s honesty. Yeah, I mean, there’s there’s times you just like, “This is a first for me.” Mhm. Yeah. Yeah. And you should appreciate the honesty because the next thing that follows is going to tell you whether that’s going to be a good relationship or not. I’ve never seen this before, but here’s exactly what we’re going to do. Jason: Yes. That’s when it gets a little red. I’ve never seen this before, but I’m going to

[64:53] do some homework. I’m going to ask around. I’m going to find some people who have experience with this. And we’re either going to get you over to see them or I’m going to have them help me know what’s going to be the best for you. Yeah. Lots of good answers. What’s happening? Okay, there we go. How many — who has the most points? I don’t know if this is a point or a — you keep taking all the answers. It’s probably Kathy. Okay. Next one is absolutely no wait time ever.

[65:24] I can get you in in 5 minutes. Yeah, they’re either very fast, very new — very new. Yeah. Or there’s a reason you can get in. Yeah, it’s like eating at the empty restaurant. Yes. And then we got one last one. Oh, actually, no, couple more. One, the provider hugs you goodbye. Oh, heck no. No, no, no, no, no.

[65:56] It’s a hard no for me. Yeah. The issue here — there’s a couple. Number one, what happens if somebody sees you hugging a patient? Like how does it make other patients feel? Especially if they don’t get hugs. Right? And they have to wonder what happened in that room, what’s happening between those people. If it’s a family member and I hug them goodbye, that’s easy. They’re like —

[66:26] I tell them if they see me hugging somebody and it’s a family member, I say, “That’s my sister.” Right? “That’s my lawyer.” My daughter’s going to be a lawyer. But yeah. And also the message that it sends to patients is not good. It is — it’s an ethical boundaries overstep. I don’t like it. Do you guys hug everybody at Kathy: at Encore? I’m a hugger. Yeah. Yeah. So,

[66:58] boy, this is our first disagreement. Is it? Okay. All right. Yes. Like hardcore disagreement. Okay. All right. I’m a spiritual person. Mhm. There is obviously some boundaries that you have to hold, but when someone’s just so excited Jason: Mhm. Kathy: to see you and that you helped them feel better whether physically or emotionally. Sometimes people just come in to get stuff off of their chest. Finally, this is the conflict we’ve been looking for.

[67:28] Yes, this is it. Thanks for listening. Can I give you a hug? And I say, “Yes.” Do you think it’s different for men and women? Yeah. Yeah? Yeah. Okay. Maybe I’m just more huggable than you. People ask me all the time. Can I hug you? And I say, “Yes.” It’s easier to — it is — around me. They usually ask, “Can I hug you?” Uh-huh. So. Okay. That’s good. Yeah, I don’t initiate the hug first. Yeah. It’s a green — it’s a red flag. They’re like, “That’s all the time we

[67:58] have for today.” Oh, wait. Wait. Where are you going? Get over here. Get in here. Nobody leaves without a hug. How are YOU GOING TO GET BETTER? How are you going to get better? Nobody leaves without a hug or doing squats. Yeah, uh-huh. Cool one right here. Look, this is one of those right here. Raul, get us to the next one. Okay. Next one, your provider calls it a healing journey. I’ll pass.

[68:31] Yeah. Yeah. I don’t — to each their own. I think that there’s a way to do that and it’s just fine. I don’t know. It’s just — yeah. It’s like, I don’t think that it’s anything bad. I — yeah, I would never say, “Oh, they called it a healing journey and that’s bad.” It’s just sometimes it’s weird, you know? But some people, it’s what they want. It’s what they came to you for — a healing journey. Don’t come to me for a healing journey, I guess. Well, there you go. It just sounds like something you put on

[69:01] Instagram. Yeah. Come with me as I take you on a healing journey. Maybe you need a healing journey. Yeah, it’s not bad. I’m going to — I’ll give it a green. I’m feeling generous. You get a green light for a healing journey. Yeah. Okay. And then we have one last one. And that’s you walk in and there’s a testimonial wall with celebrity photos. I’ve seen those. Yes. I kind of have one a little bit.

[69:31] You do? Yeah, my Beaver Dam. Yeah, and that’s because Mandy was like, you know what? Nobody’s going to believe that you actually work on players unless you get some pictures of players on the wall. So it’s like I have — I have a — I have a few things up. Mhm. I feel weird about it though. Mhm. Yeah, I don’t know. What do you — what’s your take? I think the celebrity can lend credibility. Definitely. But also you hope that that celebrity did well. Yeah. Yeah, oh yeah.

[70:01] Yeah. Oh yeah, this is — I used to treat Aaron Hernandez. No. Exactly. Oh yeah, double murderer. Exactly. Yeah. Yeah, oh this is me and O.J. Simpson. Yeah, look. Mhm. He’s — Louise. Yeah, here’s the Joe Buck. I think it’s risky. But I think it lends credibility. It’s also — can feel a little boastful. It does, yeah. Well, and you hope that those celebrities have a signed HIPAA

[70:32] form on file so that it’s okay that you’re displaying that this is a patient of mine. But yeah, it’s — I think that kind of swings both ways and I know some very good doctors. I’m not talking about myself. I know some very good doctors that have impressive celebrity walls, like our friends at Beaver Sports Medicine. Yeah. They have — they have tons of like memorabilia from patients and things like that. So. Yeah, it’s it’s kind of cool.

[71:03] Yeah. But there’s some doctors that just get such a big head about it. It’s like, all right. Anyhow. All right, I think we’re way over time. Way. Way. Way over — nobody’s listening to this episode now. Yeah, everybody who was listening to this in their car is now in another state, cuz Amy’s listening. She has that long drive from Austin. Yeah, that’s — yeah, that’s true. That’s true. Amy. Yeah, she might be in the ocean now though. So we got — we got to land this plane. We do. All right, take homes. Take homes.

[71:35] It’s kind of where I started. Know what you’re looking for in a healthcare provider when you seek one out. Yeah, my take home is — I guess I have to start hugging more people. Don’t initiate it. Yeah, oh okay. They’ll ask. New policy. They will ask, can I give you a hug? With every hug you get a free bottle. Buy one get — buy one get one free bottle. of these essential oils and I will give you a hug.

[72:05] Yes, exactly. Exactly. How about this? If I’m burning incense in the room, I want a hug. Now I — I think the big thing, if I could reiterate something, it’s advocate for yourself. You have a very important part to play in the quality of your visit and your provider will understand. You are doing a few doctor’s visits. Your doctor does many, many — and so you can give feedback and share concerns and things like that, and

[72:36] chances are things are going to go just fine. Yeah. All right, we love you all. We do. And there’s one more thing. There’s no I in PTCH.