Folgen

  • Digital Health is revolutionizing healthcare. Adam Whitman, now with Medbridge, was a practicing clinician for 12 years including running a concierge PT service for NFL athletes.







    Adapting to Emerging Tech



    (listen to my recent recording with Casey and Kim)



    I have my hands in most aspects of the company



    More recently I have been focused on improvement in remote care possibilities.



    Demand for healthcare is growing



    More and more providers are getting burned out and leaving the profession



    Are you trying to take my job?



    All of our movement assessment uses AI



    AI has greatly improved since the beginning of the internet…but it's still a tool for you to do your job.



    With billable hours telehealth was a real problem.



    What led to the burnout?



    Documentation



    Lack of income



    But it was honestly the patients



    People want the provider to fix them without their participation



    High school application of Digital Health Skills



    HEPs are the simplest way to meet them where they are…on their phones



    Digital video to demo the exercises.



    Coming soon is a digital self-motion analysis that helps you know when to correct the exercise



    The AI helps us understand the acceptable level of adaptation



    The digital tool also gives us the opportunity for outcome measure data collection 



    With some AI models, the exercises can automatically adjust to tailor to the needs of the patient based on the motion capture



    The Non-Clinical PT



    What do you bring to the table?



    Do you understand what it takes to build? Can you make an app invisible?



    You have to address the fundamental problem the person presented you with.




    It is a tool



    Break your habits



    Stop printing papers

    Digital prescriptions meet them where they are.





    Data is far greater than an individual can

  • Emerging Concussion tech can be big business. Casey and Kim join the podcast to discuss some of the new tools and trends for Sports Medicine professionals managing concussions.







    What has gone away?



    Clear edge test



    New Concussion Tech:



    What is new?



    EyeBox - you put your chin on a chin rest and then track the marker in the EyeBox



    Wavi - EEG



    Mind Mirror - uses a front-facing camera and focuses on pupilometry 



    Mouthguards - 



    What is new with SWAY?



    We stay up to date with the consensus statements.  We updated our documents from SCAT 5 to SCAT 6



    Our tests mirror what is going on with the common research



    We listen to our customers and now have it in English, Spanish and French.



    We added the sleep survey



    PHQ9



    EMR integrations are a big thing for us.



    Shortened the test if results were consistent



    Helmets detect concussions real-time: 



    What is your time-to-treatment?



    How long does it take from injury to the time the injury is being treated by a specialized professional?



    Contact Us:



    Kim Wyand - [email protected]



    Casey Paulk - [email protected]



    Jeremy Jackson - Sports Medicine Broadcast on IG

  • Fehlende Folgen?

    Hier klicken, um den Feed zu aktualisieren.

  • Casey and Kim share Emerging Technology in Sports Medicine







    Emerging Tech in Sports Medicine



    Rehab



    Xothrm smart pad



    Blazepods 



    Firefly recovery



    Healthy roster, RankOne and EMRs



    GameReady



    BFR Owens/Delfi, SujiBFR



    Virtual Reality



    Sidelines



    Sway Medical App 



    Avive



    Perry weather



    Emerging tech for At Home



    Medbrige



    Evaluation



    InFlow Hydration monitor



    Spark Motion



    Dartfish



    Sway Medical App



    Force plates



    Mind Mirror







    Contact Us:



    Casey Paulk



    Kim Wyand



    Jeremy Jackson

  • Working definition: Athletic dry needling vs non-athletic dry needling.



    There is not a difference between the wording.  We aim to take and make dry needling practical and easy to use.



    We filmed professional-quality videos that are included in the course.



    What got you started in Dry Needling?



    I took 12 CEUs per year for 10 years



    What is your favorite application?



    The cervical seems to give the biggest outcomes



    I love when people are stumped or out of options and willing to try anything



    Weirdest needle



    Needling has a systemic effect



    Pelvic floor dry needling



    There are a lot of barriers to entry for the secondary school AT.  



    How do you walk through those?



    Get the waiver specific to dry needling.



    Use a lot less needles



    Include stim and needles to reduce the number of needles needed.



    Typically I use 16 -20 needles



    Young kids, I use less than 10.



    If someone is scared of needles, can they do this course?



    We get this often.



    I try to get them to try a few and see



    We have only had one person no-show on the next day due to the fear of needles



    When would you apply E-stim to needling?



    Allows you to dose needling - essentially make it more or less intense.



    Best used for pain mitigation



    If they are hesitant



    Find out their objections



    You can have anything in the world you want if you help enough people get what they want. - Zig Zigler



    Call to action:



    use SportsMedicineBroadcast.com/DryNeedling for your exclusive discount























    Contact Us



    Scott Dixon - [email protected]



    Scott - 904-853-1921



    Jeremy Jackson -

  • Mark, where are you from and how did you get into Athletic Training?



    A family friend owned the Milwaukee Bucks



    We used to landscape his yard.



    I was a sophomore or junior in high school and got connected with the Bucks AT.



    Went through the Internship route



    Worked Minor league baseball with the Brewers



    Started working with Bellin Health after my internship



    Passed on a low A ball job and stayed with Bellin



    Tell some of your family origin story…did you have kids, tried but couldn’t, chose to not do natural childbirth…



    Been married since 2010



    One month before our wedding my wife-to-be ran a marathon and collapsed most of the way through.



    2 months into our marriage she did a tilt table test and learned she had low blood pressure.



    2011 convention in New Orleans and she was still running



    She had a cardiac incident while in the pool…as in she actually died.



    She ended up needing an internal defibrillator.



    Talk about your adoption journey.



    We were trying to have kids, but the heart meds were possibly affecting her.



    We started using IVF and failed once, tried again and then my dad fell and broke his femur.  Then we learned that it failed again.



    It was heart breaking.



    Then my dad passed away the next week.



    Most of the football season was a blur due to all of the family trauma.



    My wife took the lead in looking into adoption.



    We did not know if we wanted local, foreign, foster care, straight adopt.



    We connected with adopt help out of California and a social work back here.



    Once people know, the stories started coming out of the woodworks.  Lots of people I knew were affected by adoption in one way or another.



    April 1st, 2014 we went live with our adoption.  Which was coincidentally our birth mom’s birthday.



    What conversations have you had with other ATs about the choice to adopt?



    Our adoption is open.



    We get lots of friends asking us to speak to friends in family in similar situations.



    Our son knows he has a birth mother and a mom and dad here.







    Contact



    Mark: IG, Twitter



    Jeremy - SportsMedicineBroadcast on IG

  • Mitigating Secondary Loss is something that hits home for me. Bubba Wilson has taken his role with ATsCare to another level. We recap the summer and one of the best CEU talks I have ever heard.











    Where has AT taken you?



    JJ: 



    Thibodeaux, LA



    Dallas, Texas



    Arlington



    Fort Davis



    South Padre



    Lansing Michigan



    Hot Springs



    Las Vegas



    New Orleans



    San Antonio



    JJ Road trip



    5 weeks



    One van



    7 people



    Chad from Candid AT



    Michigan AT Society Meeting



    Meeting Cookie Tuesday in Detroit



    Megan Smith at the University of Delaware.



    Favorite tourist thing: 



    Niagara Falls



    Least favorite tourist thing



    Statue of Liberty



    Bubba



    All this travel means you need to have your stuff in order…



    I teach and followed the DaveRamsey plan to get out of debt, budget, and have my financial house in order



    Talk about secondary loss



    Nok box



    I Am Dead, Now What



    Bubba’s Quick Start Guide



    Video from Trinity Sports Medicine Update



    Call to action:



    Contact:



    Bubba Wilson -@ATCLATBubba - on X



    Jeremy - @MrJeremyJackson on socials

  • LEADS Academy was created to build foundational leadership and empower the next generation of leaders in the Michigan Athletic Trainers Society. Jacob Ortega-Schultz and Courtney Lewis join me live at MATS 2024.







    LEADS



    Leadership Excellence and Development Series









    MATS Leadership

  • Brian Parker spoke for an hour at the Michigan Athletic Trainers Society annual meeting. Energy drinks, stimulants, drugs and the need to educate athletes.



    Taylor took anabolic steroids to get bigger faster stronger. 



    He quit cold turkey and that lead him to depression and he chose to take his life.



    Brian speaks at a lot of regional meetings and would love to come share Taylor story with your group.



    3 questions to ask:



    1. Contains banned substances?



    2. Am I using it properly? 



    3. Is it necessary? 



    Just one energy drink can hurt your blood vessel function. 



    ALL ME podcast

  • Professional Boundaries ebook from Dr. Sadie Adado and the ATvantage.







    Dr. Adado, what are some professional boundaries you have put in place?



    Scheduling (personal and professional time blocks for zone of Genius)



    “Self-care” (exercise, meals, meditation, yoga, reading, walking, family/friends)



    Quality improvement project on how I spent my time.



    Why did these need to be established?



    As a young professional, I hadn’t yet learned what I needed. It took a lot of self-awareness and reflection to understand my own needs so that I could practice putting boundaries in place. 



    Walk us through some of these Professional Boundaries conversations.



    Self-awareness is a journey. It doesn’t end, it’s continual and ever-changing. 



    Tuning into self in each moment will help to outline needs that can be met. 



    It is your ownership of that, responsibility that matters. Take action for yourself, no one else will. 



    What are some of the boundaries you see other Athletic Trainers needing help with?



    I hear ATs talk about being taken advantage of, lowest paid, constantly overworked, etc. The story feels redundant at this point. I wish more ATs felt empowered to change their own script. If you’re burnt out, who has the power to change that? Stop pointing fingers at the system and start being an agent of change. 



    Establishing boundaries helps create life balance.  What does life balance look like for you currently?



    For me right now, I love my work but it’s definitely not what I spend most of my time or energy on. Some might scoff at that, but truly it’s been a process of shifting the scales so that I came first. My body, my mental health, my spirit, and then my family friends pets.. it took a lot of practice and still does (every day) of ensuring that my cup is full so I can give. 



    I love Financial Peace University and we are debt-free including the house.  How do you think finances play into life balance?



    I also love the messages about financial peace. Finances play a big role in this balance. 



    It can be tough… I was an AT with a Masters salaried working 60+ hrs a week and paid under $40k. I had 3 job offers in the same week and that was the highest… needless to say I lived paycheck to paycheck for a long time, feeling totally stuck. Eventually, I moved to working 5-6 jobs at any time to get “unstuck” but then found myself burnt out. I’m sure this story is familiar.



    I decided to put energy into one place. For me, that was starting my small business. This created freedom of my time which is actually the most valuable. Long story short, this journey brought me to where I am now. And I still have multiple sources of income but it’s much more harmonious. 



    I think for ATs the balance of life and work does revolve a lot around money. I think we need to talk about it more often. We need to justify and prove our worth not just “say” it.







    Contact Us:



    Dr. Sadie Adado

  • IMG Academy offers opportunities for Athletic Trainers different from most secondary settings. Kaitlyn Deshaies and Jared White share what life is like at IMG.







    Kaitlyn, how did you get into Athletic Training, and what led you to IMG?



    I was an injured athlete in high school.



    I met an AT while traveling with the team and knew Athletic Training was what I was meant to do.







    Jared, How did you get into Athletic Training



    Planned to go to med school and do orthopedics because I loved being in and around sports.



    A random guy was sitting behind our bench with a little black bag and I started asking questions about him and what he did.



    I had zero previous experience with Athletic Trainers.



    Went to Anderson State University then transferred back to middle Tennessee State



    Worked with Vanderbilt



    GA at Auburn



    Season intern with the KC Chiefs



    Became the head AT for the KC Brigade Arena football



    Became head AT in Nashville at a D2 school for about 7 years.



    At the interview, I loved the IMG academy environment and leadership.



    The academy has a boarding school with the traditional student life.



    We do not have tryouts, but we have 12 support teams for the one baseball director.



    We also have campers throughout the year.



    Many pro teams use our campus as an off-season host site.



    We are a for-profit business.



    We have a very diverse population of TV Stars, a 10-year-old tennis player who is the son of an Abu Dhabi prince, professional athletes, and working-class athletes.



    Wayne said there are a lot of unique growth opportunities for an AT at IMG.  Can you explain?



    You may have a camper here for a week or a student with a torn ACL.



    Our ATs have a lot of physician interaction and see a lot of injuries.



    Both Kaitlyn and Jared have been forced to grow.



    As a for-profit business, we have to help the company make money.



    Personal and professional growth.



    We are focused on customer experience. Our staff has to understand the ins and outs of the business.



    We are housed in a building that houses strength coaches, nutritionists, mental health specialists, leadership and character development, and sports science and data analytics.



    We get to work with a lot of sponsors like Gatorade or Under Armor.



    IMG Academy’s summer hires are looking for a staffer who can be part of our team in the future.  



    A good candidate needs to be a part of the team and do the same tasks as the full-time staff.



    You do need to be an LAT to work in Florida.



    We started the growth summit where we host an entire week of education for our AT staff.



    How to read imaging



    Dermatology issues



    Suji BFR will host a course



    Emergency Med situations



    CPR AED, Emergency transport



    ROM and measurement education



    Where have some of the ATs who left IMG gone to?



    Some have gone home and had a family, and some have springboarded into their dream jobs.



    We have alumni in almost all aspects of athletic training.



    Clinical, hospital, LPGA, NFL



    How does IMG Academy provide life balance?



    We have 23 athletic trainers now and hire 7 during the summer camp season.



    We do not have a “hard” PTO schedule.  If you can swap with someone to attend to a personal event then do it.



    We only have 9 sports and have multiple ATs working baseball but have 200 baseball players.







    Contact Us:



    Jeremy Jackson - THE SMB on IG



    Kaitlyn - [email protected]



    Jared - [email protected]

  • Wet Bulb Globe Temperature is the standard for protecting from heat illness which is 100% preventable in athletics. Tom Woods discusses where we are as a state in adopting it.







    What is the ATLAS ambassador?



    What changes would you make to protocols in Texas?



    WBGT takes in several more important factors than Heat Index



    Don’t forget about band, dance, cheer in your WBGT needs



    What is the next major tech advancement you would like to see?



    Switching to WBGT and becoming a mandate rather than a recommendation.



    NFHS covers 48 states..but not TEXAS



    Will heat illness training become a required training?

  • Turf Toe is ever-changing. Dr. Paul Shupe and Joseph Eberhardt discuss some of the facts and history of turf toe at the Memorial Hermann sports medicine update.







    What can I do to benefit my athlete since turf is here to stay?



    Making sure the field is well maintained, and proper personal protective equipment is significantly important. A lot of football players like to wear narrow cleats which can contribute to lower extremity injuries based on the cleat pattern, length, and width of the shoe. The time of day we practice is important as well. 



    Is there any data or research done about laces and appropriately tying the shoe with appropriate arch support?



    Great question, I’d have to look into that. I’m sure there are studies - I didn’t delve into that. These are very important questions, I think that core strengthening is a very pertinent point as well. 



    You spoke about an increase in PCL injuries. From my education, the mechanism of injury for PCL is that dashboard injury, coming from direct force on the anterior tibia. Is there any research, or from your background and knowledge, why is it that we’re seeing more prominence from that mechanism on that turf?



    When it’s not a dashboard injury, the common mechanism is that you onto your knee bent at 90 degrees, your toe has interacted and your cleat is stuck in the turf so it's not giving away.



    Your foot is in this dorsiflexed position and you land on that knee with all of the force going back through, as opposed to if the shoe gives out allowing you to land on less of a 90-degree angle. 



    Is there any correlation to gastrocnemius weakness regarding those Turf Toe injuries?



    I think that's a valid argument, I don't have enough science or background to say but I do think that would be an interesting thing to study. 



    We talked about the history of turf in your presentation, would you say we’ve moved in a safer direction? Are we moving to a safer surface?



    I think we are, I think we’re moving to a safer surface for our lower-level athletes. I think our higher-level athletes have different muscle builds and different muscle types that may lead to some of those injury at a higher level.



    I do think the technology that's going into it is moving towards a safer playing surface, I don't think there's much we can do about the heat and some of the other things, and they are looking into that. I think we are moving there, the important thing here is that turf isn't going away, I don't think that we’ll ever go back to grass.



    With technology moving forward, I do think it's becoming safer. I don't think it'll ever be 100% safe but with education, and proper maintenance, I think we can make it as safe as we can. 



    You mentioned the coconut or the cork, those things are natural materials that would rot, and putting turf in is a lengthy and expensive process. How does it make sense for a high school field to put something that might rot underneath there?



    So part of it is just the turnover of it, so it's got to be properly maintained. So when we use the proper equipment and the proper rakes just to shift it around that's a valid question, especially in a wet and humid environment like it is here. It’s not being used a ton yet, and I think that's yet to come. We may determine years from now that it's a bad idea.



    Rice uses wood instead of rubber on their field, I found that interesting when we played there last year. 



    Did you notice any difference?



    Thinking back, I think your point about feet being sore on these fields; is a major problem. Your feet hurt at the end of the day on the rubber. There’s less of that impact.



    We did have in our Rice game, but I don't think it makes a difference in injury, we had an ankle fracture that game, we had a significant hamstring rupture, and a couple of other things so I don't think it makes a difference as far as the interaction of the cleat but it may make it as far as the softness. 



  • EMRs are like most things, it is not one size fits all. When looking for a solution for records management Will Ryan wanted to share his search results with all ATs.







    Discussion topics: 




    Searching for EMR



    How to obtain EMR



    How to Familiarize yourself with EMR



    Communications with EMR Companies




    What has been your process for searching for an EMR?



    Identifying limiting factors like cost. Sportsware and AT Genius are cheaper options.



    Barriers to documentation - time, limited resources, uncertainty of what to document. NATA has created guidelines regarding methods of documentation. Consider the legal aspect of documentation.



    How do you approach your school about obtaining an EMR?



    Build value in the documentation. Explain how EMR protects patients, coaches, and healthcare providers; and keeps everything secure. Convenient place to store all UIL-required documentation.



    What is the best way to familiarize yourself with EMR’s?



    CAATE standards have now included EMR’s. 



    Pearland ISD uses Rank One - signs in upon entry and documents almost everything. We introduce our MAT program students to Rank One and have them document all patient interactions. 



    Did companies offer demos of their EMR systems during your search?



    Rank One, Healthy Roster, Healthy Monitoring, Sportsware, AT Genius.



    All provided demos, and were very open and helpful.



    The creator of AT Genius took the time to meet with me. 



    Collecting some data is better than none, do what you can. 



    Use documentation to show the dollar value of your care and how much money you save parents by providing care. 



    Christina Instagram:



    Cmfry16



    Sydney Instagram:



    sydneyhayes95

  • Combat Sports Medicine seems like an extreme environment to practice Athletic Training. Dr. Ethan Kreiswirth created Blackbelt Sports Medicine to provide Athletic Trainer care for combat sports athletes.











    You are always posting gnarly pictures and videos on IG. What gives you pause or catches you off guard?



    As an Athletic Trainer, I started covering tournaments around 1997.



    Personal experience in the sport helps me understand the types of injuries that occur.



    Tournaments now are 40 mats over 6 days



    Dislocations, unconscious used to give me pause.



    Now it is just running a company.



    Or working youth tournaments, those are always difficult for me.



    Does Blackbelt Sports Medicine have tournaments across the United States?



    Yes, we work with the BJJ organizations to help provide medical care for combat sports.



    A new AT is going to work in combat sports medicine.  How do you prep them?



    Gloves, gauze, skin lube, and nose plugs.



    An Athletic Trainer working with Black Belt Sports Medicine could almost get away with just bringing their fanny pack, like the Nexus Deadbug



    There is almost no taping done, maybe some finger taping.



    You do a good bit of suturing…discuss that as an AT. 



    Many of these BJJ athletes are from out of state or another country.



    Suturing on the sidelines helps them out tremendously.



    I have done about 10 sutures so far.



    There is a lot of practice involved with the practice kits.



    Not being licensed gives me more freedom to practice the emerging skills.



    We take a table behind the scenes and do the standard prep work.  We also instruct them to follow up with their HCP.



    The larger tournaments have an overseeing physician onsite as well.



    Sign up for a tournament and see if Combat Sports Medicine is for you.







    Contact:



    Dr. Kreiswirth - https://www.facebook.com/Blackbeltsportsmedicine/



    IG: https://www.instagram.com/dr.kreiswirth/



    Jeremy - https://www.instagram.com/sportsmedicinebroadcast/



    Resources:



    Pub med research

  • Bubba Wilson discusses Crisis Behavior or Crisis Etiquette live from the Memorial Hermann Sports Medicine Update. He has been leading D6 in ATsCare since its inception and has learned a lot over the years.







    Discussion topics: 




    AT Cares



    Crisis Management



    CCISM Credential



    COVID Impact on AT Cares Program



    NATA Gather Program



    Mitigating Secondary Loss




    Did crisis management help you be prepared for being inducted into the SWATA Hall of Fame?



    AT Cares drove me there.



    CCISM credential:



    Certified Critical Incident Stress Management - Level 1 deals with individuals in crisis, the majority of AT Cares population. Level 2 deals with groups in crisis. 



    Began Crisis Management training in 2019. 



    AT’s managing grief:



    Grief comes in at a later time, ATs have to finish the game/event after a critical injury/event.



    AT Cares reaches out once notified to ensure assistance is provided where needed



    NATA Gather Program Integration:



    Young professionals can use NATA’s gather program to find mentors. 



    Crisis on campus - what is the best method to find that definite grief to counsel them?



    Don’t counsel them. Listen. Refer out. 



    Soapbox Warning - What is step 1 in managing the secondary loss of loved ones?



    Have affairs in order. Have a will, have life insurance. Have your burial wishes written down. Have the conversation. Have a list of your account usernames and passwords. Know how many death certificates you may need. Legal Zoom is a good resource. Make sure you constantly update your affairs. The primary loss will be exacerbated if we don’t handle our affairs. 



    Currently working on a presentation with AT Cares members regarding their experiences with loss and what they’ve learned along the way.



    Thanks, Sydney Hayes for creating the Crisis Behavior show notes

  • Practical Preceptor Tips from Christina Fry at Dawson High School in Pearland, Texas. They do an amazing job with the Sports Medicine staff, their student aides, and as preceptors for the University of Houston MAT program.







    Discussion topics: 




    Advancing students in the profession



    Preparing students 



    Outfitting students



    Providing learning opportunities 



    Scheduling



    What to avoid



    Practical Preceptor Tips




    How long have you been a preceptor?



    7 years. 



    Can you share some of the things you have done to help master's students be involved and advance in the profession?



    We treat the masters' students as an extension of our staff, we want them to be respected in our ATR just like us.



    We have our high school students refer to them as Mr/Ms/Mrs. We interview them to make them feel that they are in a professional setting.



    My assistant, Thomas, likes to ask them “What did you learn today?”. We outfit them, invite them to our pregame meals, we make sure that they feel respected. We make sure that every day they learn something new.



    You interview them for the position, but they’re already assigned there?



    Correct. We ask them to submit a resume, and for a lot of them this is their first job “interview” and ask them interview-like questions and ask them to submit a cover letter.



    We then give them critiques so they can start working and build that resume so that when they are done with their program they can apply and be successful for their interviews for their actual job. 



    Do you do that just once, or every week, every 3 weeks, etc?



    So our level 2’s are with us all year long, we make sure we give them monthly updates. Our level 2 this past year wanted an update every day, every week, so we always were helping her and growing her, anytime there was a hiccup or something she was unsure of, we gave her that reassurance and feedback.



    For the level 1’s, it takes a while to get into that comfort zone, but we always try to give them feedback when we notice something, good or bad. 



    You talked about outfitting them to make them feel welcome, do we give them the ones that say athletic trainer, or the ones that the students wear, do they keep them; what does that look like for you?



    So it varies, level 2 vs level 1. Level 2’s we’ll give them the game day polo for the year, and require them to look professional when they come into the ATR.



    Our students will wear Nike shorts and a T-shirt. We ask that our UH students either wear something UH to differentiate them or they wear a polo with either nicer shorts or nicer slacks, with their UH ID badge. And that way it identifies them as an adult and not a student.



    More Practical Preceptor Tips: Include them in almost everything! So for GHATS, we made a fun t-shirt for the t-shirt contest, and we had a team-building activity of tie-dying the shirts.



    We invited our UH students to join in since they went with us to GHATS, and they were allowed to wear that shirt as a fun GHATS representation. For our level 1’s, if there’s an event going on during the time that they are with us we’ll give them one of the students' shirts, but for the most part, we’ll give them our practice shirt for the year that they can wear to Saturday treatments, etc.



    One of the things I’m trying to still work out is scheduling, how do you balance that out and hold them accountable while keeping in mind that they’re college students?



    You and I have the luxury of working in a high school setting, so we automatically have Sundays off, that is the one day a week they have off because they are required to have at least one day off within a 7-day span. So we keep that in mind.



    We use something called “Homebase” which is a scheduling app, where our students, ourselves, and our UH kids can submit their days off requests, so we honor that.



    We always remember that they are students first, so they can communicate with us if they have a big test coming ...