I was born in Ely, MN. Ely was created by the iron ore industry but recently is better known as an entry point to the Boundary Waters Canoe Area Wilderness (BWCAW). I currently live in Blacksburg, VA, in the Blue Ridge Mountains. Blacksburg is the home of Virginia Tech University which creates a wonderfully diverse culture.
I did my undergrad as well as my graduate work at the College of St. Scholastica in Duluth, MN. Post-grad I credentialed in Mechanical Diagnosis and Therapy (MDT). I am currently involved in outcomes accountability training.
I am a physical therapist in private practice and 95% of my practice is treating individuals with spine problems. In my practice, I strictly utilize MDT. MDT is a validated method of assessment that reliably subgroups patients for predictably effective treatment outcomes. In other words, not all exercises are helpful for all spine patients, but specific exercises are helpful for the specific individual with a spine problem. MDT determines which individual requires what specific exercise. I have been practicing 100% modality free for 15 years. I had the privilege of working with Dr. Stephen Grubb since 2003 in a truly collaborative spine center, until his recent retirement when I ventured into private practice.
I have been a NASS member since 2009 when I joined due to a colleague’s recommendation. More importantly, I maintain my membership because I continue to see value in surrounding myself with the NASS spine care community.
I see a few pressing issues, but it all starts with the clinical process. Reliable clinical processes are lacking. Correction requires establishing efficient reproducible care pathways and utilizing well-trained providers in a genuinely collaborative process. This is a massive undertaking that comes with a cost. Second, improved data analytics are necessary to process all the outcome data produced by the current clinical process and even greater by the above clinical scenario. Which outcomes/parameters should we use? Ultimately, value will be defined by these outcomes over the cost. Lastly, a reimbursement schedule must be created based on the value of the service. We may be able to determine who or what will actually produce value in spine care. This may change reimbursement models, which is a touchy subject with multiple stakeholders. The current health care landscape appears volatile and the burden of proof is on the clinician. In this upcoming era of metrics and outcomes, I hope health care does not lose sight of the patient for the numbers.
Our language and interaction with the patient holds immense weight. A skillful history and physical exam are an art that must be monitored and practiced. Measure multiple aspects of your practice to identify your strengths and areas for improvement. Reserve time regularly to reflect on clinical practice as it relates to your outcomes and interactions. Foster professional accountability by actively participating in professional organizations.
It is important to get involved with health care advocacy because if you do not, the voice that speaks for you may not be saying what you want. NASS has provided me the opportunity to contribute to a low back pain guideline, a clinical practice guideline for a third party administrator; and as an appropriate use criteria rater.
NASS meetings provide peer engagement with focus and structured content that is evidence-based and concisely delivered. The venue locations make for great off-time exploration. We could have the next five annual meetings in New Orleans and I would be happy. Best food around!
Sensationalism. I do not consume significant health care media, but I can’t remember the last time I saw an unbiased evidence-based piece that was produced for a community service. It might be that nobody would watch it. However, a reality show about spine care would probably get huge ratings.
My wife and I have two girls, 3 and 7 years old. Between youth soccer, track and swimming, we stay busy and try to have family outings on one of our local bike trails, walking paths or have a picnic at a duck pond nearby. We love exploring the outdoors. When we get a babysitter, my wife and I enjoy long dinners with good wine and uninterrupted conversation.