Episodes
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In this episode, we share our growth-spurt experiences as physical therapists. We realized during mentoring that ALL physical therapists experience growth spurts. Itâs how we evolve our clinical practice! So long as we keep learning, there will always be periods of change followed by periods that are more steady as we integrate the new information into our practice. We also share our signs of being in a growth spurt and tips for navigating these with less overwhelm!
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
We have spent 36 episodes exploring how to work with someone, build better rapport, collaborate, move past our own and the patient's roadblocks to improving our quality of care and work. We realized that we haven't talked about when PT is not the answer and how we know we need to end care.
In this episode, we explore the reasons why you may choose to recommend discharge, including what we say and examples of how we handle these conversations. We can practice within our ethics AND support the patient to get the care thatâs best for them.
Highlights from our conversation in Episode 37
(0:34) Introduction(1:24) Ruling out medical red flags(2:39) Psychological considerations(7:52) Meaningful participation: cancellations, availability(15:51) Mismatched PT treatment approach vs patient expectations (21:56) Lack of progress (33:30) Unacceptable patient behaviorsThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
Episodes manquant?
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In this episode, we explore fear avoidance. As humans, we all experience fear and some of us exhibit fear avoidance behaviors. As people exhibit more fear avoidance, they also report higher pain intensity levels. This has consistently shown up in pelvic pain, pelvic girdle pain, and persistent musculoskeletal conditions.
We talk through Sammyâs patient who exhibited high fear avoidance and how they began confronting it. We also explore how fear-avoidance influenced Monikaâs clinical practice and how often we see this with healthcare providers. Itâs not just patients who demonstrate fear-avoidance! In order to do no harm, we need to be aware of our own beliefs and how that shapes our practice too. We hope this one helps you consider fear-avoidance in your work!
Highlights from our conversation in Episode 36
(0:34) What is fear-avoidance (1:45) A case of high fear-avoidance (4:50) Addressing the patientâs fears head-on (8:16) Graded exposure to reduce fear (12:26) Healthcare providers also demonstrate fear-avoidance!(17:51) Factors that contribute to our individual differences in fear (20:32) Changing our own and our patientâs beliefsThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 36The fear-avoidance article we reference! (1:08, 12:41) Rainville J, et al. Fear-avoidance beliefs and pain avoidance in low back painâtranslating research into clinical practice. 2011;11(9), 895â903. doi:10.1016/j.spinee.2011.08.006 (10:29) Episode 3: Identifying Patient's Readiness to Change(20:45) Episode 5: All About Pain Catastrophizing Pop Up Pro Annemarie Everett, DPT, WCS (21:13) Episode 11: Authentic Evidence Based Practice with Dr. Annemarie Everett, DPT, WCSConfronting fear avoidance beliefs with Katie (26:38) Episode 20: A Patient's Perspective of Conscious PT Practice with KatieAdditional listening: Episode 15: The Power of Understanding Patient Beliefs with Dr. Mike Nelson, DPT
Additional reading:
Alappattu M, Bishop, M. Psychological factors in chronic pelvic pain in women: relevance and application of the fear-avoidance model of pain. Phys Ther. 2011; 91(10):1542-50. doi: 10.2522/ptj.20100368. Fakari F, Simbar M, Saei Ghare Naz, M. The Relationship between Fear-Avoidance Beliefs and Pain in Pregnant Women with Pelvic Girdle Pain: A Cross-Sectional Study. Int J Community Based Nurs Midwifery. 2018;6(4):305-313.Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
One of the few positives from the pandemic was the widespread access to telehealth medical services. Our bet is that itâs here to stay. We have been providing telehealth PT since March 2021. We recognize that while itâs convenient for patients and providers, it does change the way we interact with our patients. Additionally, providing telehealth from your own home creates unique challenges for providers.
In this episode, we focus on how to prepare and care for yourself to provide telehealth. We explore the way that communication changes when itâs virtual and we offer tips that have helped us be more comfortable over video. Finally, we discuss the unexpected benefits of not touching patients, for them and for us. Whether you currently provide telehealth or not, this episode will stir up questions for you to consider that can advance your connection with patients!
Highlights from our conversation in Episode 35
(0:34) Introduction (1:37) Ensuring patient privacy(3:37) Curating your workspace (9:58) Self-care tips for clinicians providing telehealth from home (14:38) Building rapport (16:14) Identifying who to refer to in-person PT (19:08) Nonverbal communication (21:10) Expressing empathy over video (25:58) The unexpected benefits of losing physical touch(32:58) Our thoughts on the future of telehealthThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 35Nocebo effect (17:31) Episode 12: Our Words Have the Power to Heal and HarmLegislature and bills for telehealth (34:42) APTA Advocacy for TelehealthLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
Picture this: It's a long day. You're behind on notes. You're running late to see the next person and it just feels like the whole day is slipping away from you. And you're thinking, âWhat happened here and how am I going to dig myself out of this hole?â
In this episode, we focus on time management and the self-reflection required to identify strategies for change. We need to take a hard look at what factors are causing us to run behind, because it's not as simple as like, âOh, I'm just running late all the time.â If you've tried all the basic time management hacks, and itâs not working, then it's not you! Those things aren't addressing the primary driver of your time management difficulty.
We share strategies for change using The Seven Habits of Highly Effective People as our framework of discussion. We focus on the first three habits today: #1 Be proactive, #2 Start with the end in mind, and #3 Put first things first. Let us know what your favorite time management tips and reflections are in the comments!
Highlights from our conversation in Episode 34
(0:34) Introduction (2:03) Habit #1 - Be Proactive Prepping note, reviewing the documentation (4:06) Habit #2 - Start With the End in Mind(9:33) Habit #3 - Put First Things First (13:13) Sticking with a plan long enough to see change (15:04) Developing your clinical reasoning (18:05) Self-reflection is our greatest tool for improving time management (24:45) Discussing time management with patientsThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 34(1:43) The Seven Habits of Highly Effective People(4:12) The Mountain Metaphor Episode 2: The Mountain Metaphor for a Healing Journey(11:16) Pain Catastrophizing Episode 5: All About Pain Catastrophizing (11:34) Impostor Syndrome in Episode 18: Impostor Syndrome in Healthcare Providers and Episode 24: How to Thrive, Not Just Survive with Yolanda Johnson, MD, FAAPLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
Picture this, youâre working with a new student or have someone shadowing you. They are eager to learn about your field and have tons of questions to ask you AND the patient. While you love their desire to learn, itâs also affecting the flow of the session.
Weâve certainly been there, so in this episode, we dissect why and how having another person in the room affects patient-centered communication and care. This applies to observers, interns, students, mentors, and anyone else who might be a third body in the treatment space.
We discuss
How having an additional person in the room affects the way we providers interact with the patientThe power dynamics between all three (or more) of you How we can prepare the observer(s) and the patient for this interactionThe mindset shift that helps us create a collaborative win-win environment for the patient and observersUltimately, when you're the person with the most experience in the room, it really is on you to use that experience to guide the session in a way that everyone wins or at the very least guide in a way where the patient gets what they need.
Highlights from our conversation in Episode 33
(0:34) A case example (3:22) How another person affects dynamics between patient-provider (5:44) Preparing students/observers for the visit (8:27) Preparing the patient for the visit (9:28) Getting enthusiastic consent for an additional person(13:34) Introducing students & mentors(16:32) The patient is #1(18:05) How does the dynamic change with 3+ parties in the room?(23:46) The benefits of working with interns/students (25:40) Self reflection for clinical instructors/mentors (31:42) OutroThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 33(9:28) FRIES Consent Model in Episode 32: Empowering Folks During Pregnancy, Birth, & Beyond with Dr. Tasha Darden, DPT, Doula(26:37, 28:24) Impostor Syndrome in Episode 18: Impostor Syndrome in Healthcare Providers and Episode 24: How to Thrive, Not Just Survive with Yolanda Johnson, MD, FAAPLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we examine pregnancy, birth, race, and consent through Dr. Tasha Dardenâs unique lens of pelvic physical therapist and doula. During her pregnancy, she realized âââthat it was really hard to find a doula that looked like meâ and since has become the provider she needed. She shares all you need to know about doulas and how they support people in birth. But we canât talk about improving birth outcomes without talking about consent and obstetric violence. Tasha shares the Planned Parenthood model of consent: FRIES along with tips for discussing birth trauma postpartum. Finally, we dive deep into the effects of misogyny, patriarchy, and racism on pregnancy and postpartum experiences. This is a MUST listen-to episode for anyone working with pregnancy/postpartum folks!
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Dr. Tasha Darden PT, DPT is a Pelvic Physical Therapist and Full Spectrum Doula. She is the owner of Physiodoula, which has a mission to help women shift from surviving to thriving in all phases of their lives. She is passionate about being an advocate in the birth room and in the greater Los Angeles community and has created a program called Reclaim Postpartum. It aims to support Black women and families in postpartum with supplies for parents and babies, meals, hands-on support, and access to free resources such as lactation consultants, physical and occupational therapists, mental health services, etc.
Dr. Tasha feels that there is a lack of accessibility to basic pelvic and sexual health, especially in black and brown communities. She is active on Instagram sharing knowledge about all aspects of womenâs health including self-care, holistic approaches to healing, optimizing pelvic floor function, body literacy, labor preparation, postpartum recovery, the impact of racism on health, and debunking pelvic health myths.
Highlights from our conversation in Episode 32
(0:34) Introducing Dr. Tasha, physiodoula!(4:57) How pelvic PT and doula practice have helped her provide a holistic view with clients(8:42) Defining birth trauma (12:47) Screening for birth trauma as a pelvic PT in a trauma-informed way (19:11) What is a doula, what they do, their training, barriers to and benefits of working with a doula(30:31) Racism - not race - is responsible for poorer health outcomes (33:31) Defining obstetric violence(36:00) Obtaining true consent with FRIES (43:40) What would happen if we started by saying we are partners in your care?(53:11) Tashaâs Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 32(2:09) Reclaim Postpartum Community Initiative in LA (23:20) Episode 26: Supporting New Parentsâ Health with Catherine OâBrien, MA, LMFT (36:24) FRIES Consent by Planned ParenthoodLetâs Connect!Follow Tasha @physiodoula on InstagramCheck out Tashaâs website www.physiodoula.com/ for more on her Pelvic PT and Doula Services Email Dr. Tasha via [email protected] Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we finish with part 4 of the SOAP note series: Plan of Care & Prognosis. Often the plan of care is an afterthought, something we consider when documenting or perhaps the last 5 minutes of the evaluation when we schedule follow-up visits. So we asked ourselves âHow do we form a mutually agreed-upon plan, which is realistic and considerate of the patient and the provider?â
We share the tips which have helped us create more collaborative plans with patients and the assumptions and fears which have gotten in the way. Our own fears and psychosocial factors can affect the way we develop and show up for the plan of care. At the same time, we realize from this episode that there are so many ways to connect with patients to create a meaningful plan. We hope you enjoy this wrap-up of the SOAP series and would love to hear your thoughts on creating a patient-centered plan of care!
Highlights from our conversation in Episode 31
(0:34) Introduction (0:52) Presenting the plan as an array of options for the patient (3:24) How do we get people to invest in the plan?(7:05) Assessing readiness to change (7:58) Centering the patient within the plan (10:50) Redefining a successful plan of care (14:03) Understanding the patientâs goals and gauging their participation(18:37) Do we have the physical, emotional, and spiritual space to support this person throughout their plan?(22:05) Moving past our own fears to create a collaborative planThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 31(6:22) Episode 2: The Mountain Metaphor for a Healing Journey (7:16) Episode 3: Identifying Patient's Readiness to Change(14:11) Episode 6: History Taking Pearls & Pitfalls(23:12) Episode 27: Evolving Pelvic Physical Therapy Practice with Meryl Alapattu, DPT, Ph.D.Missed an episode in the series?
Episode 28: Taking a Patient-Centered History (SOAP Series #1)Episode 29: Performing A Conscious Clinical Exam (SOAP Series #2)Episode 30: Empowering Assessments (SOAP Series #3) Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we continue with part 3 of the SOAP series: The Assessment. We have broken this section out into three key considerations:
What is our assessment of the patient?What information do we share with the patient? How do we keep reassessing throughout the plan of care?In addition, we also discuss examining our own biases in assessment, practicing new conversations with peers/mentors, focusing on solutions rather than impairments, and how to fold in biomechanical explanations in an empowering way. Tune in next week for Plan of Care tips!
Highlights from our conversation in Episode 30
(0:34) Introduction (1:06) Shifting to a patient-centered assessment (6:45) Examining our own biases (8:19) How can we share our findings and plan with the patient in an empowering way? (15:14) An example: low back pain (17:49) Including tissue damage/healing into the biopsychosocial explanation of pain (20:11) Ongoing assessmentThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 30
(1:23) Episode 3: Identifying Patientâs Readiness to ChangeMissed an episode in the series?
Episode 28: Taking a Patient-Centered History (SOAP Series #1)Episode 29: Performing A Conscious Clinical Exam (SOAP Series #2) Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we continue with part 2 of the SOAP series: the Objective Exam. Most of us learned explicitly and implicitly from our training that the purpose of the exam is for us (the provider) to learn about the patient's body in order to create an appropriate plan of care. However, weâve realized that the patient is actually learning about their body during the exam as well!
Everything that we do during the exam process is teaching the patient something about their body. They are internalizing our language and reactions - for better or worse! So in this episode, we focus on tips to help us center the patient during the exam, to tailor each exam to the individual, and empower them with the exam process. Tune in next week for Assessment tips!
Highlights from our conversation in Episode 29
(0:50) Start with enthusiastic and ongoing consent(3:17) Paradigm shift: the exam is where BOTH you and the patient learn about their body (5:35) Empowering the patient by being mindful of our language (8:34) Shifting away from pain reproduction to symptom modification(14:06) Selecting meaningful and easily reproducible exam measures(22:35) Keeping the patientâs goals in mind (23:50) Modifying exam intensity(26:50) Asking direct questions and giving succinct instructionsThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 29This is part 1 of a 4 part series. Check out Episode 28: Taking a Patient-Centered History (SOAP Series #1)(2:50) Episode 8: Trauma Informed Pelvic Health Practice with Dr. Krystyna Holland, DPT(8:16) Episode 12: Our Words Have the Power to Heal and Harm(12:51) Episode 10: Grounding Techniques for Patients and Providers(19:21, 20:24) Episode 2: The Mountain Metaphor for a Healing Journey(19:25) Episode 4: âThe Fixerâ Role of Healthcare ProvidersLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
We are kicking off a 4 part series to explore patient-centered care from where it all begins - the evaluation. We break it into sections using the SOAP note model: Subjective, Objective, Assessment, and Plan. We discuss what we could do to improve rapport with our patients, our efficiency and accuracy in getting to the root of a problem while partnering with our patients as active collaborators.
In this episode, we focus on the subjective including building rapport, understanding the patientâs experience, and wrapping the subjective up into the objective. How do we learn their story and how do we tease out what will truly help us form a great plan of care with them? Tune in next week for the Objective section tips!
Highlights from our conversation in Episode 28
(0:34) Introduction(1:55) Building rapport & establishing trust (4:34) Accepting our patients without correction(9:31) Responding with empathy(15:57) Understanding the patient experience (27:33) Asking about psychosocial factors (29:32) Wrapping up the subjectiveThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 28(22:52) Psychological Approaches to Pain Management: A Practitionerâs Handbook, 3rd Edition Letâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, Dr. Meryl Alapattu, DPT, Ph.D. shares with us her experience in assessing psychosocial factors and developing âsoft skillsâ as a researcher and faculty member at the University of Florida.
âI think we were a little bit late to the game in pelvic health, thinking about psychological factorsâ including fear avoidance. âA lot of these persistent pain conditions have similar factors that contribute to the pain experienceâŠ. [When] we look at people with pelvic pain compared to people with knee pain, for example, the types of things that they're fearful of, or the activities that they may avoid related to their pain might be a little bit differentâ but the underlying processes are the same.
As clinicians, itâs our responsibility to learn about and integrate this information into our practice. âProfessional development is a career-long thing that all of us are continuing to work on in some way or another.â That includes developing our soft skills to form a therapeutic alliance, communicate with our employers and colleagues, and practice ethically. Meryl also shares what the University of Florida DPT program does to help PT students develop their soft skills.
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Meryl Alappattu, PT, DPT, Ph.D. graduated with a Doctor of Physical Therapy from the University of Florida (UF) in 2008. After graduation, she completed a year-long clinical residency at the University of Florida Health in Cancer Rehab and has continued her clinical work specializing in rehabilitation for patients with cancer and pelvic health issues. Dr. Alappattu completed her Ph.D. in Rehabilitation Science at the UF in 2014, studying mechanisms of pelvic pain in women, and is currently a Research Assistant Professor in the UF Dept. of Physical Therapy.
Dr. Alappattu has been a member of the American Physical Therapy Association and Florida Physical Therapy Association since 2006. She has served in multiple roles in FPTA, including two terms as Vice President, and currently serves as Speaker of the Florida Assembly of Representatives. She has been a Delegate to the APTA House Delegates since 2014. She also serves on the board of directors for the International Pelvic Pain Society.
Highlights from our conversation in Episode 27
(0:34) Merylâs introduction (6:09) How she came to research psychosocial factors related to persistent pelvic pain (10:50) Persistent pain education isnât mainstream yet in PT (14:10) How much of the psychological aspect of patient care is within a PTâs scope of practice?(20:12) The importance of âsoft skillsâ as students and clinicians (28:10) Fostering self-reflection in PT graduate programs (31:15) Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 27Psychological Factors in Women with Chronic Pelvic Pain: Relevance and Application of the Fear Avoidance Model (Alappatu 2011)(19:38) Empathy During Patient-Provider Interactions in Women with Chronic pelvic Pain (2021)(28:22) Professional Behaviors Self Assessment Tool Marquette University(32:21) White Fragility by Robin DiAngeloLetâs Connect!Follow Meryl on Twitter and Instagram @pundispiceEmail Meryl [email protected] us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we have the pleasure of dissecting maternal and paternal mental health with Catherine OâBrien, MA, LMFT. She shares the common issues that new parents experience which contribute to pelvic floor conditions like dyspareunia. While postpartum is a time of massive changes, we need to listen to our patients when they feel like something just isnât right.
Catherine helps soon-to-be parents create a postpartum plan because âthereâs usually a lot of prep for a birth plan⊠but nobody's like, well then what happens after we bring the baby home?... Your partner is not your plan. Theyâre in this with you. What is your plan together?â Catherine shares her approach to creating this plan from her book Happy With Baby. This is a great episode for anyone who works with parents or is about to be a parent!
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Catherine OâBrien, MA, LMFT is a licensed marriage and family therapist and the founder of HappyWithBaby.com. She created Happy With Baby in order for new parents to discover the advice she wished she had as a parent. Catherine lives in Sacramento, California, where she enjoys paddle boarding and rowing with her husband and two kids.
Highlights from our conversation in Episode 26
(0:34) Catherineâs story & founding Happy With Baby(6:06) New parent psychosocial factors contributing to sexual dysfunction(10:00) Postpartum mood and anxiety disorders (15:17) The importance of sleep for wellbeing (19:14) The need for & how to create a postpartum plan(25:55) Catherineâs book Happy With Baby(29:12) Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 26Visit Catherineâs website for more information www.happywithbaby.com(25:55) Read Catherineâs book Happy With Baby(29:50) The Power of Showing Up by Daniel J. Siegel and Tina Payne BrysonLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we discuss pelvic health from the lens of physiatry with Dr. Allyson Shrikhande, MD. She is the medical director and founder of Pelvic Rehabilitation Medicine (PMR), offering true multidisciplinary care for people with pelvic floor dysfunction.
Allyson shares what a pelvic health physiatrist does, saying âwe're trained really to look at the interplay between the organ systems with each other, as well as the organ systems with the fascia, the muscles, and the nervous system.â Physiatrists can serve as the quarterback for people with pelvic floor dysfunction, referring them to the various specialties. She also shares how all of us pelvic providers can work together and how the mind-body connection affects pelvic pain.
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Dr. Allyson Shrikhande, MD, a board-certified Physical Medicine and Rehabilitation specialist, is the Chief Medical Officer of Pelvic Rehabilitation Medicine. She is also the Chair of the Medical Education Committee for the International Pelvic Pain Society. She is working with other experts in the field of chronic pelvic pain to develop training modules for residents and physicians interested in learning about the diagnosis, treatment, and management of chronic pelvic pain. A leading expert on pelvic health and a respected researcher, author, and lecturer, Dr. Shrikhande is a recognized authority on male and female pelvic pain diagnosis and treatment.
Highlights from our conversation in Episode 25
(0:34) Allysonâs introduction & journey into pelvic health (7:02) Facilitating a collaborative approach for pelvic pain(11:59) Tips for communicating with physiatrists(14:39) Addressing psychological concerns in pelvic health(19:03) Allysonâs experience in building rapport with patients (20:17) Patient case example(23:10) The common culprit behind ânon-responsiveâ patients (25:02) When and how to refer to physiatrists(27:13) Allysonâs lightning roundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 25(13:49) Working with Physiatry for Pelvic Pain (Herman & Wallace Course)(26:36) Finding a PM&R doc Pelvic Rehabilitation Medicine LocationsInternational Pelvic Pain Society Find a ProviderLetâs Connect!Find Dr. Allyson Shrikhande, MD on:https://www.pelvicrehabilitation.com/InstagramFacebookTwitter Find The Conscious Clinician on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we unpack overwhelm and burnout with Dr. Yolanda Johnson, MD, FAAP. As a pediatrician, mom, and coach for women in healthcare, Yolanda knows that doing it all means burning out. She shares practical tips to start shifting out of survival mode and begin discovering who you are, how you want to work, and what needs to change.
For the first time, Dr. Yolanda shares her experience of impostor syndrome during residency and how that led to her passion for coaching. We dive deep into the counterintuitive need to slow down and do less when we feel overwhelmed, how to face our inner critics with compassion, and the power of mentorship in creating a sustainable practice. This episode helps us see that we're not alone in our struggles or our desires for a more enjoyable work-life experience!
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Dr. Yolanda Johnson is a board-certified pediatrician in private practice in the metro Atlanta, GA area, and a certified health and wellness coach. She is passionate about helping women in healthcare conquer overwhelm, build healthy boundaries, and get unstuck. She is mother to 4 amazing sons, and enjoys running, reading, and napping in her free time.
Highlights from our conversation in Episode 24
(0:34) Yolandaâs bio & her experience of impostor syndrome and overwhelm(5:57) Self-reflection as an antidote to burnout(10:23) Impostor Syndrome during residency and in work (15:27) Common themes from coaching women in healthcare(22:49) How to unpack your overwhelm (27:55) The power and vulnerability of mentorship (31:28) Accepting ourselves to start thriving (36:08) Practicing self-compassion to reduce the inner critic and shame(40:20) Finding a sustainable practice & discovering what we want (48:32) Lightning roundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast so we can reach more people!
Resources from Episode 24(6:22) Quiet: The Power of Introverts in a World That Can't Stop Talking by Susan Cain(6:56) Mindset: Changing the Way You Think to Fulfill Your Potential by Carol S Dweck(11:57) Imposter Syndrome Diagram Letâs Connect!Follow Yoland on IG @gobeyondcoachmd for more tips and coachingFind us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we have the pleasure of speaking with Dr. Brian Stirling, DPT, OCS who treats male pelvic health and orthopedics. Brian shares the barriers heâs encountered as a male specializing in pelvic health as he wants to expand to treating all genders of patients. We discuss inclusive care, which develops when we have the courage to face our biases, remove educational barriers, and support a variety of providers joining the specialty!
We explore how our own fears (for our license, saying the wrong thing, avoiding litigation) have influenced our practice patterns. Brian leads us into a conversation exploring male biases in pelvic health - what male-identifying patients ask for and what our own biases as providers treating them are. This episode helps expand our understanding of an inclusive pelvic health specialty for patients and providers alike.
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Dr. Brian Stirling is a residency trained Board Certified Orthopedic Specialist since 2020. He is a physical therapist at Agile Physical Therapy and treats pelvic health and orthopedics. When he first took a dip into treating pelvic health, his eyes opened up to a whole world of medicine that he didn't know existed. The amount of potential knowledge to gain, growth to inhabit, and patients to heal in a unique and fulfilling capacity made him excited to specialize in this field. He is eager to share his experiences as a male treating pelvic health.
Highlights from our conversation in Episode 23
(0:34) Brianâs introduction & how he got into pelvic health(5:36) Practicing as a male in a female-dominated specialty(8:12) How our fears have affected our pelvic PT practices (16:25) Integrating orthopedics and pelvic health (21:56) Nuances and biases of male pelvic health(26:13) Developing inclusive care practices (40:43) Removing educational barriers for male providers(45:34) Brianâs Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook.
Resources from Episode 23(47:42) Quiet by Susan CainEmail Brian [email protected] with Brian on LinkedInLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we dive deep into pain science how-toâs with Josh Bellingham, MPT. As a physio, Josh is passionate about providing accessible resources to people with persistent pain. He believes that the relationship between a patient and provider is the vehicle for changing limiting beliefs, which ultimately are the reason people make progress.
Josh is an advocate for using current pain science with ALL people experiencing pain, at any point along their journey. We explore how this looks for different populations and how to tell if someone is willing to "go there". He shares how the Loeser âonion ringâ model of pain helps us see the various layers of inputs that facilitate or inhibit pain. We also discuss how to handle imaging and âdiagnosis seekingâ in a pain-science-informed, patient-centered way.
Josh shares metaphors for describing pain as an alarm, the development of pain sensitivity, and contextual factors which create physiological responses such as muscle guarding. Heâs also an advocate of adding pain science to peopleâs lives outside of the clinic, through social media, apps, and Netflix. This episode is an easy listen to review pain science concepts and come away with new clinical pearls!
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Josh holds a Bachelor's degree in Kinesiology and a Masterâs degree in physiotherapy from the University of Manitoba. Josh began his career with a focus on exercise and sports performance, but over the years developed a passion for understanding and managing complex pain. Josh has completed a variety of courses in pain management through "Pain BC" and regularly participates in their weekly clinical discussions. In addition to working full time in private practice, Josh is also active on his website, chronicpainphysio.ca as well as Instagram to advocate for and support people living with chronic pain. When heâs not in the clinic or working on content for "Chronic Pain Physio", youâll find Josh hiking in the mountains of beautiful British Columbia.
Highlights from our conversation in Episode 22
(0:34) Joshâs background and current projects(6:03) Pain science for acute care / chronicity prevention(10:35) Metaphors for explaining pain (20:09) Loeserâs âonion ringâ model of pain in clinical practice (24:26) Listening vs special tests for understanding pain (27:01) How diagnostic imaging contributes to uncertainty, feeling out of control, and lack of information(33:35) Responding to people whoâre seeking a diagnosis(42:46) How to meet people where theyâre at for pain science (49:20) The overlap between psychology and physical rehab for pain (55:54) Joshâs Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook.
Resources from Episode 22Check out Joshâs Website - https://www.chronicpainphysio.ca/ and follow him on IG @chronicpainphysioLoeserâs âonion ringâ model of painBurnout & How To Complete The Stress Cycle (Podcast)Headspace - Guide To Meditation (Netflix)Headspace - Guide to Sleep (Netflix)Tame The Beast - Rethinking Persistent Pain (Youtube)OA Optimism with Greg Lehman (Youtube) Letâs Connect!Connect over Instagram @TheConsciousClinicianFind The Conscious Clinician on Facebook -
In this episode, we discuss how you canât separate racism from healthcare with Dr. Uchenna âUCâ Ossai, PT, DPT, WCS, CLT. As the only Black pelvic health physical therapist certified in Sexuality Counseling, UC has been empowering people to embrace their sexuality with their whole selves - and in spite of what society may be telling them.
This leads us into discussing the spectrums of pleasure, joy, race, sexuality, and how these factors all affect a personâs experience of sex. We explore the archetypes which affect black womenâs health and sexual wellbeing, in the context of a country-wide awakening to racism and oppression.
UC says âYou're going to have racist ideology and behaviors, and you're going to ascribe to it because it's in everything. It's like really not fun glitter. And once you understand that it's there, then you can actually have more peace.â
In order to be conscious clinicians, we must be aware of the systems at play around us, learn the histories that led to our present day, and seek out mentors. Only when we are aware of history can we truly begin to make meaningful changes in our friendships, educational systems, and clinics.
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Dr. Uchenna âUCâ Ossai PT, DPT, WCS, CLT is the creator/founder of YouSeeLogic, a judgment-free social media platform dedicated to the sex education and empowerment of adults/âgrown folkâ. When it comes to sexual intelligence and great sex education, Dr. UC embraces always being unapologetically real and authentically kind. She is also an assistant professor at the University of Texas Dell Medical School for the Department of Women's Health and manager of the pelvic health physical therapy program at UT Health Austin.
Highlights from our conversation in Episode 21
(0:34) UCâs intro & current projects(3:47) Pleasure as an act of rebellion (7:08) Racism in the places we live, learn, and work(17:24) How to practice inclusive anti-racist care(23:49) UC removing the performative mask & self-care(31:13) Harmful archetypes of black women which drive sexual (dys)function (41:15) Accepting the word âracistâ(44:32) Lightning Round QuestionsThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook.
Resources from Episode 21To be in touch with UC visit www.youseelogic.com and follow her on Instagram @youseelogic (20:12) UCâs course: Intersections of Race and Power: Healthcare Redefined (Live 6/26/21) (38:37) Dr. David Williamâs Ted Talk: How Racism Makes Us SickLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, we have a special guest, Katie, joining us. Katie is actually the patient from Episode 19: Putting It All Together: A Case Study of Conscious Clinical Practice. This is a unique opportunity for a former patient and provider to reflect upon their experience working together. Be sure to listen to Episode 19 first for context!
Katie shares his first reaction to E:19. In his words âIt was fascinating to hear the two of you talk together and to learn what does it sound like when practitioners are talking to each other and what are some of the common thoughts or assumptions or experiences, especially working with someone who has chronic pain.â
We dive deeper into his corrections for E:19, the power of focusing on whatâs important to the patient about their pain, how providersâ responses can build and break rapport with patients, how our time in PT was different than his prior experiences, and share how we were both affected by working together. This is not one to miss!
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Katie is a Director of Finance for a small nonprofit. His journey with chronic pain led him to change career paths six years ago, going back to school for an MBA, having previously worked in outdoor education â running rock climbing, ropes course, and canoeing programs with kids. Katie is queer and transgender, and a writer and activist on gender justice, who recognizes that chronic pain and other chronic health conditions are much more prevalent in marginalized groups who often experience chronic trauma and stress. These days, Katie enjoys playing fetch and going for walks with his goofy pitbull, Loki, but he is looking forward to rock climbing again someday.
Highlights from our conversation in Episode 20(0:34) Introducing Katie (2:01) His first reaction to Episode 19(5:44) Katieâs E:19 correction - the link between stress & pain (9:28) The pivotal moment of discovering neural tension (11:22) How providers are (unintentionally) gaslighting (15:00) Katieâs side of the initial evaluation (18:10) Whatâs important to patients vs providers about pain(22:05) A trauma-informed perspective (25:17) Providers are specialized but patients are specific (28:23) What patientâs DO want from healthcare providers(32:43) Generalists, specialists, and connecting the dots(37:04) Pain rating scale and management(40:15) On asking patients what they want (45:26) Nocebic quotes from Katieâs healthcare providers(51:02) âYouâre not fragileâ (54:48) Lightning RoundThank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook.
Resources from Episode 20(0:43) Episode 19: Putting It All Together: A Case Study of Conscious Clinical Practice(55:24) My Grandmotherâs Hands by Resmaa Menaken(58:03) Radically Listening to Transgender ChildrenLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika -
In this episode, Monika shares a case study to illustrate integrating the principles of emotional intelligence, trauma-informed, and patient-centered care. It's a story we're all familiar with: a man with chronic low back pain.
He was in the midst of a prolonged flare-up when they started working together and had seen many physical therapists before. She realized that she would have to do something different if they wanted a new result.
With this in mind, we discuss how Monika:
Prepared herself mentally and emotionally for a different approachShifted her focus from âfixingâ to collaborating Listened closelyManaged her own emotional reactions Confronted her own biases about injectionsChallenged his fear-avoidance beliefs (gradually)Tune in to hear his story and her behind-the-scenes thought processes. We hope this inspires you to reflect on a case and share it with a conscious clinician!
Note: Some details have been omitted and/or changed in order to maintain patient privacy. The patient consented to share this material.
Highlights from our conversation in Episode 19(1:41) Case introduction (5:18) Patient-centered history taking (12:06) The power of preparing for patient care (13:49) Trauma-informed care in action (16:46) The ripple effect of conscious clinical practice (19:30) How did follow-ups go?(25:24) Injections, nocebo, and self-awareness (28:58) A major turning point in autonomy (34:50) Planning for the future (38:56) Reconciling your identity with chronic pain(40:39) Wrap up and final thoughtsThank you for listening to The Conscious Clinician! If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook.
Resources for Episode 19(5:18) Episode 6: History Taking Pearls & Pitfalls(10:15; 26:02) Episode 12: Our Words Have the Power to Heal and Harm (12:17) Episode 15: The Power of Understanding Patient Beliefs with Mike Nelson, DPT (13:20) Episode 4: The Fixer(13:49) Episode 9 Dr. Brie Robertori, PsyD on Vicarious Trauma in Healthcare and Episode 8: Dr. Krystyna Holland on Trauma-Informed Pelvic Health PracticeLetâs Connect!Find us on FacebookConnect over Instagram @TheConsciousClinicianConnect professionally over LinkedIn with Sammy & Monika - Montre plus
