What It Takes to Become a Chiropractor: Lilly Hammitt Explains

[0:00] Jason: And you let a brand new chiropractor loose in your clinic. Are you brave or just bad at HR? Kathy: Well, she’s smart, she’s funny, and she hasn’t run away screaming yet. So I’ll call it a win. Jason: Today we’re talking with almost Dr. Lily Hammet, fresh out of chiropractic school and ready to spill what she really thinks about entering the profession. Kathy: Yeah, this is the advice episode that everybody has been asking for, especially like PT and chiro students. And so there’s going to — you can expect a little bit of honesty, a lot of

[0:30] humor, and even an awkward story or two. So let’s do this. All right. This is the PTCH Podcast. What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? Kathy: Chiropractors and physical therapists don’t like each other. Jason: Oh, think again. Kathy: I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger. Jason: I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Kathy: Welcome to the PTCH Podcast. Remember, there’s no I in PTCH.

[1:02] Hey everybody, welcome back. This is the PTCH Podcast. I’m Dr. Jason Young. I’m a chiropractor. Kathy: And I’m a doctor. Jason: You’re — you’re a doctor of some sort. Kathy: I’m a nerd. Jason: Oh, Dr. Kathy Lynch. I’m a physical therapist. Kathy: Yes. Good. That took a lot of work, Kathy. Yes. And so in true nerd tradition, we’ve maybe invited the nerdiest nerd of us all. This is almost Dr. Lily Hammet. Lily is a

[1:32] chiropractic student at the University of Western States for just like, what, a couple more weeks? Lily: Yeah, like eight more weeks. Jason: Eight more weeks. Well, by the time this airs, it’ll be like two more weeks. But yeah, Lily has been my intern at Body of Health Chiropractic and Wellness Center. And so I told her that if she really wants to graduate from school, she has to be on the podcast. But she’s one of the smartest people that I’ve ever worked with. Now,Kathy: I didn’t say smartest interns or smartest students. She’s one of the

[2:03] smartest people I’ve ever worked with. Jason: Wow, that’s impressive. Kathy: Yes. Yeah. You’re welcome. And so real pleasure to have you here. Now, the reason we tricked you into coming on this show is it’s been a real popular request, hasn’t it? Yeah. Kathy: Like we’ve had some PT students, some chiro students who, when we’ve asked like what do people want to hear, they want to hear about what you have to say, which is like what do people need to know about entering physical therapy?

[2:34] And they just have physical therapy. They don’t want to be chiropractors. Jason: Well, we got one. Kathy: They’re gonna get it anyway. Jason: Yeah. Right. And so, yeah. So thank you for being on the show. Lily: Yeah. Kathy: Yeah. Excited to have you here. Lily: Yeah. Excited to be here. Jason: Cool. Kathy: Great. Well, that was a good show. Tune in next time. No. Jason: Well, the first and obvious question — why, why did you choose chiropractic? Lily: I knew like growing up that I wanted to help people and didn’t feel like

[3:07] working in a hospital was going to be for me. I was a gymnast for nine years growing up, and Jason: really, Lily: and was in a car accident at the beginning of high school. And so kind of between those two things, I got a lot of experience being a chiropractic patient and just felt like it helped me so much and I wanted to do that same thing for other people.

[3:37] Jason: That’s awesome. You know, that’s such a common thing — like the chiropractor origin story. Maybe we talked about this before, like, and do you find this with like physical therapists where they’re like, I became a physical therapist because I got injured? That’s what happened with mine. That’s your story, right? Don’t make fun of me. Kathy: Yeah. And then it’s like — it’s just scary though whenever like psychologists are like, that’s my origin story. Jason: I was in an insane asylum. Kathy: No, that is really awesome. Oh,

[4:07] you know what? Can we — I need to clear the air about something first. So you were actually mentioned in a previous episode because I was wearing that bright purple shirt and I was like, “Look, I think it’s some sort of a phoenix or something.” Wrong. Lily: Wrong. It’s not a phoenix. What do you want to — correctly identify the school mascot. Jason: The UWS school mascot is an osprey. Lily: It’s an osprey. Jason: Yeah. And I swear — there’s a reason I didn’t know that. Okay. So when I was a student at Western

[4:38] States, gosh, like 21 years ago, there was no mascot. Nobody cared. I was student body president and I proposed a mascot, but apparently it was not appropriate. I thought that we should be the Blazing Joints. I thought, you know, that’s probably perfect as a mascot, but Kathy: very fitting for Portland. Jason: Yeah. Yes. It’s very Portland. Yeah. So when I saw that bird, I thought, “Oh, it’s a fiery bird.” Yeah. A fiery bird, but it’s an osprey.

[5:08] Lily: Yeah. Okay. Jason: Okay. Yeah. Lily: Still, thank you for the shirt. Jason: You’re welcome. That’s excellent. That’s excellent. Kathy: Oh my goodness. Jason: So, favorite part of school? Most frustrating part of school? Lily: My favorite part of school was entering the clinic in quarter eight — like transferring from classroom, sit, listen to a lecture for two hours, into

[5:38] actually putting these skills to use. Least favorite part was probably about the first year where it’s really hard sciences, and like it may be stuff you’ve learned in undergrad but you’re diving way deeper than you did previously. Jason: Stupid deep. Lily: Stupid deep. Yeah. Jason: So tell people like what is chiropractic school like, even like — because I get

[6:09] questions all the time where people are like, so how many years did you have to study to become a chiropractor? So like, what does it take to go to chiropractic school and what does that look like? Lily: To get into chiropractic school to begin with — Jason: Yeah. Lily: most schools require a four-year degree. There are two schools in the US, UWS being one of them, that only require a certain amount of credits. So you can enter without a bachelor’s

[6:41] degree and it’s written into the curriculum that you obtain it while you’re there. Kathy: And even if you do go in with a bachelor’s degree, you end up with another one. Jason: Sweet. They’re just handing those out. Kathy: Yeah, pretty much. So I ended up going the route where I just accumulated a lot of credits and applied to chiropractic school, and got my bachelor’s in human biology about a year and a half into the program.

[7:11] Jason: Oh, nice. Kathy: So that’s kind of like getting into chiro school. And then Jason: I just want to point out I did the same thing. That’s how the smart ones do it. Good. All right. Good. All right. Kathy: Yeah. Okay. Jason: Go joints. Kathy: Go joints. Jason: The zygapophyseal joints. Kathy: And then like the first year, year and a half is like really hard classroom learning — like your basic sciences of like chemistry, biology, a lot of anatomy where you’re in a

[7:43] cadaver lab. Jason: And it’s stinky. Kathy: Mhm. And during that time, Jason: a lot of people don’t realize that about the education is that you are — you’re doing it. Kathy: You are doing all of it. Jason: Yeah. You are learning every muscle, bone, Kathy: nerve, artery, vein in the body. Jason: Mhm. Kathy: Like I’m not just learning about joints and how to pop them. It’s learning about what else is around them. Jason: Yeah. And then kind of throughout

[8:13] that year, year and a half, you start incorporating your adjusting courses, kind of working on those skills, positioning your body, getting faster. And then there’s about — yeah, about a year and a half in — you take a test, your clinical entrance assessment, in order to be able to actually practice in the school clinic. You spend a quarter in the school

[8:43] clinic. You take another assessment in order to be eligible to practice offsite, such as like going to practice with Dr. Young, those types of things. Jason: Only the best of the best. Kathy: That’s right. Jason: Only the best of the best. Kathy: Yeah. Yeah. Cream of the crop. Yeah. And then your last year of school is primarily focused on patient care. You do have some online classes, but you’re in the clinic for up to 25 hours a week

[9:16] treating patients or working with other people on your skills. Jason: It’s like being a real doctor. Kathy: Yeah. Yeah. Jason: Yeah. Yeah. Kathy: Yeah. Jason: I want to go back to — Kathy: I want to go back to — Jason: I want to go back to when you said you take a deep dive into learning the things that Kathy: you thought you learned in undergrad, and then all of a sudden you’re like, “No, we’re going deep.” Jason: So my first — I remember my first anatomy

[9:46] class in PT school, the professor — shout out to Dr. B. Kathy: What’s up, Dr. B. Jason: Dr. B. Hey, Kathy: when you graduate, you can call her Bookie. Jason: Hey, Bookie. Oh, I graduated PT school. Kathy: She was like a 5-foot-2 just firecracker. Jason: She scared the — Kathy: the bejesus out of all of us. And she said — we got to the cranial nerve section — she’s like, “Raise your hand if you learned cranial nerves in undergrad.” And we’re like, Jason: “I learned cranial nerves.” Kathy: Oh, I know all 13 of them. No, there’s 12. And then she’s like, “You don’t know the

[10:17] cranial nerves.” And she’s like, “Let me tell you.” And so, you know, we learned — right — like not just what they are, where they are. You’ve got to know what hole they come out of the head in, Kathy: and where they go into and what muscle and what things they run. That’s knowing the cranial nerve. Jason: Yeah. There’s an existential moment where you’re like, I am learning about things that aren’t actually there. Because when you’re learning about what a hole is called, it’s like, I am learning about a piece of air,

[10:48] right? Just a passage where things come through. Kathy: It’s a space. Jason: Yeah, it’s a space. Yeah. Kathy: Every hole has a name. The Jason: foramen. Kathy: Well, and it’s crazy too because I remember — I had just gotten married before I went to chiro. No, I just had a baby. Yes. Jason: I didn’t have the baby. My wife had the baby. I swear I took embryology. I know how these things work. Yeah. Kathy: We had just had a baby before I went to chiropractic school. She was two months old. And so I showed up there and

[11:19] chiropractic school is a lot. It’s a lot of hours. It’s a ton of commitment. And I was like, “Okay, I don’t know how to feed my family.” So I was like, “We’re going to do the food stamps thing, right?” So I went down there and I applied Kathy: and the lady’s like, “Nah, you’re not getting food stamps.” And I was like, “Well, like, what am I supposed to do?” She said, “Well, get a job.” And I was like, “Well, I can’t get a job because I’m in school.” And she’s like, “Well, you go to school and you work.” And I did. I worked full-time

[11:50] and I was a full-time student in all my undergrad. Yeah. So I was like, “Okay, listen.” I said, “There’s 30 credit hours that I’m taking.” And she’s like, “You’re not taking 30 credit hours.” I was like, “I am. And I have my schedule with me.” And I showed her and she’s like, “What kind of a school is this?” I said, “Well, I’m going to be a doctor.” And she said, “Here’s what you do. You need to quit school and you need to take care of your family.” Kathy: Wow. Jason: Oh, yeah. Yeah. So, but yeah, it seriously is 30 credit hours that first term, and then that’s the

[12:21] light one and it just kind of goes from there, right? Kathy: But it’s kind of nice though, because all the subjects sort of overlap, right? At least that’s — I hope that’s the way it still is. So it’s not like Jason: you have your gross anatomy plus your spinal anatomy plus your neuroanatomy plus your histology and they’re all interrelated, and so it makes it a lot more doable. But Kathy: I know. What do you think was the hardest thing about all that? Jason: You’re super smart. None of it was — Kathy: about like all the classes. Jason: Yeah. What was the most challenging part for you?

[12:52] The most challenging part overall was just like staying organized. Like, one of our professors really encouraged us to look over our notes from earlier in the day, later before we went to bed, because she was saying that it helps with retention. Jason: Yeah, totally unrealistic. Kathy: for your notes and knowledge. But like, the thing is, by the time you get home after sitting through four one-to-two-hour lectures in the day,

[13:22] your brain’s just so tired that you don’t want to do that. Kathy: And then you’re like, “Okay, I’ll do it tomorrow.” And tomorrow becomes the day after. And then you’re like, “Oh no, I got to organize all this information not only in my notes, but in my brain, because we have a quiz next week.” Yeah. So, just kind of getting used to the pace and the quick turnaround time of things was definitely a challenge. I think the content was manageable.

[13:53] Yeah. But it is a lot for time management. Yeah. All right. So there might be one or two students listening to this, because that’s who we are. Yeah. So can you tell us — for somebody who’s listening, they’re kind of trapped in that right now — what’s that transition from learning about it to doing it like? What was that like for you? I think there were definitely a lot of nerves in the beginning, like, okay,

[14:25] I’ve only done these on simulated patients or my classmates. And there’s a level of familiarity with those people where you’re like, “Now I have to do this on complete strangers that are not pretending to have these conditions — they actually have them now.” So, kind of reining it in

[14:55] to have that compassion and not be unprofessional about it. Because I think a lot of students can definitely kind of get into the practice of being too familiar or unprofessional. Role playing’s hard. It is hard. It’s really hard. Yeah. And so I think then it becomes a little bit of a stumbling block when actually getting into patient

[15:28] care, even in a safe environment such as a school clinic, where you do have to go out of the room and check in with your supervising clinician before you do anything, or if something’s really wrong — even then it still might be a struggle. So, what advice would you have for students who are doing the role playing and it just isn’t feeling authentic? What can they do to prepare to enter the real world?

[16:01] I think maybe switch up who you’re working with. If you’re working with a classmate that you’re buddies with, you hang out on the weekend, then you’re not going to get the same experience as working with a classmate that you don’t know very well. Find somebody you hate. Yes — that’s the advice. Or that. I mean, that works too. Do some orthopedic tests. See if it hurts. Yeah. Well, and I know that we’ve had some experiences, even pretty

[16:32] recently, where it’s like, you’re going to deal with patients that you don’t like. Yeah. We had some stuff this week. We did. Yeah. I don’t know about you — I love all my… It was not all fun. Oh, well, it’s only Wednesday. Yeah. You have — I always tell students whenever I go and speak at the school or whatever — that you have no control over what walks through your door, right? You have some influence over it,

[17:03] but you just can’t control it. Sometimes you get people who walk in and they’re just kind of wild, or they have weird ideas. Sometimes you get bad people that come into your clinic. We Googled a patient once after a weird encounter and found out that they had like tried to murder somebody. Yeah. It was in the news, and so I was like, “Oh well, but everybody deserves healthcare, right?” Jason: Body of Health Chiropractic. Yeah, exactly. Hear that, felons?

[17:33] But yeah, it’s a hard thing. And one story that I tell actually, that illustrates this — not just about bad people, but you just don’t have control over the things that come into the clinic — so when I started practicing, it was like January of 2008, February of 2008, I had a patient who came in and just had like tons of red flags, like all the things that you learn about, right? In fact, I remember I was seeing her and I was like, “Can you wait here for a second?” I went into my office and

[18:06] was going through my school notes from pathology and everything. I was like, “Red flag, red flag, red flag.” And I was like, “This is not good news.” And so had to go and have a conversation with that patient about, “Hey, I think something really serious is going on.” And so then went down the road to a cancer diagnosis, which ended up being terminal. And even worse, it was my mom. And so it’s like —

[18:37] year one, it’s like week six or something like that. And I just wanted non-specific low back pain or a mild headache or something like that. But yeah, I think that’s something that’s challenging — you have to be ready for anything that comes in. So yeah, how do you role play that? I don’t think you can. I don’t think you can. I think a lot of experiences are definitely going to come with being kind of pushed into the real world, whether interning at clinics

[19:09] or finally getting out and actually working either in somebody else’s practice or starting your own — you kind of figure out, oh no, school didn’t 100% prepare me for this exact situation. I know what I’m supposed to be looking for, I know what to do as a clinician, but there are some complicating factors that I think just come with time. Yeah. Mhm. So, how do you deal with the

[19:40] discomfort then? Just kind of push through it. Yeah. I think if you’re working with somebody else, maybe bouncing things off of them — like, “Hey, this seemed weird.” Mhm. What would you do in this situation? But yeah, I think for the good of the patient, you have to work through your own discomfort sometimes. Yeah. Those are all good words.

[20:13] Do you have — let’s see — do you have a surprising patient moment in your first couple weeks? Remember your HIPAA training. Yeah, used for nicknames, but has there been a surprising moment since you’ve been in the clinic? Well, we had a surprising moment yesterday evening. Not surprising that way. I wasn’t — yeah, I wouldn’t. Um, last

[20:43] week or the week before I had a new patient with like really bad mid-back pain, so tender that even light fingertip pressure was so painful. And I did my exam as best I could and came out and talked to Dr. Young and I was like, I can barely touch this patient. Like, how am I supposed to treat her? And so he was like, his advice was, “If you

[21:16] only have one shot at adjusting this patient, make it the most clean and crisp adjustment — so fast.” Because you’re not going to be able to try a second time. And so I was definitely uncomfortable in that situation because I had not had a patient in such intense pain, to where I was like, I don’t know what to do in this situation. I’m going to go for it.

[21:48] And so I did go in and I was able to adjust and I got the adjustment to go on the first time. Delivered the adjustment of a lifetime, and I was able to work in other areas and we’ve been slowly working with her more. But it’s definitely going to be something that’s going to take a while. But in the moment I was like, I can barely touch you. I don’t know what I’m supposed to do. So yeah, I

[22:18] think that was like my most surprising one that really stands out to me right now. Jason: It’s a good story. Kathy: Yeah. Jason: Yeah. And I think that we’ve gone through that before where it’s like — in the beginning it can be really the idea of dealing with somebody who’s in pain and kind of provoking that, and this can make you better, this can make you worse. That’s super uncomfortable, right? Because it’s like it’s scary. I’m just here to help people, right? But like when you’re like, “Do one more squat.” Who knows what happens. Who

[22:49] knows what happens, right? Kathy: You get stronger. Jason: They could explode, but you know, a lot of times it ends up working out. Kathy: Yeah. Jason: That’s good because it gives you confidence, right? It builds your confidence. I think it’s really easy to look at other people who have been there, other providers — not even just other chiropractors, but you’re going to interact with physical therapists, orthopedic surgeons, and everything like that. And it’s really easy to find people that you feel like are more confident

[23:20] than you or maybe they know more than you and everything, but the only way that people get there is, you know, I call it the grind. The grind — reps, reps, reps, reps. Kathy: Mm-hm. Jason: Yeah. So, it’s not something to shy away from. You just got to kind of lean into it. And sometimes you mess up. But my malpractice company told me not to say that. We’re going to cut that, Scott. Yeah. We’re just going to cut that part. Yeah.

[23:51] Oh my goodness. All right. Moving on. Kathy: Yeah. Jason: I think Lily is going to reflect on — Kathy: Oh my gosh. Yes. Do you have questions for us, Lily? Lily: I do. Jason: All right. Because this is, I think, what the students really wanted. They’re like, “Yeah, I already know the stuff that she’s saying.” So, okay, Lily, what can we tell you? And we don’t know what her questions are. Kathy: Oh, Jason: we don’t. You know what they are? Kathy: She texted me last night. Jason: Are you kidding me? I’m the only one that doesn’t know. All right. Okay. All right. Yeah. See,

[24:22] I’m here for it. Let’s go. Lily: Yeah. I was just thinking these on the fly yesterday after you told me I needed to prepare some. I know how people always talk about their favorite part of what they do — what is your least favorite part of what you do? Jason: Should we say it on three? Kathy: Yeah. Jason: One, two, three. Both: Chart notes. Kathy: Yeah. Jason: And really, you could swap us out

[24:53] for any healthcare provider and you would have probably gotten the same answer. Kathy: I mean, even doctors who have to tell family members, “Yeah, I’m sorry, your loved one didn’t make it” — they would still say chart notes. Jason: Yep. Literally. Yeah. I don’t want to do another chart note in my life. Well, and it’s weird because I’m sure that whenever you were like, I want to go to chiropractic school, and you went and did the preview and everything, they weren’t like, hey, you know, 60% of your job is going to be writing stuff. Kathy: Yes. Jason: Sitting in front of a computer. Kathy: Sitting and justifying what you just did.

[25:24] Like, this is what I did today. Dear diary, I made them do three squats, Jason: yeah, Kathy: four lunges, and then stretched their quads. Jason: Yeah. Right. Kathy: Please send me money. Jason: And then they send you money and they’re like, “Dear doctor, send that money back.” Well, and it is a weird thing because it’s like I think one of the few jobs out there where you do a job and then you’re hoping somebody’s going to pay you for that job and then they might pay you for that job

[25:55] and then they might ask for the money back — regardless of whether you did a good job or not — and they don’t pay you as much as you asked them to pay you. Kathy: Yeah. Jason: And then they want some of it back. Kathy: Mm-hm. Jason: So, charts and then dealing with insurance being a close second. It’s all kind of the same thing. And chart notes are important. They are. Kathy: They are. You got to know what you did with the person. Jason: Yes — continuity of care. If I drop dead and you need to be able to take over care, stuff like that. But

[26:26] I’ve got to remember what I did last visit — there are things like that. But there are just certain elements to it and the repetition of it, and the fact that we have to do it just to get paid is, to me, Kathy: yeah, Jason: an aggravation. Kathy: It’s a real grind. Jason: That’s it. Well, and so here’s something else to think about — I think I added it up and I’m probably at 15 to 18,000 patient visits that I’ve done, and that’s 15 to 18,000 notes. Kathy: Yeah. Jason: Yeah. And it’s like, how come I’m not

[26:57] Jason: Getting paid novelist money, right? Kathy: How many pages is that? Jason: Yeah. Right. I mean, it’s like I’m not J.K. Rowling, sure, but like — or Stephen King — but it’s like Kathy: Yeah, that’s a lot of writing. Jason: It’s a ton of writing. Kathy: Yeah. And there’s only so many ways to say “I adjusted that spine.” Jason: I was just going to say that there’s only so many ways I can talk about a tight hip flexor. Kathy: She did bridges. She did them again

[27:27] and she did them really well. Jason: Yeah, she was moderately better. She’ll probably do them again next week — again next week — with my cueing. Kathy: Okay. So, yeah, I think we beat that one to death. What else can we tell you, Lily? Um, y’all kind of asked me what the transition — or like the hardest part of transitioning from school to practice, or just even being an intern. Mm-hmm. What was the hardest part for y’all of switching from school to actually

[28:00] practicing in physical therapy and chiropractic? Jason: I think we kind of touched on this too — building the confidence. You know, obviously we’ve all gone through clinicals that you’re going through now, but you have that supervision. You kind of step out — like, “I got this question.” Well, you know, when you’re first hired, you might have a mentor. If it’s a good company, you should have a mentor, right? But if you don’t, you’re like, “Should I be supervised here?” Hello. Kathy: Yeah. Hello. Jason: Hello. Hello. And you’re — it’s just you

[28:31] and the patient. And so building that confidence, getting those reps, was the hardest transition. And to be honest, being — you know — every day, 10 to 12 patients for me a day and no chart notes, was just brain-numbing. Kathy: It’s a lot to manage. Jason: Yeah. And honestly, my hands were so tired my first year, and now they’re like — Kathy: Iron Man. Jason: Yeah. Boom. Kathy: They got so tired my first year. I remember being like,

[29:01] Jason: yeah. Well, for me, I started practicing during the Civil War — the American Civil War. So, we didn’t have indoor plumbing, you know, stuff like that. So that was just a harder time in general. Kathy: Crappy situation. Yeah. Yeah. Yeah. So, no, it wasn’t that long ago, but definitely what you said. I didn’t

[29:32] — I didn’t start with a mentor. I just opened a business. Kathy: That’s — Jason: because I love pain and suffering. No, my wife and I, when we were talking about it, we’re like, “Let’s just go ahead and do this.” And we were committed to making mistakes and learning from mistakes. And so

[30:03] we made a lot of mistakes and we learned a lot of stuff, and it became our brand and who we are. Like, we raised our kids in the clinic, and so it was tough, you know, because I didn’t always have a safety net. So I had to rely on — you know, we talk about confidence a lot, but I actually had to rely on humility a lot, where I would tell patients,

Kathy: yeah, I’m not exactly sure, but I’m going to research that for you, right? Or give me a second — I want to go look at some notes. And I don’t know if people want to hear that from their doctor, but that’s what we did. And I think that actually ended up being a strength because it built a lot of trust with people. And yeah, so just learning a lot of

[30:34] things about business was really difficult. But I’m grateful that we did it that way because it just doesn’t stop, right? You’re always having to learn things. It’s one of the things I really like about working with you — we sit and we have conversations. You may not know this, but I learn things from you, right? And so it’s like — Kathy: “What? We’re screwed.” Jason: So, yeah, I think that was the toughest thing in the

[31:06] transition. And I’ll tell you this — you actually graduated. She graduated. Kathy: Oh, Jason: yeah. She graduated — Kathy: June 20th. Jason: June 20th. Who’s counting? Congrats. Kathy: Right. Not me. Jason: Yeah. So she’s already graduated. She goes through that ceremony. And it’s like the day before — and you’ve been through this too — I was just Jason. Kathy: Mm-hmm. Jason: And then I get this little piece of paper and now technically I’m Kathy: Dr. Jason, right? Jason: So uncomfortable with that. I was super

[31:37] uncomfortable with that because I didn’t feel any sort of change in me. And so my first year of practice I just went by Jason. Like, people would come in and they’re like, “What should I call you?” I’m like, “Just call me Jason.” “Should I call you Dr. Jason?” “No, just Jason. It’s cool.” I’m just a dude, right? Big mistake. It hurt patients to just have some guy named Jason

Kathy: cracking their spine, because that’s all that it was to them — was a guy named Jason cracking their spine. Jason: And patient compliance was terrible.

[32:08] Like, people did not do the exercises I prescribed. They did not follow the treatment plans I laid out. And it’s because I was just Jason. And I started actually hearing people talk. When they would talk to my staff, my staff called me Jason too. It was like, “Oh, just Jason.” And I was like, “Oh.” And I talked to a mentor about it and they’re like, “Yeah, you’ve got to start using your title.” And it changed things. It changed me and the way that I operated, the way that I thought, the way that I treated people. It changed the respect that patients

[32:38] had — not just for me, but for what we were doing together. And then also, you were talking about the hands. Kathy: Yeah. The injuries. Jason: The injuries. The first year, every single month I had some sort of really bad injury — both shoulders, hip, I’d hurt my back — because it’s tough to learn to adjust people. You’re always working on your buddies, right? But then somebody comes in — you get one person who’s 400 lb, and then you get the next person who’s 89 years old and they weigh 4 lb, and

[33:09] it’s like — and so taking care of my own body and my own joints was really difficult. A lot of injuries that first year. So,

I think that’s my answer to that. Kathy: Yeah. Okay. Jason: What was the question? Kathy: Yeah. Um, I know that even as students, and it’s a common theme in the healthcare world — this idea of burnout. Have you guys experienced burnout?

[33:41] Jason: So, did you say are we experiencing burnout? Am I correct? Are you, or have you in the past, experienced like feelings of burnout while practicing, and like how did you deal with that or overcome it?

Kathy: I’ll try to listen with a straight face. Yeah, I know. Why don’t you go first? Okay.

Jason: Yeah. Mm-hmm.

Kathy: It’s kind of a — it’s a constant state. It’s a constant battle.

Jason: Mm-hmm.

Kathy: To not get burned out in healthcare. I

[34:12] think a lot of healthcare providers say the same thing. And so for me, I have to be really aware and conscious of trying to get myself away from work, and actually working on my time management in the clinic so that I don’t always have to take notes home with me and do it on the weekends and at night. And so it’s kind of a constant ebb and flow of what stage of burnout are you in?

Jason: Yeah. Yeah. Yeah.

[34:42] Kathy: Mm-hmm.

Jason: Yeah. It’s a lot. It’s —

Kathy: It is. It’s not just a job, it’s an identity. Like it really — it really consumes everything.

Jason: And sometimes you’re seeing people on their very worst day,

Kathy: right? And so there’s definitely some transference there. Gosh, I had this one week where it was like five patients in a row had lost a parent.

Jason: Oh my gosh. And it was like, “Yeah,

[35:12] right.” And so you just can’t help but soak some of that up. And but that’s the job. That’s what you’re there for. And I want to have compassion for the people that I’m working with, the people that I’m working on. And so sometimes it’s just a matter of like reminding myself this is what I signed up for, right?

Kathy: Sometimes it gets really really busy, like super busy. And it’s like I don’t even know how I’m seeing this many people. And I just have to remind myself once upon a time when I thought about

[35:42] having a clinic, this is what I wanted. I wanted to be really busy. I want to be able to, you know, touch a lot of people. I wanted to be able to, you know, change a lot of lives, help a lot of people get — heavy heavy heavy.

Jason: No, that’s when I was doing strength training. I want to help a lot of people get healthy.

Kathy: And so this is what I wanted. But it is really important to manage burnout. It’s the number one problem in healthcare for providers.

[36:12] And it’s not just physical therapists. It’s not just chiropractors. Dentists have tremendous problems with burnout. Any sort of ER doctor, nurses, surgeons of all kinds. Yeah. Healthcare is totally overloaded. It is so easy to become burned out. You can almost guarantee it’s going to happen. So I think the things that are helpful to me — number one, you remember your reasons for why you’re doing it.

Jason: Number two, you make sure that

[36:42] you’re compensated, right? So you’re in a situation where you’re not only feeling like I’m doing too much, but I’m doing too much and I have nothing to show for it, right? In part, what that means is — not just from the standpoint of I’m getting paid, but you’re building something. So you’re saving money.

Kathy: Mm-hmm.

Jason: Right. You’re saving money. You’re surrounding yourself with the people, the team that you want, right? So I put

[37:12] a lot of value into my staff and those relationships. That’s a form of compensation for me. And so sometimes when I’m really burning out, I look around the clinic and I’m like, I’m around people that I really really like.

Kathy: This is cool. And if any of you are listening, I’m not just going to pay you extra because I just said that I liked you. Okay? So don’t come asking —

Jason: but yeah, so kind of being able to craft that life, I think, is really important. And then another is you really need to have colleagues that

[37:42] you trust, and it doesn’t have to be people that you’re working with, but I’ve got people that I can call up and I’m just like, bro, this is hard, right? Or I don’t know what to do about this or what to do about that. And I tell doctors all the time, do not practice on an island, right? Don’t just be out there. Even if you have a solo clinic or something like that, you have to connect with other providers, even if it’s somebody outside of your discipline, because you can really help each other keep your heads above water. So

[38:13] that’s all I have to say about that — that’s a quote from Forrest Gump.

Kathy: Yeah, those were great answers. Is it game time?

Jason: Is that all the questions? Oh, we did. We made it to game time.

Kathy: That was three questions.

Jason: Three questions. Okay, that was your allotment. Good. All right, so I thought of a little game for you, Lily. All right. So this one — when I was thinking of a game, I already said that you’re one of the smartest people that I know.

[38:44] You’re very sharp. And I figured if I gave her something like, “Oh, what would you do in this situation or that situation?” she’s just going to get that. So what I thought that we would do is you have to pick out the accurate story. We’re calling this game — on paper, this game is called Doctor’s Orders. I don’t know if that’s going to make sense here,

Kathy: but we seasoned veterans are going to share a couple of clinical stories. One of them is going to be true. The other one is going to be false. And you just have to pick out which is the true

[39:14] one. Okay.

Jason: Okay.

Kathy: I’ll go and Kathy will go.

Jason: Okay. You’re free to ask questions about any of these situations, but you have to sus out the sus

Kathy: story.

Jason: Story. Yeah. Sus out the sus story. Okay. Do you want to go first or should I go first?

Kathy: You go first.

Jason: All right. I’ll go first. Okay. Situation number one.

Kathy: Mm-hmm.

Jason: I have a gentleman come in and he has a fake eye and neck pain. And as I was adjusting his neck, I thrusted so

[39:45] vigorously that that sucker popped out of his head, and it rolled across the carpet and it bounced off the wall — and it made like just like the — and yeah, that’s the story. And that’s pretty embarrassing, to adjust somebody vigorously enough that their eye pops out of their head literally. Okay. All right. That’s number one.

Kathy: Okay.

Jason: Number two, I was adjusting a woman and I was kind of hovering over her a

[40:16] little bit and when I went to thrust in and adjust her neck, her hand shot up and she punched me in the face. Okay. And the next time she came in before I adjusted her neck, I said, “Just a moment.” Went to my office, grabbed a pair of boxing gloves, and I was like, “Put these on to protect your hands.” And she never came back. So, I have to figure out which one’s true and which one’s false. Jason: Amazingly, only one of those is true. Yeah.

[40:46] Kathy: Oh gosh. I’m going to say that the boxing gloves is true. Jason: The boxing gloves is true. Kathy: Yeah, Jason: you are correct. Kathy: Wow. Jason: And you know what? She actually did come back, but it was like six or seven years later. And when she came back, I was like, “What are you doing here?” And she’s like, “I came back because my neck hurt.” I was like, “That was the whole punchline of my story about you was that you never came back.” And she’s like, “I just didn’t have pain.” And I

[41:16] was like, “Huh.” So, but yeah, sweet lady just got a little startled, punched me in my nose. So, Kathy: oh my god. Jason: Very good. I told you she’s smart. She’s Kathy: all right. Jason: Kathy, Kathy: smart. Jason: get her. Kathy: Okay. Situation number one. I had a patient who came into the office with back pain, like I got some back pain. I got this little numbness, tingling in my legs, you know, yada yada yada. And so we get into the exam room and then

[41:46] all of a sudden she — I ask her to get up and she doesn’t get up. I’m like, “Ma’am, get up. I need to see you move.” She’s like, “I can’t stand up.” And so once I — I then tried to help her stand. She couldn’t stand. And so when she couldn’t stand, I decided, you know what? I think it’s time we’re going to call the ambulance. So the ambulance came and she had surgery later that day. Jason: Oh my goodness. Kathy: Mhm.

[42:16] Jason: No. Kathy: I thought she was just tired or something like that. Okay. Jason: Yeah. All right. Kathy: No. No. Situation number two. I was actually at my lunch hour. Jason: that’s not true. Kathy: physical therapists don’t take lunch. Jason: We don’t take lunch. Never. Kathy: It was my 5-minute lunch hour. And a patient came back in to the clinic. It wasn’t actually my patient. It was my boss’s patient. And came back in and he’s like, “I just had my visit. My leg’s really killing me.” I was

[42:47] like, “Okay, sir.” And I’ll take a look, but you just saw my boss. So, he’s like, “This really hurts a lot.” And I’m looking at him and it’s really hot — his foot, his leg is really hot. And he had just had surgery. So I’m ticking off the red flags, right? You’re thinking what I’m thinking. So I say, “Okay.” He’s with his wife and I said, “You know, I think you just need to go to the ER. I think you have a blood clot.” And just go to the ER and say PT said, “Hey, I think you have a

[43:19] blood clot.” And so he went, he had a blood clot, they had to amputate his leg, and I saved his life, and his wife came back with flowers the next day. Jason: All these sound true. Kathy: So you’re really good. Jason: Above the knee. It was below the knee. Kathy: I think she made up the flowers. That’s what it was. Jason: I definitely know that the lunch portion is made up. Don’t take lunch. Kathy: I want to say the first story, the kidney stone story is true.

[43:52] Jason: I got you. You got her. Kathy: She did have lunch and she got the flowers. I did flowers and it saved somebody’s life. Jason: Holy — here’s the thing that’s crazy about that is I’m sitting here listening and playing along and I was like, I think she’s told both of these stories. I think I remember both of these stories and I was like, “Oh no. Oh no. Kathy didn’t understand the game. She was supposed to —” Kathy: No, you’re so good. You’re so good at that. So — oh, fantastic. Yeah. Yeah.

[44:23] Jason: All right. Well, oh, this is the part that we call final advice. And we call it that because that’s what it says on my notes, final advice. So, this is each of us. Okay. So, we’re each going to go around and give a piece of advice to a current chiropractic or PT student. Give a piece of advice to somebody who is transitioning into professional life, and maybe a resource that you found to be invaluable,

[44:53] like a book, or maybe a podcast featuring a chiropractor and a physical therapist, or anything. Kathy: Yeah. Yeah. One of those. One of those. Yeah. So, who wants to start? Jason: Okay. So, I’ll go. Kathy: Okay. Jason: So, are we going to do all three at once? Kathy: Yeah, just do all three at once. Okay. So, piece of advice to current chiropractic and PT students. Number one advice is find a classmate that you can study with. I learned more — not

[45:23] more, but I learned more in depth from studying with my classmates than I did sitting in lecture in class from a professor. So, I would say find a couple classmates that you can study with. Number two, a piece of advice to new grads entering the profession. I’m going to steal this from Coach Cara Lawson from Duke University. She said, “Learn how to handle hard better.” You can’t get around things getting hard. It’s going to get hard. It’s going

[45:54] to be hard. You have to learn how to handle hard better. So I love that. I love that talk that she gives. So you can Google that. And a resource they found invaluable — book, podcast, mentor. I would say mentor for me was invaluable. So if you can find a good mentor, one that you kind of fit with personality-wise, you like how they practice. Yeah. Same kind of values, ethics — I think a mentor would be a really, really good

[46:24] resource. Jason: Okay, maybe I’ll go next. Those are all really good and I think one of mine’s going to be really similar. So, for current students, I think that you have to think about how things are going to be, right? The way that things are now — listen to me closely — the way that things are now is not always how they’re going to be. And so, it’s really easy, I think, to be anxious and afraid and worried and really have a lack mentality like there’s not going to be

[46:55] enough out there for me, or I’m not going to be enough, or I’m not going to know enough. And I think one of the best things that you could do is spend some time thinking about your future, planning your future, kind of projecting — what do you want your life to be like? And that’s great to kind of keep the hope alive.

Jason: The piece of advice that I would give new grads entering the profession is you have to learn to network. I already said it — don’t practice on an island.

[47:26] When I say network, you don’t know where your next big break is coming in terms of being able to open some of the doors that you want to be open. And so if you are not excited about networking, or going out there shaking hands, or meeting new people, that is exactly what you need to be leaning into, because it’s going to get you the relationships that you want and need, and it’s also going to get you the skill set to deal with some of these uncomfortable situations that are

[47:56] coming. It’s your grinding season. You have to grind. So, network.

And then a resource that I think is invaluable. Oh goodness, this is tough. You know, I think a resource that I came across — and I’m just going to pitch it — the primary spine practitioner program

[48:26] that I completed at the University of Pittsburgh, which I think kind of morphed into their chiropractic program out there. It was really, really valuable. It gave me a really good framework, a way of digesting cases that came in. I had already been practicing for about 14, 15 years when I took that, but it’s a program that’s for chiropractors and physical therapists, and it was absolutely gold. So, yeah.

Kathy: Cool.

Jason: I like that. All right, your turn. I think one piece of advice to current students is there is a light at the end

[48:56] of the tunnel.

I promise.

It’s not a train, right?

Kathy: Yeah. And I think find ways to balance school and taking care of yourself while in school, because it’s really easy to kind of get lost into just the sheer amount of content you’re digesting on a daily basis. So kind of building

[49:27] habits to take care of yourself now while in school that will hopefully translate over into practice — maybe adjusting your schedule more — but like building those healthy habits so that you can have a long, happy, healthy practice. Like, yes, you may still get burned out, but you have some coping mechanisms. So find those coping mechanisms and develop them now.

[49:57] For new grads, I think that’s kind of —

Jason: What advice would you give yourself?

Kathy: I think that’s kind of hard, because I am there currently. But I think what I lean into day-to-day is the confidence I have in the training I was given — whether that’s adjusting, or my level of diagnostic skills, or all the practice I’ve put into these things. Just having confidence that my

[50:27] professors prepared me well for these things, my clinical educators prepared me well for these things. And so even if I don’t feel confident in actually being able to take care of this patient, I have confidence in what I know how to do. That can translate over into actually caring for this patient.

Jason: Wise words.

Kathy: And I know that confidence can be

[50:57] a hard thing to find, but even if it’s not confidence in yourself, if it’s confidence in the things you’ve done, then I think that can be helpful. And then what was the last question?

Jason: A resource that you found valuable.

Kathy: I think, yeah, a mentor — like having you to talk to on a daily basis. Even when I was working with you one day a week, we would have a weekly call of like, hey, what questions

[51:28] do you have about your patients you had on Monday? What can I help you with? Those types of things. And then I think also finding good reference material.

Jason: Like Wikipedia. We rely heavily on Wikipedia for the show.

Kathy: I mean, it’s a PTCH Podcast. Yeah, PTCH Podcast, Wikipedia — we have a partnership.

I have some books from ProHealth Systems by a WS

[52:00] alumni, Dr. Viznaiak, and I keep them on my desk at work, and I opened them today.

Jason: I was in another chiropractor’s clinic and I saw his book sitting on the desk, too.

Kathy: Yeah. Really good.

Jason: Yeah. Really good. Like, just an easy tool to just have on hand, that you’re like, I know this has good information — if I just need to reference this condition or this test.

We’re going to have to tag him in this episode.

Kathy: He’s going to love it.

Jason: I should see if he’ll come on.

[52:31] That would be a good one.

He’s up in Canada, right?

He comes to the US. He practices in Canada.

Yeah, Canadians are smart.

They are. Yeah, they’re smart.

They’re really smart.

Yeah.

51st state.

Well, awesome. Shoot — Lily, thank you so much for being on here.

So good.

I thought that you gave a lot of really good insights and advice to people. And it’s just been a real privilege to see you launch your career. I know that you’re going to do big things, and

[53:01] so yeah, just real, real —

What’s the word I’m looking for?

I don’t know.

Privileged to be associated with — see, you were worried about messing up. You’re like, “Oh no, I’m going to mess.” Yeah. Well, I’m here for that.

Leave it to us.

Yeah. So I think that we’re out of time. Okay, we’re officially out of time. But thank you so much — if you’re still watching — for tuning in to the PTCH Podcast. We love your comments, questions, and reviews.

[53:31] Please share this with a friend. If you’re a student and you’ve heard something that is valuable here, share it with another student — unless you don’t like that guy, right? If you really want somebody to fail, keep this from anybody. But otherwise, we’d love for you to share this, and we’re on YouTube, Spotify, Apple Podcasts — pretty much anywhere that you could get a podcast, you can get a little PTCH Podcast. Yeah, it’s a happy, happy thing. So, and I think there’s just one more piece of business that we have to get to,

[54:02] and that’s that there’s no “I” in

PTCH.