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Healthy Wealthy & Smart

The Healthy Wealthy & Smart podcast with Dr. Karen Litzy features top experts in health, wellness and business with a particular focus on physical therapy. We take evidence based medicine and break it down making it easier to understand and immediately apply to your life. At Healthy Wealthy & Smart our goal is simple: to provide you with the best information to live a healthy and pain free life!
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Now displaying: January, 2019
Jan 28, 2019

Ashley Micciche is the CEO of True North Retirement Advisors, an independent financial advisory firm managing $230 million in client assets, and located just outside of Portland, Oregon. Ashley specializes in helping small business owners exit their business & retire with financial security by crafting and implementing a custom-designed exit plan.

Whether you’re looking to retire in the next few years or you’re on draft one of your business plan, you should plan for the end in mind. Ashley is going to walk us through the 3 universal, must-do steps to help you get what your business is worth so you can retire with confidence and financial security!

 

Press play and get ready to take some notes!

 

More about Ashley:

Ashley Micciche is the CEO of True North Retirement Advisors, an independent financial advisory firm managing $230 million in client assets, and located just outside of Portland, Oregon. It’s a family business, that she owns with her father. 

Ashley specializes in helping small business owners exit their business & retire with financial security by crafting and implementing a custom-designed exit plan.

She started her career as a financial advisor in 2007 after graduating magna cum laude with a Bachelor of Science degree in Business Finance from Portland State University.

Early in her career, Ashley developed expertise in 401k consulting for small businesses, and she quickly realized that business owners nearing retirement were not taking the steps necessary to exit their business. She watched several of her business owner clients walk away from their business at retirement without the financial security they needed.

Today, she is on a mission to transition 300 small business owners successfully into retirement in the next 10 years.

Ashley started her first business at the age of 8 years old, taking care of her neighbor’s pets & plants, and picking up their mail when they went on vacation – for $3 a day. She ran that business (a complete monopoly with 100% profit margin!) for 3 years.

 

FULL TRANSCRIPT

Karen Litzy:                   00:00                Hey Ashley, welcome to the podcast. I'm happy to have you on.

Ashley Micciche:           00:04                Thank you so much for having me, Karen.

Karen Litzy:                   00:06                Sure. Now before we get to the meat of our interview, I would love for you to fill in the blanks a little bit from your bio that we read to introduce you so that the listeners get a little bit better sense of where you're coming from.

Ashley Micciche:           00:21                I know one of the things that was mentioned in there was I started my first business when I was eight years old. I didn't know it at the time, but you know, I was very entrepreneurial growing up and I started this business where I would pick up your paper and your mail and water your plants and feed your dogs and cats if you went on vacation. I found out really early on that if I worked really hard and I posted flyers and put flyers on mailboxes, put stuff in the newsletter and our neighborhood advertisement that I would get business from that. If I didn't work hard, if I didn't post flyers or do any of that, I got nothing. So I learned these really awesome lessons about hustle and working hard and making $3 a day doing all this work early on. And so that was a really neat experience because it taught me a lot that I have carried with me over the years and now starting my own real business.

Karen Litzy:                   01:32                And those are lessons that you know you can take with you for your whole life. And now you are at True North Retirement Advisors as the CEO and retirement plan specialist. So today you're going to share with us three universal must do steps to help you get what your business is worth so you can retire eventually which is something we all want to do. Well, maybe not everyone, but most people want to retire and we want to be able to retire with confidence that we can live a lifestyle that we want to live. So let's go through these three universal must do steps.

Ashley Micciche:           02:13                So what we do is exit planning for business owners. And I think what's really unique about that is that we don't have any skin in the game. Like it doesn't matter to us who you sell your business to or you could sell it to a family member, another employee, you could sell it to an outside third party. We don't have any skin in the game in that regard. So what we do is we really just work with our clients to identify those goals and what's important to them and what the value of their business is so that they can achieve what they're looking to do when they exit their business.

Karen Litzy:                   02:50                Oh, I was going to say, because I'm assuming everyone's got a different goal to exit their business. Right? And so it has to be personalized and individualized.

Ashley Micciche:           03:00                Yes. And so we have a step by step process for this. But what I found is that the process really diverges after the first three steps based on who you end up selling your business to, what that timeline looks like. But there are three universal steps to exiting your business. And so the first universal step is valuing your business, understanding what your business is actually worth. And it's kind of like if you know, you want to retire, Exit Your Business, sell your business in five or six years or whatever that is, that's sort of like the destination on your GPS. And if you don't put a starting point in, if you don't put in where you are today, what the value of your business is today, it's almost, your GPS can not tell you how to get where you want to go. So you really have to take inventory of what your business is worth today.

Ashley Micciche:           04:00                And I find that a lot of people don't do this vital first step because they have a lot of misconceptions about what's involved in value in a business. So they think that it's going to cost them thousands of dollars. It's going to take weeks or months. Someone's going to come in to disrupt their business because they need to ask questions and you know, dig into the books and records and all of a sudden, so they're like, no, I don't want to do that. Like I'll just use a rule of thumb or hey, I know this other practice across town that's close in size to mine and they sold their business for this much. So I'm just gonna, you know, I'll go with that. But you know, if you don't start with an accurate valuation, it's nearly impossible to take the other steps necessary to exit your business.

Karen Litzy:                   04:52                Okay. So I will admit, I have no idea how to do that. Yeah. So what would you say to someone like me and I am a business owner? How do I even start valuing the business?

Ashley Micciche:           06:07                Yeah, so that's a really good question. And you're not alone, Karen. There was actually a study done about three years ago by the business exit institute. They do a lot of research in this area and they found that 98% of business owners have absolutely no clue what their business is worth and how to go about doing that. So, the neat thing about valuing your business is that more technology tools exist today. So there's a software tool that we use to value a business and anyone can access this. It's free, but really with a pie with eight pieces of information, like your revenue, what you pay yourself, what your compensation is, your debt and certain other things like if you rent or own the space where your business is occupied, but there are a critical pieces of information to value your business.

                                                            And if you get those, if you can get those eight pieces of critical information and enter it into the valuation tool, then it will spit out an evaluation for you. It'll tell you, you know, Karen's practice is worth $689,000 or whatever it is based on those parameters that you put in. And it doesn't take long. It takes like five minutes to do it. Once you've gathered the data, the toughest part is gathering the data. When you use this software tool, there's 50 pieces of information you can put in. But what we did is we went back to the software developer and we said, okay, tell me the bare minimum pieces of information that I could put into the software tool for it to spit out the valuation for my business. And so we use that, what their advice was to us.

Ashley Micciche:           07:03                Plus some of the other things that we know from what we know moves the needle on valuation. And we came up with this checklist like, Hey, if you can get these eight pieces of information, what your revenue is, your pretax income, if you owe other people money, if you have bank loans, if you rent or own the space that you're in, those are the things that have the largest impact on what your business is worth. And then once you enter that into the software tool, it'll spit out your evaluation. It's fantastic. And I'm so excited about it because what I found, this is not our core business, like this is it. So we actually make this tool available to anyone who wants to use it for free. Because what we want them to do is get unstuck, get out of the head mind space of using a rule of thumb or a really inaccurate estimate.

Ashley Micciche:           08:01                Because once you know what your business is worth, it unleashes the rest of this process. And when you see that number tangible, you know, Karen's business is worth this amount, then you can start to make some important decisions about, okay, so is this going to be enough that, you know, if I want to exit and a year or two years, you know, what do I need to do if this isn't what I hoped it would be? So it really influences a lot of the other decisions we make in the process. Valuing your business and knowing how to value your business is step one. So what is step two? Step two would be establishing what your timeline is and your goals. So you know, a lot of people have this idea in their head, I want to retire and exit my business in 10 years or five years.

Ashley Micciche:           09:00                Or maybe it's like January 25th you know, 2021 like they've got it dialed in down to the day. And so that would be the first thing. And not just when you want to leave, but figuring out, okay, how were you involved in your business today? And then how do you see that involvement evolving over time? Because the reality is for most people who are not business owners or entrepreneurs, they have a very specific set retirement date and they go from working full time to retirement date and then fully retired. But for a lot of business owners there, they sort of have this phased out exit. And so it's important to kind of think about how to do that, which is great for a business owner because if you have somebody else who's taking over ownership at or who's doing a lot of the day to day management or seeing patients or whatever that may be, you can pull back over time a little bit and have this phased out retirement so that you can test the waters and make sure that whoever that person or those people are are fully equipped to be able to run things in your absence.

Karen Litzy:                   10:16                Yeah, that makes perfect sense to me. And also I would think it's really hard for some business owners. Have you found that with the clients that you work with that that's not easy?

Ashley Micciche:           10:28                Yeah. I mean, cause your business, it's like your baby, you know, blood, sweat, tears. You've made so many sacrifices, a lot of it too.  It is very much a part of your identity and who you are. And that's okay. You know, I totally get that. I think that the important thing about this establishing your timeline and goals is what feels right to you and what do you want. It's not up to me to tell you what you should do. It's up to you to figure that out.

Karen Litzy:                   11:00                Not Easy, not easy. But this is good. As you're saying all of this, I'm kind of thinking in my head like, okay, I should probably be thinking about this stuff cause it's not even something that's on my radar right now. But I guess it's never too soon.

Ashley Micciche:           11:14                No. And actually the best exit plan starts when you start your business, but most people are so heads down focusing in growth mode that rarely if ever happens because it really does require this mindset shift. But you have to start it before you're burnt out. So I've seen a lot of business owners who, because they didn't plan, they didn't start this process, you know, five, 10 years out, which is really an ideal timeframe to be doing this. They wait until they're sick and tired of working and they're ready to retire. And so they don't have the time to be able to craft that ideal accent or maybe they sell their business to somebody who in a fire sale where they just want out and they don't care what they get for their business, but if they would have planned more, they could have got, you know, what they wanted in a lot of cases.

Ashley Micciche:           12:18                I didn't work with this person on their exit, but I know somebody who just retired this past summer and he was a third generation owner of his family business that his grandfather started. It was a good business, a good cashflow, it was a solid business. But he didn't do any planning and didn't identify a successor and he just got way too burnt out and literally just walked away and shut the doors and left with nothing. And that, to me it was really sad just because it was, you know, third generation. And he was fortunate because he didn't need to sell his business in order to retire. You know, it wasn't a must do, but for most people, you know, your business is your largest asset. And so it's so important we plan for all these other things, like when we're going to take social security and investing in all these things, but a lot of times the business and the value of the business gets neglected.

Karen Litzy:                   13:29                Yeah. There's no question. I am in a lot of different entrepreneurial groups and this is a topic that never comes up.

Ashley Micciche:           13:39                Oh really? That's surprising.

Karen Litzy:                   13:40                Yeah. It's a topic that never comes up and it really should because now that as you're speaking more and more on this, it's got me thinking about my sort of long-term plan and where do I see myself and what should my goals be. So this will be something for 2019 for me to really sit down and give it the time and space that it needs. So I think it's great. Okay. So, number one, valuing your business. Number two, establishing a timeline and goals that I'm assuming are realistic. We don't want to say, well it's January, so I want to retire in three months and now this is it.

Ashley Micciche:           14:25                And actually before we move on, can I give you a couple of other questions that I think your listeners may not say. So obviously it's important to consider the WHO. So who is best suited to take over the ownership of your business after exit. Now a lot of times, especially in family businesses, there are family considerations and we'll just kind of a trick question cause there was always family issues, like maybe somebody is involved in your business, like one child out of your three children is involved. And you know, most parents want to do what's fair for their kids and so it can create a lot of strife in the family, when there's family involved. So we want to be really careful about that. And I think a lot of business owners make some not so good decisions because of that family element.

Ashley Micciche:           15:20                Like I'm sure we've all seen it where you have a second generation who doesn't have the same mindset, doesn't have that same fire and isn't very well equipped to, maybe they were a good employee, but they're not very well equipped to run the business. So that's really important as well. And then the other thing that I think really drives who you want to look at to be your successor is whether or not how important it is for the business to stay in the community. So a lot of business owners are really heavily involved in their community and no matter what an outside buyer tells you, that dynamic is going to change. So it's really important, especially if you're looking to sell to maybe like a competitor or someone like that outside of your immediate community. It's definitely going to change, you know, that experience from your client or your patient's point of view.

Karen Litzy:                   16:21                Oh yeah, definitely. Especially in health care because if you're in any sort of healthcare business, you are deeply entrenched into that community and they depend on you. Yeah, that's a great consideration to think about during this timeline and goal step. Anything else that we really need to think about in this second step?

Ashley Micciche:           16:48                You know, a couple of other things have to do with the financial element. There was this other study that was done that looked at most business owners want to retire in the next 10 years. And that same study that I mentioned before from the business owner acts or business exit institute said that they found that 75% of business owners would exit today if their financial security was assured. So most entrepreneurs, business owners who aren't looking to exit, aren't doing so because they feel like financial aid, they're not ready yet. So that really plays into the next step that's universal in that process, which is to determine if you have a gap financially. So you know what your business is worth, you know, what your other financial resources are. And when you look at all of those things, is that going to be enough to, do you have enough to retire?

Ashley Micciche:           17:51                Is that going to be enough to provide the income needs that you have and your family has in retirement or not? That's really the third step. And so what we do in this step is we look at what are your assets? We know what the business is worth, but we also have to consider the after tax business value. Cause that's a big surprise, right? Then you have what you get to keep after Uncle Sam does. So you know, we have to plan for that. And then you might have other assets like your investment portfolio or rental properties and all of these things are, or social security, you know, all these things are providing income for you in retirement. And so you have to replace whatever income you were getting when you were working in the business.

Ashley Micciche:           18:45                That’s usually the challenge is because most people, they do have a gap. The business or their personal financial resources are enough to provide the income that they want and desire in retirement. So, we have to start making some decisions about what levers we can pull. So sometimes you can pull levers to increase the value of the business. Depending on what the business looks like, sometimes there's not as much flexibility there. So it might be, you know, rethinking what your plan was for retirement. Like are you willing, you said you all work five more years, are you willing to work six, seven or eight more years if that's going to help fill the gap. So understanding if a gap exists or not, and discovering your gap, that's the third step because it really leads to how much are you either going to need to grow your business value or on the personal side, your personal assets and income in order to make sure that that gap is filled.

Ashley Micciche:           19:55                I would think that that third step is where you really have to start making some hard decisions depending on how you want to live your life when you retire. And actually one of the things that comes up a lot is if sometimes people get revenue from very limited sources, you might have, you know, five or 10 clients that provide 50, 60% of revenue or maybe you have a practice that especially on the medical side, maybe are more dependent on insurance reimbursement. And so one of the things that can increase value is if you can convert or incentivize more of those people to pay with cash. Know that can be something that's more attractive now to an outsider versus relying on insurance reimbursements found that true for dental practices. I would imagine it's true pretty much across the board for most medical or physical therapy type companies.

Karen Litzy:                   21:00                I would agree with that. And I think there is a big trend moving towards a cash based therapy practice. That's what I have. So I don't take insurance. I'm out of network. I'll help you get reimbursed. But my clients pay me cash for my physical therapy services. And I think there's definitely a big trend to that, especially now with rising costs of healthcare and large deductibles. Everybody's cash based at this point because some people have deductibles of $10,000, which needs to be paid before you can get reimbursed anyway. So everybody's paying out of pocket.

Ashley Micciche:           21:45                Yeah. Well good. Karen, you've already increased the value of your business by doing that.

Karen Litzy:                   21:50                All right. Yeah, go through this tool and look at my goals and all that other stuff and get at least a rough idea of the value of what my business is. I even think about retiring and I always said, you know, Oh, I've got like 30 more years before I retire, but I feel like I said that like 10 years ago and I'm 10 years older. You know what I mean? So this is a good reality check for me and hopefully for the listeners as well to really start thinking about your business and how you want to, like you said, how you want to exit and how you then want to move on into retirement years at whatever time frame that is for you. Do you have examples of clients, you don't have to obviously say their names, but clients that you worked with that did a really good job at all of this and how that ended up improving their retirement?

Ashley Micciche:           22:50                So one of the clients that comes to mind is somebody who's actually still in the process of exiting, but I think the key for this client was that they really started early on. So this is actually another medical practice and they have two other partners and both of whom are younger, but one of them is in their early forties, and then the other one's in their 50s and then the one who's retiring is in his sixties. So the trick is, the younger people have to be able to afford to buy out this older owner, but they have a great relationship. They've talked and communicated with each other along the way to minimize any misunderstandings or potential lawsuits or breakup of their partnership, so they've done a really good job of planning that and having those discussions.

Ashley Micciche:           23:46                He’s a planner by nature, so he's done a really good job in making sure that, this is what the practice is worth, this is what I need when I exit. And he's most likely going to get that just because he's done all this planning and all the partners are on the same page and they're structuring his buyout in a way that they can afford and they're not going to rely on bringing in somebody new or doing that before he exits. So just the planning element and the communication is really helping them out. We’ve had other clients in that same boat who did successfully exit. And it all started with just understanding what was required to exit the business. What do I need to do? What are the levers I can pull to increase either the value of my business or the value of my personal assets. So I'm not relying so much on the business now. Some people, their business is so huge as far as their net worth, the percentage of their net worth that they have no other choice than to really focus and hone in on that to maintain the same lifestyle that they had or provide a legacy or you know, satisfy some of those other exit goals.

Karen Litzy:                   25:15                Yeah. And it sounds like aside from these three universal steps to exit, that communication with other stake holders within your business and your family and business partners is paramount to having a smooth exit. So there's no surprises.

Ashley Micciche:           25:33                Yes. And actually that is something that we tried to do. So if we're working with a client x in the business before we ever draft the exit plan, it's kind of like the strategic plan, but it's for your exit. So before that's ever drafted, we bring everyone together the team. So family is involved, especially the spouse and if your children is in the business, we want to involve them early on in the discussion so we make sure everyone's on the same page. And then also all the others like CPA, attorney. There's a lot of people who have a role in making this process as successful as possible. And so part of our job is to facilitate all that and to help move the process along by getting the attorney or the CPA involved at the right stage of the game.

Karen Litzy:                   26:31                Yeah, absolutely. If you're not an entrepreneur or you're not a business owner, you don't realize how many people are on your team, how many people are working behind the scenes to make your business successful. And so it's obviously important to involve all of them in your exit plan cause everybody's going to be affected in one way or another. Now is there anything that we missed going through these three universal steps?

Ashley Micciche:           27:00                No, I don't think so. It's about sally in your business. First and foremost, figuring out where you're at and then get most important goals and what that timeline looks like and then figuring out if there's a gap or not and then what to do about it if there is.

Karen Litzy:                   27:15                Well, this was great and I have to tell you, I am really going to start looking at this more seriously now after having this conversation. Hopefully the listeners will as well who are entrepreneurs or even for people thinking about being an entrepreneur. So maybe you haven't started your business yet. Like you said, the ideal time to do this is when you start. So they'll have like a leg up on all of us entrepreneurs who have not done this yet. I'm a little jealous of those new bees. Now before we end, I always ask everyone the same question. And that's knowing where you are now in your life and in your career, what advice would you give to yourself as a new Grad out of college?

Ashley Micciche:           28:00                Gosh, that is such a good question. It's funny cause when I graduated college I pretty much, I didn't have a lot of fun in my twenties. Honestly I didn't, I didn't travel. I started in what I'm doing today straight out of college and that was 11 years ago now. So, I think if you would've asked me that question a few years ago, cause I always regretted not having a bit more fun in my twenties and now that I'm in my thirties, I actually am glad that I did. I did what I did and I didn't travel more and I just really focused on my career because I think I'll have a few more options down the road. But honestly, to answer your question, the thing career wise that I wish I would've done when I first started as a fund generalist financial advisor, one of the things that I was told by a lot of mentors who had been advisors for 20, 30 years was that the best way to grow your business when you're new is to cold call.

Ashley Micciche:           29:08                And so I did that and I cold called for two years, I made over 25,000 calls and I wouldn't say it was a total waste, but when these people who are giving me this advice very well meaning advice, they were genuinely trying to help me. They built their business cold calling in the eighties and nineties before the do not call lists before, people hated you if you were calling them cold. And so it's a different world today. So I think I learned career wise is that I wish I would have been a little bit more creative and trying other things in order to grow my business early on because I feel like now if I would have done that, I would've obviously done some other things and not relied so much on a strategy that for me it just didn't work very well.

Karen Litzy:                   30:07                Yeah, I think that's why the advice to give to yourself and we've all been there definitely doing things that looking back on it, you're like, what was I thinking?

Ashley Micciche:           30:17                Yeah.

Karen Litzy:                   30:19                Where can people find you? Where can they find true north? Let us know where we can connect with you online.

Ashley Micciche:           30:28                Sure. So the website is http://www.truenorthretirementadvisors.com/and for the free unlimited lifetime access to the valuation tool where you can enter that information, go to https://truenorthretirementadvisors.com/valuemybusiness/ If you go there, you'll get access to the checklists. So it's a pdf checklist that explains to you here are the eight pieces of information to gather, where to find it quickly and easily. And then from there you'll get access to the valuation tool. And the beauty of this is you could go in and do the valuation for free and then you can update it in six months or a year or you know, if your business changes and see how some of those adjustments have changed or valuation. So it's cool. It's not a one and done and it's totally free because we really want people to just, we found that if they can figure out what their business is worth and that's the key to unlocking the rest of the steps that are so necessary to exiting.

Karen Litzy:                   31:41                I'm going straight to that url and I'm going to get this valuation tool because I think it's awesome. So thank you so much for sharing that. That's such a generous share. And how about social media? Where can we find you?

Ashley Micciche:           32:10                Yeah, so our YouTube channel where we go a little bit more in depth on some of these exit planning, retirement planning topics. We have our biggest presence on LinkedIn.

Karen Litzy:                   32:29                Yes. And just before we went on the air, I said, is this how you pronounce your name? And I got it right, but only because I watched your YouTube videos. I knew how you pronounced it, but don't worry, everyone will have a direct link to the youtube and to linkedin and to of course the free gift that Ashley has so generously shared with all of us. So Ashley, thank you so much. This was eye opening.

Ashley Micciche:                                   Thank you so much, Karen. This was a lot of fun. And I'm so happy to share this with your listeners. Awesome.

Karen Litzy:                                           And to all of you listeners, get that free gift and we will be back with you in a couple of days. Have a great few days and stay healthy, wealthy, and smart.

 

 

Thank you for listening to this episode with Ashley Micciche!

 

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Have a fantastic day and stay Healthy, Wealthy and Smart! 

 

Xo Karen

 

Jan 21, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Dr. Evangelos Pappas joins the show to discuss the editorial in the Sports Medicine Journal, Time for a Different Approach to Anterior Cruciate Ligament Injuries: Educate and Create Realistic Expectations.  Dr. Evangelos Pappas’ research interests are in the areas of sports medicine, biomechanics and musculoskeletal physiotherapy. Specifically, his interests are in the areas of etiology of lower extremity sports injuries, effectiveness of injury prevention programs, motor control re-training for the prevention and treatment of knee pathologies, epidemiology of ACL injuries, rehabilitation of lower extremity injuries, and dance medicine

In this episode, we discuss:

-How patients interpret the practitioner’s language and use of medical terminology surrounding ACL injury

-Strategies to communicate the medical management of ACL injury to set realistic patient expectations

-The limitations of the research in determining who will benefit from surgical versus conservative treatment for ACL injury

-Physical therapy utilization and patient outcomes

-And so much more!

 

“We have identified a big discrepancy between the expectations of the patient and the research and the outcomes that we know are produced after conservative or surgical treatment.”

 

“It is very frequently a life defining moment.”

 

“We do fail to communicate accurate information to our patients.”

 

“It is really risky to advocate to all patients conservative treatment including those who want to return to high level pivoting sports.”

 

“We don’t have good data to know who’s going to do well with conservative management at this point.”

 

For more information on Dr. Pappas:

Professor Evangelos Pappas trained as a physiotherapist in Thessaloniki, Greece before pursuing a Masters in Orthopaedic Physical Therapy at Quinnipiac University and a PhD in Orthopaedic Biomechanics at New York University in the USA. Prior to coming to the University of Sydney, He taught for 11 years at Long Island University-Brooklyn Campus in kinesiology, clinical decision making and musculoskeletal pathology and physiotherapy. His excellence in teaching was recognized by his nomination for the Newton award for excellence in teaching. A/Professor Pappas joined the University of Sydney as a Senior Lecturer in 2013 where he continues to lecture in the areas of musculoskeletal physiotherapy, and particularly as it relates to the upper and lower extremities.

Professor Pappas is also active in musculoskeletal research. His research has been funded by the National Institutes of Health and intramural grants. He has presented his work in more than 50 national and international conferences and he has been interviewed on the radio as an expert on knee injuries. His publications appear in top journals in the fields of physiotherapy, sports medicine and biomechanics. One of his publications received the T. David Sisk award for best review paper from Sports Health; a leading multidisciplinary journal in sports medicine. In addition, Professor Pappas has served on the research subcommittee of the awards committee of the American Physical Therapy Association.

Resources discussed on this show:

Zadro, J.R. & Pappas, E. (2018). Time for a Different Approach to Anterior Cruciate Ligament Injuries: Educate and Create Realistic Expectations. Sports Med. doi: 10.1007/s40279-018-0995-0. https://www.ncbi.nlm.nih.gov/pubmed/30284693

Episode 227: Dr. Evangelos Pappas: ACL Rehab & Research 101

Episode 048: Physical Therapist Dr. Evangelos Pappas

Evangelos Pappas Twitter

Evangelos Pappas Facebook

Email: evangelos.pappas@sydney.edu.au

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart! 

 

Xo Karen

 

 

Jan 18, 2019

F. Scott Feil chats with Mike Connors, Mark Milligan, & Dana Tew regarding the upcoming opportunity for the state of Texas to have Direct Access passed along with how PTs in Texas can get involved and contribute to making this a reality.

Texas Physical Therapy Association Website: https://www.tpta.org/ 

TPTA Capital Area District Facebook Page: https://www.facebook.com/CapitalAreaDistrictTPTA/ 

APTA Direct Access Page on Website: http://www.apta.org/StateIssues/DirectAccess/ 

APTA Action App on APTA Website: http://www.apta.org/ActionApp/ 

 Texas House Bill 29: https://legiscan.com/TX/bill/HB29/2019 

Evidence:

1. Texas Department of State Health Services. (2018) Texas Projections of Supply and Demand for Primary Care Physicians and Psychiatrists, 2017 – 2030. Austin, TX: Texas Health and Human Services https://dshs.texas.gov/chs/hprc/default.shtm 

2. Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort
ME Horn, JM Fritz BMC health services research 18 (1), 887 https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-018-3699-0 
 
3. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Frogner et al Health Serv. Res. 2018  https://www.researchgate.net/publication/325319327_Physical_Therapy_as_the_First_Point_of_Care_to_Treat_Low_Back_Pain_An_Instrumental_Variables_Approach_to_Estimate_Impact_on_Opioid_Prescription_Health_Care_Utilization_and_Costs 
 
4. Denninger TR, et al. The influence of patient choice of first provider on costs and outcomes: analysis from a physical therapy patient registry. J Orthop Sports Phys Ther. 2018;48(2):63–71. http://pt-cpr.com/images/jospt.2018.7423.pdf 
 
5. Rhon, D. I., Snodgrass, S. J., Cleland, J. A., Sissel, C. D., & Cook, C. E. (2018). Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule. Perioperative medicine (London, England)7, 25. doi:10.1186/s13741-018-0105-8   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249901/ 
 
 
 
Biographies: 
 
Michael Connors, PT, DPT, OCS, PhD received his Master of Physical Therapy degree from University of Medicine and Dentistry of NJ-Rutgers University in May 2003 with honors.  Dr. Connors obtained his post professional Doctor of Physical Therapy degree from Temple University in December 2008.  He became a board certified specialist in Orthopaedic Physical Therapy by the American Board of Physical Therapy Specialties in June 2011. He completed a PhD degree in Physical Therapy from Texas Woman's University in August 2017. Dr Connors is the current President of the Texas Physical Therapy Association. He also is an assistant professor within the UNT Health Science DPT Program.
 
Email: mjconnorspt@gmail.com  
 

Mark Milligan PT, DPT, Cert TPS, OCS, FAAOMPT

Mark Milligan is an orthopedic manual therapist that specializes in the evaluation and treatment of musculoskeletal and spinal conditions, both acute and chronic. He is Certified in Therapeutic Pain Science, Applied Prevention and Health Promotion and dry needling, Board Certified in Orthopedics and a Fellow of the American Academy of Orthopedic Manual Therapy.  He earned his Doctorate of Physical Therapy at the University of the Colorado School of Medicine in Denver, Colorado.  He went on to complete an Orthopedic Physical Therapy Residency and Orthopedic Manual Physical Therapy Fellowship with Evidence in Motion (EIM). He is a full-time clinician and Founder of Revolution Human Health, a non-profit physical therapy network and he also founded a continuing education company specializing in micro-education. He is currently a physical therapist with Encompass Home Health in Austin, Texas. Dr. Milligan serves as adjunct faculty for the Doctor of Physical Therapy Programs at South College and The University of St. Augustine.  Dr. Milligan is also primary faculty for Musculoskeletal Courses for EIM. Mark has presented and spoken at numerous state and national conferences and has been published in peer reviewed journals. He is an active member of the TPTA, APTA, and AAOMPT and is current the Capital Area District Chair for the Texas Physical Therapy Association and has great interest in public health and governmental affairs.  

Revolution Human Health is a non-profit physical therapy network in Austin, TX that transforms the healing experience by offering access to treatment, education, and movement based therapy for all. 

Continuing education division specializes in customized, micro-education for physical therapists across the country. Customizable options of courses include manual therapy, spinal and extremity manipulation, dry needling, clinical reasoning, and preventative care and population health. Please contact us about customizing a course for you and your team!

Email: markmilligandpt@gmail.com  

 
Dana Tew PT, DPT, OCS, FAAOMPT
CEO/ Program Director of OPTIM Physical Therapy and OPTIM Fellowship Program. Dana specializes in orthopaedic physical therapy. His experience includes clinical management of patients with both acute and chronic orthopedic injuries in the outpatient environment. His practice is focused on integration of manual therapy and exercise into a holistic, evidence-based and biopsychosocial approach to physical therapy treatment. He is the residency manager of Harris Health System’s Orthopedic Physical Therapy Residency Program. He was honored by the Texas Physical Therapy Association Southeastern District, as clinical instructor of the year in 2013. He is also a guest lecturer at Texas Woman’s University and has presented at multiple conferences. Dana earned his APTA Board Certification in Orthopedic Physical Therapy and is also a Fellow, in the American Academy of Orthopedic and Manual Physical Therapists. He has served locally for the Southeastern District, as a delegate for the TPTA, and nationally on the American Board of Physical Therapy Residency and Fellowship Education credentialing council for the APTA.
 
Email: danatew@gmail.com  
Jan 14, 2019

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Jamey Schrier back on the show to discuss business fundamentals.   Jamey is sharing his practice freedom methodology to practice owners all across the country who are looking for financial prosperity and a better quality of life. His book, The Practice Freedom Method: The Practice Owner’s Guide To Work Less, Earn More, And Live Your Passion, has been an Amazon #1 best seller.

In this episode, we discuss:

-How to establish a clear vision and find the why behind your goals

-Why comparisons to others will keep you small

-The importance of sharing the narrative behind your practice with your team

-Planning and budgeting for the bottom line that aligns with your goals

-And so much more!

 

“Measuring your progress, measuring your success compared to where you are now and where you’re going—when you do that—you stay in line with who you are.”

 

“When you put a pen to paper, it’s powerful.”

 

“Alignment is everything in our business.”

 

“Not knowing the answer isn’t the problem, it’s asking the right question.  The answer is out there.”

 

For more information on Jamey:

In 2004, Jamey Schrier was facing the soul-crushing struggles of private practice ownership. He couldn’t figure out how to grow his business without sacrificing family, income or time.

Armed with an insatiable curiosity, Jamey invested the next 9 years and over $300,000, to learn how to free himself from his practice. At the end of his journey, Jamey finally discovered the formula to creating a self-managed, profitable and stable practice that allowed more time with his family and more time to work “on” his business.

Jamey is sharing his practice freedom methodology to practice owners all across the country who are looking for financial prosperity and a better quality of life. His book, The Practice Freedom Method: The Practice Owner’s Guide To Work Less, Earn More, And Live Your Passion, has been an Amazon #1 best seller.

 

Resources discussed on this show:

Jamey's FREE training on howto generate referrals

The Practice Freedom Method Website

Jamey Schrier Twitter

The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change

Start with Why

The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing

Free online community for NetHealth

Email: jamey@jameyschrier.com

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart! 

 

Xo Karen

 

 

Jan 10, 2019

On this episode of the Healthy Wealthy and Smart Podcast, I welcome Jeanette Bronée on the show to discuss mindfulness.  Jeanette helps leaders and companies rethink performance by asking the “Right Why®.” She teaches them how to create a culture of care by unlocking what truly drives performance, engagement and motivation from the inside out. For 15 years, she has coached clients and delivered speeches about how physical health and emotional-mental wellbeing affect performance and prevent stress and burnout. She shows how focusing on how our mindset affects our self-care habits at work and at home and believes, that when we leave our humanity at the door when we go to work, we leave behind our most valuable resource for success. She incorporates her background in integrative nutrition, mindfulness and hypnotherapy to help people work better by working healthy.

In this episode, we discuss:

-How to ask the right why to find a way forward

-Practical exercises to ground yourself in stressful situations

-The use of metaphors to describe experiences

-How mindfulness can facilitate change

-And so much more!

 

“If we can refocus our question, then our unconscious mind will help us find the answer.”

 

“We find solutions by acknowledging what’s not working and then moving into curiosity.”

 

“If we don’t pause for a moment, we can’t even listen.”

 

“We’re not running out of time, we’re running out of focus.”

 

“We don’t solve problems in a new way under stress, we just repeat what we’ve always done.”

 

“Our self-talk really creates our experience.”

 

For more information on Jeanette:

When Jeanette Bronée’s parents both died of cancer just one year apart, she was told it wasn’t a matter of if, but when she would get cancer, too. So she took charge of her health and wellbeing, sharing what she learned about the power of mindfulness by founding Path for Life in 2004. Since then, she has taught more than half a million people how to ask the “Right Why” to unlock the answers that prevent burnout, fuel peak performance and create a culture of care.

Now, she helps leaders and companies rethink performance and culture to create sustainable success by supporting our most important resource -- our human resource. She has delivered TEDx talks, as well as keynote speeches and workshops at corporate events and workshops around the world.

Her book, EAT TO FEEL FULL, a guide for eating to thrive, gained nationwide recognition in the news media as a new approach to health and eating that helps us break with our dieting mentality and focus on eating to fuel our performance. 

She holds a business, marketing and communications degree and is a certified Integrative Functional Nutrition and Meta-Medicine Health Coach. As a Hypno-Therapist, she uses the power of the mind to create change (but don’t worry she doesn’t do tricks). She is also a Certified Felt Sense Focusing Professional, which she has found to be the key to learning what drives our choices and how we can take charge of our wellbeing.

 

Resources discussed on this show:

Path for Life Website

Jeanette Bronée Website

Jeanette Bronée LinkedIn

Jeanette Bronée Twitter

Free Gift: Use code “Healthy” for 30% off the yearly online program Get Healthy Online

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart! 

 

Xo Karen

 

 

Jan 7, 2019

Happy New Year from the Healthy Wealthy and Smart Podcast family! On this episode, I welcome Shanté Cofield on the show to discuss how to set achievable goals for 2019.  Dr. C. Shanté Cofield, aka The Movement Maestro, is a former Division I athlete with a passion for movement surpassed only by her passion for learning. Shanté graduated from Georgetown University and then continued her educational pursuits at New York University, graduating with a Doctorate in Physical Therapy (DPT) and becoming a Certified Strength and Conditioning Specialist (CSCS). Shanté is a board certified Orthopedic Clinical Specialist (OCS) who practices in Los Angeles, California with specialties ranging from CrossFit injuries to pelvic floor dysfunction.  Shanté is the creator of The Movement Maestro, a website and social-media based platform devoted to all things human movement and mobility related.

In this episode, we discuss:

-The importance of understanding the why behind a goal before setting the goal

-Why boundaries are important to set before pursuing your goals

-How to bring human connection into social media

-Building a supportive community that will serve you

-And so much more!

 

“People don’t know how to set goals.”

 

“We tell our patients all the time you have to be patient, and yet we don’t apply that to ourselves.”

 

“What social media has become is another language –it’s another way to connect with people.”

 

“We don’t attract what we want, we attract what we are.”

 

“You have to be ok with the fact that not everyone is going to love you.”

 

“If you’re selling something—you’re marketing—you have to push it more than you want to.”

 

For more information on Shanté:

So, this is the place where it’s standard practice to give you a sterile glimpse into my professional life and hopefully convince you that I’m qualified enough for you to let me treat you. But, you should know, I’m anything but traditional. Before you keep on reading, I’d love it if you could take a few moments to watch the video from the home page (if you haven’t already) and learn a little bit about me. I know that four minutes is a lot to ask of someone in 2018, but, that video IS me.

I’m a firm believer that everything in life is about connection. As it relates to our bodies, we are a united whole, with all the parts working together and affecting each other, and as such, that is how I treat. As it relates to the universe, we are all connected in some way, be it blood, physical proximity, belief systems, or energy. And as it relates to choosing a provider, choosing to listen to a podcast, or choosing to attend a course, I believe that it is paramount that you are able to connect with that person. As such, I teamed up with a close friend to film something that I felt would give you a better understanding of who I am, what I’m about, and hopefully make you realize that I am an actual person, not just a picture on a screen, a voice in your headphones, or words on a piece of paper. 

BUT FOR THOSE OF YOU WHO STILL WANT THE INSIDE SCOOP, HERE’S THE RUNDOWN:

Hometown: Summit, NJ

High School Sports Played: Soccer, basketball, lacrosse, ice-hockey (for real), javelin

College: Georgetown University (’07)

Sports Played: 4 years of Division I soccer, rugby (1 season)

Graduate School: New York University

Date Graduated: 2010

Degree Earned: Doctor of Physical Therapy

Additional Certifications:

OCS – Orthopedic Clinical Specialist

CSCS – Certified Strength and Conditioning Specialist

CF-L1 – CrossFit Level I Trainer

SFMA – Selective Functional Movement Assessment Provider

FMS – Functional Movement Screen Provider

FRCms – Functional Range Conditioning Mobility Specialist

NKT – NeuroKinetic Therapy (Level I) Provider

FMT B/P/B/A – RockTape Basic/Performance/Blades/Blades Advanced Certified (I am a RockTape Lead instructor, I had better be certified in all these things!)

Other Hobbies and Activities: CrossFit, ex-marathoner, indoor rock-climbing, professional meme viewer, guitar, sneakerhead, SoCal lover

So, if you’ve made it this far, I commend you. I’ve got my fingers crossed that if you didn’t know anything about me before, you’ve now got enough to formulate some kind of picture and make a decision about our future together. Be nice. If you want to rendezvous, contact me. If you want to hear me talk, subscribe to the podcast. And if you want to be like Aerosmith and never miss a thing, subscribe to my newsletter. Thanks for your time.

 

 

Resources discussed on this show:

The Movement Maestro Website

The Movement Maestro Instagram 

Email: shante@themovementmaestro.com

Maestro Courses

Rocktape Courses

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart! 

 

Xo Karen

 

 

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