Healthy Wealthy & Smart

The perfect combination of healthcare and business! At Healthy Wealthy & Smart, we interview THE top experts in the fields of medicine, physical therapy, fitness and entrepreneurship to allow you to increase your health, increase your wealth and live your best life.
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Now displaying: May, 2019
May 30, 2019

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Megan Rigby on the show to discuss how she found success with her online nutrition and fitness consulting. Dr. Megan Rigby is a doctorate prepared pediatric GI Nurse Practitioner, IFBB Figure Pro, blogger, macro lover and online coach. She is on a mission to help others become fit, healthy and happy.

In this episode, we discuss:

-How Megan started her side hustle and when she decided it was time to leave her corporate job

-The pro’s and con’s of being an online entrepreneur

-The importance of vulnerability and integrity on social media

-And so much more!



Macro Mini Website

Macro Mini Instagram

Megan Rigby Twitter

Macro Mini Facebook

Macro Mini You Tube


For more information on Megan:

Megan Rigby is a Doctorate-prepared GI Nurse Practitioner, Certified Nutrition Consultant, IFBB Figure Pro, and Owner of MacroMINI. She is passionate about educating others through her coaching, as well as publicly speaking on topics surrounding food, fitness & healthy mindset. Megan has helped hundreds of people experience great physical and overall lifestyle changes. She is on a mission to empower others to become healthier, happier versions of themselves while still enjoying food as one of life’s simple pleasures.  In 2018, Megan left a corporate position as a Digestive Nurse Practitioner to open her own coaching business & has made over 400k+ within her first year. Megan has been featured in Oxygen & Strong magazines as a content creator, along with appearances on News Channel 12. She has been recognized as a top industry leader within her community.


Read the full transcript below:

Karen Litzy:                   00:01                Hi Doctor Megan Rigby, welcome to the podcast. I am happy to have you on.

Megan Rigby:                00:06                Thank you so much for having me. I'm excited to do this with you today.

Karen Litzy:                   00:10                Yeah. And so what we're gonna do is we're going to talk about your sort of entrepreneurial journey, your business story, because, as I said in the intro for you, you are a doctorate prepared GI nurse practitioner and a nutritional consultant and a whole bunch of other stuff. But, something that I think the listeners of this podcast can relate to is there's a lot of healthcare workers, things like that who are listening to this podcast who maybe have started their careers in a hospital and clinic, but maybe you want something a little bit more. So I would love for you to kind of share your story of how you made that transition from, I love that you say you were like a corporate girl in a hospital or clinic, but when you're in healthcare, that's kind of the equivalent. So go ahead and tell us your story. How'd you do it?

Megan Rigby:                01:03                I never planned on being an entrepreneur having my own business. That's just not something I ever saw in my future. My Grad program, I had focused on family and childhood obesity. It was my dissertation. I love health and nutrition. I think it's the preventative to a lot of health care. So I always tried to teach all my clients that, but I started to get frustrated a few years in just because working for corporate, you're kind of inside a box. And I think there's a time and place for complimentary medicine and modern medicine and sometimes that can be hard when you're working for a hospital. And so I started having more and more people talking to me on the side about health and nutrition and fitness and people would just start asking, Hey, can you give me an advice? Give me tips and I'll pay you. And so slowly I started doing nutrition plans and education on the side.

Megan Rigby:                02:05                And over time I was able to build it into an online business. I realized that my limitations that I have within the clinic are able to actually be kind of removed online. I get to spend more time with my clients, educate them, and truly provide a service that's unique to them. So with time it took probably, I mean two years I was doing a lot of my own online stuff, while working full time in clinic. And then I gradually dropped down to more of a part time position once I started picking up online. And then within the two years I was actually able to make more than what I was making clinic with the online business and I transitioned over and I left September 2018 and now I run my own company doing health, fitness and nutrition.

Karen Litzy:                   02:57                And I would imagine that there are pros and cons to this. So I'm just going to name one pro and one con. Right. So the pro, obviously you can probably help more people with online programs. Con would be, do you miss having that person sitting in front of you?

Megan Rigby:                03:16                I do. I missed that. But the beautiful thing about online is you can still do zoom calls face to face. So there is still that where you can talk to them. So almost like a telehealth. I would say one of my biggest cons is when I used to leave the clinic, it was kind of like my work was done. Like my charts were done, I was done seeing patients. Now, I feel like I'm on a lot more so my day doesn't end nine to five. I work a lot more around the clock. I feel like, and that's something I'm still trying to work on as a new entrepreneur.

Karen Litzy:                   03:50                Yes. And that is absolutely true. I think a lot of people when they think I'll just start my own practice, they think you can leave it at the door when you leave, but you cannot. You're always doing something. I mean, there are times like last night it was midnight and I'm working.

Megan Rigby:                04:09                Yes. It never goes away because it's now your business, you're responsible for everyone you're taking care of and you're responsible for bringing more clients in. And so definitely you work, I think a lot more being an entrepreneur, but at the same time you have more freedom, which is nice.

Karen Litzy:                   04:26                Yes. You have a little more flexibility, you have a little more freedom. So there's pros and cons to all of this. But let's start, how, if you can get even a little more granular into your kind of transition from hospital to on your own. So my first question is how did you have this conversation with your employer? That's a question I get asked all the time.

Megan Rigby:                04:51                Yeah. So I think you have to just be honest about it. And that was something that they knew that I loved the nutrition aspect of things. I love being able to teach and spend more time. So when I went down to part time, you know, I let them know that I was, you know, on my side I was, you know, just educating and teaching people about nutrition and health. And that was not going to interfere with my job. And I think that's the biggest thing. If you can, you know, let them know, reassure them that you're not letting it interfere with your work and how you come in every day and interact with your patients there that you know, helps them as well, as well as not ever taking any of the businesses patients.

Karen Litzy:                   05:37                Of course I think we say that of course, but maybe people do. I don't know.

Megan Rigby:                05:46                Yeah. And that was something where it's kind of drawing, you know, a line in the sand and making sure that both of the jobs stayed away from each other and they never came together. And I think that's something that a lot of people have to remember. Like I would love to have been able to work at work, but you can't do that. I mean, I came home at night and I saw my clients from online at night and there was no crossing that during the day at all when I was clocked in and I was being a nurse practitioner in the clinic.

Karen Litzy:                   06:13                Yeah. And I think that's great advice. And it's just dry and clear boundaries for yourself and also being respectful of your employers.

Megan Rigby:                06:21                Yeah. Because in the end, if you decide to go back to clinic, you need recommendations and burning bridges is not something you want to do because who knows? I mean the venture that we have or I have, it may, may die down one day and I do need to go back to the clinic. So I never want to slam that door shut because it provided me so many opportunities.

Karen Litzy:                   06:42                Absolutely. And I remember when I left the physical therapy clinic I was working at, it was really hard to do because I really loved working there. But they now refer patients to me and I refer patients to them. Right. So it's like you don't want to burn those bridges because guess what, they can help you and you can help them. And I think you want to really make this a win, win for everyone. So you have this conversation with your employer, they're understanding, you go down to part time for you, what was, if you can describe kind of the hours worked in clinics or are you down to like 20 hours a week or less and obviously we know you're working then on the online part, but what was the breakdown for us?

Megan Rigby:                07:33                They let me go to three and a half days a week, which was nice. And so that was considered more of a part time position there. So I worked Monday, Tuesday, Wednesday, and then half day Thursday and I was off Fridays. So I would make sure that all my check ins and my main communication with my clients would be on the weekends. That works best for me. So Thursdays I would do all of my prep when I got off work. And then Friday, Saturday, Sunday, those were my days that I was really able to devote to the actual online business and evenings whenever I, you know, was able to after work I would come in home and I would do what I needed to do. But otherwise it was an 8:30 to 4:30 Monday through Thursday, half day.

Karen Litzy:                   08:21                And since going completely on your own, do you give yourself a schedule? Because it must be difficult, right?

Megan Rigby:                08:28                I'm still close the computer when there's still work to be done and I always want to make sure that everyone is getting the, you know, service and communication that they deserve. And I think that just comes from being a healthcare professional that you know, you want as much time devoted to each and every client. And so it can be hard to kind of turn that off and feel like you still have unanswered questions or things going on.

Karen Litzy:                   08:59                Yeah, there's no question. And again, that's where kind of setting boundaries for yourself comes in handy or making sure that you know, you have scheduled times that you're working even with the online clients and that they know that. Not that they're taking advantage because I don't think they are, but if you allow yourself to be available 24 seven then guess what, people will take you up on that offer.

Megan Rigby:                09:27                Yeah. So it is, it's creating boundaries too. And that's what I have learned. It's been hard, but yeah, working, you know, maybe nine to like four and allowing lunch in there, is something that I'm striving to be more consistent with. But it is nice because if you have appointments, you know, you can schedule those in and that's where the flexibility has been really good. But also drawing the line of when you kind of cut it off at night.

Karen Litzy:                   09:52                Yeah, absolutely. And now how do you advertise? How do you market yourself?

Megan Rigby:                09:56                So social media is kind of where it's all at, as exhausting as it can be. I have, you know, my page and that's where a lot of people find me word of mouth has been the biggest thing and I value that the most. I think if people can refer other people to me because they've had great experiences and outcomes, that's where I've actually gotten a lot of my clients. I don't really do a lot of paid advertisement or anything right now. Like I said, it's just word of mouth and then making sure people who do follow me or start following me understand, you know, where I'm coming from and really being open and vulnerable on social media so everyone kind of knows who I am and there's no hiding.

Karen Litzy:                   10:44                And what advice do you have for the listeners on how to be vulnerable? Because that's hard.

Megan Rigby:                10:50                It is really hard.  I think it's just to be true to you and stand by what you believe in and how you practice. And provide honest, you know, education, advice and share yourself I think with people has been the hardest thing because a lot of people will look up to healthcare professionals, you know, and think that there may be on a pedestal or something. And I think making yourself relatable is the most important thing because we're all humans and so we all have struggles as well. And I think putting those out there so people can relate to you is going to bring more clients in and more, you know, followers as well.

Karen Litzy:                   11:30                Okay. So how do you make yourself more relatable? Because isn't social media is supposed to be like, it's your highlight reel. We don’t want to show people that we have any problems. Right.

Megan Rigby:                11:40                With me, it's a pretty easy with the nutrition and the fitness and health because I think, you know, as a female we struggle with appearance. We struggle with, you know, day to day eating healthy, making the right choices, preparing food for our family. So I can relate to a lot of that. You know, I've had my own insecurities and I'm not perfect every day with how I eat. There are days that I want to go to dairy queen and have a blizzard. So I'm able to really relate to people in that spectrum and then talking about, you know, different health issues that so many of us women struggle with and it can affect how we lose weight and really making sure that we stay on top of those. So whenever I talk about something, I try to draw in my past experiences with it and I think that usually helps a lot.

Karen Litzy:                   12:28                Yeah. I think that's really good advice. And what would you tell people who maybe have these great stories and we know this is what you should do to kind of get people to get to know you, like you and then eventually right purchase from you. Right. What if you're scared to put yourself out there? Like how do you overcome that fear?

Megan Rigby:                12:53                I think you have to jump in with both feet. Like if you are truly passionate about starting a business, that's vulnerable in itself and then putting yourself out there on social media. Like you just have to realize that people are gonna love you or hate you. And as awful as that sounds, it's the truth. I mean, people are going to be drawn to you. So just jumping in and sharing it, whether it's just the writing at first. I know a lot of people are camera shy, so sometimes they say like blogging at first is really good. Or just sharing it on your Instagram through words, before going into any of the videos or anything like that. Even you know what sharing with your family sometimes too because you can be vulnerable with them and getting feedback sometimes can be a little bit comforting if you're not ready to just jump.

Karen Litzy:                   13:40                Yeah, I think that's great advice kind of sharing with friends and family are sharing within a trusted circle.

Megan Rigby:                13:47                Before it's scary. You're going to get judged. That's human nature I feel like so people will judge, but people also will be able to relate to what they hear from you. And those are the people you want following you and interacting with you.

Karen Litzy:                   14:05                Yeah. And do you have any sort of memorable comments or notes or things that people have sent to you that have stood out because you've been a little bit more open?

Megan Rigby:                14:17                Yeah. So when I do stories I try to talk about topics that have affected me recently. I usually always try to keep things kind of close to my heart. And so when people message me and say, oh my gosh, I needed this today. It's been such a struggle, like it, it's so nice to know someone else's out there going through it with me or I appreciate the advice. So those things always help to kind of reaffirm like there are people listening and what I am saying is holding others. So, you know, it makes me want to keep doing that more and more.

Karen Litzy:                   14:52                Yeah. I love getting those notes. I think it's so cool. And I always think to myself, Gosh, you never know who's watching, sitting, listening. You just don't know.

Megan Rigby:                15:01                Cause you're always impacting someone. There's always someone out there watching and listening. Like she said, you never know. So if it's something you're passionate about, something you love and you want to be heard, then it's worth sharing.

Karen Litzy:                   15:15                Absolutely. I agree. 100%. We’ve been talking that you're in that nutrition, fitness realm, very crowded field. Every time you turn, everywhere you look, someone is talking about nutrition, whether that be good or bad evidence based or not. It's out there. So what advice do you have to stand out amongst all this competition? Because I'm sure it can be applied to almost any industry.

Megan Rigby:                15:49                It can. I always say be true to you. So whatever you believe, stay with that. It's so easy to get into the comparison game of you know, what they're doing or you know, this is the new trend, but you have to do your own research. You have to believe in what you believe in and talk about that. I think that's the most important. So many people in the fitness industry just jump from one trend to another. And so it's whatever the hottest topic is. And I think when it comes to, you know, this industry, you have to really stay true to the basics and what is science saying and what you believe in. Because if people hear it consistently and they can expect the same thing from you, which is the honest truth in what you believe in, they will trust you. It's the people who kind of jump all around that, you know, you kind of start to say, Hey, wait, last week you were talking about this. And that was the best thing there was. So that's what I found is people, they expect the consistency from me and they know that I believe in what I'm talking about.

Karen Litzy:                   16:52                Yeah. So not jumping on the bandwagon every time something comes out, but rather look at it critically.

Megan Rigby:                17:00                And not comparing yourself. I think that derails a lot of us is when we start to look at what other people are doing in the same field and we feel like we need to mimic that or we need to jump on that. And that can be very distracting too.

Karen Litzy:                   17:20                But it's so hard.

Megan Rigby:                17:24                It is so hard. I do my best actually not to follow a lot of people in my industry. I'll follow the people who I think provide me motivation, but if there's anyone who evokes jealousy, or you know, kind of gets under my skin, I figure that's negative, you know, vibes and I don't need that. So I really tried to just stay with the people who motivate me the most. I think social media should be a positive outlet. And it's so easy to make it negative. And I really tried to avoid that.

Karen Litzy:                   17:58                Yes. As a matter of fact, I'm part of a Oxford debate in a couple of weeks at a physical therapy conference. And so the debate topic is social media and it is, we believe that social media can be hazardous to the profession of physical therapy. And you know, people will argue in favor of that and against that and that can easily go either way. But in the end it's a tool. It is a tool and it's not the tool, but it's the user.

Megan Rigby:                18:36                It is. It's how we allow ourselves to use social media. No, I agree. I'm curious to hear how that goes. So I hope you will talk about that.

Karen Litzy:                   18:48                I will talk about that. I'm curious to see how it goes to, I hope it goes well. I'm a little nervous about it, but I think it's supposed to be this like fun debate, like lively, fun and funny. But you still want to win the debate of course. So we'll see what happens. So is there anything else about kind of your entrepreneurial journey that you really want people to learn from?

Megan Rigby:                19:13                I think starting small, and a lot of people when they tried to start a business feel like they have to dump a ton of money into it. And I've learned that you don't, with starting small and using the skills that you have, you're actually able to start a business that may, you know, not be as profitable as you want in the beginning with time you can reinvest that money you make back into it without taking up such a huge loan in the beginning, especially when it comes to the online type of business. I think there's so much that we can do on our own before we have to really start spending money. And I think that's something that, you know, a lot of new entrepreneurs who are wanting to go the online business, just have to remember that it doesn't take a ton of money to get up and going and get clients. It just takes, you know, the passion and the time and the knowledge.

Karen Litzy:                   20:09                Yeah, absolutely. And I have one more question for you. The question that I ask everyone and that is knowing where you are now in your life and in your business, what advice would you give yourself, not to someone else, but what advice would you give to yourself at like the day you graduated and we'll say with your doctorate, why not? Because you’ve got like advanced degrees here. So let's go with the doctorate. What advice would you give to that gal?

Megan Rigby:                20:40                Okay. My advice would be to not change anything, to enjoy the ride and kind of allow it to take you where it's going to take you. Because there are times that I wondered, you know, why was I where I was and what I was doing and it all led me here. So I think the biggest thing is enjoy the ride. So often we keep wishing the years away and if only I was here, if only I was there. But every step and every moment you have is leading you to where you really need to be.

Karen Litzy:                   21:09                Very nice. It's like that sounded like from Game of Thrones and that's not a spoiler or anything for anyone listening. If you haven't seen the finale, it's not a spoiler, but that was very Bran like of you, it was great. Now where can people find you if they want to get in touch with you, if they want to work with you, they want to follow you. Where can they go?

Megan Rigby:                21:36                Yeah. So on Instagram, I'm macro_mini. And then why a website is

Karen Litzy:                   21:47                Awesome. And just so in case you know, you don't have a pen and paper and you're not taking notes right now, like I am, you can go to We'll have all the links, one click will take you right to all of Megan's info so that you can get to know her, like her, trust her, and work with her. So Megan, thank you so much for coming on and sharing your journey. I think it will give a lot of people in health care a bit of a boost, maybe a little kick in the butt too, and the confidence to go out and kind of do what you're doing.

Megan Rigby:                22:23                Thank you. I appreciate that. And thank you so much for having me on.

Karen Litzy:                   22:26                Yeah, my pleasure. This is a great conversation and everyone who's out there listening, thanks so much. Have a great couple of days and stay healthy, wealthy, and smart.



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!

May 27, 2019

LIVE from the WCPT Conference in Geneva, Switzerland, I welcome Christina Le on the show to discuss youth kinesiophobia following knee injury in sport. Christina Le is a PhD candidate in Rehabilitation Sciences in the Faculty of Rehabilitation Medicine at the University of Alberta in Edmonton, Canada.

In this episode, we discuss:

-What is kinesiophobia?

-Preliminary results from the University of Alberta research team focused on prevention of early onset osteoarthritis

-Why clinicians should address kinesiophobia early and often in rehabilitation to minimize poor long-term health outcomes

-And so much more!



Christina Le Twitter

World Congress of Sports Physical Therapy 2019

Tampa Scale for Kinesiophobia


For more information on Christina:

Christina Le is a PhD candidate in Rehabilitation Sciences in the Faculty of Rehabilitation Medicine at the University of Alberta in Edmonton, Canada. As a clinician, she frequently treated athletes with anterior cruciate ligament (ACL) injuries. This experience has motivated her to pursue research to better understand health-related quality of life (HRQOL) following a sport-related knee injury in active youth. Her research include identifying what factors impact youth HRQOL during rehabilitation and developing strategies to improve long-term HRQOL.

Christina continues to work part-time as a physiotherapist at the Glen Sather Sports Medicine Clinic. She treats patients on weekends, participates in multidisciplinary clinics with sport medicine physicians and orthopedic surgeons, and teaches an ACL rehabilitation group class called the Functional Agility and Strength Training (FAST) Program. Find her on Twitter as @yegphysio or online at


Read the full transcript below:

Karen Litzy:                   00:00                Hey everybody. Welcome back to the podcast. I am coming to you live from Geneva, Switzerland at the WCPT meeting and right now I have the distinct pleasure of sitting across a table from Christina Lee. She is a PhD candidate at the University of Alberta and she's also a physio therapist. So Christina, welcome to the podcast. And today Christina did a wonderful platform presentation on Kinesiophobia after knee injury and we're going to definitely get to her study on that. But before we do, Christina, can you tell the listeners what is kinesiophobia?

Christina Le:                                          So kinesiophobia is taken from the chronic low back pain literature and has been applied in our knee injury population as well. And it's an excessive and irrational fear of movement due to feeling vulnerable to pain or reinjury.

Karen Litzy:                                           And so now let's get to your study. So what I'll have you do first is maybe tell us why you thought this was an important thing to look at.

Christina Le:                  01:02                Yeah. So I think after knee injuries in sport, knee injuries in particular, and we're looking more at our youth, we know that there are a ton of different consequences that happen after knee injuries and they spend the physical, psychological and social domains of health. And this is just one that hasn't been studied to great length in our youth athletes in particular. And it's something that I think can contribute to poor long term health outcomes because it's the most common reason for kids quitting sport after they get injured. It's related to physical activity. So it's something that maybe we can manage a little bit better as clinicians and moving forward to help out with better long term outcomes.

Karen Litzy:                                           Right. And that sort of lack of return to activity, lack of return to sport can, like you said, have long term outcomes. So we know that inactivity can lead to obesity and childhood diabetes and a lot of downstream consequences.

Christina Le:                  01:58                Yeah, exactly. Posttraumatic osteoarthritis is probably one that’s stuck in my head right now. Just coming from the International World Congress as well. And we know that that can affect almost up to half of our youth injuries that have a knee injury as well.

Karen Litzy:                                           All right. So let's break down the study for us. So I will just have you kind of take it away and talk about the study now that we know the why behind it. Go ahead.

Christina Le:                                          Yeah, so we are currently running an ongoing prospective cohort study at the University of Alberta. It's a part of the prevention of early onset of osteoarthritis research group, I guess that was initiated out of the University of Calgary. And we're looking at youth athletes aged 11 to 19 who have sustained a sport related knee injury. So tibial femoral Patella femoral injury within the last three months. They had to have seen a physio therapist, a doctor or some sort of medical professional and had to have missed at least one session or one game from their sport to be considered injured.

Christina Le:                  03:02                And then we're comparing them to age, sex and sport match controls. I'd say kind of 75% maybe through our study right now. And so this study that I presented on today is just a preliminary analysis of what our baseline data was. And what we were looking at was self reported kinesiophobia. So using the Tampa scale for Kinesiophobia and its influence on bilateral knee strength, using isokinetic dynamometer and triple single leg hop and Y balance test.

Karen Litzy:                                           Okay. So those were all of the things that you are looking at, that's the data you are collecting? All right. Before we go on, I think most people know what a single leg three hop test is and the Tampa kinesio phobia scale you can look up, but can you talk about what the Y balance test is really quick just so people have a frame of reference as to what you're doing?

Christina Le:                  03:53                Yeah, sure. So the Y balance test is we ask our participants to stand on one leg, hands on hips, so they can't use their upper extremity to help out with their balance. They're reaching as far anteriorly as they can while standing on one leg. And then they also do a posterior lateral and a posterior medial reach as well. We do three trials and we take the average of the three direction reaches. So one point they're planted on the injured or the index side and then the other time they're on the other side.

Karen Litzy:                                           Perfect. All right. So continue. Now we know what you're measuring. We know who you're measuring. So now let's talk about how?

Christina Le:                  04:41                So we are looking at our mean within paired differences.  So we take our injured scores, we subtract them from our uninjured scores in terms of study groups, and then we're just looking at the differences between the two groups on all those variables listed. And then we're also running a logistic regression model that's accounting for our match design. So it means that we are looking at the odds of scoring higher than 37 on the TSK. And we're looking at if there's a difference between our injured in uninjured groups in scoring higher or lower than that 37 and the 37 is based off of chronic low back pain literature where a study dichotomize their participants based on high fear responders are low fear responders based on that TSK score.

Karen Litzy:                                           Right. And just so people know, the lower your score on the TSK, the less kinesiophobia you have and the higher score, the more kinesiophobia you are experiencing.

Christina Le:                  05:39                Yeah, exactly. So I always say TSK is like a golf score. So higher scores worse lower scores better. And then we're also running separate multivariable linear regressions as well. So effectively looking at the Association of TSK on strength or triple single leg hop or Y balance.

Karen Litzy:                                           Okay. And what did you find with that analysis?

Christina Le:                                          So what we found was with our mean within pair differences, so when we're looking at our injured versus uninjured groups, just based on these variables alone, that the injury group scored on average about eight points higher on the TSK than the uninjured, which means that they are reporting greater kinesiophobia or higher kinesiophobia as you said. And they're also scoring lower on strength, which isn't maybe the most surprising finding considering they've just been injured. So we're testing them on a median of six weeks after injury.

Christina Le:                  06:39                With our odds ratio where we found that the odds of scoring higher than 37 on the TSK was about 10 times greater for the injured group than the uninjured groups, which again, just means that they're more likely to be kind of in that high fear responders group. And then with our multivariable regression, we found that there is an association between our TSK scores and our knee extension strength bilaterally and actually flexion strength bilaterally as well. The differences or the relationship strength itself isn't the strongest. So if we have a one unit increase in our knee extension strength on our injured side for example, it just corresponded to a 0.1 decrease in the Tampa scale for Kinesiophobia, which is a minor change.

Christina Le:                  07:40                It's probably not something that we can detect in all honesty or that's clinically relevant, but just tells us that there is some sort of association between Kinesiophobia and strength.

Karen Litzy:                                           Got It. And so we know the results of your findings. What are your recommendations? What conclusions did you come to as a result of this study?

Christina Le:                                          Yeah, so I think the two big take home messages is that kinesiophobia is present as early as the three months leading up to or after an injury. I think as clinicians we generally tend to look at this closer to the return to sport end of the spectrum of Rehab. But it's something that might be early, as our present, as early as three months. So we should be dealing with it as early as three months. And that it's potentially something that might affect both sides of the body as well.

Christina Le:                  08:28                So if you've had a right knee injury, doesn't mean that you don't necessarily have kinesiophobia on that left knee as well. So it's just trying to get clinicians to think maybe a little bit more bigger picture here and that I think ultimately if we can address kinesiophobia early after an injury, then potentially we can set people up for more physically active lifestyles, that sort of thing. And then hopefully help out with that reduction of those poor long term negative health consequences.

Karen Litzy:                                           And so as a practicing clinician, so let's say I am seeing a, just making this up off the top of my head this is not a patient I have I swear, I am seeing a 16 year old boy who plays Lacrosse and let's say he will use a term sprained his knee, maybe let's just say it's an ACL strain or sprain.

Karen Litzy:                   09:22                So not a tear doesn't need surgery. So they're coming to me, should I be using the Tampa scale on the first visit that I see this person? Or do you wait for a little bit further down the line?

Christina Le:                                          I don't think it hurts to be using that right away. I think that what these individuals with knee injuries or any MSK injury, realistically they might be fearful of different things at different times in their rehab. And I think picking that up early on might be able to detect that, oh, maybe he's scared of going downstairs or something like that. Whereas later stage Rehab, maybe it means that he's a little bit more fearful of changing directions with contact around. I don't think it hurts to necessarily use that Tsk early by any means.         

Karen Litzy:                   10:13                Okay, great. So that's a nice take home for the clinicians listening that hey, this is easy. It's simple, it's free. You can get it online and just have your patient fill it out and it’s easy to score. We just heard if you're over 37, maybe that's something to worry about. The lower the number, the less kinesiophobia. So it's something that we can easily incorporate as clinicians with youth knee injuries. Can this be extrapolated to other injuries outside the knee and let's say the back?

Christina Le:                                          So the tricky part with the TSK is that it actually hasn't been validated for knee injuries yet. So it's hard to say is this something that we can use in other areas? I'd really think that there is a need to validate this tool or if it's not, then to generate a tool specifically for knee injuries.

Christina Le:                  10:59                Cause I think it's something that we discuss a lot as researchers, as clinicians with our patients. So for now I guess it's the best tool that we have but it doesn't mean that it's necessarily the right tool yet.

Karen Litzy:                                           Yeah. Well something to add to your list. Get Jackie Whittaker and get your team together. And that's another study you can do because you have the time. Right?

Christina Le:                                          Totally. Really hoping to bring on Doctor Johanna Krista at some points on this topic as well. So I think she's a good one to look at if you're curious about the kinesiophobia stuff in our knee injured population as well.

Karen Litzy:                                           Awesome. And then because you said you're about 75% through the study of preliminary data. Where do you see this going?

Christina Le:                                          So in the grand scheme of things for my own PhD, I'm going to be using this data to look at more health related quality of life in our young adults and our young athletes with sport related knee injury.

Christina Le:                  11:55                I'm a big proponents of kind of that bigger picture. So again, I think as clinicians, we're really honed in on the whole return to sport thing as are our indicator of successful recovery. And looking at the literature, we know that only 66% of people return to their pre injury sport at the pre-injury level. And we don't really have great numbers for anything past probably two or three years either in terms of sport participation. So are we may be selling our patients short if we're only focused on that one thing as recovery versus again, kind of thinking bigger picture. Can we set them up in terms of physical health, psychological health, in terms of Kinesiophobia specifically, social health as well, so that they are able to maintain these healthy, active lifestyles, avoid osteoarthritis, avoid obesity, all that kind of stuff.

Karen Litzy:                   12:47                Awesome. Well it sounds like you have big plans and I think it's only going to help clinicians and help the young athletes and young adults and teenagers and tweens that we treat on a regular basis. So thank you for your work. And now I have one more question. I probably should have told you this ahead of time, but I didn't cause I forgot. But the question is knowing where you are now in your career and in your life, what advice would you give to yourself as a new Grad out of physio school?

Christina Le:                                          I would've said seek mentorship early and often. I think it took me a long and windy road to kind of get where I am and in all honesty, that's probably made me who I am now as well.

Christina Le:                  13:32                But I think it would've been great to have maybe a little bit early on into my career as a new Grad, a little bit more mentorships with somebody or some people to kind of cling on to more or less to have a little bit of guidance in terms of what I should be doing, where I should be focusing my efforts on and spending my energy on.

Karen Litzy:                                           Awesome, great advice. Now, where can people find you?

Christina Le:                                          I am a on Twitter, I'm @YegPhysio, Yeg is the airport code for Edmonton, Canada. So that's why I'm that. And that's pretty much the only thing I'm active on in tems of social media for professional stuff. So, yeah.

Karen Litzy:                                           Perfect. Well, thank you so much for taking some time out of your schedule here at WCPT to come on the podcast.

Christina Le:                  14:17                Thank you so much. I'm going to throw a quick plug in for the world sports physiotherapy Congress in October in 2019 I'm hoping that all of you guys are going to be there cause we are going to be there. So you should have a lot of fun of you'll come.

Karen Litzy:                                           Yes. And it's in Vancouver in and around that first weekend of October. Yes, the lineup looks fantastic and even if you don't work with a sports specific population, you can take all of this information and you can pair it down or you can pair it up to the population that you're seeing because it's all about concepts. It's not necessarily sports specific.

Christina Le:                                          Yeah, exactly. I think it's something that's going to be useful for every MSK general practitioner out there. Whether again, yeah, you're in sport or not so highly, highly recommended. Yeah, you guys should all come out and hang out.

Karen Litzy:                                           Yes, absolutely. We will both be there and I'm definitely looking forward to it. So, Christina, thank you again and everyone, thanks so much for listening. Have a great couple of days and stay healthy, wealthy, and smart.


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!

May 23, 2019

LIVE from the WCPT Conference in Geneva, Switzerland, I welcome Daniel Board on the show to discuss torture-survivors’ experiences of healthcare services for pain.  Daniel Board is a Specialist Pain Physiotherapist working in a pain management clinic at Chelsea and Westminster Hospital in London, UK. Clinically, he helps people with a variety of persistent pain conditions and has a special interest in refugee healthcare.

In this episode, we discuss:

-Torture-survivors' experiences of healthcare services for pain

-The importance of the patient-clinician relationship and communication skills

-How to avoid burnout when servicing this patient population

-And so much more!



Daniel Board Twitter

Chelsea and Westminster Hospital  


For more information on Daniel:

Daniel Board is a Specialist Pain Physiotherapist working in a pain management clinic at Chelsea and Westminster Hospital in London, UK. Clinically, he helps people with a variety of persistent pain conditions and has a special interest in refugee healthcare. Daniel is also an early career researcher and recently conducted a qualitative study investigating torture-survivors’ experiences of healthcare services for pain.


Read the full transcript below:

Karen Litzy:                   00:01                Hey everybody, I am coming to you live from WCPT in Geneva, Switzerland. And I have the pleasure today of interviewing Daniel Board. Daniel's a physio therapist in the United Kingdom and he specializes in persistent pain. So Daniel, welcome to the podcast. And today you had a really interesting platform. So I want you to kind of give the listeners a little insight into what your platform was, because like I said, you are specializing in persistent pain, but you really have a very unique perspective.

Daniel Board:                00:35                Yeah. So my background is in working with people with persistent pain problems. And part of that is that I'm lucky enough to work in a specialist clinic for torture survivors at Chelsea and Westminster Hospital in the UK. The platform presentation I did today was presenting the findings of a research study that we did last year, looking at the experience of persistent pain in survivors of torture survivors are kind of an underrecognized group. They have a variety of psychological, physical, and social, kind of consequences and burden as a result of torture. For example, persistent pain rates succeed. 80% inspires of torture. Rates of PTSD and depression exceed 30%. Issues aren't just standalone. Many certainly the torture survivors that we encounter are living in a country of excile and there are also lots of problems associated with that, such as seeking asylum, lack of social support, and also obviously the language barriers, and kind of what they're not necessarily knowing what their rights are with regard to accessing services within the UK. So that's the population.

Karen Litzy:                   01:49                And what did your study specifically look at that you presented today?

Daniel Board:                01:54                So what we looked at from the evidence base is very limited. There was a Cochrane review last year that looked at interventions for managing pain in torture survivors and they find that there was no evidence to refute or support any intervention currently for managing persistent pain. Clinically, we see, as I said, quite a complex population and typically outcomes from treatment aren't great. We also find it quite difficult to engage them within our services. We have high sort of failed attendance rates and that really affects their ability to access and benefit from healthcare. So the study that we looked at or the study that we did was a study looking at what's torture survivors experiences of pain services in the UK is like so often, torture survivors that generally the first place they'd go to is that GP with a pain problem.

Daniel Board:                02:48                But they would also, the participants in our study, had seen GPs, they'd seen physiotherapist, pharmacist, they'd been referred to trauma orthopedics, cardiology, rheumatology, and that in itself posed a number of issues. So one of the first things we find was actually there was a big confusion over or a lot of confusion from the survivors of torture perspective over what their diagnosis was. So because they'd seen lots of different health care professionals, they're often confused. So for example, one of the quotes in our study was, ‘One says you have fibromyalgia, one said you had PTSD and another one said a slipped disc.’ So all of these things, they don't necessarily mean a lot to the patient and it can often leave them confused. So it was the first thing that we found.

Karen Litzy:                   03:34                And with the finding like that and like the confusion of the patient, is that a reason that may be why they're not seeking out physical therapy or maybe why they drop off?

Daniel Board:                03:46                I think to be honest, I think there's a number of reasons why they might not engage very well. I think there's a couple of issues with diagnosis and let's maybe start with that. One of the things we noticed in the study was a really overly biomedical approach to diagnosing and treating pain, which isn't isolated to torture survivors. It's widespread, but certainly with this group that was relevant. So participants receiving diagnoses like degenerative disc disease or disc derangement. These were things that were noted in our study. And even if they didn't fit necessarily with the participants picture of pain, so they might have had widespread pain or pain that didn't fit that specific diagnoses. That does a couple of things. First of all, providing a diagnosis, which doesn't necessarily fit the clinical picture.

Daniel Board:                04:38                It takes away, I think, ownership of being able to do anything about it. So by saying you've got disk to arrangement that's going to instill fear, that's going to take away any kind of ability that they might perceive they have to change that situation. So that was one of the things with diagnosis. The other important thing we find was that there was a distinct lack of recognition of torture experience when diagnosing pain. So if torture was recognized often it was done. So the word that came up quite a lot in the study was that participants had a biopsychosocial overlay, which in itself is a pretty ambiguous term. And there was a real lack of recognition of the affective and cognitive components of a pain experience and how torture experience might influence that within a pain experience. So I think that would affect how do they engage with services because I think it takes away some of the ownership by providing that kind of diagnosis.

Daniel Board:                05:31                I think the other thing is that it's not as simple as there's not one thing that is the problem with us engaging this population. Rates of PTSD and depression are very high our participants said that they struggled to engage with services often because they either lacked motivation to get to the hospital or they were in too much pain to complete that physiotherapy exercises, for example. So those were a couple of things. And I think there's also one of the things that we find one of the problems that we think then as a finding from the study was that there seems to be not necessarily a dualistic on the part of the clinicians. I think that's probably a little bit outdated given what we know about current pain understandings.

Daniel Board:                06:18                But I think there still is that perhaps a dualistic tendency in the organization of services, particularly in the UK. And I'm sure it applies to other countries as well, that if you have a physical problem, you go and see the physical services. If you have a mental health problem, you go and see the mental health part services. And I think that leaves populations like torture survivors who present with a really complex mix of all of these factors in quite a precarious position. So for example, they might come to a pain service, I'll see a physio, and they might say, Oh, you look like you're really struggling with PTSD. Let's get you some help with that and then come back and see me. So then they'll get referred to a psychological service, but they might struggle to engage with the psychological service because of the pain that they're in. So it just seems to be, I think the service provision we have at the moment isn't well suited to this population.

Karen Litzy:                   07:07                And so is this population, they're not being treated collectively. So if they're going to see, let's say you for pain, they'll see you and then if they're referred to psychologists or psychiatrists, they stopped seeing you and go see a psychiatrist or psychologist. It's not happening at the same time.

Daniel Board:                07:28                So at the moment, no, not in the general health services. I think the key thing with any care and specifically with this population is it is very individualized, each of their particular problems or the things that are affecting the very individualized. So, for example, we might have someone who gets referred to the pain clinic I work at and they might really be struggling with their mental health. They might be really struggling with PTSD, having regular flashbacks. And what we try and do is assess the weight of the various physical, psychological and social components and help them kind of almost line it up. As in what do you think is the most important thing to get sorted first? Do you think you'll be able to engage with the pain service?

Daniel Board:                08:13                You've actually got all this other really difficult stuff going on. So for those people we might say go and engage with a community mental health team, get some help with the PTSD and then come back. But that being said, I think that doesn't mean that people who are undergoing sort of significant psychological distress can't engage with pain services. So what we've started to do, we've just set up, a specific exercise class for this group of people, which is psychologically supported. So myself and one of my psychology colleagues, we've kind of paired the approach right down to keep it simple and actually you say kind of we understand you're really struggling with your pain problem. We can try and help you or try and help it impact you less. So actually setting some goals with you. We use the patient specific functional scales are really nice outcome measure if keep going, what do you want to do? I'm really struggling to bend over. I can't play with my kids. I can't climb stairs. Okay, great. Let's see if we can start doing that. And I think well slightly off on a tangent. Pain education is a really important part of that. But I think sometimes it gets lost in translation particularly.

Karen Litzy:                   09:23                Yeah. I was just going to ask if it is a language barrier talking about pain education, we know that we can simplify it. Not Dumb it down but we can simplify it. But if there is this language barrier that Gosh, that must make it so much harder.

Daniel Board:                09:35                It is really, really difficult and there is some really nice work being done. The evidence base is limited, but there is some really nice work being done. April Gamble, who is a researcher who I've met here with the conference has done some really nice work looking at pain education in groups within their cultural setting and has come up with a variety of different tools that can be a cultural accessible tools that can be used. So she's definitely a person, a good person to speak to you. I think what we try and do in the clinic is find one very simple metaphor that we can use with patients. So I'll talk a lot about the volume on your nervous system being really high or I don't know, when you're assessing you find something that works for them and then when we're doing stuff in Vivo, kind of let's do some exercises, what's showing up for you?

Daniel Board:                10:23                Kind of what thoughts are coming in your head, how that might be a barrier and that's where the psychologist is really helpful. But then looking at reassurance, lots of reassurance and actually, okay, you're not damaging yourself. It's just a volume knob on high and I will mimic turning up a volume knob about a million times a day, I think with my patients. And yeah, it seems to work well for a group. But again, we can't be prescriptive and actually it doesn't work with everyone and we still need to look at other ways of engaging that group that it's not necessarily working for.

Karen Litzy:                   10:55                Yeah, great thoughts. Thank you. And anything else? Did we miss anything else from the study?

Daniel Board:                11:04                So they key things, I'll summarize them cause I can remember them cause we just talked about them. I guess the key things were that there was a distinct lack of recognition of torture experience when diagnosing and treating pain. There was something which we haven't overly covered, which was that the patient clinician relationship.

Karen Litzy:                   11:23                We're going to touch on that in a second. That was my next question, but go ahead.

Daniel Board:                11:27                We'll hold that one. And then the last thing was the current organization of health care services and how that's not necessarily conducive to such a complex population.

Karen Litzy:                   11:36                My next question, if you didn't bring it up, was going to be how do you as the therapist, how are you able to connect number one and number two, is there a burnout rate for the therapist, working with people in this population? Because if you're an empath, let's say someone who's very, very empathetic, I would think this would be a really tough group to work with until you kind of get your bearings with them. So can you kind of touch upon that?

Daniel Board:                12:08                Absolutely. Starting with your question about the patient kind of clinician relationship and how you foster a kind of a good therapeutic relationship. I think you can probably over complicate it a little bit. I think from a therapist perspective, I think one of the key things that we have as physiotherapists is we're very good at talking to people and we're very good at helping people kind of be open. And I think actually what physios in the clinic, when we spend time with people, we're often the first sort of people that they might have told about that specific problem. I think we're really lucky. I'm really lucky that I'm able to work with psychologists, so if there's anything that is really significant that they're on hand and they can help me.

Daniel Board:                12:53                But I think as Physios, certainly when I was not working in pain, I think we look at mental health as a bit of a Pandora's box. And I think there is a fear amongst some therapists of going, well, I don't know. I don't want to ask the question about your mental health or how your depression is, or whether you've been taught, for example, because I don't know what I'm going to do with that information afterwards. So if I get an impression of you being a low mood and then you tell me that you've got some suicidal thoughts, I've got to act on that. And that's scary. So I think personally myself, I used to be perhaps that way inclined. But actually I think as I said, we're very good at talking.

Daniel Board:                13:31                A lot of what we do is talking as a profession. And I think actually just having a really good listening ear to someone, being able to say the things that come naturally to you with patients. So I'm not acting in shock at someone's telling you what's happened to them or avoiding questions about things that might be difficult and then dealing with whatever it is that comes up and that probably will have an element of you knowing what your support processes are within your service. So we have a really good pathway for suicidal ideation, for example. I think that patient clinician relationship is really, really important. And I think we as therapists, we've got really good chance to just be open and talk to patients. In the same sentence though, not with all survivors specifically. One of the things in the study was that actually some people really wanted to tell you about their experience and some people didn't. Some people were really avoidant of it. And I think it's just being careful that you're not overstepping. Just being kind of a really sensitive approach is important.

Karen Litzy:                   14:31                So the other question was, as the therapist, how do you protect yourself from burnout, from feeling just so empathetic towards these people that you're taking it home with you at the end of the day?

Daniel Board:                14:46                I guess there's a couple of things. I'm very lucky as I said that I work with a really good team of Physio, psychologist, doctors, nurses, and I would feel very comfortable being able to say or talk about anything that I was worried at with them. I think, sadly you do get a bit used to those conversations at times. I think they do affect you less. But inevitably you're going to hear stuff, which is, which is horrendous. And I think the key thing in the same way that you would do with any other kind of mental health is not keeping it bottled up and actually if you need support, being able to talk about it, with your colleagues to get some support if you felt that that was needed.

Karen Litzy:                   15:23                Yeah. No, that's fair. That's fair. Well, I mean, I have to say I think it's a wonderful service that you're providing for this group. It's not easy. I have never worked with that population so I can't put myself in your shoes. But I admire it greatly because these are truly marginalized group of people who really need the care. So congratulations to you and your clinic on doing this.

Daniel Board:                15:50                Thank you.  I think this population encounters physios every day, I think we're just lucky that we've got a service, which is nicely set up to help the people.

Karen Litzy:                   16:00                Yeah. All right. So I have one last question before we finish. Well two actually, but we'll start with one and it's a question that I ask everyone. So knowing where you are now in your career and in your life, what advice would you give to yourself as a new Grad straight out of physio school?

Daniel Board:                16:19                Very, very good question. As a new Grad, I'm going to say is probably the key thing is say yes to everything. Opportunities. A good physio colleague of mine, Dave Reese when I was applying to do the masters of research we did last year, I was unsure. I kind of had that imposter syndrome and I think we often feel that, and he said a really good, a good thing, just lean in. So any of those kinds of experiences, which might seem scary, like presenting at a conference or being interviewed for a podcast or whatever it might be in your professional life, whether that be clinical research, I think, yeah, just take any opportunity to develop and learn from people that perhaps know more than you.

Karen Litzy:                   16:59                Great Advice. And then lastly, where can people find you if they have questions they want to follow you on social media, where can they find you?

Daniel Board:                17:05                I'm relatively active on Twitter and my Twitter name is @BoardDan that's probably the easiest way to get me as well.

Karen Litzy:                   17:14                Perfect. And just so all the listeners know, we'll have links to your clinic and links to everything at So you can go over there one click and it'll take you to anything if you want more information. So, Dan, thank you so much for taking time out of your day at WCPT. And everyone, thanks for listening. Have a great couple of days and stay healthy, wealthy, and smart.


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!

May 20, 2019

LIVE from the WCPT Conference in Geneva, Switzerland, I welcome Efosa Guobadia on the show to discuss entrepreneurship in physical therapy.  Efosa L. Guobadia, PT, DPT, is the founder of the integrated wellness company FFITT Health; President and CEO of Move Together, a 501(c)3 for purpose organization dedicated to improving access to quality rehab medicine around the corner and around the world; Co-Founder of the initiative Global PT Day of Service, which has spanned 60 countries since its inception; Founder of the informational website PT Haven; and also developed and led the international volunteer program ATI MissionWorks for ATI Physical Therapy.

In this episode, we discuss:

-Efosa’s entrepreneurship in underserved communities

-How to approach roadblocks and tackle them head on

-Three qualities of inspiring leaders in the entrepreneurial space

-Exciting ways you can get involved with service through PT Day of Service

-And so much more!



Move Together Website




Move Together Instagram

PT Day of Service Website 

PT Haven Website


For more information on Efosa:

Efosa L. Guobadia, PT, DPT, is the founder of the integrated wellness company FFITT Health; President and CEO of Move Together, a 501(c)3 for purpose organization dedicated to improving access to quality rehab medicine around the corner and around the world; Co-Founder of the initiative Global PT Day of Service, which has spanned 60 countries since its inception; Founder of the informational website PT Haven; and also developed and led the international volunteer program ATI MissionWorks for ATI Physical Therapy. In 2017, he contributed a chapter on sustainability as well as the closing afterword for the book ‘Why Global Health Matters”, edited by Dr. Chris E. Stout, and with a foreword by Nobel Laureate Jody Williams. He received his BS in Kinesiology from the University of Massachusetts in 2007 and his Doctorate of Physical Therapy from the University of Scranton in 2010. He is recipient of the 2017 Distinguished Young Alumni Award given by the University of Massachusetts/Amherst School of Public Health and Health Sciences and is a 2018 American Physical Therapy Association Social Impact Award Recipient.  He is currently based out of Guatemala City, Guatemala.


Read the full transcript below:

Karen Litzy:                   00:00                Hey everybody, I'm coming to you live from the WCPT conference in Geneva, Switzerland. And I have the distinct pleasure of sitting next to Dr Efosa Guobadia who is a physical therapist from the United States now based in Guatemala. And he has also the cofounder of PT Day of service and move together, which we will talk about during this interview. But first, what I'd really love to talk about Efosa is you were on a panel today about entrepreneurship and physio therapy. So can you give us the highlights?

Efosa Guobadia:            00:34                Yes. Well, Karen Litzy is such a high pleasure to share time with you. The only time I get a chance to hang out with you, you put a smile on my face. I love the energy and all that. So yes, the panel is about entrepreneurship. So one of the things that I certainly talk about, I said entrepreneurship is a mindset, you know, it's about bringing the vision and the vision of your heart and the idea in your mind into actuation, you know? And with that being said what I also said, I think everybody has, it has the potentiality and the capacity to be entrepreneurial or you sometimes talk about product market fit or passion market fit and where does your passion, your idea slash your product meet the market. You know, and I think that's also very important. A friend of mine recently we're having a concept about what's an entrepreneur? He says an entrepreneur is the intersection of your idea, fundamental value and the wants, desires, desires and the understanding of the client and consumer. And that sweet spot is so important. If it's just about your ideas, you may be a starving artist, you know, but if it's a too much about the client, you know, you may be selling out a little bit. So find that great amalgam and that sweet spot and I think that's very important.

Karen Litzy:                   01:37                Yeah. Thank you for bringing that up. I think that's great. I usually tell people when they're like, not sure if this idea can actually turn into a business. And I'll always tell people like, make a list. Like, what are you good at? What are you really passionate about? And what would someone be willing to pay you for? And if you can find that sweet spot, and again, it's like you just said, it's your passion where it intersects with what the consumer needs or what the consumer doesn't know they need yet. And that's where entrepreneurism really comes into, I think, a great place for the person. So let's talk about what you're doing as an entrepreneur.

Efosa Guobadia:            02:16                I love that so much. And I agree. To piggyback on what you just said, Karen, it's about fundamental value. And I think this is true in any industry. So whatever this thing, this fundamental value, your product service, after a person comes into contact with it, are they better off? And then well, we can talk about marketing or this or that, but that should be the first thing that you curate. So that's very foundational. I'm living a pretty interesting existence right now Karen Litzy so this past November in 2018, I actually decided to move to Guatemala and now I'm doing two different things. So I feel a part of my bandwidth is for the global health sector. You know co founding, you know I lead the organization move together and our mission there is to increase access to quality rehab medicine around the corner and around the world.

Efosa Guobadia:            02:56                I've been going to Guatemala now for the last seven years I've been doing this global health work for the last seven years. I moved together under that umbrella. We've been doing some pretty interesting work there for the last three years of amazing partners on the ground and amazing participants and volunteers that have joined us from the US and other places around the world. We help to build the development of rehab clinics in underserved communities. And the keyword there, this is the keystone where there's the operization, the local PTs and students on the ground. They run these clinics that we co set up throughout the year and on the ideas that it thrives uder them and we are glad to say it has been so. And then we have other programs under them, the nonprofit move together, PT day of service, which you mentioned, we have a program called that pro bono incubator and that's US based in which we dispense funds to pro bono projects in clinics in the US over the last two years we just spent $20,000 to a 11 different projects and a mentorship and resource to many more than that as well.

Efosa Guobadia:            03:53                So that's been pretty fun. So that's one part of my existence. The other part of my existence is entrepreneurial. This past I officially opened this March, but I did some ramp up work to it this past march. I opened up a clinic in Guatemala City and it looks at three verticals. It looks at mobility, which is Rehab. And I do some movement analysis with the movement three d camera. We do look at nutrition. I'm hiring some nutritionists to look at because nutrition is important for a few reasons, right? For pain. It's relationship with inflammation and with energy and a certainly with weight management, weight management is predicated on nutrition. I think above all cardio and then lean muscle mass. So it's looking at it through that portal has been important. And the third vertical has been mindset that, you know, a routine and breathing and sleeping and all that good stuff. So creating a team that helps me do those things in an ecosystem systematic way has been fun. You know, the early part of it has been mobility and people have been responding so very well to it in Guatemala. They're telling me now I can't leave, but you know, some of my clients and it's been fun.

Karen Litzy:                   04:56                Awesome. And now, you know, your version of entrepreneurship is let's say different than maybe some traditional entrepreneurship where you're setting up shop in a very developed country and it's certainly different than what I do as an entrepreneur. I think from a practical standpoint, different, but I think from a fundamental standpoint and where our mindsets are and what we're trying to do for our clientele, it's pretty similar. Would you agree?

Efosa Guobadia:            05:23                A hundred percent fundamental value around the world. Its fundamental value in each industry needs to know their fundamental value. Let's say for us, our fundamental values as healers is help people move better so they can live better. That exists and is needed anywhere in the world. So again, know fundamental value, build the architecture and fit it to the market into the behavior and the knowledge and the awareness of your customers or customers to be and that's how you make it make sense wherever you go.

Karen Litzy:                   05:47                And for maybe listeners out there who would like to replicate what you're doing in an underserved area or in an underserved country, what were some of the biggest roadblocks you experienced in the beginning that you would like to advise people on? Maybe how to avoid or at least how to minimize?

Efosa Guobadia:            06:07                Oh, interesting. I think it's so important to identify roadblocks and barriers. I sometimes say this with my clients now you need to know the dragon and sort of delineate the dragon so you could slay it. You know, so it's the transcend another general thought. Anytime Challenging things happen. I cheer this in the panel as well. It's information, you know, it's that when a situation happens, good or maybe not good to the way you want it to happen, it's situation. What's good about situations, it leads to solutions. So once you figure out how to handle something, now you have this tool of this extra solution. Now you can play defense and prevent that from happening again. Or if it does happen, you can handle a quicker, and actually turn it into a good, et Cetera, et cetera. So that mindset, that paradigm shift, the mindset.

Efosa Guobadia:            06:50                If you're an entrepreneur of how do you engage with things that don't necessarily happen the way that you want to have it on the, for me and some of my experiences, every country has its own things. And one thing is you go through the legal process is setting up your business. What I just had to learn is a little bit different from the US so tagging in this is a truth for all entrepreneurs and all projects, you know, identify and tag and the right people who could best help you with what you need to do. And then that saves time and that maximize your efficiency as well as your effectiveness.

Karen Litzy:                   07:18                Yeah. So when you kind of hit those roadblocks, I love the way of reframing it as not a, Oh my gosh, I'm so stupid. Or how did I not see this coming? Oh great, now I'm sunk and I'm going to go sulk into a corner. But instead you're saying to reframe it as, well, here's this roadblock, but guess what? Now we have a system in place to avoid this from happening again. So being very intentional about how you're thinking of roadblocks or I don't want to say failures or things like that in your business, but being intentional so it doesn't happen again, and then you can go out and help others do the same.

Efosa Guobadia:            07:54                You said that perfectly. Nothing to add to that.

Karen Litzy:                   07:55                Okay. All right. So let's talk a little bit more about entrepreneurship, specifically leadership. So if you're an entrepreneur, you're a leader, right? You're either leading yourself, you're leading others. So what do you feel like are qualities of, let's say leadership within the entrepreneurial space?

Efosa Guobadia:            08:15                Yeah, I can say a few of both. They overlap and they're interrelated like you're saying. But on the leadership front, I think, there's three things that are important. You know, maybe I'll break it down to three C’s. So one C is courage, the second c is compassion, and the third C is credibility. So I'm gonna explain what I mean by those. But first of all, with those three things, you start with yourself. You need to serve yourself. You need to lead yourself first, before you can think about leading people. So on the coverage piece that then set on your heart or the things that you believe in, do you pursue them or do you stand up for them? And the micro moments and the macro moments. And it's like a muscle you have to cultivate and you’ve got to work it out. You know?

Efosa Guobadia:            08:51                So expressing when things are more macro and big and where things are really intense. You've had this muscle, I'm going to be strong, I'm going to be courageous. I'm going to be dictated and guided by what I see is right and righteous. So courage is important. The other part is credibility. Again, starting with yourself. Do you do the things that you set that you intend to do we get the to do list. Have you written out 20 things consistently for the last month. I've only got three things done. You're telling your conscious and your subconscious, you can't trust what you write down. So start there. Create credibility and trust with yourself and then it’s metaphysical it transmits to your team, you know, you can't really have credibility with others without having credibility with yourself. And then caring and compassion. You know, one of the most important words in my life, caring, you know, caring about yourself, being compassionate about yourself.

Efosa Guobadia:            09:33                To be able to do that with your team. You need to be able to do it yourself. There's one politician and I heard say it as a couple of years ago, the best thing a leader could do for his team, his or her team is to care about them. You know how you do that by actually caring about them, you know, so actually care about yourself to take care by yourself, actually care about your team, to care about your team, on the entrepreneurial realm. A lot overlaps with say consider our focus decision making capabilities. And I will also say reasoning, you know, able to multidimensional think a lot of entrepreneurism is problem solving and thinking ahead and thinking what's coming down the pike. So that's the critical reason. A lot of the decision making, whether you've got to make quick decisions or deep decisions.

Efosa Guobadia:            10:14                What's your prototype, what’s your paradigm, how do you handle that? How do you stay calm under pressure? Maybe that goes to a curse a little bit. And then in focus, you read all the greats, you know, whether it was old school philosophy or current CEO's, one of the most important things that they talk about is the ability to focus on your task at hand and to chop wood on your task at hand as their old quote. I forget who said it now, the way you do anything is the way you do everything. So for me to close on this, I enjoy doing dishes. I don't do it that much, but when I do dishes, I'm locked in. I've tried to clean it as best as I can and I know that it's going to transmit to my clinical treating and my leadership or building your footing. So those would be some thoughts there.

Karen Litzy:                   10:56                Yeah. And I loved the compassion I had a woman on a couple of weeks ago who talked about having compassion for yourself and forgiveness for yourself and how can you even make a decision if you can't even give yourself compassion? So, those qualities of leadership, courage, caring and compassion, and credibility. Yeah. So if you can't give that to yourself, then how can you give it to your business and be a successful entrepreneur? And courage by the way, this year was my word of the year on my vision board. So when you said that, I perked up and said, oh, courage. Yes. So that's something that I'm working with and I've been in business for a while. So I think another thing for everyone out there who's an entrepreneur or wants to be an entrepreneur is it's not like, oh, I have courage one day and then that's it. It is for ever, you are forever working on it. At least that's my view.

Efosa Guobadia:            11:56                I agree. Excuse me. I agree. It's a muscle and it's not this goal to achieve and that you're good at. It's an attention and intention really has to do a behavior and courage and you’ve got to be smiling in this world. It's so much about courage is a call to adventure. What is it in your heart, what do you feel pulled to and are you willing to answer that call and say, heed that call. Even if it's a small step, even if it's a big step, even as a small step that leads a big step. If you do, if you heed the call, if you go for it, if you stand up for the things that you believe in, you will live a life in full. You know? And it’ss be a certainly an interesting one.

Karen Litzy:                   12:32                Wonderful. I have nothing to add to that. Now before we went live you were talking about how it's such an exciting time in physical therapy and we're here at WCPT with 4,500 people from around the world. And I have to say it is exciting. So what is your version of now is an exciting time for physical therapy?

Efosa Guobadia:            12:51                It's a combination of things. You know, there's so many exciting and interesting people doing exciting and interesting things you with your cash based practice you with this podcast. So many other people. The prehab guys, you know, I don't even know those guys, but I admire them from Afar, how they're growing, how they're fitting something in the market, how they're influencing and inspiring clinicians and clients have like so many others. So many exciting people doing exciting things. So that's one variable too with technology. You know, technology is allowing us to do a multiplication of things that we couldn't do six months ago, 12 months ago, and then certainly two, three, four, five years ago. So understanding where the tech is now or where the tech might go, it's a variable that leads to a multiplication. And then the consumer that, you know, they're more intentional with where they spend their time or where they spend their dollars, how they engage with health and health care and all that good stuff.

Efosa Guobadia:            13:39                So they're becoming more of a partner. That's how I treat my clients and my consumer, my patients as a collaborator in the journey. So you play with those different variables of technology ideas of different people, a consumer that's wanting to be healthier and then wanting to be fit. And intentional in that healthiness in that fitness, we're at this place really where anything is possible and everything can change. And I think in the next 10 years Karen the next 10 years, we're going to see an evolution slash revolution of efforts and actuations within our profession. And certainly the other step is how we collaborate with other verticals and other industries and other professions as well because not just about what we could do alone by what we could do is by what we could do together.

Karen Litzy:                   14:21                And on that, that is just the perfect segway because the next thing I want to talk about is move together and PT day of service. So let's give a plug to both of these, well move together, the parent organization of PT day of service. So let's talk about that a little bit so that the listeners know what the heck you're doing.

Efosa Guobadia:            14:42                Yeah, sounds good. So move together is a 501©3 that I cofounded in 2016. And the way we define mission is that we measure everything that we do and say by. So the mission for the organization is to increase access to quality rehab medicine around the corner around the world and access being the keystone word and the keystone structure cause with access that we've seen in some of the places that we've been to, the place doesn't exist for people to go to or the place does exist. They don't have the means to go there of it does exist. They have the means that placement, I have the things that that community member that community needs. So it was a multidimensional challenge, so it needs a multidimensional approach. So that's been pretty exciting.

Efosa Guobadia:            15:18                I smell inside and out every time I think about our vision first. But the way we defined vision, vision is Simon Sinek talks about this a lot. Do you need to be able to see it? You know, that's why we call it a vision. And then when I think about it, I think about it as a guiding light or the northern star that's shining the way forward. I also think about it as the horizon. There's always going to be necessary distance between your horizon. That's the definition of horizon and so it becomes this pursuit and then you're pursuing the doing of good and doing and what your vision is, which I'll share in a moment, but also how you enjoy the journey. You're able to turn around and look at the shore, see how far along you've gone and also set up beacons and objectives along the way to measure your progress.

Efosa Guobadia:            15:58                Our vision for the organization is a clinic in every community and a sense of community in every clinic, a clinic in every community speaks to the horizontality of where we want to go, the geographical breadth of where I want to go. Community in every clinic speaks of punctuating depth and the verticality of what we do and the places that we do go. So a clinic in every community and community in every clinic. And that really drives what we do. We have three pillars in our organization, one that looks at increasing the quality and quantity of clinics. We do that. We have a program, PBI in the US and other clinic development program around the world or work with municipalities and mayors. And, and our community leaders to build development operationalized clinics. We have a second pillar called empower local clinicians. You know, not just a going and leaving going and leaving something behind and power and local capacity.

Efosa Guobadia:            16:42                Mike Landry talks about that term about local capacity. So most of our projects abroad we usually teach, you know, and learn and do labs things of that nature and we partner with other kinds of organizations to start doing it more in an architectural way for sustainable change. And then the third pillar, which ties into PT day of service is catalyzing servant leadership. What we've seen about our profession, certainly beyond our profession, PTs and PTAs and students, they like to serve we are a  profession of heart and compassion. You know, so many people have been doing so many good things already, but for many people they don't know where to start, you know, so how can we create this junction of Bi directionality where people can be fulfilled while fulfilling other's? We see path for academic leadership and association leadership and corporate leadership and those are great.

Efosa Guobadia:            17:25                It was very important for us as an organisation. Josh and I, we talk about this a good amount is creating a path for servant leadership. You know, so we have two programs right now in that pillar program. We're very excited about anybody listening that is interested in our mission and vision. This would be a good portal to join, call the catalyst club and it’s all family for the organization. It's a critical mass to volunteer team that's going to help us fulfill the vision and pursue the vision. And then of course we have PT Day of service. Just an amazing program, really driven by amazing, amazing team which Karen, we love you so much for being on our team since really the beginning and then amazing people around the world participate in a PT day of service when we challenged students, clinicians to do an act of service on the same day and around the world.

Efosa Guobadia:            18:07                Year one we had 28 countries participate. Year two we had 42 countries participate. Year three we had 55 in year four we have 56 give or take, we're in year five which the big year for us and we're very excited and we’re looking to grow not just for the sake of numbers but to grow in the sake of service and showing that service can grow at the end of the day. What that program is about PT Day of service. It's about local service for a global effect and a global impact in your backyard in multiple places.

Karen Litzy:                   18:35                Yeah. So this year it's October 13th and if you want more information you can go to or move

Karen Litzy:                   19:01                And we'll have all of the links to everything, under this podcast at So one link can take you everywhere. So Efosa before we finish, I have one last question. I cannot wait to hear your answer. I'm like super psyched about this as a question I ask everyone and it's knowing where you are now in your life and your career, what advice would you give to yourself as a new Grad fresh out of the University of Scranton, right?

Efosa Guobadia:            19:27                So were you saying I'm having a conversation with a 24 year old, Efosa that guy was interesting. I wish I could have a conversation with that guy. So what I will say, I'm actually gonna say, he's gonna be interesting. So are you asking me to look back and what advice I would give that person will be to actually look ahead. So there's an exercise that I do sometimes called futuristic retrospection. I came with this term several years ago. And what the exercise you actually do is visualize yourself as an older person and this is similar to other activities but futuristic retrospection, it goes to visualize yourself as an older person. So 24 year old me is talking to 90 year old me, maybe I'm hanging out in pajamas, you know, and a cat is just doing whatever I'm doing.

Efosa Guobadia:            20:10                And in that conversation I would tell my 24 year old self do this. In that conversation, ask your older version of yourself, what do you wish you did? What do you wish you did at 24, 25, as soon as you graduated, what do you wish you did? Where do you wish you were at? Who do you wish you where? et Cetera, et cetera. And then, certainly you have to extrapolate what you think that answer might be. And then whatever that answer is, you've got to let it guide you. You know, there's an article I read at slate a couple of years ago that said, when we think about an older version of ourselves, the same part of our brain lights up as if we're thinking about a stranger, at least in the Western world, right? When we think about an older version of ourself, the same part of our brain lights up as we're thinking about a stranger.

Efosa Guobadia:            20:47                So this exercise allows you to get feedback and thoughts from your subconscious. The person who really knows you the best, and it's pretty powerful. Jeff Bezos, he utilizes something similar called the regret minimization framework. You know, think about an older version of yourself and what then do you think you regret not doing, you know, and then to make sure you do that. And then the other thing at least the character Togo has this quote, we're presented with insurmountable opportunities. So there's a never ended amount of opportunities in the world, you know. So with that being said, it becomes about being essential with your time. You know, people going to ask you to do things, you know, which is good, which is fun. And the better you are at things hopefully the more that you’re going to get asked. The honor is the ask, you don't have to say yes sir. So be essential about what you're doing so there’s this balance of knowing your measures, knowing your markers. Know you're vision and let that guy that didn't create or the things you accept and you multiply that by being adventurous as well. You know, trying things, finding that sweet spot will allow you to maximize yourself. Your time. 24 year old, they feel similar.

Karen Litzy:                   21:54                Wonderful Advice. Thank you so much. Where can people find you if they want to ask you questions or find out more about you? Where are you on social media and all that kind of fun stuff?

Efosa Guobadia:            22:03                All my handles on social media or my first name followed by my last name, @EfosaGuobadia.  I do a lot of mentorship talks with folks that are certainly a lot of folks, new professional folks, students and all that good stuff. I take much joy in that and is very conversational. A lot of the answers are within you and I guide you to some thoughts. So somebody is interested in that, shoot me an email and we'll find a time in the schedules, they can shoot me an email address. That's my first name, and you know, so whether it's email or whether we do a 30 or 45 minute talk, that's one of the ways I enjoy serving. So, be intentional reaching out cause I mean that.

Karen Litzy:                   22:46                Well, and for all those of you listening, take advantage of that because to have Efosa mentor you or just talk to you about anything, you will walk away knowing more and feeling I don't know better about yourself somehow. I don't know how that's even possible, but that's the sense that you get after speaking with him, you're going to walk away with value. So take advantage of that. So folks, so thanks so much for coming on and taking time out of WCPT.

Efosa Guobadia:            23:15                Karen, thanks so much. I think this may be the third time between Josh and I are hanging out with you, we have so much love for you, I thank you so awesome. Thank you for this, another way for you to serve this information.

Karen Litzy:                   23:26                Thank you. And everyone, thanks so much for listening. Have a great couple of days and stay healthy, wealthy, and smart.



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May 18, 2019

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Ryan J. Lingor, MD and Michelle Cummings, PA on the show to discuss HSS Ortho Injury Care.  Dr. Lingor serves as an Assistant Attending Physician at Hospital of Special Surgery, faculty at Weill Cornell Medical College, Medical Director for HSS Ortho Injury Care, and Team Physician for the New York Rangers.  Michelle is a physician’s assistant who enjoys helping patients get back to their active lifestyles while also providing them with a thorough understanding of their orthopedic diagnosis.

In this episode, we discuss:

-The unique offerings of HSS Ortho Injury Care

-Expanding patient’s access to quick and affordable medical care with the HSS Ortho Injury Care business model

-How to market your services and gain trust with your community

-And so much more!



HSS Ortho Injury Care


For more information on Dr. Lingor:

Dr. Lingor serves as an Assistant Attending Physician at Hospital of Special Surgery, faculty at Weill Cornell Medical College, Medical Director for HSS Ortho Injury Care, and Team Physician for the New York Rangers.


Upon graduating from St. John's University in Minnesota, Dr. Lingor obtained certifications as a Registered Dietitian, Certified Athletic Trainer, and Strength and Conditioning Specialist. He went on to complete athletic training internships with the New England Patriots and Miami Dolphins and was named Head Athletic Trainer of NFL-Europe's Hamburg Sea Devils.


Dr. Lingor graduated from medical school at Loyola University Stritch School of Medicine and completed his residency in family medicine at Illinois Masonic in Chicago and his sports medicine fellowship at the University of Notre Dame. He is board certified in family medicine and obesity medicine with a subspecialty in sports medicine. His previous experience includes working as an Assistant Team Physician for the New York Jets as well several local high schools and colleges.


Having professional passions in weight management and comprehensive sports medicine, Dr. Lingor utilizes his background in nutrition, athletic training, and strength and exercise training to provide a comprehensive, personalized approach to help his patients achieve their health and performance goals.


At HSS, Dr. Lingor utilizes musculoskeletal ultrasound for diagnostic and therapeutic purposes, performs and conducts research on biological treatments for chronic tendon problems, provides comprehensive concussion management, and employs dry needling for muscle and tendon problems. He is active as a researcher and regularly presents at national conferences in primary care sports medicine.


Outside of medicine, he enjoys traveling, cooking, and being active outdoors, having competed in several marathons and three Ironman Triathlons, including the Hawaii Ironman World Championships.



For more information on Michelle:

Michelle Cummings graduated magna cum laude from the University of South Carolina with an undergraduate degree in Exercise Kinesiology. During her studies, she spent three years as an undergraduate research assistant working on a study which focused on implementing health and nutrition programs into churches. Michelle then earned her Masters Degree in Physician Assistant Studies at the Massachusetts College of Pharmacy and Health Sciences. Prior to going to HSS, she worked as a PA for a private orthopedic and sports medicine practice focusing on upper extremity injuries. Michelle enjoys helping patients get back to their active lifestyles while also providing them with a thorough understanding of their orthopedic diagnosis. In her spare time, Michelle enjoys running, cycling, hiking, traveling, and crossword puzzles.


Read the full transcript below:

Karen Litzy:                   00:01                Hi, Doctor Lingor and Michelle welcome to the podcast. I'm really happy to have you guys on today to talk about the HSS Ortho Injury Care. So thanks for coming on. Alright, so let’s sort of start from the beginning. All right, so what is the goal of this new clinic? What is the why behind it?

Dr. Lingor:                    00:27                It just has always been a good place for orthopedic and sports medicine conditions. One of the problems that we've had at the hospital is getting appropriate access early on when patients need to be seen. So our providers tend to be pretty busy. So what we wanted to do is create a resource for patients to be able to go for their acute sports medicine and orthopedic needs.

Karen Litzy:                   00:55                So that takes me to the next question is why sports medicine over other specialties? Obviously there was a hole to fill, right? So why this over others?

Dr. Lingor:                    01:08                For myself, I really enjoyed helping keep people active and I think somebody’s activity correlates with their quality of life. And so if we can help, you know, people when they get injured or something to hold them back from, from being active on a daily basis, that's kind of where I wanted to help out.

Michelle Cummings:      01:33                For me, It's two fold. One because I'm so passionate about sports in general and secondly, the specialty itself, you can actually make people better a lot quicker than in other specialties. So that's what drew me to sports.

Karen Litzy:                                           I agree. I think with those sports injuries, I know coming from the physical therapist’s perspective, you kind of see this progression, right? So regardless of the age of the patient you kind of see from injury and you can really follow them through to recovery, which is really exciting from my standpoint and now, what are the commonly treated injuries seen in the clinic?

Dr. Lingor:                    02:14                So we see all sorts of musculoskeletal injuries, the common stuff if somebody has a shoulder injury or just shoulder pain, we see a lot of knee injuries after athletic event, hip pain, all sorts. So any of the extremity injuries we do specialize in. And for patients that have back pain, fortunately we are a suited at HSS to have a back pain clinic. So we direct those patients to the right, the right place.

Karen Litzy:                   02:47                And so why should a patient come to this Ortho care clinic versus going to the ER? What is the difference?

Michelle Cummings:                              So the difference? Well, the ER you'll always have long wait times and they're not always apt to treat just orthopedic and sports injuries. So here we have an x ray onsite. Quick access to films as well as splinting and casting availability here. And what's Nice is you can actually schedule appointments online or call directly and we schedule same day and next day appointments. So if a patient sprains their ankle, you know, a night at basketball, they can go on and schedule an appointment early the next morning. So to try to shorten the wait time to the ER.

Karen Litzy:                                           So you alluded a little bit to the splinting and casting, but you know, as non-operative clinicians, what types of conservative treatment are you providing for these patients as they come in?

Dr. Lingor:                    03:49                So a lot of this stuff, you know, fortunately for us and most patients just don't want it to be checked out to see if they have something that they need to be more concerned about and kind of be directed in the right area. And fortunately we're kind of at a good position to give them access to all the resources that we have at the hospital for special surgery for those patients that need it. For stuff that we can take care of in the office here, we do have, as Michelle said, the x rays, we can do injections into different areas as necessary and we have the use of ultrasound to make sure that we are accurate with the injections and the care that we're providing.

Karen Litzy:                   04:36                So this is how new? It's pretty new, right? When did you guys first open?

Michelle Cummings:                              Yeah, we first opened in November of 2018 so it's been a couple of months now.

Karen Litzy:                                           And as with everything new, every new venture, right, it has its ups and downs. So what are some of the challenges that have come up since this clinic opened?

Dr. Lingor:                    05:02                Well, the biggest challenge is just getting our name out there and letting people know that we exist. We've been very fortunate to have a lot of interest both in our hospital and in the community to get people in the door when they need to be seen and get them moving in the right direction. So there's been a lot of positive energy that we've been able to benefit from in our first few months and we're still working out some kinks and not everything is smooth as you mentioned when you first get going. But, we've been very blessed to have a great staff around here that, that are all interested in, in doing what's best for the patient and providing exceptional patient care.

Karen Litzy:                   05:46                And so you have some challenges, I'm sure there's also been some pros, right. So what have you found since opening the clinic have been a real positive or maybe even things you didn't even expect?

Dr. Lingor:                    06:03                I think one of the nicest things is that our patients generally are in a pretty good mood when they come here because they're oftentimes patients, they're looking to go to the ER and they anticipate, you know, waiting for a couple hours and may have been told to follow up with her orthopedist at that time. And so patients are, excited when they come to a very reputable hospital and then being able to get an appointment the same day or the next day. And so they're pretty excited about that, about that opportunity. And so that's just kind of fun to work in that kind of environment where everyone is in a good mood off the bat.

Karen Litzy:                   06:44                Yeah, that sounds amazing. And I would also have to think that, you know, when you go, if you have an orthopedic injury or like you said, it's soft tissue ortho injury and you go to the ER, you're not guaranteed to get an orthopedic specialist to treat you in the ER. Would you say that's correct. So is that how this kind of differs?

Dr. Lingor:                    07:04                That's exactly right. If you go to the emergency room, they have the resources for, you know, taking care of the life threatening or really serious things. And that's perfectly appropriate for the ER because we don't treat those sorts of things. And with patients that go to the ER and have a lot more of the, you know, 90% of the orthopedic injuries where it's appropriate for us. And so this is a way for us to cut down on patient’s wait times and their costs as you know, an emergency room bill. Get them moving in the right direction right from the beginning.

Karen Litzy:                   07:50                Do you guys take insurance?

Michelle Cummings:                              It's actually listed on our website. So if a patient had questions about the insurances we take, it's all listed on the website, but we take all major insurances.

Dr. Lingor:                    08:04                And that's pretty easy to find if you just Google HSS ortho injury care, you'll see it pops right up and you can see the insurances that we take and you can book yourself online and really booking an appointment is about a three minute process.

Karen Litzy:                   08:19                Nice. And is this something that you patterned after? Like is there another clinic like this somewhere else in the country or is this one of a king clinics?

Dr. Lingor:                    08:33                To our knowledge, this is one of the first ones in the region. I think a lot of other orthopedic places that have walk in clinics and stuff like that. I think this is the first stand alone clinic that operates, kind of how we do and you know, something we saw as a need and it's been a wildly successful in our first few months.

Karen Litzy:                   09:01                Which is amazing. Dr. Lingor, I have a question for you. So aside from being an orthopedic physician, you also have a nutrition background, which I find really interesting. So are you able to infuse any of that within this clinic or do you see that as maybe something that you might want to infuse into in the future?

Dr. Lingor:                    09:23                Well, with the sports medicine and medicine in general, being a field of nutrition in its other fields, it is something that I really enjoy learning about and trying to keep up with. In the clinic right now, it just helps me to better counsel patients and answer questions that they have, about nutrition and things that they can do to optimally heal and prevents some of the chronic conditions. And so I utilize it that way. And fortunately at HSS we do have a nutrition and dietetics team that we call upon as well as physicians who specialize in nutrition. We need more help. So it's not, I don't solely practice in the field of nutrition now, but kind of more as a complement to what we offer at the clinic.

Karen Litzy:                   10:16                Yeah, I think that's great. Where do you see this going? Where do you see this, you know, that old question, where do you see this going in five years?

Dr. Lingor:                    10:29                Yeah, so we're kind of looking at the hospital for special surgery as branching out to a couple of different other sites around the city, as well as a couple of places throughout the country in Las Vegas and in Florida. And so we're looking at kind of making this, you know, this being the flagship and then kind of model after the places just because it has seemed to do so well for our patients and for our physicians as well to get patients in. So by that I mean that when patients call other doctor's offices and they can't be seeing those to us, and then if necessary, then we get that patient back at an appointment that's a little bit more expedited then what the other physician would have been able to originally see them.

Karen Litzy:                   11:26                Yeah. So you're sort of like, that patient could come in to you guys and if you feel like a referral is necessary, then you can kind of help streamline the process for the patient, which is amazing for patients because that's what they want. Because they come to you, they don't know what's going on.

Dr. Lingor:                    11:41                Yeah, that's exactly right. And often times when they call one of our surgeons office, it may be a day at the surgeon just happens to be in the operating room and you know, regardless of how bad they want to see that patient, if they just don't have the ability to get them in. So, that's why I always say that we are here when the patient needs us and kind of get them moving in that right direction.

Karen Litzy:                   12:01                And you know, and looking on the website, you have Michelle, a physician assistant and then a couple of other orthopedic physicians. How do you guys all kind of work together to make this clinic run?

Michelle Cummings:                              Now that’s a good question. So Dr. Lingor is here more than anyone else as the medical director. So He's here usually five to six days of the week. We are closed on Sundays and I come in later in the morning and cover the night shifts and then we have the other providers that will cover sometimes on the Thursdays and also on Saturdays they cover in the need to fill in the gaps.

Karen Litzy:                                           Got It. And this will be kind of like you said, your flagship operation and then hopefully kind of move this model throughout the country. I guess my question is from where you are now then from where you started, I mean, you obviously see this as something that's sustainable, right? Because I think a lot of people, when new things kind of move into their communities, there are always a little hesitant. What do you do for the community? And New York City's a big community, right? Like you said, getting the word out is part of it. But do you have any plans on kind of being part of like really being part of maybe even smaller communities, New York is gigantic, but really kind of getting into the community to get people to trust?

Dr. Lingor:                    13:39                Yeah, I think that's really great point. And that's one of the things that just in our area, we're located on 65th street and second avenue. And so we see a lot of patients just in our area with, you know, a few block radius of patients walking by who have seen the signs a little bit and then come in and check it out to see what it is and say, Oh yeah, I have this knee issue. I wonder if you guys can take a look at it. We do welcome Walk-in's we prefer patients to make an appointment just to decrease their own waiting time. But we do see a lot of that and just providing that access to patients when they need it. I think has really helps build our name in our own little community that we serve right now.

Karen Litzy:                   14:22                Yeah. I have my own practice and that's always the hardest thing, like you said, is getting the word out, letting people know you're there. What other marketing things, have you guys done that you've found successful so that if people are listening, they're like, wow, I really wish we had something like that in our community. Maybe they want to start it. What would your best advice be?

Dr. Lingor:                    14:49                Well, one of the things that fortunately New York City has a plethora of is sporting events around being open during those times. So, like for instance, when the New York City Marathon is going on, you know, on that Sunday will be open that day to provide, access and for again, people in the area just to kind of get our name out a little bit more that people are walking by and having, you know, welcoming people in if they need to be seen by one of our providers that day and not, you know, that for the runners. Cause they're a little busy that day. Right? Yeah, exactly. Hopefully not too many of them. But we are just one block off the race course over the edge of some of those special events and volunteering with those groups. It's something we look forward to.

Karen Litzy:                   15:48                Yeah. So kind of making partnerships within the community so they know you're there and they can refer to you and all that fun stuff.

Dr. Lingor:                    15:56                Yeah. So we have several of our positions that do volunteer in past years with those events. And so we see when patients come in for the marathon Monday that they host after the New York City Marathon. Those patients, you know, they're seen by a medical professional that then if they need to get further testing done now we can provide that access to people.

Karen Litzy:                   16:24                Fantastic. I mean, it sounds like you've got a great, a great niche over there and that you've definitely found a way to kind of plug that hole, right. You've found a way, you saw this sort of lack of accessibility and have made something a lot more accessible. So is there anything that we missed or anything that, you know, you want to the listeners to kind of remember about the clinic?

Dr. Lingor:                    16:53                Yes. Things come up and unfortunately musculoskeletal injuries come up unexpectedly at the worst possible times. And there's a lot that can be done if when patients have that time of need, whether they're going on vacation or have a major life events. That's our primary goal is to provide access for the patients when they need it and help them sort through some of the frustrations. And difficulties that come along with musculoskeletal and sports injuries and you know, get them back to their level of health and quality of life that they're used to enjoying.

Karen Litzy:                   17:38                Awesome. And Michelle, how about you? Anything that we didn't touch upon or any closing thoughts that you want to share?

Michelle Cummings:                              No, I think just thank you for having us on the show and helping us get the word out. It's very helpful from different aspects to get out the word out in New York. So thank you for having us.

Karen Litzy:                                           Yeah, you're welcome. And you know, I think it's also important, like now as a physical therapist, this is great for me to know because you know, we see patients directly now, so someone comes to me and I'm not sure, then for me it's great to say, Hey, there's a clinic that specializes in this. And then what it does for me is it kind of builds up my credibility with the patient because I'm sending them to a place where they're going to get the help that they need.

Dr. Lingor:                    18:25                I’m very excited that physical therapists have the direct access, so through the physical therapy and find that, you know, the physical therapists that we commonly work with. It's been a great relationship with that. We look forward to expanding on that. And again, thank you very much.

Karen Litzy:                   18:46                My pleasure. My pleasure. Thank you so much for coming on. So again, if you want to find out more information, you can go to Is that right?

Dr. Lingor:                    19:06                The easiest thing is just go to Google and type in Ortho injury care.

Karen Litzy:                   19:14                Or you can go to and we'll have the link right there for you so you can just click on the link and go right to it. And hopefully we see more and more of these types of clinics popping up around the country because it certainly does fill a gap. So thank you guys for all that you do to help people with sports injuries, musculoskeletal injury. So thank you. And everyone, thanks so much for listening. Have a great couple of days and stay healthy, wealthy and smart.


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