Episode 17

Walking With Your Patient

Physical Therapist at Premise Health, Matt Huey, joins Allison to break down what a great patient journey looks like. Some of what we talk about: Matt explains the McKenzie Method How to incorporate care plans into the patient’s lifestyle Matt’s thoughts on caring for athletes
Published on 11/02/2023
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Episode Transcript

Allison Jones: Good morning, good afternoon, and good evening, and welcome to the Therapy Matters Podcast, your one-stop resource for expert insights and advice on everything therapy and rehab. I’m your host, Allison Jones, and today I’m joined by Matt Huey, owner of Strong & Healthy Rehab. Matt, thank you for joining me today.

Matt Huey: Thank you for having me. 

Allison Jones: It’s great to have you here. Matt, before we dive into today’s topic, I want to give our audience some background on who you are. Take a minute to introduce yourself and tell us about your experience in your clinic.

Matt Huey: My name is Matt Huey. I’ve been a physical therapist for 13 years now and have been in outpatient orthopedics the entire time. I am a diplomat in MDT, meaning the McKenzie approach, if anyone is familiar with that. I’m also a Fellow of The American Academy of Orthopaedic Manual Physical Therapists, that long acronym on there. Everyone says I got the alphabet soup after my name. Along with that, I am a certified manual trigger point therapist as well. 

I’ve had my clinic roughly three years now. I started it in early 2021, and it’s just been growing ever since I started it up. It’s been a very, very fun experience as well.

Allison Jones: Excellent. All right. In today’s episode, we’re going to focus on the patient journey and patient experience. This topic really fascinates me from a personal and professional point of view. I’m a marketer by profession, and I’ve been in marketing for all of my career. Anytime we’re considering building a business or you’re driving growth, the customer experience is always an integral part of that customer journey. This is always a key part of that story. 

But I’m also a patient, and I’ve had the pleasure and the pain of interacting with clinicians and therapists throughout my life. Whenever I go in for an appointment, I always pay really close attention to how I’m treated, probably because I’m a marketer, but I think in general, most patients pay attention to how they interact with the front office, with their clinician, and throughout the experience. I’m excited to dive in and talk to you about your approach and how it’s helped your patients thrive, because I think you have a really interesting story. 

When we did prep for this episode, you used the phrase “walking with your patient” to describe your approach to patient care. Tell me a little bit more about what that means to you.

Matt Huey: For me, I see myself as a guide with a patient that really, we’re going to go from a to b. The patient comes in, we’re dealing with all this pain or limitation or something like that, and they have this goal that they want to reach and really just being that person that helps them along that journey. It’s just not only the stuff we may do one on one, but also being a resource when they start going back to their life, of saying, well, can I go back to the gym? Can I go to work? Can I take that trip I have in a couple of months? I’m just giving them an outline or guideline to say, hey, play within these bounds while you’re going about your life right now. 

As they reach that end point, they’re very confident. They cross it, and they’re like, hey, I feel really good. For me, I just see it as I’m just being a resource for them about really anything that may be going on with not only the condition that they’re dealing with, but maybe they find other stuff out there. Somebody tells them, I have this back pain, and I’m getting better. But a friend of mine, they told me I need to do this, or I got to go see this person. What is that about? I get a chance to talk to them as well to say, that could help you, or no, we don’t really want to do that, or this is what this is, so just being really a resource for them as well.

Allison Jones: It’s really beyond the traditional patient-provider relationship. It’s almost like you’re creating a relationship with them. It’s almost like a friendship where they feel like they can come to you with almost any question or concern beyond even just their care.

Matt Huey: That’s really what it is. I always say that you think about, if somebody came up to me and is like, I need to get my hair done, where am I going to go? I’ll say, oh, go to my hairdresser. Or, I need to get my teeth cleaned. My tooth hurts. Go to my dentist. 

I tell people, I want to be your therapist on that so that they feel that they have a phone number or a contact in their phone, if I have some health question, I can go to this person. I can send them a text message. I could call them. I could email them, and they’re going to be there for me. 

Allison Jones: We talked about larger PT providers, and they typically are scheduling multiple sessions per week. They’re prescribing an exercise regime that might take an hour a day or longer. How does your approach differ from that? 

Matt Huey: I really look at what the person needs and what they’re going back to doing. I say it’s nothing bad about anyone who may work for a larger corporation. There are great therapists. They do amazing things. They help so many people. But I just saw for me, one is I was conflicted with some patients because it’s like your condition, you don’t need to come in twice a week or three times a week. You don’t really need that. I have enough confidence in what you can do on your own. You’re already a very active person. You probably can do way more than what I can do in this clinic. 

It’s based upon some limitations as well that we can have as therapists. With insurance, they may limit the number of visits with a patient. They’re saying you can only see them 30 times in a year. Do they need to come in three times a week now because we want to have more later? We could work around that. Or again, this person is very active or something, and they go into the gym. I don’t have that same equipment here just because of limitations in the facility and things like that, so I can’t have it here. 

I was seeing this as, if we just open our communication and talk, I see you for something I want you to get back to your function. I want you to go back and do those things and just talk to me while you’re doing them. They are being functional and getting back to doing what they want to do, and they’re understanding if I start having this, I know how to do that to help it or whatnot. 

I have a very interesting case. A patient I just saw not too long ago—wife, mother, probably mid or late thirties or so—had knee surgery. She contacted me saying, do a rehab, sir. Perfect. Over three or four weeks, she was doing really, really good. She was up walking with no assistive device. She could get up and down off of low surfaces. She was able to drive. She was able to go out with her family. There are still some limitations, like she felt a little shaky on stairs, but overall, very, very good.

She saw her surgeon, and he said, you need intensive physical therapy. I was like, what the heck is intensive? Is that a clinic to go to? She goes, I don’t really understand that either. I said, well, what did he say? She goes, he wanted me to be able to do jumping and cutting and running. I said, do you do that in the first place? She goes, no. I said, do you even go to the gym? She goes, no, I just walk around the neighborhood. I have a treadmill and elliptical upstairs; I use those. I said, we don’t really need to do running and jumping and cutting. Do we need to do these really crazy dynamic things for you in another couple of months to stop doing them and never do them again?

I said, we’re going to get you back. Now if you want to start going to the gym, we could build you up where we can get you to that point. But really, just going back to her normal thing, she wasn’t going to do that in the first place, but we got to where she was very stable with long walking and telling her, go to the mall. Go take your kids and family to the mall. You walking around for three hours can do a whole lot compared to what you can do in just a little bit of time with me. Also, you probably don’t want to sit and look at me while you walk for four hours. But as I said, just live your life, do what you can do, and we’ll just work within that.

Overall, well, it saves me a lot of cost. I don’t have to buy a lot of equipment. I don’t have a huge facility. It saves a lot of time on the patient. Patients are like, I’m not taking hours out of my day or hours out of my week. I’m interjecting my therapy in my normal day. They really liked that. 

Allison Jones: I imagine that taking that approach, it’s the practicality of incorporating it into their everyday activities that there is better compliance with the care plan, so you’re getting ultimately better outcomes at the end of the day.

Matt Huey: Yes. I still run into the, oh, I forgot. However, I will say I am specialized and unique that the patients that reach out are like, I’m going to listen to everything that you say. But likewise, as you said, giving somebody two sheets with 12 exercise on, so 24 exercises, this mountain of stuff may just be like, whoa, that’s way more than what I want to do. But if I say, I want you to do this one thing X number of times during the day, oh, it really fits into my day. Then we can find the spots where they can do it as well. 

Allison Jones: You were a college athlete. How has that experience informed how you help your patients? 

Matt Huey: Way back when, I just thought this was the most interesting thing. Why can I do this in college as an athlete, but I cannot do that with anybody outside of it? If I did track and field—I was a shot putter and hammer thrower—if I was hurt, if I was sick, if I was whatever, I walked right into the athletic trainer’s office. He could assess me, and say, this is just a sprained ankle. We can start working with you right now. No, you need to go see the doc; let’s get you an appointment. He was this point that could do so many things for me. Why do we not have that outside of it? 

I try to base it upon that. Somebody can contact me, hey, I’m having this weird pain. Is this normal? Okay, I can assess you and say, this is something that we can treat; we can go from there. If it’s not, okay, here is a local shoulder person or the knee person or a cardiologist. I can give them that so at least I can be just somebody that can help direct as well with what they do. I really saw that’s just a really good model to have on it. I trusted the athletic trainer, and I want my patients to trust me in that way as well. 

Allison Jones: Did that serve as your inspiration for going into therapy? 

Matt Huey: It did. I was injured in high school. I broke my leg, and I had a few aches and pains and stuff like that in college. I had a wonderful athletic trainer I’ll never forget. 

I mentioned that I am a diplomat at McKenzie, so I’m all the way at the top of the McKenzie ladder there. I’ll never forget one day I was in the trailer. He told me, I learned about this thing called the McKenzie approach, and he just gave me, looking back now, the worst explanation of it whatsoever, like somebody who’d just taken one course in it, like the worst thing in it. I thought it was really cool. 

He also wanted people to be very active in the recovery of it as well. He didn’t want you just to come in, oh, you pulled your hamstringing, ice and stem. Okay, before practice, we’ll do some heat; just stretch it. He was very, very active in it. You need to do this, you need to do these things, just load you up. That really shaped what I would like to do. He directed me into the world of physical therapy, and here I am today. 

I will tell this funny story about him as well. We went to the CSM conference. I think the statute of limitations is up on this. It was in San Diego in 2010. He snuck in. We’re walking around, and we go to the McKenzie booth. He knew some of them, and he’s just chatting with them. He said, scan your badge so you can have a free membership. I scanned my badge, and a couple of weeks later, I get a letter, you won a free membership. You got a couple of journals. You get 10% off the courses. I think I used that 10% to sign up for my first class. Then that led me down this road, and I tell everybody at the McKenzie, you got me because you gave me a free membership.

Granted, they probably gave everybody a free membership. I found the letter, and I keep the letter. Just cleaning up some stuff from school, I found the letter, and I said, I’m going to keep this. I said, y’all got me with a free membership. I went all the way through it. 

Allison Jones: Well, there you go. That really speaks to my marketing heart, that little freebie there brings people in for sure. For those that might not be familiar, what is the McKenzie method? 

Matt Huey: Robin McKenzie was a therapist from New Zealand and a very practical guy. He has a book called Against the Tide, which is his life story. He looked at therapy just a little bit different. He said, we had these things where I saw people with thoracic injuries. We had to make them do breathing exercises and realized this really didn’t work. A patient came in one day with his bad back and leg pain. He had him lay on a table, which the head of the table was up. The guy said, my leg feels better. 

He started exploring, what does this do? What if we start doing certain movements and things in certain directions? What does it do? He developed this method, and it’s been expanded upon lots of research out there. It’s a huge debate over a lot of stuff on it. But really, you look at somebody and try to understand, do they have, we say, mechanical pain or not? That’s what I would tell everybody. 

First and foremost, we want to understand is your pain mechanical? If it is, we can treat it. If not, it may be something else. I may have to direct you to another provider or something else. But I say also, it lets me know, can I help you or not? Because if it is mechanical, I probably can help you. It also could be mechanical, and you just don’t like me, and it won’t help you. Or we found this is something we need to send you off to have surgery or maybe counseling or anything. 

So really, I said, that’s the basis of it. It gives me an understanding of what to do with a patient. It’s getting the patient moving, and they feel better, and it really sets this guideline of how I treat. If you really read the book, his story, it gets way deeper than some of the books that other people have read, such as the Treat Your Own Back, Treat Your Own Neck, where he was very big into getting people moving of, he called it, play hardening. He’s like, if you can go swing a golf club, I don’t have that fear of hurting my back if I could swing a golf club. You could tell somebody, go play three holes of golf. Oh, yeah, I played three holes of golf. I could bend and twist and do all this stuff, and it didn’t hurt. Perfect. This is the basis of what I do. 

Allison Jones: Excellent. When we were prepping, we were talking a little bit about power lifting. You treat some power lifters. You had mentioned the dynamic there of working with power lifters. Some PTs may advise lifters if they’re experiencing some pain that the advice might be, stop lifting such heavy weights, and you won’t experience that pain anymore. But what’s your take on that approach, and how would you do things differently if you were faced with a lifter coming in and saying, I’m having some pain when I lift heavy? 

Matt Huey: One thing I see with what we do in therapy, and really any medical provider, is really, we need to understand what the person does. I’ve met so many therapists from my PT school class who are not athletic whatsoever, and they don’t understand a sport. Again, somebody like a power lifter going to someone who doesn’t even go to the gym who may do another form of exercise or something, they don’t understand what they do on it.

That’s one thing. Then I always say the term heavy is relative on it. Really, what is heavy? When everybody says, kids shouldn’t lift heavy. What’s the cutoff? You shouldn’t lift heavy weights. What’s the cutoff? 50 pounds, that could be heavy if that’s a bag of dog food. But if your car weighed 50 pounds, that’s not very heavy. Even somebody lifting weights, somebody who weighs 100 pounds, a 200-pound deadlift could be heavy to them compared to somebody who’s 300 pounds. A 200-pound deadlift may not be heavy to them. Or that 100-pound lifter is an elite athlete, that 200 pounds is nothing to them. That 300-pound person just started lifting last week, and 200 pounds is extremely heavy to him. It’s understanding what they are doing and building them back up. 

A lot of it also comes down to educating the lifters and getting their buy-in, too. It’s like, I’m one of you. I’m in the community. I lift too. I don’t believe that lifting heavy is bad for you if you’re managing your load and sleeping and you’re eating and you’re doing all those things right, that you can get back to lifting heavy. We can get you back onto that and build you back. The same thing as you built your strength up, we’re going to build you back with your rehab on it.

I tell them, you don’t have to stop lifting necessarily. If you had a surgery or something is really inflamed, you may need to stop. But as I tell them most of the time, no, we’re not going to have you stop lifting. We want to build you back up to get you confident again to lift heavy where you’re not going to have any pain anymore.

Allison Jones: Right. It goes back to what you had said in the beginning: walking with your patient, understanding them and getting them back to where they want to be. 

Matt Huey: Yeah. That group is a very fun group because you really can walk with them all the way back to a big meet. There’s this little funny point that they get– okay, there’s two funny points. One, the moment they feel better where they dump all the rehab stuff, and they’re like, oh, I can go lift again. No, we are not there yet. That’s the thing. But also that bridge from, it doesn’t hurt to walk around or pick up my kids, it doesn’t bother me when I do any of that. But as soon as I put this weight on my back or whatever the lift is, I start having discomfort again. I was like, we’ll just have to bridge you. 

What we were doing was working. We may have to push you a little harder. We may have to do things a little bit different, really work some stuff because you’re working at a way higher level than an average person. We may have to do a couple of different things with you, but don’t worry about it. We can get you over that. You’re in a different class. We have to bridge from normal things being pain free to your extreme or heavy workload is pain free.

Allison Jones: Absolutely. Tell me, Matt, how has your approach of walking with your patients helped you grow your practice? 

Matt Huey: Really, it’s people see that therapy doesn’t have to be this giant burden or this giant time away from their life. Now granted, if they are really hurting or a surgery, they understand, this is necessary. We really need to do it. But those people that this is kind of bothering me, this is annoying, I tell them, we’re not going to take a lot out of your day. You’re not going to have to drive 30 minutes to see me, spend an hour in here, drive 30 minutes home. That’s two hours that you’ve just spent. We can interject something in your day. We’re not going to give you a ton. I’m not going to give you 30 exercises to do, all this stuff to do. I’m not going to do that. I just want to allow you to keep living your life, and we’re just giving these guidelines. 

We’re talking about different things as we go along, and they say, I really like that. I see that I’m not having to go three times a week at six hours, three hours, or whatever. It’s not this huge chunk of time away from everything. Also, I can talk to my therapist whenever. I tell them all, and I give them my phone number and say, text me. I’m going to text you in two days. If you have questions, we’ll talk, and we chat. If they say, I don’t think I’m doing this exercise right. Okay, let me see. Shoot a video of you doing it. Put your leg here. Oh, okay. I feel that. There you go. I’ve even had them on a weekend or something. Oh, I did something; I think I tweaked my back. We may just chat a little bit, and it puts them back on that path. They really like it. As I say, you’re not taking away from your normal life to do therapy. It seems like more people with little nagging, annoying issues will reach out compared to when it gets full blown and really bad.

Allison Jones: As we wrap up here, any final thoughts for other practitioners that are looking to grow their business, any advice for them? 

Matt Huey: Really, I would say find your niche, what you like, what you really know on that. There is the thing I see that as therapists, they try to be a generalist and just treat everything. I’ll tell people what I don’t know. Somebody says, my mother had a stroke. Can she see you? I said, I’m really not the best therapist to see for somebody who just had a stroke. That’s not my strength. But if you have back pain or neck pain, I’ll gladly take care of you.

As well as just having a relationship with your patients, you can just start with your community that you get known as the person to go to for this issue and the person that they go to for knee issues or this or that, and because you just build this thing up and you’re willing to talk to people and willing to communicate. I say a big thing to ask with people, it’s just why? If somebody disagrees with you, why do you feel like that? Do you want to have a discussion on that? Then they start buying into you more and more and more just because they feel like, I could talk with this person. This person is going to talk with me about what’s going on.

Allison Jones: Excellent. Well, Matt, we are out of time for today, but I wanted to thank you for joining us. We really appreciate you coming on and sharing your thoughts with us today, so thank you for joining us. Thank you to the audience for tuning in to the Therapy Matters podcast, your one-stop resource for expert insights and advice on everything therapy and rehab. We look forward to seeing you on the next episode. Thank you. 

Thanks for listening to Therapy Matters. Do you like the podcast? Give us a five-star rating, subscribe, and tell all your friends about the show. Want to be a guest or know someone that would be a great guest speaker? Contact me at allison.jones@raintreeinc.com. That’s A-L-L-I-S-O-N.jones@raintreeinc.com.

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