Healthy Wealthy & Smart

In this episode, Co-Owners of Kornetti & Krafft Health Care Solutions, Dee Kornetti and Cindy Krafft, talk about all things maintenance therapy and care. Today, they talk about maintenance therapy in the home, diversifying revenue, and they bust a few maintenance therapy myths. How can maintenance patients have a goal statement if they're never going to get better? Hear about home-based therapy, teaching patients to self-manage, Medicare part B, and their book The Guide to Delivery of Home-Based Maintenance Therapy, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways "It's never been that if you don't improve, then services aren't covered." "Rehab potential is the responsiveness to care." "The myth of coverage has some roots in the denial issue." "If there's room for improvement, a restorative or improvement course of care is what your skills would be indispensable for. That's what would make your care medically necessary under the Medicare benefit." "If someone else can do it just as well as I can then this is no longer considered skill." "We are helping patients be accountable for their chronic disease management." "There are times that we are indispensable to help people improve and recover function back to a prior level or maybe beyond, and then there's times we are needed to preserve and stabilise their exiting function so that their quality of life can continue on in the fashion that it currently is." "Be a bit more open-minded with how physical therapy really works in reality. Don't assume that what your path at the moment is THE path and can't vary and can't change. There are many other ways you can utilise your skill to benefit those around you." "Don't be afraid to ask questions, and don't think you have to know it all." "If you've got a great idea, or you have something that is a passion, and you've got that intersection of your passion and your skill set, go for it. Start to explore that. The possibilities are endless."   More about Dee Kornetti Dee, a physical therapist for 35 years, is a past administrator and co-owner of a Medicare-certified home health agency. Dee now provides training and education to home health industry providers as Owner/Founder of a consulting business, Kornetti & Krafft Health Care Solutions, with her business partners Cindy Krafft and Sherry Teague. Dee is nationally recognized as a speaker in the areas of home care, standardized tests and measures in the field of physical therapy, therapy training and staff development, including OASIS, coding, and documentation, in the home health arena. Dee is the current President of the American Physical Therapy Association's Home Health Section and serves on the APTA's national Post-Acute Work Group. She serves as the President of the Association of Homecare Coding and Compliance, and a member of the Association of Home Care Coders Advisory Board and Panel of Experts.  She has served as a content expert for standard setting for Decision Health's Board of Medical Specialty Coding (BSMC) home care coding (HCS-D) and OASIS (HCS-O) credentialed exams. She holds current credentials in Home Health Coding (HCS-D) and Compliance (HCS-C) from this trade association.  Dee is also on Medbridge's Advisory Board for development of educational content on its  home health platform, and has authored several courses related to OASIS, Conditions of Participation (CoPs) and therapy. Dee is a published researcher. on the Berg Balance Scale, and has co-authored APTA's Home Health Section resources related to OASIS, goal writing and defensible documentation for the practicing therapist. Dee has contributed chapter updates to the Handbook of Home Health Care Administration 6th edition, and co-authored a book, The Post-Acute Care Guide to Maintenance Therapy published in 2015, along with an update in 2020 titled, The Guide to Delivery of Home-Based Maintenance Therapy that includes a companion electronic workbook. Dee received her B.S. in Physical Therapy from Boston University's Sargent College of Allied Health Professions, and her M.A. from Rider University in Lawrenceville, NJ. Her clinical focus has been in the area of gerontology and neurological disease rehabilitation.   More about Cindy Krafft Cindy Krafft PT, MS, HCS-O is an owner of Kornetti & Krafft Health Care Solutions based in Florida. She brings more than 25 years of home health expertise that ranges from direct patient care to operational / management issues as well as a passion for understanding regulations. For the past 15 years, Cindy has been a nationally recognized educator in the areas of documentation, regulation, therapy utilization and OASIS. She has and currently serves on multiple Technical Expert Panels with CMS Contractors working on clinical and payment reforms and bundled payment care initiatives. Cindy is an active member of the National Association of Home Care and Hospice (NAHC) and currently serves on multiple committees. She has written 3 books – The How-to Guide to Therapy Documentation, An Interdisciplinary Approach to Home Care and the Handbook to Home Health Therapy Documentation – and co-authored her fourth, The Post-Acute Care Guide to Maintenance Therapy with her business partner Diana Kornetti PT, MA, HCS-D.   Suggested Keywords Maintenance, Therapy, PT, Physiotherapy, Improvement, Assessment, Goals, Home Care, Rehabilitation, Accountability, Medicare, Myths, Health, Healthcare, Sustainability,   Book Discount Code (10% OFF): KK2021 The Guide to Delivery of Home-Based Maintenance Therapy   To learn more, follow Dee and Cindy at: Email:              kornetti@valuebeyondthevisit.com Website:          https://www.valuebeyondthevisit.com Facebook:       Kornetti Krafft HealthCare Solutions Twitter:            @Dkornetti                         @KornettiKrafft LinkedIn:         Kornetti Krafft HealthCare Solutions   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript Here:  Speaker 1 (00:01): Hi, D N Cindy. Welcome to the podcast. I'm happy to have you guys on. Welcome. Welcome. Thanks for having us happy to be here. Glad to be here. Excellent. So today we are going to be talking about maintenance therapy. So when a lot of physical therapists think about maintenance therapy, they often think that, well, this is something that's not reimbursed. This is something that maybe the patient doesn't quote unquote need. So today we're going to talk about what it is, some of the myths and a lot of other stuff surrounding maintenance care. So my first question is, can you define what maintenance care is or maintenance therapy? Speaker 2 (00:47): Okay. Karen, this is Cindy. I'll take that one. I think, you know, just as you were saying, the word maintenance, I'm sure at least one listener twitched, a little, the eye Twitch, the uncomfortable many times when you say the word maintenance, it looks like, you know, people react like you swore in church to like, oh, I don't do that. Or I, you know, somebody does that and get in trouble. And, and I think even the word has become a barrier. So Dee and I have tried to reframe the conversation by getting to the heart of what it is by referring to it as stabilization of function. So putting aside that baggage and the history of the word, the approach to care is saying I'm utilizing all the wonderful things I know as a therapist, my ability to assess and all of those great things and develop a care plan. But the end result that I'm going for is a stabilization or preservation of their functional level or slowing of decline. I think maintain can get people tied up in knots and miss the point or think that we have to do all kinds of different things, which we'll talk about in a moment with the myths. But I really think it helps to, to approach it as we're talking about stabilizing someone's function. Speaker 1 (01:58): That makes a lot more sense. And I really like that word. And you're right. I feel like maintenance care does kind of give people that, oh, I don't know if that's quite my lane, but when you say stabilization of function, preservation, decreased speed of decline. I think physical therapists are like, yeah, of course that's what we do. We'll think about it. We, we, we treat patients that have these chronic diseases right there. We don't share them. They go to doctors, numerous doctors, you know, cardiologists primary care, right. With their, with our heart conditions, they see nursing, right. They see all kinds of disciplines and all kinds of professionals. But they're never getting cured. They're it's management of their symptoms, right? So, so it's to like Cindy said, we are, we're going to preserve function. We're going to, you know, optimize their ability. Speaker 1 (02:50): We're gonna re hopefully use our skills, knowledge, and ability to reduce their demand or their requirement, higher cost centers of care. What happens when you have poorly managed symptoms of chronic disease, like COPD or CHF or diabetes, these people use urgent, emergent care. These people go in the hospital. This is extremely costly to our, to our medical system. And it's, it's not sustainable as an aging pie, you know, as we age as the population. And so this idea that there's things we can do to have people function optimally, no matter what phase or stage of this chronic condition they're in too, so that they're not as dependent or on higher cost centers of care, or they don't realize the kind of sequella, you know, think about a diabetic with poorly managed blood sugar, you know, that starts to develop retinopathy Neff, prophecy, peripheral neuropathy, right? All these other problems that happen. You know, that's all very manageable. If we can get an early and often and preserve an optimized, I even say optimize function. So we're not improving people necessarily because sometimes they haven't already experienced a decline. A lot of times we're just going in there to share what we know so that they can be accountable and manage these chronic diseases themselves. Yeah. That makes so much Speaker 2 (04:16): Karen. I would add to that, you know, for your listeners, cause some folks, you know, D and I have been talking about this for years. Some folks have a difficult time with this conversation, not just the word, but the concept. It sounds good. It sounds valuable. But I think we have to take a moment and acknowledge how deeply as therapists. We have defined ourselves by that word improvement. You can see it in our documentation. If you're going to get physical therapy, you're going to walk five feet more or 10 feet more, every time I get near you because that's, that's what I have to do. And that if I'm not improving you, we've all been told that if, you know, after a certain number of visits or certain number of treatments, if you don't see improvement, you're obligated to discharge people. When you start finding out that, that isn't really true and it hasn't really ever been true. Speaker 2 (05:06): I think we've got to give ourselves a little bit of grace here and realize that this can be quite the seismic shift internally about how we value ourselves as therapist, how we define ourselves and how we're defining ourselves to our patient populations. I think to the patients, to the potential patients, to our other members of the interdisciplinary team, we've done such a bang up job, talking about improvement, that when they don't feel that they're going to improve as, as the beneficiary or other members of the team say, well, that's patient, isn't going to get better. They don't even refer them to us. They don't even come to us because we've created this wall of you have to be able to get better, or you can't come to physical therapy. Speaker 1 (05:47): Yeah. Oh, I'm sorry. I was going to say, Cindy, what's your favorite line? When you talk about how we are addicted, like we, we are ingrained with improvement. What is your favorite line to say? Speaker 2 (05:57): Oh, well, I created a little, self-assessment like you answer these questions to get these points about how addicted are you. Because it, I feel very comfortable using that word because this challenge is a lot of those core beliefs. And we have identified ourselves by this. So tightly that it's like, okay, we, we have to step outside of our comfort zone a bit. And then as we see therapists start to do that, then we get the questions. Then we get the, okay. I kind of understand it, but what about this? And what about that? And what about this other thing? And that's when the myths all start to bubble up to the surface with where did that even come from? Speaker 1 (06:40): Yeah. So let's talk about some of those myths and see if we can bust them. So I will, I'll take, I'll throw it over to you guys. Either one of you can start, but let's talk about a couple of myths of maintenance therapy for me. One big one is, well, it's not covered. Speaker 3 (06:58): It's not covered by insurance. Speaker 1 (07:00): I'll take that one. This is thing. Yeah. Well you know, maintenance has been part of the Medicare benefit under any Medicare beneficiary part a or part B, since you can find it in the Medicare benefit policy manual, as far back as the, as the 1980s. So it's been around forever. This is not new, that Jimmo V Sebelius case that was brought forward. Just kinda shine the light on it, but it's never been that if you don't improve and services aren't covered or you don't have no, this idea that rehab potential is the ability to improve no rehab potential that we all typically document at some point is the responsiveness to care, right? That's what rehab potential is. Whether the care is going to allow you to improve from where you are at the baseline of assessment or to maintain or stabilize your function from where you are now without any unforeseen event in the next three, six, nine, 12 months, two years, are you going to be able to manage this condition and not decline, right? Speaker 1 (08:13): Or if you're in a progressive type of disease process, are you functioning optimally? And are we slowing that deterioration or decline? That is a normal part of the condition. So Cindy, I can pop a punch it over to you. And since we talk about it being paid, I think we busted that Karen. Right? We busted that pretty good. Okay. So, so other payers, I don't know, but anybody that is a Medicare provider, so under part a or part B, it, it is part of the benefit. Okay. So Cindy, talk to me about what are the type of conditions that are covered by maintenance as if the diagnosis determines it? What do we know about that? Speaker 2 (09:00): Well, very often what we hear is, okay, I understand maintenance therapy. I know what it's for. It's for people who have progressive neurological conditions. So it would make sense for Parkinson's. It makes sense for Ms. It makes sense for ALS. So it must be those three patient populations that are maintenance. Okay. We got to step back for a minute. There are patients with those three conditions that benefit and have the ability to improve with therapy. So it's not Parkinson's is synonymous with maintenance. And there's nothing in the coverage criteria that is diagnosis specific. Diagnosis is only one piece of the conversation. It is where are they functionally? What are the, what is the impact of this diagnosis and their resorted comorbidities on their functional ability? And what does a therapist know? What does that skill that you bring to the table that is unique to that discipline that is indispensable to this patient? Speaker 2 (09:56): But I think the myth of coverage has some roots in the denial issue. We, we can't go past this point without acknowledging that therapists have seen denials for providing maintenance therapy, that you did not show improvement in wham. They took away payment for part of this care, which is what drove the Jim versus civilians conversation that led to the court settlement with CMS to basically say, you know, Hey, we've looked at this benefit. It doesn't say you have to improve to get services. And, and we're, we're good friends with Judah Stein who was the lead attorney in that case, and still has the ability to call CMS back on the carpet and the legal sense about how that settlement has played out since, because CMS basically approached it with a oops, you're right. It doesn't say that shame on us, but it's like, wait a second. Speaker 2 (10:48): You've been denying coverage of services for a long time. And so it's very hard to say, yes, it's in there. And we understand it's in there. And D and I've explained the fundamental pieces of that, but there's still that I got denied, or I know somebody who got denied this can't possibly be true and it's unfortunate. And my personal opinion is I have a really hard time with CMS, just kind of Oop, seeing it versus, you know, ownership. And we saw a subsequent event to the initial Jimmo case that compelled CMS to put on their resources, particularly on their website, where they had to quote disavowal the improvement standard. So not just say oopsies, but say you have to flat out say that does not exist. And if beneficiaries qualify for these services, they absolutely should get them. Speaker 1 (11:36): Yeah. The, the, the woopsies sees that my bad defense never, ever seems to go over well, does it? No, no, no. Okay. So we talked about, is it covered? We talked about diagnoses covered. What other big myths are there surrounding maintenance therapy? All right. I Speaker 2 (11:59): Got one for you. D I got, you know, where I'm going. We very often hear they say, okay, so if it's not about their diagnosis, I need to assess the patient. Right. Figure this out. So now looking at what I typically do in an assessment, oh, test and measures. Well, those must not apply. Then I wouldn't be using tests and measures on a maintenance patient. And we would say, well, why not? Well, why would I measure something if I measure it again later? And it's the same, then why did I measure it to begin with? So any thoughts on those tests and measures in the maintenance patient D Speaker 1 (12:32): Yeah. Well, and, and I'm going to tie it to goal statements too, from there, right? So, so this idea, why do we take objective measurements of patients to establish a baseline, right? And we need to do that regard, you know, based on the presentation of the patient, regardless of their diagnoses and comorbidities, because we want to see if they're functioning at, or near where we would expect them think of a class three heart failure patient, are they functioning where you would expect, you know, a class three heart failure patient to function, or are they functioning like end stage, right. Class four, are they functioning below where you would expect them to function? And so obviously if there's room for improvement, a restorative or an improvement course of care is what your skills would be indispensable for. That's what would make your care medically necessary under the Medicare benefit part a part B that's what it would do so that the tests and measures, establish that baseline. Speaker 1 (13:30): And you compare, this is how the patient's functioning. This is how we'd expect them to function. Now, when you get a patient who is functioning at, or near where you would expect them to function with, with their PR their presentation, the question you have to ask yourself, as you don't just jump right to maintenance, right? You can't just say, okay, this a maintenance patient. They need me. Yeah. Basket. What do they need me for? You know, is there something I can teach them, train them, provide them so that they continue to stay, be stabilized, maintain, be accountable for their care over longer period of time. Right? And if the answer is yes, then you absolutely should pick them up on, on, on a maintenance course of care, because there's some sort of skills, your knowledge, your expertise, that which makes you, you, what I like to call the magic, that is me as a PT, right. Speaker 1 (14:21): And we've all had those magic. That is me moments. When you ever, whenever you walk or, or you, you readjust a, an assisted device to properly fit a patient and people look at you like, oh my gosh, why didn't we think of that? And it's just like, because you're not the magic. That is me. I mean, I, and we take it for granted. So the idea is that tests and measures absolutely help you establish a baseline and determine if there's room for improvement or they're functioning at, or near where you would expect them to function based on the severity, the course, the interplay of these disease processes. And then that helps you pick which course of care restorative or improvement, stabilization, or maintenance. And then you have to say, this is what my skills are going to be medically necessary for. So, so I'm going to tie that now to the next thing that comes, because if we get people this far down the myth-busting trail, Karen, the next thing they say is, well, how am I going to write a goal for that? I mean, if I'm not going to write something to improve, I mean, our, our documentation is called progress notes. I mean, you want to see how addicted we are. That's Cindy's line, right? We write on progress notes you know, Cindy, talk to us about goal statements. How can, how can maintenance patients actually have a goal statement if they're never going to get better? Speaker 2 (15:43): Well, I think, you know, we talked, we talked about coverage criteria, and then the documentation piece goes with that because I can't, and I'm going to kind of work backwards because what we'll see at times is therapists kind of go, okay, I understand it. And then you go to the goal statements and every one of them says, maintain this to maintain that I'm maintaining strength to maintain ADL's. And it's kind of like, okay, let's, let's take maintenance out of it for a minute. That that doesn't measure anything. What ADL's are you talking about? You didn't give any sort of quantifiable way to say what you're trying to maintain. So the goal solution is not to stick the word maintain in there as many times as humanly possible. It's still looking at it as we should be looking at it is what is that quantifiable element? Speaker 2 (16:29): How am I measuring something so that I can demonstrate whether or not we've improved it or stabilized it or slow the decline. And then the end piece is how was this functionally relevant to the patient? So I think what happens at times when D and I work with agencies about writing goal statements for maintenance, the by-product is actually their goal writing overall gets better. Because I think we've lost focus. We think, oh my gosh, I have to have an HCP goal, right? Because that's another addiction, you know, patient will have, you know, visual be independent with Hep. Well, it doesn't say what it's for. Why do you tend for them to do it forever? We don't know, but you have to have that goal. Then you have to have a strength goal. So, oh gosh, this has maintenance. I'm going to put, you know, increase a quarter grade. And yes, Karen, I have seen that documentation, the plan to increase one quarter grade, it's like, can you just go to maintenance and stop trying to improve in minuscule, teeny tiny amounts? Speaker 1 (17:27): How, how is that measured? I Speaker 2 (17:30): Have no idea. I thought half a grade was bad, but then we get into quarter grades. We see assessments that contain the terminology of severely poor. I thought poor was like the basement. I didn't know there was a tunnel under the basement. So this goal writing is really a good place to say, am I focusing in on, what am I quantifying? Why is this functionally relevant to this individual? Then we're setting the stage as to why therapy is in fact necessary for this person. I think the, I will maintain this to maintain that. Doesn't really speak to that. And then we'll go see, I got a denial. That means this whole thing is, is self fulfilling prophecy. They don't pay for maintenance. I will never do this again. And it's like, yeah, but did you really cover what you needed to cover and speak to why the therapy was important and why they needed to have it now? Yeah. Oh God, Speaker 1 (18:24): No. I was going to say, that's great. Thank you for that. Speaker 2 (18:29): But I think the extension of that, and I guess my way to push the ball back to D here as it were, is okay. So I've assessed them. I did my test and measures that wrote some goals. Now the issue becomes, I got to establish a care plan. So how often am I going to see them? And this is where at times, you know, when we had the ability to see folks in person, I swear people's heads are going to start spinning around in confusion because we start talking about things like you don't necessarily see these folks every week. You may see them once a month. And then D what about PRN visits? Can, can therapy use visit frequency? I mean, don't, we have to go or see them or interact with them at least once a week or else this won't be paid for. Speaker 1 (19:14): So talking about service utilization, you know, it's my answer is it depends. What does the, what does the beneficiary, what does the patient need, right? And so do I have to go three times a week for them to stabilize function? Do I have to go once every three weeks? What does it take? What is it that I'm doing that is indispensable for them that only can be provided by a therapist? You know, they can't go to the local you know, green, orange theory and have somebody work out with them in the gym and get the same benefit. What, why, why do you know, why does it have to be me? And so we, so we have to have an understanding of what's it going to take? How often do I have to go? And so when Cindy's talking about PRN visits, that's like a big no-no in home care for therapists, right? Speaker 1 (20:04): Under the Medicare part, a benefit in reality, it's not nurses do it all the time. You know, when they have to adjust Coumadin levels, right? For, or blood thinners, when they have to, if people still even on Coumadin, when they have to do sliding scale insulin adjustments, when they have to run labs, when they update or they're changing wound care orders, they write PRN visits all the time, but supposedly therapists can't do that. Well, that's not true because think about it. I think in, when I'm making this care plan, I'm not writing everybody for three weeks for I'm writing this person in five times a week, because they just got out of the hospital for an elective surgery. And I'm going to go every day, because if they went to an ER for SNIF, rather than home, they'd probably get daily therapy. Right. Okay. And this person was referred from maybe from their physician. Speaker 1 (20:54): And, and we're in the second episode of care, if you will, the second certification period. And there were still as ensuring that they are being, that they're stabilizing function. They're still teaching training oversight, checking, following up on 30 day reassessments to confirm that our interventions are actually working well, if I'm waiting on a piece of equipment, maybe that I decided, okay, we're going to get them a splint or something to meet, or we're going to get them this, this device. And we have to go through all the machinations with DME. I could write that I'm going to go out one time a week for four weeks. But what if that device doesn't come in for two weeks, what am I going to do? Just go, yada, yada yada. And the second week of that 30 day period, or do I just write like a PRN visit that says, you know, when the device comes, if it's not a, you know, when I would normally go out, if it's not going to be there, when I'm planning to go out, I'm not going to let it sit in my office or the back of my, you know, the boot of my car for another week. Speaker 1 (21:52): Or I'm not going to write an add on order. I'm going to have this PRN, but well, it's come in. I wasn't planning on seeing you for a week. I'll bring it out there, fit, adjust it, set it up, teach you how to put it on Don and doff it, you know, check your skin, how to wear it, everything you need to do. It's the same thing. Think about when you think about Karen, when you tell your patients, oh, Hey, if you have a problem with this exercise program, give me a call. How many calls do you get? I don't get that many calls. And then I go back out there and they're doing like rhythmic gymnastics with the Sarah band. And I'm like, that's not what we taught you. Right. That's not the correct exercise. So, so this is a way this, this kind of go out as often as you need to, and not one visit more is appropriate, not just for maintenance, right? Speaker 1 (22:37): So, so writing, writing utilization is really hard for people to understand, because they're used to seeing their patients every week and that doesn't sometimes have to happen. How long do you have to wait to see if the exercise program was efficacious two weeks, three weeks, four weeks, how long, you know, you've got to base it on what, you know, what the evidence shows us? What, what, what our, you know, our, our scientific literature says that's important. So, so I have one more myth to kind of finally push the ball back to Cindy since utilization depends. So now we've got people test to measure some kind of goals that aren't just written, maintain. We have utilization. That seems to be very beneficiary specific, Cindy now, cause they're on maintenance. I got to see them for the rest of their life, right? Speaker 2 (23:29): Yeah. That that's, that's very common and, and it kind of splits into different ways. Karen, sometimes it's the, I made a lifelong commitment because they could decline at any point in time. So by that standard, this is forever or there's the gleeful hot maintenance, a great way to go for patients that don't want to be discharged. So as opposed to them crying, when I talk about discharge or the daughter runs back to the doctor and keeps getting orders, I'll just put them on maintenance and then everybody's happy. Okay. You can't do either one of those things you still are accountable to skilled, reasonable, unnecessary. So the benefit is clear. You can't just keep going or having them come to see you at the clinic, just because you're nice. This does need to require the skills of a therapist. We're still accountable to all of those criteria. Speaker 2 (24:19): And as di said earlier, if there's nothing left to teach, train, or do I can't just do it because you either don't want to, unless I stand here or the caregiver doesn't want to have someone else can do it just as well as I can, that this is no longer considered skilled. And that's what drives the decision to discharge as well is when I have taught you what I, everything that I can the program I've given you is effective. It is in fact stabilizing function. There are no more adjustments to make. There are no things that need to be changed, then you really don't need me anymore. And that's where I think that it comes back to again, how are we finding our value that I think we've gotten very used to. They come to see us X number of times per week for this number of weeks in a row. Speaker 2 (25:07): Then we say, okay, you're done. The order is done. If anything goes wrong, then come back again. Where maintenance really makes us think about a term we use very often is how are we dosing ourselves? So thinking about ourselves, like a medication, when do they actually need that encounter with a therapist? And when we've reached a point where you don't need it, there's nothing I'm doing that is uniquely therapy, then we need to stop. But I think the hard part in that, Karen is some of our skill and touched on one, oh, I had just a piece of equipment in the family looks amazed because that is a skill. You, you know how to do that because of your training. I think sometimes the decision to discharge, we jumped the gun too fast, whether it's a maintenance approach to care or restorative by this. Oh yeah. Speaker 2 (25:53): They got it. They understand it. I don't really, you know, they're just doing the same thing, but are you still contributing something? Are you still making any sort of adjustments? Are you convinced? Because on the restorative side, I've never understood these, you know, lofty strength and improvement goals for a two week care plan that suddenly, you know, the, the they've gained a whole muscle grade in two weeks. I don't know what literature I missed, but this, this, this will be great because I'm going to go join a gym for two weeks when it's safe for me to do so. And then I will be fixed in two weeks. It's all done. So I think it, again, challenges us to think about, have we done everything that we can, are we confident as do? You've said more than once. I mean, we've taken care of mitigating concerns. Speaker 2 (26:37): I mean, if they may have a completely unexpected stroke next week, I'm not expected to be telepathic, but I have looked at your condition, given you the tools and resources. And in fact, whether there is nothing left for me to adjust to do, I am going to discharge. So there is active discharge, planning and maintenance care. We are, we are not saying because of this decline risk, then I'm here forever. And we also have to be careful because a lot of beneficiary advocacy groups have done a great job, educating our patients about this, who will then come at us with the resource. You can't discharge grandma because I've got this GMO thing. And it says, you have to, that's where I think some therapists have gotten caught and been like, oh, okay. That looks like an official document. I'm going to keep having you come to the clinic. I'm going to keep seeing you in the home. And it's like, wait a minute. That's why you have to know what the rules really are because yes, beneficiaries should be educated, but they don't necessarily understand the coverage criteria very well, just because they want this to continue. Doesn't mean it's automatic because of that, Jim. Okay. Speaker 1 (27:43): Yeah. And I think that that is where your judgment as a physical therapist and as the authority figure in that situation, you really have to come down from on that and, and be able to explain exactly why you're making that decision instead of just being like, oh, okay. I guess I'll just keep seeing the men, even though it's at this point, not medically necessary. So what, what advice do you have for the physical therapist who might be in that situation? How do they then speak to the caregiver, the patient, et cetera. So that's, that's happened to me cause I've been providing maintenance therapy. When I had my Medicare certified agency in central Florida, way back 2008, 2009, been doing it a long time because we get tired of people. We get them better and then they'd go off and then they decline and then they come back on. Speaker 1 (28:41): I'm like, we're missing something. We have to be able to monitor these people. I watched nurses do it all the time with the monthly catheter changes, right? Because most people are not good at self cathing and preventing infection and doing it accurately. So they'd end up in the hospital, you know, with some sort of puncture or something or an infection. So, you know, monthly catheter changes can happen for years and years with nurses. So what were we missing here? Here is the bottom line for clinicians. I, when I have taught and trained everything and my skills are no longer necessary. You ask yourself, is there somebody that could oversee that could carry this out with you? Because it really just requires sometimes the assistance of another person or a cheerleader or somebody to motivate you or supervise you. What we have a lot of patients that might have cognitive and limitations. Speaker 1 (29:31): And even if that person isn't available, just imagine, just ask yourself the question. If that person holographically appeared in the room, right, and said, teach me train. And they were capable. Would you give it to them? And if the answer is yes, then you should no longer be going anymore. So what I tell patients is I will say to them, I understand that you want me to come, but as a licensed physical therapist, I have a fiduciary responsibility to the payer and the payer has requirements. And one of them is medical necessity. And at this point you need to do this, but you don't need me as a physical therapist to do this. So I can teach and train you, your spouse, your family member, a paid caregiver, or you can pay me to come, right. But I cannot bill your insurance for this because I would be in essence, fraudulently saying, it's still required. Speaker 1 (30:27): My skills, knowledge and ability when I'm telling you it doesn't, it just requires another pair of hands or somebody that could be shown a lay person, how to do this. And so they're like, oh, well you calm. And then I'll tell them, this is what it costs to privately to pay for a physical therapist. And some people take me up on it. And some people say, oh no, I'll get my grandson to come over. Can you show him how to do it? And I'm like, that's great. So, so I think we have to, like Cindy was saying, we have to understand the regs. We have to understand this. Doesn't go on forever. We have to understand that when we are going to sign our name with our credentials, so hard earned right through through education and practice that we are basically signing an affidavit. If you will. Speaker 1 (31:13): That says, I attest that this meets the requirement of this third-party payer. If Benny therapists stopped, many clinicians heck stopped and thought about that. They might not provide some of the services that they're told they have to provide or do the things they have to do, but it's really comes down to our license. So when I sign that and say, this is medically necessary, I I'm going to make sure that I show that my skills and my contribution to that visit is a billable visit. If I no longer have needed for that, then I can teach and train someone else, or I can discharge them from the third-party payer and they can pay me privately. They could, it can be a cash based service. And that has happened. Speaker 3 (31:56): Yeah. Yeah. That Speaker 1 (31:57): Makes so much sense, guys. This was so good. I just know that therapists are going to have a much better idea of what stabilization care is versus maintenance care. We won't use that term anymore. Maybe we can, we can change that preservation of function, care stabilization of function, carrot just, it sounds it's. I think it sounds better for the therapist and quite honestly, like more humane, more human for the person that we're caring for. Instead of just maintaining someone, you know, we're preserving their function, we're their ability to do the things that they want to do. Just sounds so much more, I don't know, human than maintenance care. It sounds so cold and sterile. I don't know. Maybe it's just me. No, I think, you know, for me, when you say that, it makes me think that we are helping patients be accountable for their chronic disease management. Speaker 1 (33:01): Right. We are teaching them what we know and how important it is for people with aerobic impairments that they have to maintain that lung capacity you know, within the confines or the constraints of that disease process so that they can continue to do their self care, which is metabolically demanding. Right. So, so it, it really, it really shifts responsibility. I think maintenance is a very passive sort of thing that, you know, we're, we're maintaining range. You know, I, I think you know, people that were doing stuff to versus where we're in we're we're arming people with the ability to manage and be accountable for their chronic disease and to, and to function optimally within the constraints of those, that disease or those diseases through a stabilization or preservation of function. Yeah. Speaker 2 (33:55): And I think it's important to, to just kind of circle back a minute that we don't want the visual now to always be maintenance patients or stabilization patients are very debilitated, have to have a caregiver, very ill individuals. These, we can teach these types of programs to the patients themselves, for them to self manage. I think sometimes, you know, okay, I'll give it up. It's not Parkinson's ALS and Ms. I got that point, but these must be like really sick, bad off people. They might be, but they might not be, they might be the heart failure patient that's functioning pretty well right now, but has a history of pushing themselves too hard. So the now kicks in the fluid overload. It ends up back in the hospital because they're overdoing. How do you better task plan? How do you help someone understand when their disease process gives them good days and bad days? Speaker 2 (34:45): What, what do we want them to do on a good day? What do we want them to do on a bad day? Because we know many of our folks that are receiving therapy. Cause they basically think that we're gym instructors, we're gonna, you know, show up for the treatment, wearing spandex and tell them to drop and give us 20 anyway. So we're trying to get past that, but on a bad day, too many of our patients, regardless of diagnosis, sit and wait until they feel better, maybe, you know, with a recent orthopedic surgery, a little bit arrest, okay. We encourage some rest. That's not a problem. And some of these chronic diseases, you're one day turns to two days, turns to a week, you haven't done much of anything and now you've compounded the problem. So I think you're right. It does feel like we're utilizing our skills in a more person focused way meeting them where they are. Speaker 2 (35:34): But I think, you know, very often just briefly we'll get the, well, what are the treatment interventions for maintenance you didn't in this whole conversation, give us any treatment strategies because it's not about the treatment. It's not about the assessment. We do what we do. We have the tools in the toolbox, but what, what are we trying to get to? What is the end vision for this individual? And then I'm going to utilize what I know how to do best in that context. I just think for a lot of us, we felt that door was never open. That you were not supposed to do that. That if you could not show significant improvement that you had to discharge and Dee and I have seen therapists, when you see the wheels turning, I've said a couple of times we need to develop like a stages of grief equivalent for the discussion of maintenance, because we'll have people get mad. Speaker 2 (36:21): Like I can't believe nobody told me this. And then you'll see guilt, you know, oh my gosh, I've had patients and I discharged them. I thought I was doing the right thing. I'm a horrible therapist. What am I going to do now? And it's like, okay, let's just start looking at the information and change what we do going forward and not go backward and be all upset and think we're horrible or mad about who lied to me. It didn't tell me about this before, but we do need to start making a difference. Cause D and I heard far too often, you know what? That was interesting ladies, but we don't do that here in this clinic. We're not going to do maintenance therapy. And it's like, wow, you just get to unilaterally, decide you're out. If you want to be out, that's fine. But then you want to direct them to a clinic that does do it because if they need it and they qualify for it, then find them a provider who will, but this kind of, oh, I never heard of it. I'm not participating thing is, is very frustrating in the current environment. Speaker 1 (37:14): It's, it's not correct. I mean, we have to understand beneficiaries have paid into this benefit. They are entitled to it. And if their presentation is such, that stabilization of function is the appropriate course of care. They are entitled to it. It is part of their benefit package. You don't have a right to say, oh, we'll take you on care. But you know, you're not going to get that. That that's that's you, you can't do that. I mean, you either provide the care that is within the insurance. Right? I mean, think about it. If you went to Jiffy lube for your 32 point checkup and they charged you 90, 95 and, and you only got 10 of them because that, oh, we don't do those other 22. Would you be paying for, I wouldn't as like, listen, I'm entitled to this. This is what I'm appropriate for. Speaker 1 (38:07): It's part of my benefit. Maybe you don't do it, but you can't determine that I don't get it if it's part of my benefit package. So it really comes back to the beneficiary. If they're entitled to it, we, as professionals are not ones to say, we can recommend and say, I don't think that's the appropriate course of care. But to literally say, we're, you're not getting that component of your benefit. I don't think that would go over very well. Do you care? Do you not? No, not at all. Not at all. Especially with, you know, like you said, people have been paying into this, their whole working lives. If it is part of the benefit you should offer it. For sure. And if you're a physical therapist who says, I don't know how to do that, well, you better get educated and learn how to do it. Speaker 1 (38:56): Exactly. The things that I am not the most gifted at as a therapist. So I'm not just going to start dabbling in dry needling. Okay. That's that's not my area. Oh yeah. Just give me some, you know, go into the pin cushion and let me start working on you. It's a skill set and it's something that you have to understand the rules and regs. You have to understand what the payer source requirement is, but we as clinicians don't need any other evaluation skills. We don't need any other tests and measures. We don't need special interventions. What we need to understand is that there are times that we are indispensable to help people improve and recover function back to a prior level or maybe beyond. And then there's times we are, we are needed. We are indispensable to preserve and stabilize their existing function so that their quality of life can continue on in the fashion that it currently is perfect. I was going to say, do you want to button it up? But I feel like that did it, but now listen, before we wrap things up, let's talk about the book, the guide to the two delivery of home-based maintenance therapy. So talk about the book, where can people find it? And what will they get out of the book? If people go and purchase this book, what are they getting? Speaker 1 (40:16): Well, they're going to get DNA, Cindy. That's what I'm going to start with. They're going to get us, they're going to get us. They're going to get an updated version. I think it's the only book. And actually it's our second edition and really focused on community-based care part a and part B for Medicare, right? Whether it's part B in a clinic or part B in the patient's home. And we really focus on the rules and the regs. And we and, and literally walk you through common case scenarios. We try to myth bust, and we try to give you a how to like how to start to think about this, because I think theoretically or conceptually when, Cindy and I talk about this and we've been talking about this for eight or nine years now. And teaching on this, people don't disagree with this. They fundamentally understand, they just don't know how to operationalize it. They don't know how to, if they see it. Okay. Well, I understand what you're saying. I understand. I, I agree with you. That would be, I could see where that would happen, but then how do I do these things we've talked about? So Cindy, what does this second edition really afford them? This time around that, you know, it was kind of like a value. Speaker 2 (41:30): Well, I think part of it came from, we were folks, as you just said, understand the concept, but then struggling to say, I got chew on this for awhile. This is really going to change my core, that I am not just defining myself by improvement. I got to work through some stuff and figure out how to do that. And so our first edition started out. We have a consistent scenario throughout to really talk about assessment and goal writing and detail and all of those pieces. But then as we looked at the second edition, we said that that's a good place to go. You got a nice, consistent scenario. It builds throughout the entire book. So you have opportunity to do that. But then this time around you know, I think you got the sense. I tend to be more in the regulatory nitpicky, wheelhouse, and D tends to go toward the operationalization side. Speaker 2 (42:18): And so she brought up, why don't we put a workbook with it? Why don't we add to that idea of a consistent scenario and say, what are some additional knowledge application activities? How do you comment that same thing about assessment or goal writing a little bit differently than one scenario to really get the juices flowing about how to do this. Now, the challenge is, is there a right answer? Like, do I just go to the answer key? And there was only one way that could have been done while listening to this conversation. There was quite a few, it depends. How often would I go? What would I focus on? So the answers give you some context, some suggestions, some validation, but it was not meant to be, there's only one way to do this. And in a scenario, you know, five sentences long, you better figure out exactly what you would do all the way through this only one path, but it's really to help kind of put those guard rails on and say, well, did you think about this? Speaker 2 (43:14): Or what about that element to, to be able to say, okay, I am understanding this. So I could use that as an individual to go through that process, or I could use it in an organization and do it as a group activity, but to really help people continue to process what sounds like. Yeah, I got it. But now I have a patient in front of me and, and I'm still stuck. Old habits die hard. I still struggle with the goal. I still think I can fix this. I, I still feel that voice in my head. That's telling me if they're not getting better, you're not supposed to be here. So people need that opportunity. So we wanted to provide that in a tangible way that, you know, doesn't really lend itself to an educational event unless the thing was days and days long, and people camped out with us, which nobody wants to do. But gives them that opportunity to come to step away, think about and come back to it at their own pace. Speaker 1 (44:07): Awesome. And just so everyone, all the listeners out there the book, the guide to delivery of home-based maintenance therapy, it's on the Kornetti and craft website, but we will have a link that takes you directly to the book and, and listeners. If you use the coupon code KK 2021, you'll save percent on your purchase. We will have all of that at the show notes at podcasts on healthy, wealthy, smart.com under this episodes, you don't have to remember it. You don't have to send everybody DMS and things like that. Just go to podcast at healthy, wealthy, smart.com click on this episode, it'll be under the resource section in the show notes. So we will make it very, very easy. That's all you got to do is one click, and it'll take you right there. So now before we wrap things up, the question I ask everyone on the podcast is knowing where you are now in your life and in your career. What advice would you give to your younger self? Speaker 2 (45:19): Come on Cindy? I would say, well, I, I would say to my younger self to be a bit more open-minded with how physical therapy really works in reality. I think career-wise would come out. I came out very, this is what I'm going to do. And, and briefly my goal is I'm going to work in a traumatic brain injury unit. I loved working with that population as a student, I'm going to be a famous therapist in a big old rehab facility. And now I'm going on nearly 30 years in home health and have never actually worked in a, in a fancy schmancy rehab clinic. I started this kind of on the side, fell in love with it and never went back. I tell, I tell students all the time, don't assume that what your path is at the moment is the path and can't vary and can't change whether you go into teaching, whether you go into other avenues there's a lot more possibilities and it took me a little while to process that piece to say there, there are many other ways you can utilize your skill to benefit those around you. Speaker 1 (46:28): Excellent. D I would say to my younger self I may not come across that way now 30 going into my 36 years a PT, but I would say don't be afraid to ask questions and don't think you have to know it. All right. So I, I think that I kind of stayed in my box a little bit more and got really, really good at what I did. Some of that time, Cindy was in a traumatic brain injury a locked unit and I got very good at what I did, but I had a lot of questions about, but what if, but why not? Right. And I think sometimes I kind of just that maybe I shouldn't ask that question. I was a little bit too con you know, self-conscious about it. And so I, I think the idea is ask those questions, be fearless. Speaker 1 (47:18): And, and instead of asking, why would I do that? You know, look around. Why not? You know, I'm a big, why not, if you've got a great idea, you have something that is like a passion, and you've got that intersection of your passion and your skillset go for it. Right. A good friend of Cindy and mine Dr. Tanya Miller started event camp for kids. Like when she was like a new grad PT. It's like in it's what, 27th year. And she's written grants for it. And, you know, they take these kids on ventilators out in kayak. I mean, you can do it, you can do it. So be fearless and don't be afraid to ask questions. Don't don't, don't think, oh, well, I don't know as much as Karen Litzy or I don't know as much as Cindy craft, you know, start to explore that the possibilities are endless. That's what I would have told myself when I was younger, fabulous advice from both of you. And I couldn't agree more. Thank you so much for coming on for sharing all of this great information and your book, and it's just sounds great. So thank you so much, Dee, and thank you so much, Cindy, for coming in. Thanks for having us, Karen. It's always nice talking to you. Pleasure. We had a great time. Excellent. All right. And everyone who's listening. Have a great couple of days and stay healthy, wealthy and smart.  

In this episode, Circus Medicine Specialist, Emily Scherb, talks about all things circus. Today, Emily talks about recreational circus, how physical therapy comes into play, common circus injuries, and the things physical therapists should be aware of. How is "circus" defined? Hear about important lingo, one of Emily's favourite circus stories, and get some valuable advice, all on today's episode of The Healthy, Wealthy & Smart Podcast.     Key Takeaways   •       "Circus is everything that can happen in a performance environment that would be defined as 'circus.'" •       "Ask questions. It's okay to not know. With these artists, they're expecting you to not know." •       "Figuring out the demands of the sport can be really challenging if you don't speak the language." •       "Every circus artist has a video of them training on their phone." •       "Use the knowledge you have, and then seek more information." •       "Circus really is for everyone." •       "Be brave enough and take the time to listen more. It really does take bravery to admit you don't know everything."     More about Emily Scherb   Dr. Emily Scherb is a physical therapist specializing in circus and performing arts medicine. Through her 30 years of training and working in the circus arts she has gained deep insight on how circus bodies work in the air and on the ground. Emily now teaches workshops for circus artists, instructors, and healthcare providers with the mission of improving health and safety in circus training and performance. Her bestselling book Applied Anatomy of Aerial Arts was published in 2018.     Suggested Keywords   Circus, Physiotherapy, Medicine, Artists, Safety, Injuries, Lingo, Performance, Healthy, Wealthy, Smart, Healthcare, Training, Fitness,     Get 80% OFF Emily's Course: Learning The Ropes Course 12 Weeks of Circus-Based Knowledge and Content: Circus Fusion   Circus Vocabulary List: Circus Vocabulary   Get Emily's Book: Applied Anatomy of Aerial Arts       To learn more, contact Emily at:   Email:              Emily@thecircusdoc.com Website:  https://www.thecircusdoc.com Facebook:                        The Circus Doc Instagram: @thecircusdoc Twitter:    @thecircusdoc LinkedIn: Emily Scherb   Subscribe to Healthy, Wealthy & Smart:   Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy- smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:                                    https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript Here:  Hi, Emily. Welcome to the podcast. I'm happy to have you here. Speaker 2 (00:06): Hi, thank you so much for having me. It's really exciting to get, to spend some time talking about circus with you. Speaker 1 (00:11): Yes, and I'm excited because as we were talking before we went on the air it was, it sort of changed my outlook on what circus is and what circus quote unquote performers are. So we're going to get into all of that, which I think the audience will really love. But before we do that, can you talk a little bit about your journey into this niche, into working with circus performers or circus athletes? Speaker 2 (00:40): Absolutely. I started off as a kid who loved gymnastics love to flip and fly and just be in my body and move through space. And I stumbled on circus as a hobby at a summer camp when I was a kid. So I started doing circus and I was really young and realized that I loved to perform way more than I love to compete. So the competition aspect Gnostics was fun for me, but I really just liked being out there in front of the judges and smiling and doing my thing. And I realized I could do that with circus. And it was a really collaborative collaborative environment and very challenging and very similar ways. And so I started circus as a kid went through high school, continuing to expand my knowledge about spickets and my own body. When I could, there was not a lot of resources for learning circus at the time. Speaker 2 (01:27): And after high school, I moved out to the West coast and joined some aerial dance companies to continue to pursue professionally knowing I'd go back to school eventually. And I did. So I went, I went to undergrad every summer, either working at a summer camp teaching circus, cause that was a popular place for circus schools to be, or wherever I could get a job teaching circus doing circus during the summers after college, once again, much, much to my parents' chagrin. I took more time off to go back and do more circus. And I moved to New York to your neck of the woods, spent some time there working with a dance company called strep and with trapeze school, New York while I was there and teaching circus, doing circus and professionally using my body through space as a performing artist before going back to grad school. And then even in grad school, I may have taken residencies and done my clinical rotations where there were circus schools. So captain was part of my life for sure. Speaker 1 (02:29): That's amazing. And now before we go on, can you define what circus is? So you're teaching circus and people think, wait, circus is, I thought circus was a show or an event. So I'm a little confused. So can you define what that is? Speaker 2 (02:47): Really great question. When I say circus, it's also going to be slightly different than when someone else says circus circus is everything that can happen in a performance environment that would be defined as circus, which is debatable even in the circus community. So circus is acrobatics. It's aerial artists, it's juggling, it's clowning, it's acting, it's dancing, it's communicating through movement, it's performing arts and what qualifies a circus is kind of the definition of the individual company members that are involved in the, in the creation. When I say I'm teaching circus for me, I'm primarily teaching aerial arts, I'm teaching flying trapeze or I'm teaching aerial silks. It's like that fabric that hangs down or I'm teaching a static trapeze or rope or web there's lots of different apparatus and lots of different challenges for the body. I just prefer my challenges to be off the ground and in the air. So when I say teaching circus, I personally mean Ariel. Generally I have taught tumbling as well. But circus is a huge, huge arena for challenges to the body and performance challenges in space. Speaker 1 (04:09): Awesome. And now when, when we're talking circus and when people think of circus, they might think of Ringling brothers, Cirque de Solei, these, you know, grand extravagant performance artists. But I know what you want to talk about is the growth of what we would call recreational circus, recreational circus athletes, let's say. So I want you to talk a little bit more about that. I'm just going to throw the mic over to you to let the listeners know what the heck is that and where does a physical therapist come into play? Speaker 2 (04:47): Absolutely. so circus in the U S has grown exponentially in the last 15 or so years. We went from having maybe 10 schools for all levels. But like I said, I started a summer camp. That was an opportunity. A couple of the universities around the country have had circus schools. So like Florida state university has one. There's some youth circuses in, in like circus Ventas in Minneapolis, Minnesota when actually youth circus out here in Washington where I am, those have been around for a really long time, but then there's this phenomena of circus rapid rapid growth in this last 10 years. We've gone from those 10 or so schools to having over 800 schools in the U S that I know about, and that's counting circus schools. That's not including aerial yoga. And that's not including pole-dancing studios that might have an apparatus or gymnastics gym that might have an apparatus or two in their space. Speaker 2 (05:46): So circus has not only grown for recreational use of it's not only grown for recreational artists across the country to, to try to do after work or on the weekends. It's also growing in these other niches and, and kind of just keeps expanding. So there's things that we can all do after work or on the weekends to keep our bodies healthy. This can be our, you know, our soccer game instead of soccer game, I'm going to go take a class and I'm going to stay fit and stay strong and build my community through the circus world. The other thing that's really happening in, in an interesting way in circus is the development of what's called social circus, which is using social using, just using, Speaker 3 (06:35): There we go Speaker 2 (06:38): Social circus, which is using circus to do outreach and community building through specific groups often involving a social worker or using trainings that have a lot of which have been developed by search delay through a program, they call sick demo to do outreach in schools and in different settings that make people grow and increase physical literacy to also increase health literacy. There's a urban youth circus in St. Louis called circus harmony. That's been around for decades. I should know when, but it's been around for decades and they have youth classes and they also have these youth performers performing every weekend at a, at a museum. And they perform every weekend. They have the social responsibility of showing up, getting their work done. They, they really have that community building element. There's also been studies all over the world, but the one I'm thinking of in Canada in the fiscal education system that uses circus is as PE class to have an equal growth of both boys and girls. Speaker 2 (07:47): And they find that that does not have a gender differentiation. Everyone has an increase in physical literacy in those, in those groups. So it's a great way of reaching out that way. Here in Seattle, we have a women's group, a women's circus group. That's run by a social worker here which is a really great resource for, for these women. We also have a boys and girls club group that comes in and we have on the other side of things on the more medical side of things, we have circus it's been adopted for anyone to participate. There are juggling tools that don't actually involve throwing and catching. They involve rolling in gliding so that they can be a little more accessible. We can take our aerial apparatuses and lower them down to the ground. So we can use it like the aerial silks, more like a sling or a hammock where you can tie the bottom together. Speaker 2 (08:36): And you can use that for compression. You don't need to have quite as much balance or grip strength. So we've been able to do work with kids with cerebral palsy and had great work with them on the trampoline, kind of getting some, some input with them there and then taking them to the air and they get to do things that are cooler than their friends. They have to go back into and tell stories. And on the other side of that, we have adults with Parkinson's and we have a Parkinson circus group and using the novel learning novel movement, learning of circus with Parkinson's to make improvements and give them more comfort moving in their bodies as well. So circus has just really expanded into the recreational world and into every aspect of movement, which has been incredible boon to, to see, and, and to be on the sideline of, as a physical therapist, my personal interests tend to be more on the orthopedic side, but if there's someone out there who really loves working with pediatrics, and you want to get involved with circus, how cool, you know, someone, someone comes in your door and they have difficulty with dorsiflexion, but what if the goal is to hook their foot on something instead of just trying to make their ankle move, you know, and it gives different goals and different levels of excitement for all sorts of artists of all ages and abilities. Speaker 1 (09:53): I mean, this is so much more than I was thinking. I was literally thinking that what you do within circus medicine is just working with like Cirque de Solei or professional. Like I had no idea, the large umbrella that is sort of circus and that is circus performing and yeah, so much more fun, Speaker 2 (10:19): So fun and so cool. And it's incredible because all these schools have popped up that most of us can within a couple mile radius find a circus school to take a class in on the weekends if we want, or are likely to, as healthcare practitioners have a client will walk in the door, who's taken a class and wants to get back to doing it as their physical activity. Speaker 1 (10:39): Okay. Well, let, now let's talk about that. So, because let's say you're a physical therapist and maybe this is not your specialty, but like you said, if there's this huge rise in recreational circus, we may be seeing people who are coming in for an injury that maybe they got well doing circus. So let's talk about what are some, and if there are common injuries that one may see understanding to all the listeners understanding, like we said, this is a huge umbrella, so we're not going to go over every single injury, but let's talk about some common ones that maybe the everyday PT might see from one of their recreational circus athletes. Speaker 2 (11:23): Probably the most common one that I see in my practice is chronic overuse of the shoulder. And when I say overuse, I mean under preparedness for the activity that they're undertaking and that's because most of us live our day-to-day life, especially right now in front of our computers, typing away with their arms in front of us and reaching out to our laptops. And then when we go into the circus world and we're all of a sudden asked to bring our arms all the way up, overhead stabilize our entire body weight, without relationship to the ground, or only in relationship to the ground, if our legs are over our heads and we're in a handstand, our shoulders just aren't necessarily prepared for that level of load. And so there's definitely a pattern of different shoulder problems that crop up. So there's, there's a lot of chronic shoulder pain. Speaker 2 (12:13): And some of my job is also go into the circus schools and educate these artists that, that chronic shoulder pain is not normal and that they can get rid of it. So that's also a huge, huge thing is there's a, a saying in circus that is pretty pervasive, which is circus hurts and circus does hurt in that you're pushing your body in new ways. You may be having pressure against an apparatus. Maybe you get a bruise and that's okay, but circus shouldn't hurt like an injury hurt like deepen the joint hurts. So that's one of those things I try to get out there and, and explain to people there's of course, more acute injuries both of the shoulder and the rest of the body, but that, that's one of the biggest ones, especially in my aerialists and a little bit in my hand balancers. Speaker 2 (13:01): And even my recreational contortionists, that is a thing we have recreational contortionists now, which is incredible. The other really big injury is hamstring strains, proximal, hamstring strains are a huge one. I can. Same thing. Yeah. So we're getting to end range possibly with dynamic motion. So maybe if there are tumbling and working in the ground and they go to do a Cartwheel for the first time as an adult, or the first time in a very long time as an adult, and you're kicking your leg approaching end range rapidly without necessarily the preparation, strength and control at that end range. So that's, that's another one that's really common. And then, Oh, go ahead. Oh, say one of the, the third, probably most common injuries are ankle sprains, either from landings or falling off mats. So often protective equipment can also be in an interesting challenge as well. Speaker 1 (13:55): Oh yeah. That makes a lot of sense. I was a gymnast for many years when I was younger and I always had an ankle sprain. So I would feel like I remember being on crutches at least once a year, once every other year from an ankle sprain. So I can definitely see that now let's say you're a physical therapist like me or others who do not don't have like this vast knowledge on circus and what is involved. And someone's coming in to see me with chronic shoulder pain. I don't expect you to go through a whole eval here, but what are some things, maybe some questions we want to ask some things that we should be aware of and then maybe even some resources you can send us to, to look at, Hey, what are these people doing? Speaker 2 (14:45): Yeah. So great question, because I think it really will be a challenge that we will face soon. I hoping circus keeps growing beyond the pandemic. And as, as circus schools keep keep expanding. And I hope that you will get to see eventually a circus status walk into your clinic. So the first thing is, ask questions, ask questions, ask a lot of questions. It is okay to not know with these artists, they're expecting you to not know. They, they probably learned relatively recently, all the things that they're learning about circus. So ask questions, ask them what their discipline or their apparatus is. Ask them if they're an aerialist or a ground Acrobat. Are they doing handstands on the ground? Are they doing handstands on another person holding them up? Are they hanging from a bar or a horizontal apparatus grabbing kind of like with normal shoulder flection or are they holding a vertical apparatus? Speaker 2 (15:43): Like those aerial silks where they might be grabbing one hand up stacked on top of each other. Let's just give you, gives you an idea of what kind of shoulder range of motion they're going to need. And what they need to do with their body is also asking what level they are. Because as recreational circus grows, circus artists people are defining themselves as circus artists in different ways. So the recreational artists may still say, I'm a circus artist. And so might your professional. And so really diving down, what does their training look like and who are they? And then specifically to the shoulder, I just want to reassure everyone that circuit shoulders aren't that different. They are just functioning at, at end range. So you just need to make sure that all the things you normally look at are working and are working at and range. So if they need to get into field reflection, making sure those last 10 to 15 degrees, if their mechanics look perfect and I do a lot off the ground sorry, I do a lot on the ground without them being in the air. And you can learn a lot just by watching their movement through everyday activities. Even if they're not having pain with those, they may only have pain with their circus activity, but there's still things you can see with your professional life that really can be helpful. Speaker 1 (16:57): Awesome. And then obviously when you ask those questions, you look at that end range being so important, and then you get into the treatment. And again, this is where, you know, as a physical therapist, you're looking at, what are the demands of the sport? What does this person have to do? And how can you create a plan around that? Is that about right? Speaker 2 (17:17): Yeah. And so figuring out the demand to the sport can be really challenging if you don't speak the language or you don't know what the apparatus, the discipline is that they're doing. And here's the cool thing. Every single circus artist has a video of them training on their phone. Speaker 1 (17:31): Oh, that's so smart. Of course. Right? Speaker 2 (17:33): So everyone's like setting their phone up in the corner and watching themselves trained. If they have a move that's painful, they usually have a video of that too. If you didn't ask them in advance to take one, if you have that opportunity, that's fantastic. And if not, just ask them, Hey, you have a video of you doing that and you can get a general idea of what they're doing. If you, and, and that's interacting with your patient as well, in a way that's kind of building that trust trust with them, that that level of interest, if you have advanced knowledge and you kind of know what's going on, Google it, it's amazing. There's so many beautiful performers out there and you can Google almost any apparatus and see how they interact and what they need to do. Again, it's going to depend on their level, but it gives you an idea or even better. If you do have access to a circus school, taking a class, if you have the have the ability to do it, or just go out and observe and see kind of what's going on with their bodies it can be really fun and educational and the, both the students and the coaches usually love it. They love knowing that healthcare providers are interested and want to get involved with their bodies and help them perform better. Speaker 1 (18:41): Awesome. That's all great tips and great advice because I just don't want PTs to walk away from our conversation and be like, well, that was really cool, but what am I supposed to do? Well now, you know what to do. Speaker 2 (18:53): Absolutely. Yeah, yeah. There's plenty of resources out there. There's not plenty of resources out there. There are, there are resources out there to seek knowledge in how to work specifically with circus artists, but there's so much you can do with the knowledge that you already have. And that's the real key is use the knowledge you have and then seek more information. The artists are great resource themselves, and they really want to get the most out of the treatment and that interaction. I have learned so much from my artists. I give them an exercise, they come back making it three times more relevant, and I've taught me so much over the years, which is just absolutely incredible. Speaker 1 (19:35): Yeah. That's pretty amazing. And is there like lingo or jargon that if you're going to be working with this population that you should really know, Speaker 2 (19:46): There is some lingo, some jargon I can happily get you a link to a vocabulary list that I have. And I'll, I'll get that over to you. So that there's a little bit of a little bit of lingo that, that helps. There's some things that just having a few words mean so much to these artists to just feel welcome. So taking the time to look over and things like that is great. Some of the lingo you should know is Ariel is anything off the ground. A bass or a Porter is a person who throws someone else or move somebody off. And they place them in space, either from the ground or from hanging the flyer is the person who's being manipulated. Right. And then some other things that are really helpful, kind of coming from the domestics world, the idea of opening or closing a joint is kind of a similar to flection or extension opening in the shoulder cases. Speaker 2 (20:47): And closing would be extension hips. Closing the joint would be fluxion opening extension. So like when they're artists are saying things like that inversions are hand balancers are doing inversions when they are turning upside down. Our air lists are inverting when they turn upside down as well, but they're hanging from their hands. So that's another really common place that there's pain is as we're changing through all those planes of motion. That's another really helpful term to note as well. And then that, that vocab sheet just has some of the common ones on it. Of course the circus being so broad, it doesn't cover everything, but it gives it a good starting point, at least a starting point for us. Speaker 1 (21:29): Yeah, absolutely. And, and I'll have that in the show notes at on the website under this episode so that people can, can click and download that. And, you know, as you're saying all of this, gosh, it does sound a lot like the competitive cheerleaders, the flyers, the base. So, you know, learning about the rehab, learning about rehab within the circus space can really translate out to a lot of other areas of, of athletics, I suppose, Speaker 2 (22:03): And the other way around. So if you are working with St gymnast or park core artists or climbers or cheerleaders there's, there's so much inter relatedness of the movement, other, so there's so many connections in, in how there's so many connections and how these artists move to other things, because circus is so broad, it comes from a tumbling background, it comes from a climbing background. It comes from all these things that have been pulled into what is now currently circus either in a contemporary or a more traditional sense. Speaker 1 (22:38): Yes, yes. I think that's great. And, and for me, this cleared up a whole heck of a lot because I had no, I mean, I had an idea of maybe what a physical therapist can do, but boy, it's so much more, it's just so much more, so it was great. So much more than I thought. Like, I, would've never thought of working with children's cerebral palsy or adults with Parkinson's or the recreational, the growth of recreational circus didn't even come into my head and I'm in New York city. I see that trapeze on the Hudson, you know, like I know it exists and I know it's not professionals using it. Know, we all saw that sex in the city episode when Sarah Jessica Parker was flying on that trap piece. Right. Speaker 2 (23:27): Absolutely. I was happy to be involved with that school at the time. And it was a blast to be there. Speaker 1 (23:33): Yeah. Oh, I bet it was. Yeah, I bet. So I, so when people, when therapists say, Oh, I'll probably never see anyone that works in the circus, ah, you don't have to be a professional. So you might, Speaker 2 (23:48): I don't have to be a professional and those recreational artists need help. And if I have a moment to tell a story, I would love to, one of my favorite stories is I had the pleasure of talking to someone, not a patient actually. She's 72 year old woman. And she was telling me her story, which is she went golfing and she hurt her shoulder, playing golf for club into the ground, hurt her shoulder. And she was fine doing everything she does except for pole dancing because she was also a recreational pole dancer. And so she went to go see her doctor. And she said, doctor, my shoulder hurts my pole dance, but I'm fine. Otherwise I heard it playing golf. And he said, well, you shouldn't pull down. That's dangerous stick to golf. And it's like, it's just so interesting. Our preconceived notions of what our normal activities for our body. She's 72, she's spinning in space. She's holding her body weight up. She's doing proprioceptive training, strength, training full body movement, mobility work. How much better could it be than that? And, but golf is the normal activity. So the more we normalize recreational circus and make it more part of our practice, the more helpful we can be to keep our patients healthy and active in doing the things they love. Speaker 1 (25:01): Amazing. And now I have to tell you, after watching the super bowl halftime show, not this year, but last year with Jayla and Shakira, I was like, okay, I think I, I need to do some pole dancing here because, Oh my gosh, like J lo is out of this world, you know, Speaker 2 (25:20): It's an amazing fitness tool. It really is. Yeah. It's on so many aspects. Speaker 1 (25:25): Yeah. Oh, and I never thought of that as being in circus again, under that circus umbrella, but of course it is. It's just your apparatus is the pole versus the silks. Speaker 2 (25:35): Exactly. Exactly. And again, it'll depend on the person and how they want to define circus because it keeps changing. But there are many circuses now that do include pole and there's even something called swinging pole or hanging pole that moves in space instead of just staying. Speaker 1 (25:50): Oh my gosh. No, thank you. Oh my gosh. That's crazy. Well, is there anything, do we gloss over things? Is there anything that we didn't hit that you're like, Ooh, I really want the listeners to take home this. Speaker 2 (26:06): I just really want the listeners to understand that circus really is for everyone that you can go take a class right now and that you might have a client in your waiting room at any moment that has at least some experience with it. And being able to speak that language or having a little understanding of what they do can really go a long way. Speaker 1 (26:23): Excellent. I love it. Now, where can people find you? Where what's your website? Where are you on social media? If they have questions, they just want to say, wow, this was awesome. Where can they find you? Speaker 2 (26:34): They can find me on social media at the circus doc on Instagram, on Facebook, on Twitter. I'm on most of the things I was going to say, all the things that I'm on Tik TOK yet. But I am out there on at the circus doc and my website is the circus doc.com. And through there you can find the courses I teach and lots of information lists of physical therapists that like to work with circus artists and other resources to help improve your knowledge about circus bodies. Speaker 1 (27:04): Amazing. Well, thank you so much. And before we sign off, I have one last question and that's knowing where you are now in your life and your career. What advice would you give to your younger self let's say right out of, right out of PT school? Speaker 2 (27:18): I think the biggest thing is taking the time to you. The biggest thing is to be brave enough to take the time to listen more. I think it really does take bravery to admit you don't know everything and to do more listening and do more and better question asking both of my patients and of mentors and of just the resources around me. I think in the last couple of years, I've just done such a better job of connecting with humans like yourself and, and taking the time to ask questions because you just never know what you're going to learn and where you can help each other on this great journey that we're not in competition and having the bravery to collaborate. Speaker 1 (27:58): Amazing. What great advice, Emily, thank you so much for coming on. This was great. I'm like so excited because I feel I learned now and like, I was like, I want to go take a class. So next time I'm in New York, we'll go together. Perfect deal. I will hold you to that. Thank you so much for coming on. Speaker 2 (28:15): Thank you so much, guys. This was a bunch of fun, Speaker 1 (28:17): Everyone. Thanks so much for listening. Have a great week and stay healthy, wealthy and smart.  

In this episode, author of The Full Spirit Workout, Kate Eckman, talks about achieving success and fulfillment. Today, Kate talks about the 5 P's of Confidence, the story behind the Full Spirit Workout, and how we can find personal fulfillment and success. How can we boost our mental metabolism? How can we achieve our goals? Hear about coaching programs, how to handle perfectionism-itis, and get some valuable advice, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways "Coaching isn't consulting. It's not therapy. It's not problem-solving." "Remember to stay in your own lane, think about the impact that you want to make, and the work that you're here to do." "So many people see the end result and they just want that, but what they dont see is all the work that we have put into it." The Five P's of Confidence (and 2 Bonus P's): Presence. Being fully present where you are, in the moment. But also, showing up like you mean it. Patience. "Hold on loosely." Put in your work, take those action steps, and then take your hands off the wheel, gently lean into trust, detaching from those outcomes, release expectations, and trust in the process. Purpose. This is your 'why'. It's important to have a strong 'why' that will keep you going, even when it doesn't feel like anything is working out for you. Preparation. Build habits that lead to better behaviours that lead to better results. Practice. Your talent warrants investment. Pause. Take a moment of mindfulness. Person. Be a person. Lean into not only the person you present to the world, but the messy person behind-the-scenes. "We don't often give ourself the grace to expand our inner selves." "You can do whatever you decide is important enough." "Everyone is struggling with something." "Even if you don't tell someone else, tell yourself the truth." "It's all happening. Keep going. Keep trusting. You're doing a great job. I'm so proud of you. Just go relax and have some fun. You're doing great."   More about Kate Eckman Kate Eckman empowers high-achieving individuals to actualize their full potential. She leverages her experience as a well-known communications, performance and mindfulness expert; accomplished entrepreneur; and former elite athlete to equip leaders with the tools, methodology, and energetic boost they need to compete and win at the game of life. With a results-driven approach rooted in neuroscience, positive psychology, and whole-person coaching techniques, Kate helps her clients succeed in and out of the boardroom and on and off the field. She guides them to identify who they are beneath their titles and labels, clarity their priorities and values, and then co-create a game plan to get them from where they are now to where they most want to be … adding in some fun and humor along the way. Kate incorporates a mind-body-spirit approach into her coaching engagements, recognizing that when we take care of our inner world, our outer world takes care of itself. Clients report that working with Kate leads to greater focus, energy and presence; increased performance and resilience; more meaningful relationships and newfound confidence; and greater overall well-being and fulfillment. As someone who is known to thousands as a broadcast journalist and an international TV personality, Kate understands the pressures and demands to be always "on," perform at a high level and be an exceptional team player. She brings that high-level presence, professionalism, and infectious enthusiasm to each coaching engagement. Kate recently led and organized the team behind the launch of QVC's first and only proprietary beauty brand, which made more than four million dollars in sales the first day alone. Known for her incomparable salesmanship, she helps global beauty brands shape their vision, strategy and innovation to inspire the achievement of breakthrough results. Kate earned her B.A. in communications from Penn State University, where she was an Academic All-American swimmer. She received her master's degree in broadcast journalism from Northwestern University's Medill School of Journalism. She graduated at the highest level from Columbia University's executive and organizational coaching program. Kate is also a certified International Coaching Federation coach (ACC) and a licensed NBI consultant. Kate is the author of, The Full Spirit Workout: A 10-Step System to Shed Your Self-Doubt, Strengthen Your Spiritual Core, and Create a Fun & Fulfilling Life, which helps readers excel at the game of life with research-backed strategies (New World Library, April 27th, 2021). Passionate about mindfulness practices for both brain and body health, Kate is a meditation teacher and course creator for Insight Timer, the world's number-one ranked free meditation app.   Suggested Keywords Coaching, Spiritual, Perfectionism, Mental Health, Workout, Community, Confidence, Goals, Support, Presence, Patience, Purpose, Preparation, Practice, Pause, Person, Health, Truth, Fulfilment, Success, Impact,   Pre-order the book for FREE gifts: https://www.thefullspiritworkout.com   To learn more, follow Kate at: Website:          https://www.kateeckman.tv Facebook:       Kate Eckman Instagram:       @kateeckman Twitter:            @kateeckman Pinterest:         @kateeckman LinkedIn:         Kate Eckman YouTube:        Kate Eckman   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:                https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the full transcript here:  Speaker 1 (00:01): Hi, Kate, welcome to the podcast. I'm really excited to have you here. Thank Speaker 2 (00:06): You so much for having me. It's my joy to be here. And now, Speaker 1 (00:08): As I said, in your bio, you are the author of the full spirit workout. And we will talk about the book in a little bit, but what I'd love to talk about first? Well, a couple of things. So one I, one thing I'm actually quite curious about, I noticed on your website that one of the coaching programs you went through was the Columbia three CP program. And I know a lot of listeners are always wondering what, what is a coaching program? How can I get into that? So can you talk just briefly about that before we get going? Just so listeners have a better idea of where you're coming from? Sure. Speaker 2 (00:48): So it was a very, very rigorous intense program. It was about a year, a little over a year, and it was, it was deeper and harder than master's degrees. And I had colleagues who went to Columbia business school. They said it was harder than that. I mean, it was really intense and hardcore, but it was such thorough training. And we learned whole person coaching techniques and neuroscience and positive psychology. And it was just so much peer coaching and, and really going through a really detailed process and going through the guiding principles of coaching and going through just so many programs and processes that they had developed. And that main man named Terry [inaudible], who started the program, who is a genius. So I was just working alongside so many top notch people and minds, and the faculty was incredible and, you know, coaching right now is I feel like everyone in their mother is calling themselves a coach. Speaker 2 (01:48): And it, it, it kind of disheartens me a bit because it is a serious role where you're holding someone's well-being and in your hands. And it needs to be, I think, a bit more regulated and taken a bit more seriously. And that's why I chose this program. And I wanted to have this knowledge and, and taking the profession very seriously and not to sound like a total nerd, but I also loved that they required us to write a massive research paper that was almost like writing a thesis and, and really dive into the art and the practice of coaching. That's Speaker 1 (02:19): Amazing. I have to, I didn't think that it was going to be that rigorous year because oftentimes I hear, you know, kind of coaching programs might be a couple of months, three or four months. So that is much, much more than I thought. It sounds incredible. Speaker 2 (02:33): It was, was probably the best investment I've ever done. And I, I have gotten another graduate degree at Northwestern years ago and journalism, and I was about to say, I love that program. I liked it. It was it, that was another superintendent. Was it a year intensive program that I took an accelerated program and nearly killed me. It was, it was so much work. So between undergrad and grad and then this program, the Columbia was I think my favorite and just rewarding and just to be able to help people and an impactful way. And so much of it is, is, is underneath the surface level though, you know, it's listening to what people aren't saying and, and really reading and feeling body language and just opening up this space and container for people to come to their own conclusions. I think that's another misconception about coaching, coaching. Speaker 2 (03:22): Isn't consulting. It's not therapy, it's not problem solving. You know, when I first got into coaching, that's what I thought it was like, if you were my client and you came to me for example, and said, I want to make more money. I thought it was my job to come up with this business plan or to come up with the solutions. But really it's, we're focusing on the client's agenda and you have all the answers. It's my job to ask the questions that will make you reflect so deeply questions. You've never been asked before to take you into the depths of yourself where you actually have the answers. And of course, I can say some things I can ask for permission to add here and there, but really it's about bringing out your own wisdom. That is way more powerful than anything I could say to you or tell you to do. Does that mean makes sense? Speaker 1 (04:08): Yes, absolutely. And, and I thank you for that because I agree the word coaches all over the place these days. And I think that was a really succinct way of saying, Hey, this is what coaching is, and this is how I learned how to be a good coach. And I think that that makes a big difference. Speaker 2 (04:29): And it, it really is a partnership. I like to say, I'm your thought partner and, and we are co-creating together. And it does become about that, that container. So, you know, I, everyone who's in the field obviously wants to help someone. I just invite and encourage people, whatever your field is. And you know this from your profession too. I think this, I come from a family of doctors. So I come from a family where you go to school for years and years and years, and you have to have the medical school and the fellowship and the residency and all the things before you can, no one can just call themselves a doctor on Instagram, you know, or a physician. And so I see, I see I've seen what my brother has gone through, for example. So I think I wanted to, I want it to be there and, and, and have longevity and just the type of people that I wanted to coach who quite frankly, are not going to put up with any nonsense, know the high achievers are professional athletes. Speaker 2 (05:23): They expect you to come in and be on top of your game. And that takes training. And that takes research. And that takes working on, on yourself. And then as I like to say, you have to fine tune your instrument before you can play it for the world. And there's no escaping that. And you know, when you're in the midst of the hard work and you're paying a lot of money to work really hard, and you see people around you who have no credentials and are making 50 K whatever on Instagram to sell something, that's when you have to just remember to stay in your own lane, think about the impact that you want to make and the work that you're here to do, because it wouldn't be tempting. I can see why people like I would never go back to school or I would never pay money or do some intensive program. That's too much work, but I just, I just have to ask what kind of impact do you want to make? And I can even feel some eyes rolling or, you know, a lot of people, I think don't want to hear what I'm saying, but for me, this is, was the right decision. Speaker 1 (06:21): Yeah. Well, I think I can say with confidence that I feel like my audience does want to hear what you're saying, because you know, as physical therapists who go to school for seven years, Speaker 2 (06:31): You know, my mom's a PT, so I Speaker 3 (06:33): Love you already. Yes. Yeah. Speaker 2 (06:36): So I, I, I, okay, so your audience gets it because I, you do a lot of the Instagram crowd. They, and I'm not saying that that's your audience, but they kind of think I see it, that culture thinks the opposite. And it is kind of frustrating because same with writing a book, for example, I think so many people see the end result, whatever it is, and they just want that. But what they don't see is all the work that we have put into it. And this, this reminds me of even a story that just came to mind that comes to me often, which is interesting because it literally happened 20 years ago. But in 2001 country singer Shelby, Lynne won best new artist. And when she accepted her award, this is the only acceptance speech I have ever remembered at the Grammys ever 20 years ago. And she was gracious. And she said, thank you. But also kind of mocked the award and said, best new artist. It only took me 13 years and six albums to get here. I just thought, yeah, because people think you just show up and no, you have to put in the work. And I don't know why people aren't wanting to hear this or understand this. And so all everyone listening who has been through your seven year program, I honor you, and you will have a much greater impact and you will have the longevity. And, and if I was your patient, I would feel so held in your care. So thank you. Speaker 1 (08:05): Yeah. Yeah. That's great. And you know, I, as I mentioned, I said, I could say with good confidence that my audience would agree with you and that this is a nice segue to talk about. One of the things that that you coach and that's confidence. So what are the five PS, the letter P just for people know of confidence? Speaker 2 (08:28): Sure. So it's presence, patience, purpose, preparation, and practice, because I love you and your audience. I'll give you two bonus piece. And that is pause and person as in be a person, and I'm happy to quickly go through them. And it's something that we can all discuss later, even offline or online somewhere, but presence. So presence obviously is being fully present where you are with whomever you're with, even if it's just yourself. So the phones and the TV and all of it is off. And you are just there in the moment, focusing on your breath, focusing on the task at hand right now, I am locked into you. Nothing else. There's a million other things that could be going on, but being present. And then with that comes, bringing your presence. So showing up like, you mean it. So many people tell me, oh, I'm not getting a school. Speaker 2 (09:25): This isn't happening. And I'm like, I don't think that you care, you're showing up. Like you don't care. So I think bringing that energy, bringing that enthusiasm to everyone, you meet and to everything that you do, patients, oh man, I think of that 38 special song that says, hold on loosely. So I think sometimes we're all guilty of gripping. So tightly to our goals, we want this relationship. We want this job. We want this money. And when we grip so tight, we actually repel it. So putting in your work, taking those action steps and then taking your hands off the wheel and gently leaning into trust and detaching from those outcomes, releasing expectations and Shelby Lynn, the story I just told what a perfect example of patience, right? And trusting in the process and confidence stems from the words to trust, to do something with trust, which is great because you can build on that. Speaker 2 (10:18): And it's something that comes from within purpose is your why. So it's so important to have a strong why that will keep you going. Even when it's hard, when you want to throw in the towel, when it doesn't feel like anything is working out for you, that's what this book. I had a really strong why. My two friends who are no longer with us and they kept me going when it was really challenging. And I think a lot of people, this is where they get tripped up because I'll ask them, well, why do you want to do this? And they often don't have a good answer. Or the answer is impressing other people or just money is the only goal. Things like that. It's like the people who say, well, I want to be a parent because when I post pictures of my kids on Instagram, I'll get more likes. Speaker 2 (11:01): Ooh, probably going to hate parenthood. And your kid's probably not going to go over well. Yeah, yeah. Not a good reason to be a parent. Yeah. So I, I, yeah. And, and if you are a parent, you are my personal hero. I don't know how parents get anything done. I, I bow down to them every day. Preparation of course is about, you know, building habits that lead to better behaviors that lead to better results. So that boosts your confidence when you're prepared and practice, there's this misconception that we don't have to put in that much work. It's like what I was saying about school and the credentials. And I think of Tom Brady, because we're the same age. We're both big 10 athletes. He's still winning super bowls. And my knees hurt when I go to Pilates. So Tom Brady are an inspiration, but Tom Brady is the best because he practices harder than anyone. Speaker 2 (11:52): You know, people think, oh, well, if you need that much work, you must be the worst. No, you, you P he practices that much. Cause he's the best, not the worst and your talent merits investment. So practice pause is really what the, this inner fitness program is about. It's, it's taking that moment before you respond to the upsetting email, before you tell the jerk what a jerk they are. It's taking that moment of mindfulness and thinking, okay, I'm really upset, but I'm willing not to be. And who do I want to be instead? So it is about non-reactivity again, I got to practice this a lot. And, and the last one is, is, I mean, they're all my favorites, but this one makes me laugh, be a person. My speaking coach, Eduardo, plusser always says this to me because I'm someone who has struggled with perfectionism and performance and obsession with performance. Speaker 2 (12:39): And he always says, just be a freaking person. And this is really about our humanity and just leaning into not just the person we present to the world who has put together, but that really messy person behind the scenes, just trying to keep it all together. He or she is awesome to let let's embrace that and just be a person. Cause that's where that's, what's really beautiful about us, right? Our humanity, and just being willing to show up, even when it's hard. And, and that's, that's another, a key building block of confidence is, is our willingness to show up and not be great first or ever that's to be in dance class, never going to be a great dancer, but you show up, I build confidence because I dare to put myself out there and not be good and a room full of dancers and feel like a complete, but it's fun. And, and it's, it's that one activity I can do where I it's such a rebellion against my inner perfectionist. Cause there's, there's never going to be a perfect performance dance class. It's, I'm just there to show up and, and, and move around and, and release some energy. Speaker 1 (13:40): Absolutely. You're speaking my language. Totally. I, cause I took, when I was at Equinox, I always took this dance class. It was like six 30 in the evenings. And it was with this guy, Johnny, and some days it would be like jazz hands. Some days it was hip hop. So I'm not a dancer, but I would show up and I would have the best time. And I mean, there are women in there who were clearly dancers in their early years. I mean, they're like in their sixties and seventies and they're splitting and high kicking and doing all this stuff. And I'm like, I can't even touch my toes when I'm sitting. And these women have like, their, their stomachs are on the ground, you know, but it's true. You go out there, you put yourself out there. And the more I did it, the more confident I was as a dancer, not that I'm a good dancer, but I was confident in what I was doing because I practiced. And the more I did it, the more, and I also think the more I really enjoyed it. Speaker 2 (14:34): Yeah. And, and those moments, then we become a dancer and I had this woman in class who was a gorgeous dancer and I had to perform in front of these people. Let me restate that. I got to be a person in front of these people. And they, they wrote the one woman wrote me a note after class. And she said, you are a dancer. And I thought, yeah, I am. Cause I'm here dancing. It's not about being ushered J lo or you know, whomever it's I'm yeah. I'm here dancing and I'm a dancer. Speaker 1 (15:04): Yeah. That's great. And you know, and it brings me to that concept of perfectionism and performance, which a lot of high achievers have they have perfectionism itis or performance itis. I don't know that those are words, but you know what I'm talking about. So what do you say to those high achievers where it's all about high performance and perfection? Yeah. I first Speaker 2 (15:32): Would want to work with people like I had to do with myself and just ask, where does this come from? Where does this thought process come, where you even think you have to perform or achieve at this high level to even be worthy or valuable or loved. And it really is about feeling safe in the world and not feeling so alone. And that's the story I tell in the book about being the four year old at the swim club and being in swim lessons that I didn't really like and overhearing my instructor, tell my mom that I'm not a very good swimmer and how heartbreaking it is for me as an adult to think of my sweet little innocent. Four-Year-Old thinking like, oh gosh, I, I love my mom and dad. I want them to be proud of me. I don't want them to have a daughter who's a bad swimmer, especially since they're so athletic and then going on to break every record at that swim club, because my mentality was I have to perform at a really high level to be safe and not just when the love of mom and dad, but I guess I need to impress strangers. Speaker 2 (16:34): So they say nice things about me and I can feel worthy. And, and then people will love me because I'm good at something. And they can be wowed by my quote unquote performance and what a trap that is. So I think it is about taking ourselves back to where we even come up with this mentality. But I think when we are in that place of obsession, it's like I said, you have to go back to being a person, but you have to also go back to why do I even, why am I even doing this? And, and I think when you are more clear, even I have a client who's extremely wealthy, extremely high achieving, and he's coming to that point in his life. He's about to turn 50 where he thinks, what does all of this even mean? What is my cause? He had a health scare and what if I pass away, what is my legacy that I made a bunch of money? Speaker 2 (17:22): And, and so he's starting to think of what impact he wants to make, or, you know, like many of us, we experience external success, but then we feel unfulfilled on the inside or insecure full of self doubt, full of anxiety. And so I think it's just coming back to what, what really matters to us and who are we underneath all of the titles and the labels and the achievements and the accolades and awards, all of that stuff, and really clear on that. And then your desire to be perfectionistic or to always have to perform at a high level goes away because you know who you are without all this stuff. And then spoiler alerts, you actually end up achieving more and less time and attracting the people, experiences relationships, because you've become the person who just gets to have that or gets to be that rather than striving and forcing and controlling. Does that make sense? Speaker 1 (18:19): It does. Yeah, absolutely. And it has me going back in my head, like, is that why I did that? Is that why I did this? Was it for, you know, to have your parents feel proud of you or to have people tell you, wow, that was so good. Or for, yeah. I need to do a lot of inner work thinking about this right now, Speaker 2 (18:43): But what a great practice that I invite you and everyone listening to do is go back and think of that limiting thought or think of, wow, I am so anxious and it's because I feel like I have to impress people or earn someone's approval and try to go back. And it's always in childhood something. And it's something that we don't even think of. I hadn't thought of that swim club moment until I was doing heavy thought around this book when I was writing it and doing a lot of meditation and reflection, and that story came I'm like, where did this come from? This obsession and how crazy right. And that we hold onto, and then also inviting everyone to, instead of the criticisms or the society that tells us how we don't add up ever, especially as women. So really think of the compliments or think about your strengths and, and, and making that the root of your core belief system instead of all that other crap. Yeah. Speaker 1 (19:36): Oh, it's so good. And now let's talk a little bit more about the book. So the full spirit workout. So what is, what was your why for writing the book, talking about purpose, right? So let's tie it together. What is your why? Speaker 2 (19:52): Oh, you're so good. My, why is salmon Roth? There are two dear friends. They were both two of the loves of my life and they both decided to leave us. They both took their own lives almost a year to the day of one another. So I lost both of them in one year. And this project, I call it a divine assignment. It's the most challenging life assignment I've ever had, certainly the most rewarding, but I did it for them. And for everyone who has felt like them in a place of hopelessness or despair who didn't have the tools who didn't feel confident or secure or safe to reach out for help, who thought they had to do it all on their own or hold it all in. And the, the name of being a man or looking cool to the outside or not wanting to show their dark side for lack of better term, and also wanting it to be a celebration of life for everyone. Speaker 2 (20:47): And, you know, I talk about society and, and it's really sick right now. And it bombards us with all these messages about how we aren't enough and it doesn't give us the tools to, to be healthy and happy. It's just, it's the constant negative. And so, you know, I was a competitive swimmer for 17 years and knew how hard I had to train my physical muscles to compete at a high level. And after losing them and finding myself at the Dwayne Reed on eighth avenue and 34th street contemplating taking a bottle of pills, I knew that my life depended on answering this wake up call and shifting the way that I was choosing to live my life. Like everybody, I will say everybody is guilty of placing their worth outside of themselves. Some may not even realize it, but that's why they have the emptiness feeling on the inside at times. Speaker 2 (21:38): And I really just dove into so much studying and research and spiritual tools and practices and, and, and went back to school and just really wanted to put a program together for everybody. You know, someone said, who is this book for? And I said, everyone who can read, because we all need these practices, just like, we all need to exercise our physical bodies to stay healthy and fit and strong. And it's not about looking hot in a bikini. It's about being able to navigate the world and do everything that you, you want to do and can do whether it's travel or get out of bed. This isn't about a six pack abs, but this, my program will give you a six pack spirit, and that will lead to health on every level. So I just encourage everyone, even if it's five minutes a day to do some of these practices, I wrote this book and a fun is in the subtitle. Speaker 2 (22:27): So this is fun. It's, it's a workout you're going to actually want to do and return to. And, and I return to these practices daily because it's just like exercise or sleep or eating. It's, it's part of our health that we need to tune into every day and, and give ourselves this gift. And if I've learned anything this past year, my wellbeing comes first, no matter what, I'm not willing to go to a dark place. Again, I, I'm not, I'm not doing it. And I, I just, I see so much struggle around me. I it's been such a challenging year for everyone. That life was challenging way before COVID and then everything else we dealt with, especially in this country this past year, it has just been trauma and chaos after trauma and chaos. And so this is really within these pages, just such a place to be in self discovery and be in self-growth and really get acquainted with yourself again and feel really good. And it's all there for you. So let's go, I'll just do it. Speaker 1 (23:28): Yeah. And I loved it. The thing that I really picked up on, you said, you know, you want to be able to like you work and you exercise and you move to help kind of expand your world. Right. I mean, as physical therapist, I mean, I have patients who are in pain, osteoarthritis of their knees, so they can't walk. They can't, they can't do the things they want to do. And they, and, and she said to me, just today, she's like years ago, my world was, I could do anything. Now it's just narrowed so much because I don't have the physical capacity to do the things that I used to do. And, you know, you hear that. And it's, it's so upsetting to hear, you know, and she has some other systemic issues going on as well. But so when you just said, you know, you want to kind of work on your inner spirit and your inner self, just like you would your, your health on the outside. Because again, you don't want to narrow your, your mind and your spirit, like you would, if you didn't exercise and move on the outside. That just so Speaker 2 (24:37): Brilliant what you just said. Yeah. Speaker 1 (24:40): It just really, when you said that, I said, oh gosh. And we see it all the time. And people from a physical standpoint, and we don't often give ourselves the grace to, to expand our inner selves as well. So I, Speaker 2 (24:54): I love it. That's such a great analogy. And that's why I did, because there is such an obsession with the physical and this world, right? What we physically look like face hair, skin, body, all of that. And the obsession with, with working out where it goes too far, the other direction where it becomes unhealthy and that's the whole diet culture and all of it, but that's such a perfect example. And people see that like, oh, I break my leg. I can't do X, Y, and Z, but so many people are injured on the inside because, or they're there, you have the spiritual flag, the emotional flag from just not working out are inside. And it's the same. It has the same limiting effect. And so when, when you do get fit and strong and resilient and optimistic on the inside, really the world is yours. Speaker 2 (25:37): And you, you, like I said, you attract the opportunities, experiences. You become the person who can actually attract and achieve your cherish goals and live the life you say you want to live. And I think a lot of us have forgotten that we have access to this and that we are powerful. And so I'm just gently reminding everybody to tune back into that and to live from that place so that you don't feel limited. So you don't feel like you have a broken leg or like, oh my gosh, I can't physically even exercise. I feel miserable. We're doing that to ourselves, with our minds and with our hearts and our spirits. We just, we don't even realize it. Yeah. Speaker 1 (26:15): And you know, I was going to just ask you what is the book's core message, but I think you just said it, is there anything you'd like to add? Speaker 2 (26:22): I mean, I, it is, I, I get very, almost like dramatic and passionate about it. Just reminding people who they are and, and being comfortable with who you are right now in this moment exactly where you are and reminding yourself of, of your strength and your inherent worth, and that you can do whatever you decide is important. I think people think, oh, this is just as good as it gets, or I can't have that. Or even had some woman say to me, well, you're beautiful. You can get anything you want. And I think, wow, are we still doing that to each other where we're, we're judging or policing or thinking that it's about what we look like? Or you can do everything because you have a nice house and, and diminishing each other and, and everyone is struggling with something. And, and I wish people would, would talk about it more and tell the truth. Speaker 2 (27:09): And even if you don't tell someone else to tell yourself the truth and sit, I call it my sit and stare time where it's, non-negotiable at least five minutes a day. And I sit and stare out the window or stare ahead. And I talk to myself like I would a small child and say, how are you doing, what do you need? What's working. And it has saved me so many times. And, you know, I can hear some people saying, well, it must be nicer. I don't have time to do that. Just like people say about meditation. And I say, I don't have time to be angry. I don't have time to treat people badly because I'm exhausted and overwhelmed. And at the end of my rope, I don't have time to be miserable. I don't have time to be sick. I don't have time to be rushed to the hospital and pay some crazy bill or whatever, you know? So I think it's just asking yourself, what do you really want? And who are you? And, and be willing to show up and just keep going and take little baby steps here and know that you're going to get stronger and stronger. And then you will crave this. You'll crave the sit and stare. You'll crave these journaling exercises and this time to really get to the core of what's happening inside of you. Speaker 1 (28:25): Excellent. I love it. Thank you so much. So again, everyone, the book is the full spirit workout. And now Kate, where can people find, you find the book, et cetera, et cetera. So Speaker 2 (28:38): You can find the book@thefullspiritworkout.com. And that will also link to my website, which is Kate ekman.tv, E C K M a N and Quebec men, everywhere on social. I'd love to connect with you. I love meeting people who are ready to kind of take on this journey and have fun with it. And we can all support one another. I really believe in community and collaboration over competition. And we're all in this together. So let's go, Speaker 3 (29:03): As you said, let's do it. Let's just do it. Yeah. Excellent. I love Speaker 1 (29:07): It. Thank you so much. One last question that I ask everyone, and that's knowing where you are now in your life and in your career. What advice would you give to your younger self? Speaker 2 (29:17): Ooh, hold on baby. It's it's all coming. It's all happening. Keep going, keep trusting. You're doing a great job. I'm so proud of you. Just go relax and have some fun. You're doing great. Speaker 1 (29:32): I love it. I love how you said. I'm so proud of you. That's so nice. Such a good exercise to do. I love it. Kate, thank you so much for coming on for your book and sharing all this great advice. And I just thank you very much. Thank Speaker 2 (29:47): You. You're the best. I appreciate you having me Speaker 1 (29:49): Pleasure and everyone. Thanks so much for listening. Have a great couple of days and stay healthy, wealthy and smart.  

In this episode, Optimal Self Coach, Jeremy Herider, talks about how he discovered, and strives toward, the Optimal Self. Today, Jeremy talks about "the Art of Becoming the Best Version of You", why it's important to you but more important to those who look up to you, and why we should prioritise #GenerationalHabits over #GenerationalWealth. Hear about the moment he started re-evaluating his identity, his three most important values, and his advice to his younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways "If I'm going to have success in any endeavour, it's going to come from what happens when no one's watching." "Don't get your identity caught up in things that are out of your control." "Integrity is do what you say you're going to do. Character is 'be who say you are.'" "You can be what you want to be but, at the same time, not at the expense of someone else." "If you're lacking motivation today, normally it's not lacking motivation, it's lacking clarity. When you get clear on something, motivation jumps out of you." "You either give that thing 100% of you, or dont, because 99% wont work." "You're leaving something behind whether you like it or not." "Stay the course. It's going to take work. Don't be afraid of the work."   More about Jeremy Herider Meet Jeremy Herider, life coach, business consultant, professional athlete, podcaster… the list goes on. How can one person even have so many titles? That's just what you get when you're living as your Optimal Self. As a pioneer in two professional sports, Jeremy has spent a lifetime building the elite habits necessary to thrive not only in pro sports, but in every other venture that he's been a part of. Originally from Lancaster, California, Jeremy found his strength as an athlete from an early age. He was a three-sport letterman in high school and an MVP in baseball. He graduated from Gonzaga University where he was an All-Pac10 Infielder. His pro baseball career took off not long after. But his drive didn't stop there and neither did his list of accomplishments. Jeremy was the first contracted player with the Diamondbacks to get a hit in the history of the organization. He was later drafted by the LA Reign, officially making him a two-sport professional athlete. More recently, Jeremy has been named a CrossFit Champion, taking home 1st Place for the Deadlift/Box Jump event. Of course, now Jeremy has shifted his focus once again as a productivity consultant for Fortune 500 companies, private business coach, and motivational speaker. Jeremy's Optimal Self Coaching program and podcast boil down this lifetime of achievement into tangible, attainable habits that anyone can adopt for success. No success story, including Jeremy's, happens by accident. Begin yours with Optimal Self.   Suggested Keywords Motivation, Identity, Improvement, Habits, Wealth, Health, Smart, Success, Achievement, Integrity, Character, Generational Habits, Priorities, Clarity, Empathy, Empowerment, Choices,   To learn more, follow Jeremy at: Website:          https://www.optimalself.today Facebook:       @OptimalSelf1 Instagram:       @optimal_self YouTube:        Optimal Self TikTok:            @optimalself Optimal Self:   Optimal Self linktree   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript:  Speaker 1 (00:01): Hey, Jeremy, welcome to the podcast. So happy to have you on today. Well, Speaker 2 (00:05): Thank you. It's so happy to be here. I know Speaker 1 (00:08): A fellow podcast host, we'll get into your podcast later on in the, in the episode, but I always love to have a fellow podcast host on for a number of reasons. Number one, being good sound. Speaker 2 (00:21): That's so important. That's so true. Speaker 1 (00:24): So important. All right. Now, before we get into the meat of the interview, what I'd love for you to share with the listeners is how your background of being a professional athlete baseball, CrossFit I can Zaga, right? Almost they almost did it. Oh my gosh. Are you just dying? Speaker 2 (00:53): Was except for that game, we didn't really almost get it. We really got crushed by Baylor. So hats off to Baylor. They, they, they did not miss a beat and they crushed us about halftime. I was, I was already turning the channel a little Speaker 1 (01:06): Defeated, but close. Yeah, absolutely. Absolutely. Okay. So enough NCAA talk. So let's talk about how your life as a professional athlete kind of shaped your views on your life now and kind of what you're doing now. Speaker 2 (01:25): But I love that question cause it can, it's, it's so many different things in, in regards to, you know, you see what most people see is the end result, right? Is, is you running on a field? In my case, it was baseball. They, they see the end result. They see you on a field with the stadiums packed and the lights are on, you know, and, and, and it's, it's incredible, right? Cause we all watch it. If those of you that are out there that are, that are sports fans, you know, it's just, but we get to see the end result. What we don't see is the work and we don't see the behind the scenes. We don't see it. So as far as is shaping me today is it's still the same way. What I mean by that is this, is that what I, what I loved about athletics was truly not the game. Speaker 2 (02:14): Although the game is the icing on the cake. I enjoyed practice. I, I love getting up and going to practice. My mom tells a story, you know, cause you know, with my girls, I have two girls in, you know, mine were like, they didn't want to go to practice. They were like dad, really again. And my mom tells the story that she's like, no, you'd get done with school and you'd walk in the door and already being your uniform ready to go. And you're like, no, I know you got like two hours and I'm like, no, no, no, let's, let's go now just drop me off. She said, you know, she'd be pulling up and I'd be, the door would be open before the car was even stopped and I'm running. So it's, that's kind of the thing that's been ingrained in me since a kid. Speaker 2 (02:57): And, and so I enjoy that work and, and moving into your adult life. And when that, you know, when that side of my life ended moving into other aspects, which now I'm in a real estate and in starting optimal self and doing what we do now, you know, I just love the work it's so it's, it shaped me the same way. Is that what I know to be true? Is that the true success that actually people see? Cause a lot of times, you know, people see that success and I, let me be clear. I didn't, I didn't reach my goal. My goal was to be a 20 year major leaguer and a hall of Famer. And you know what I mean? And, and be, you know, Canton, Ohio and be putting on that hall of fame jacket and giving a speech and B I was nowhere near that. Speaker 2 (03:43): I didn't get close to that. You know? So my w but when most people see the accolades and they go, oh, wow, you've done this. They, they think of success, right? So again, that is kind of the outsider looking in, but what they, what they never see is, is the work that's put in and that's what you have to love. And, and that happens today is whatever people think is fine. They what they see and what we see of others, that little tip of the iceberg, that's, it's poking out, right? You always see these memes and these things on the internet. It's, what's underneath that water. Well, what I learned is if I'm going to be successful or have success in any endeavor in my adult life, it's going to come from what happens when no one's watching it. What happens when they're not looking with those, those sessions in those days, in those moments. And so that's, that's probably what I learned the most. And it's, it's what I've brought into my adult life from, you know, into these other businesses, from being an athlete. Speaker 1 (04:44): Yeah. And that makes perfect sense. And, you know, I liked practicing too. I like the games. I like the practice. I like the teammates, the camaraderie, that feeling of being on a team is always so great. And that teaches you a lot as well. Just being part of a team and being responsible to someone else for someone else and, and being held accountable as well. Yeah, definitely. Speaker 2 (05:07): I, yeah, you're, you're spot on. Which is interesting because going from, you know, being a baseball player again with 25 guys on the team, nine guys on the field at a time, right. Is, is you are, you're, you're a hundred percent responsible for, for everybody around you. And, but here's what I'll say. And it kind of goes into optimal self as well. Cause it's the optimal self is the art of becoming the best version of you is that one of the things that I think I failed at in those days was not is, is focusing on, on wanting to be the best at my position or in that league or whatever. And what I should have been doing, what I've learned over time is just truly be the best version of me. Like that guy is still, could be the best, but, but if I'm just stopping and always, then I lose sight of just truly who I am and what I can do. Speaker 2 (06:03): And so, and what you're saying is, is very true because going from baseball to where I was accountable to all those guys and coaches and, and, and, and the team, and then when I got into CrossFit and you're all by yourself, you're all by your lonesome, in that a lot of lonely nights at the gym, lonely mornings at the gym training, because nobody has that same goal, right. To, to be a champion or to want those things that a lot of guys would come to the gym and train with me, but I would have to literally put a different guy in at each time, like, oh, we're running, I'll get the good guy, the guy that likes to run, oh, we're lifting the B find the guy that likes to lift. Oh, we're, you know, and so you put, you, you put in all the different people. Cause there was nobody that was just going to be like, yeah, Jeremy, I can't wait to get up at 6:00 AM with, you know, Jeremy, I can't wait to be there until nine o'clock at night with you. So again, I, I, I love what you're saying. Cause that's true. And the truth of life is you do have to have some accountability and the team would definitely show that. So yeah. Speaker 1 (07:03): You're spot on. Yeah. And now you mentioned sort of the art of becoming the best version of you. So mentioned it a little bit. Nice segue into why is that important to you? Speaker 2 (07:16): So it goes back to that same timeframe is when, when baseball ended and for most people in, in an athletic endeavor, it doesn't end on your terms. Very often, there are very few people that, that get that right. They get to Speaker 1 (07:32): Be Derek Jeter, Speaker 2 (07:36): Jeter, Tom Brady's like very viewed people are, are those, those people, right? That get to win the world championships, get to be the MVPs and then get to say CNR when they, when they choose. So, you know, most are on, on, on my side where they, they tell you to you're you come to the stadium and the uniform is not in the locker room anymore. We're not renewing your contract. And thanks for your service. It's no. So, but I mean, that app is everybody. It's, it's nothing, but what I learned and I went through a time and I'll be honest. I didn't know it was this right. Is that I was in a form of depression if you will. Is that because I didn't have an identity, my identity was attached to a hundred percent to baseball. Like I was a baseball player and I knew I was in trouble. Speaker 2 (08:28): It wasn't that the game was over. I was okay with that. Honestly, like I knew that there was more things I had, you know, two little, little girls in those days, they were tiny, right? Like dad got to be around and we got to go to the park and I got to, I get to do stuff that I, that I hadn't been able to do really. So that was wonderful. But what I was, what I failed to, to start to understand was how my identity, how I had attached myself to being a baseball player. And I was in the store one day and I ran into a gentleman that, that knew me. And he was like, yeah, Hey Jeremy. And all his Isley comes over and he's like, how are you? And I say, great, man, how are you? One of those guys that you see their face, you know, but you don't remember their name. Speaker 2 (09:09): Right. And he's like, can you stay here for a second? I want my son. So he calls over. Then here comes his little dude rolling up seven or eight years old. And he goes, Hey, you know, Mason, this is Jeremy, this is the baseball player I was telling you about. And I hadn't played baseball in a few years. Like I hadn't got a paycheck or been on a baseball field in a few years. And it crushed me inside. It was that moment that I realized like, oh shoot, something's wrong. And so I talked to him and we talked baseball and you know, gave him some pointers and you know, you can do this kind of thing. Right. I was the little guy and, you know, we, he was like, he's so small. And I was like, you know, so it was, I, I didn't grow till after. Speaker 2 (09:53): Yeah. And we talked a few stories, but when I left there that day, I knew, I was like, okay, I got it. I gotta get this together. Because that, that it shouldn't feel that way. Right. And I knew at that moment that, because he called me a baseball player and I knew I was not a baseball player anymore. Right. Or in the side of being a physical, getting on the field, practicing, playing, getting a paycheck from the Mino, a major league organization. So that's when I knew, I was like, okay, we got it. We got to work on some stuff. We gotta figure some stuff out. Cause th and again, now it becomes getting away from putting my identity to anything more than just being me. And who is that guy? How does he show up in the world? How does, what is the, what are those fulfilling things that happened that I can do on a daily basis that beat me up. Speaker 2 (10:45): They, they get me excited. So that, and again, when somebody says, Hey, you're not a baseball player. Cause I almost stopped them. Like I almost had to say, Hey, no, I'm not what to mean. It was just like, oh my goodness. And here's this little boy, you know, and you know, try to keep it together on the outside because on the inside I was just dying. But I hope people, what I hope people get out of that is understanding that don't get your identity caught up in things that are out of your control. It was out of my control of being a baseball player. Somebody had to give me a chance. Somebody had to say, yeah, this is this guy's good enough. Here's a contract. We'll take a chance on you. Somebody has to say, Hey, here's a scholarship. We'd love for you to come to play at our university. It's it's, it's not totally in your hands. The practice, the work, the time, the energy, the effort, the desire. Yeah. That's stuff that I can control. That's the stuff I got to work on, but not tying my identity to the actual act. Right. It's what I do. It's not who I am. And that was a big turning point for me. Speaker 1 (11:48): And what advice do you have for someone who maybe is at this crossroads of, you know, maybe they lost their job. Maybe they are came out of a relationship, a long-term relationship where that was part of their identity. So what advice do you have for someone or maybe an exercise or something that you did that helped you pivot that at that moment? Love Speaker 2 (12:13): It. That's such a great question. Perfect. So, you know, there's a lot of different ways to look at this and what I, what I go back to is, is the clarity piece in the sense that, who am I? And so then it becomes, start answering that question of what do I stand for? What's important to me. Right? And you know, there's so many different catch words and I'm just going to give you mine for people. So when I sat down and said, okay, what, what matters? Well, what matters the most to me is, is integrity. And so that is a pillar of my life. One is integrity. And what integrity means to me is simple. It's do what you say you're going to do. If you're going to meet me here at five 30 Pacific standard time, then I'm going to be there and I'm going to be ready and I'm going to be prepared. Speaker 2 (13:01): So, so integrity, just, just living that way. And then the second thing is, is character. And a lot of people associate those two things together, but here's the difference, integrity being, do what you say you're going to do. Well, character is be who you say you are. If you're a dad, then be the dad, right? If you're that, that worker. And I think that character shows up in many ways, especially for people. Like what you're saying right now is, you know, if you, if you had that breakup and it's going tough because, oh my gosh, now who am I without that partner? Or a job or whatever is understanding first, we got to dig inside ourselves. And so, okay. Who, who do you want to be? How do you want to show up in the world? Well, for me, character means be who you say, you're going to be, if you say, you're going to be that, then you be that every step of the way, and that type of clarity will, will, will actually help you make all the decisions in your life. Speaker 2 (13:55): And so, and the third one is empathy for me. So I'll just give you my three integrity, character and empathy. And so I've built it around their empathy. Again, to me was I grew up with women. My mom was a single mom, right? Since she only had sisters, right. Nana and Papa pop was there too. But, but my, my grandparents but, but it was a lot of Nana, right? I was, I was, I was the first born. My mom was 16 when I was born. And so that was not something, you know, no, I don't think there's any 16 year olds in the world that are truly ready to be a parent, right. Or a mother at that at that matter. And so would that being said, right? Like I've been around women that I hear, I get these. And I get blessed with two little girls. Speaker 2 (14:36): And my job for them was to empower them, to know that they can be and do anything they want in this world that, that the gender was not. And so I say this in this regard is that empathy means I need to put myself there. I need to listen to them. I don't have to agree. Right. Even if it was, you know, you can go down, whatever. I don't have to agree with you. We don't have to believe the same things, but it means a lot. If I can, if I can listen in and at least try to understand your point or your view on something, it doesn't mean I have to agree, but it does make it a lot easier. And if that, if that's reciprocal, man, how powerful that can be. So I've always wanted those girls to, to understand that. And to know that yes, you can be what you want to be, but at the same time, not at the expense of someone else, you don't have to put somebody else down for you to be for you to be great. Speaker 2 (15:26): You don't, you can just be great. It's okay. You can be unapologetically. Great. And, and the thing is, is, I mean, as we grow, so to go back to kind of summarize. So in what you asked was how could somebody would just start with yourself, start with who you are. What, what are those words that you have? And I mean, there's so many different things out there. I mean, I'd love to, free to use ours. We have, when you could sign in and get in, put your email address, we send it to you for free. It's an identity creator. It has steps in it and all that kind of stuff. But even so again, it's free, but if you don't want ours, you can, I can Google. There's so many great things out there that can help people. You know, I'm not, I'm not the one to say, this is the only way there's not, there's so many different ways, but I know this. Speaker 2 (16:16): If you're lacking motivation today, it's not, normally it's not lacking motivation, lacking clarity, because when you get clear on something, motivation, jumps off out of you, it will jump out of your skin. Right. And most people can identify with that when they go, oh yeah. When I knew right where I wanted to, where I was going, man, did I take them steps to get there? Right. So, so I think taking it back in that sense for me was all right, who am I? You're not a baseball player anymore. Who are you? What do you want to stand for? How do you want to show up in the world? And let's go be that guy. And again, it also allows you to make incredible choices because the moment you have that clarity, it's like, wait, does, is, is this who I am? Nope. Okay. That doesn't go in my mouth. Speaker 2 (17:07): Okay. That's not what I do. Okay. That's not what I, I choose to. You know what I mean? Like you can literally go from every single piece of how you move, what you eat, the people you hang around, you can start to see. And what's really crazy. Karen is this is that you start to implement those things in your life. You start to be it not no other way. Not words on a page, not just talking about it. Yeah. You actually start living it. You start to see the people around, you change all of a sudden other, your, your whole, your identity starts to attract that when you're being that. And it's an amazing with, without even, without even purposely doing it, because what you radiate, what people hear, what people see when, when they say, because again, I'll go back to my life. Like those guys that I was hanging out with, even at the end, right? Speaker 2 (17:58): Like it was nothing to go to Monday night football and have, you know, eight or 10 beers on a Monday night and drink a bunch and eat a bunch of wings. It sounds fun. And it's great. But I can tell you this, the moment that, that I, that switch started to happen for me. And I started to pay attention to it. Those weren't the choices that I made anymore because they weren't serving the life that I wanted to live and where I wanted to go. And, and it, and again, it makes things a lot easier for yourself. Cause it's, I call it a hundred or nothing. You either give that thing 100% of you, or don't because 99% won't work because there's always that 1% time that somebody something's going to crack when you leave a crack open, that crack will get used and it will get destroyed and it will be, and it will get bigger. So the more you can give to exactly what you say you are going to give, when you give that a hundred man hundreds easier than 98 or 99, because 98, 99, you haven't really made a full decision yet. And you know, this decision is the, is the key to all of it. Cause the moment you do make that decision, man, how the, how the universe will conspire with you to make it happen. Speaker 1 (19:08): Yeah, absolutely. So it sounds like I'm just going to recap quickly that when you're at that sort of crossroads of, of your identity, of, of who you are as a person, you really want to try and get clear on your values, write it down, write down the value, why it's important to you and really like dig deep, you know, it's might be uncomfortable. It might Speaker 2 (19:34): Be uncomfortable making that. You're, you're Speaker 1 (19:37): Really asking yourself the tough questions. And if you don't like doing this on your own, like you said, there are tools out there. You have a tool, there are tools out there, ask your friends, ask your family. If you have good relationships with said people if not, you can hire someone and they'll help you. But really getting deep and asking those questions. It's the same thing that you would do if you're an entrepreneur and you're trying to figure out your vision of your business, you know, you just want to figure out that vision of yourself as well, and it'll probably help your business. That's a whole, that's a whole other conversation. We'll be here for hours. Now I love when you were kind of talking about what people can do when they're at that crossroads, and you talked about your mom and your grandparents and your children and, and you know, we're talking about generations of a family, right? And so a question I have for you is why generational habits should be taught versus generational wealth. And if you can even explain what you mean by generational wealth, do you mean wealth of money, knowledge, X, et cetera, et cetera. So I'll hand it over to you. Speaker 2 (20:56): Yeah. So that's, again, what we see in, in, in at least in our country for sure is, you know, we, you know, that there are families that have, you know, through industrial age, in, in, in all the different times that have handed down, then let's talk w in this case, we're talking money, right. Wealth, right? Whether it be real estate, whether it be, you know, the buildings and things like that, whether it be business, the railroads or the steel or, or whatever that is. And what's, what's, what's incredible is that the majority over time gets, it ends up failing by the third, by the second generation or the third generation. And the reason we say that is the person who built it. They might be handing over the wealth side of things, but they haven't handed over the habits that it took for them to get there. Speaker 2 (21:50): And so when you start to get second and third generation away from the actual being that that created it, it starts to dissipate. And so they don't have those same habits, that work habit, that work ethic, that, that mindset that they, that this was built under. So when we talk at optimal self, when we talk about it, we talk about leaving that generation. We start talking about generational habits. And the reason we say that is this is that you're leaving something behind whether you like it or not. You're leaving a legacy, whatever the term is you want to use, you're leaving that now, right now, somewhere, somehow you, because you have interaction with people, whether you have children or not children, you have interaction with people. You're, you're either at a job. Your, you know, if you're in school, right, they're going to know you, somebody, some they're going to be able to describe you and what are they going to describe? Speaker 2 (22:45): What are you leaving behind? So what, what we talk about is, and this goes back to what we started this with, is that the only way I can help and I, and I use my family, I use because that's the direct connect, right? My girls, the only way I can help them is by me being a better me. Because again, how many of you out there right now are telling your kids to go make their bed? And they walk by your room and your bed's not made, what are we really telling them? Right? What are we really teaching them? And so when I talk about generational habits, I'm talking about, listen, be the person, right? You've, you've heard Gandhi. You've heard it for years of, of all kinds of Nelson, Amanda, about we have to be the change. Well, well, truly, all you have to do is you can be the best version of you and you will inspire others to do the same. Speaker 2 (23:35): What are the habits that you want those children or the people around you to have? What do you want them to learn from you? And if you, if we can at least frame it up that way, then the chances of us living to our own standard are much better. Because sometimes that's what it takes. You know? I mean, our world today is built around social media. Let's be clear, right? It is whatever your view is on it. I don't want to go into my own view because it's really doesn't matter. But there is a bit of it that is corrupting all of us in, in ways myself included. And that's what kind of spins us away from it. So let's get back to saying if, if, because you, we do, I like to tell people I don't care what you think, but I do. Of course I do. Speaker 2 (24:20): Like, and I don't mean that I'm going to do something different because of it. If you don't, if I, if I'm living to the best version and you don't like that, then let's have a conversation. Cause, cause I, I, for sure don't want it to hurt somebody, right? That that's, that's not the case, but with generational habits, if we can leave, if we can start to create and be the difference in our own households, that's how we start to create better environments at all times. So we put our kids in better environments. We choose better environments because those environments are, are more conducive to what our habits are. So yeah, we talk about generational wealth as well, because there's nothing greater than that. I mean, if, if my girls can have more than I had, how incredible would that be? That's that's and their kids' kids, right? Speaker 2 (25:09): Like, let's talk, let's, let's make it. But at the same time, what I have to be able to help them and what they need to be able to see from me. Not just words on the page or words out of my mouth, but what they need to be able to see from me is how I live. How do I personally get up every day? What is important? What, you know, my hydration, how we eat, the things that we do, the things that we consume, right? Consumption what, not just what we eat, but what we hear, what we watch, what we say, because those words are very powerful. Every word that we, we say, we say to ourselves, you're your cells are eavesdropping that they're paying attention. That subconscious is paying deep attention to that. So again, generational habits or what are you leaving behind? What habits in art. Speaker 2 (26:01): And again, because you asked that question and you're like, oh man, as I've done it for myself, I'm like, oh my God, I do do not want my kids. When the kids are a little, this is this is some of you out there that our parents can remember the time that you said something, maybe to you, your wife or your husband or whatever, and your kid repeats it. And you're like, oh, you don't even realize it. Right. We're like, oh my goodness. So again, thinking along those lines, just even if you don't have kids, is what are the words that I'm saying, how am I being and can I help? So can I show people better habits that can, that can inspire them to do the same? Speaker 1 (26:43): I love it. That makes so much sense. And, and we'll hopefully be able to instill confidence and allow those next generations to keep building on whatever it is. You're leaving from a wealth, even from a wealth standpoint, from a health standpoint. It's, it's just a great, great way to look at that. Handing down of one generation to the next. I love it. I love it. Okay. So before we start to wrap things up here, where can people find you? How can they get in touch with you? Great. Speaker 2 (27:19): So we are on all the social media platforms, Instagram, Facebook optimal self Facebook is optimal. Self one. Igg is optimal underscore self as well. But our, our webpage is optimal self.today, optimal self.today. And on there our, we do have some courses everything up there that we're even showing, right, right now is, is free. So we can, you can jump in we'll, we'll get you in. We have a private Facebook group that we, we put a ton of stuff in that you can actually, you know, it's getting, it's getting pretty good. There's a lot of really cool people in there doing some really cool things. Because again, it's not about us. It's not about me. It's about building a community of like-minded people that want to pull for each other root for each other. You know what I mean? Like environment matters. And so we're trying to build an environment that, that, that people are, are, are trusting of. But they're also contributing back to, because man, to see some of the things that these people are doing just using some of the principles of optimal self is pretty amazing. So we'd love to have everybody. So if you're interested, please optimal self that today. We'll get you there. Speaker 1 (28:30): Awesome. Thank you so much. And who can want a little more encouragement and support in their life. And now before we end last question that I ask everyone is knowing where you are now in your life and in your career. What advice would you give to your younger self? Speaker 2 (28:48): Man, so much. No, I think that I, I think for myself is the thing that when you, when you ask that the, the, the very first words that came to my head is stay the course and what that means, what I mean by that is a lot of times we, we believe something. We want something we're afraid to talk about it. And I will say this as an athlete. You know, when I was very little, yes, my, the, you asked me what I was doing. And I was like, I'm going to be a baseball player. Like, that's what I was doing, you know? And I wasn't the best. Let's just be very clear. I wasn't your all-star game guy. I wasn't the kid hitting home runs as a kid who was getting tired. I was opposite. I didn't make all star teams. I didn't have all that stuff. Speaker 2 (29:40): And so, you know, it was, it was a turning point. I'll share this really quick because I think it'll help people out. There is I was 13 years old and my best friend's dad was our coach. My best friend was the best player, if not in the league, definitely on our team. And we grew up together. He's still one of my best friends to this day. And he was, it was a bigger kid growing up. You probably, you guys probably remember this. I was not that kid. I was the little munchkin kid, you know, you just hit over at second base or, you know so, and at 13 we won the championship in our league and it was probably the best year I ever had as a, as, as a baseball player at that young age, I thought for sure, man, this is the year I'm going to make the all-star team, right. Speaker 2 (30:23): This is the year and I didn't make it. And our team had won. So we had this, you know, the, the, the, the pizza party after. And, and so I went up to coach who was also, you know, I'd been on vacation with him because I was, you know, got to, you know, he's, his son was my best friend. And I said, you know, he's like, what's the matter? What do you want? And I said how come I didn't make the all-star team? And he looked me dead in the face. Can I can tell you this? I, I can tell you to this day, which is not even know how many 40, 30 years later he, and I said, and he, I could tell you what he was wearing. I could tell you what he smelled. Like, I could tell you everything about it. Speaker 2 (31:02): Every I could tell you what I was wearing. And he said, because you weren't good enough now don't get me wrong. The crushes, any 13 year old boy or girl, probably. But that 13 year old boy in me was crushed. He was, he still is to this day, but I'll tell you this. And I went to the side, you know, and got away from where everybody was. I went up to the lady, the pizza counter, and I asked her if I could use the phone, if she'd call my mom, because her mom wasn't there, she could dial the number for me. I asked her to come get me. She's like, what are you doing? I said, mom, please come get me, please come get me, please, please, please, please swish. She's like, find them on my lap. I didn't even wait. I just went out and sat on the curb, waited for her. Speaker 2 (31:39): She pulled up and she's like, what is going on? And as soon as I got in the car, man, tears just pouring out and she's like, what is going on? I'm like, just go, please. She's like, I'm not leaving, moving this car until you tell me what's going on. So I told her, right. I said, I wasn't good enough. And she was like, ready? Any mom? Right? Like, and here's the thing. She, you know, I said, please, don't go in there. I mean, bears don't please, please, please. Well, what do you want? What do you want Jeremy? And I said, can we go to big five? I don't even know big five as a place anymore, but in California was at sporting goods store. And I said, please take me there. And she said, what do you want? And I walked in, I showed her. Speaker 2 (32:18): I said, can we please buy me a tea? I'll never forget. It was their big yellow sign, $19 and 99 cents. And that tea is still with me today. That was my 13 year old year. And that tea, I went in the backyard and I hit minimum a hundred balls off that tee every single day. No one's watching. I didn't have many balls to start and I'd tear them up. I started using tennis balls or racquetballs and anything I could find to hit off and a hundred swings. I would not. Everyday when I got home, I'd go out and do a hundred swings or now, or I wouldn't let myself do anything else. Right. All the way through, by the time I was 18 years old, I was, I was in all league player. I was the MVP of our team. I got a scholarship and the rest is kind of history. Speaker 2 (33:02): But that, that, that T stays with me as a symbol is because that it wasn't that he was saying, I want people because most people, even when they hear this, they go, what we should have knocked that guy. And what is it? You know, where's he at today? And I'm like, it was the greatest thing that ever happened. And here's why is because he was honest with me. He wasn't saying I wasn't good enough ever. I wasn't good enough in that moment. So again, there was 12, 15 teams in that league. There's, you know, whatever, 15, 16 kids on everything. There's 80 to a hundred kids in that league. It's not like I'm the only kid that didn't make it there. 15 kids and made that all star team. If I was the 16th best kid that year, then I wasn't good enough. Right. But it's not that I'm not good enough forever. Speaker 2 (33:47): It depends on how I, how, how you look at it. But I knew this, no one was ever going to say that to me because I, because of lack of effort, you, weren't going to tell me that because I didn't work hard because I'm not, I'm telling you, I'm still not best of that in my, you know, I wasn't the best player of all time now, but I maximized my ability. I will say that like that, that's something that I want people to understand, but I want what I wanted them to see is there's somebody out there right now that has probably been told they're not good enough. They're not, they're not pretty, they're not smart. You're the dumb sister. You're the dumb brother. You're this, whatever, right. It happens to all of us. There's so many people out there that did that lives with us forever. Speaker 2 (34:26): And I'm here to tell you it lives with me today, but it lives with me in a way that he told me that, because in that moment I wasn't good enough. And I needed to prepare. I needed to get better. That was in my control. That's the thing that was in my control because I didn't make it at 14. I didn't make it a 15. I didn't make it to say let's be clear. Right. And, and I, and you probably heard this, I think it was a bill gates and say, we underestimate, you know, we, we overestimate what we can do in a year. And we underestimate what we can do in five. And again, and when I look back at those years, I think, oh my gosh, because if I would have expected after that, you know, to go out side and hit a hundred balls and then leave and go make the next all-star team. Speaker 2 (35:07): Cause I did it once I would have been, it would be a full, everybody would be like, yeah, you're crazy. Right? It's the same person that goes, oh, I went to the gym once. Like, no, it's not, that's not going to work. Oh, I had us salad. No, that's not going to work. This is about consistency. This is about finding your thing and doing consistency over time will create those results. But, but that story in that, that T is a symbol for me to remember like, Hey, starting a podcast, starting this. You're not good enough. You're not, you have to get better. And that takes the work are you with? And if you're willing to do the work, man, you get to be on cool podcasts like this with Karen. And that's that's, that's what ultimately happens. Right? You get the, you get the plug along and, and cool things happen. So I would just tell myself to understand that, listen, it's going to take work. Don't be afraid of the work. Don't be afraid of putting in the extra hours. Don't be afraid of getting up early. Don't just, just keep going, man, stay the course. Don't be afraid of the work. Cause if you do that, anything's possible. Speaker 1 (36:18): Oh, you went on mute. You're on mute. I was saying excellent advice for anyone and certainly great advice for any youngster out there trying to get better at things I want to get better at. So thank you so much for that advice. Thank you. And thank you so much for coming on today and sharing all this good stuff. We will have all the links to all of your stuff at podcast dot healthy, wealthy, smart.com. One click will take you to social media. We'll take you to the website, everything, to all the free stuff you mentioned. So we will have all of that over at the podcast website. So Jeremy, thank you so much for coming on today and giving us up, giving up some of your time. Speaker 2 (37:07): Thank you. Thank you so much for having me. I really, really appreciate it. I really enjoyed it. So looking forward to the next time. Speaker 1 (37:14): Pleasure, pleasure, and everyone. Thanks so much for listening. Have a great couple of days and stay healthy, wealthy and smart.

In this episode, TEDx Speaker, Mentor, and Certified Feng Shui Practitioner, Kate MacKinnon, talks about getting on to TEDx stages. Today, Kate talks about overcoming roadblocks in the application process, how to prepare your presentation for the event, and how she decided on the topic of her TEDx talk. What does it feel like to share an idea worth spreading? Hear about her own experience getting on to the TEDx stage, being mistaken for Kate McKinnon, and get Kate's advice to her younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways "It's not an outside thing. It's an inside thing." "We're in a society that values youth, youthful looks, the up-and-comers, etc." "Age is just a number. But I know so many women feel like they're not heard, especially if they're over a certain age." "We get better as we age. That's the thing that we really need to get." "There are a lot of TEDx talks out there. You want to vet them. You want to find out about who's producing them." "Don't bother the TEDx producers. They're not the ones to ask these questions of." "Reach out to past TEDx speakers." "Ultimately, you dont want to just be practicing in front of your cat. You're going to want to practice in front of other people." "Don't get too overwhelmed by it. You can learn." "If you want to get better at tennis, you hire a tennis coach. If you want to get better at speaking, you hire a coach that can teach you how to be a good public speaker." "If there's one person out there that I can touch and make a difference, there's that ripple effect." "You have everything you need to be successful right now. The only difference between me and you is experience."   More about Kate MacKinnon Kate MacKinnon, Feng Shui Expert, TEDx Speaker, and Mentor, is a Certified Feng Shui Practitioner, consulting for businesses and individuals for over 20 years, both locally and globally. Before becoming a Feng Shui Expert, Kate had a management technology consulting company and was Vice President for JPMorgan Chase & Co. She taught the first online Feng Shui course for the Institute for Integrative Nutrition and a workshop for the Hospital for Special Surgery and Global Real Estate Women's Group at JPMorgan Chase. Kate has also written articles on Feng Shui and been a guest and interviewed by thought leaders on Speaking, Life Transitions, and Women Empowerment. Kate's mission is to use Feng Shui's power to illuminate and inspire women to step into their power and greatness and live a life of Beauty, Grace, Dignity, and Abundance, and make a difference in the world. You can find her inspiring talk on Women, Aging, and Visibility on TED.com.   Kate's TED Talk: Women, Aging, and Visibility NetHealth Digital Marketing Solutions   Suggested Keywords TEDx, TED Talk, Speaking, Public Speaking, Feng Shui, Women, Age, Aging, Visibility, Talking, Influence, Learning, Healthy, Wealthy, Smart, Inspiration, Motivation,   To learn more, follow Kate at: Website:          https://kate-mackinnon.com Facebook:       Kate MacKinnon Instagram:       @fengshuikate Twitter:            @fengshuikate LinkedIn:         Kate MacKinnon   Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full transcript here:  Speaker 1 (00:01): Hi, Kate, welcome to the podcast. I am happy to have you on. Thank you, Speaker 2 (00:07): Karen. I'm so excited to be on with you. Speaker 1 (00:09): And just so the listeners know, as you probably heard in the intro said, my guest today is Kate McKinnon, which it is. And so how often are you getting mistaken for the famous comedian, Kate McKinnon also in the New York area? Speaker 2 (00:26): No, all the time. I just a quick funny story, because the first time it happened to me when she was just becoming popular was I made a dinner reservation at the Odeon. And when I showed up, somebody said, are you Kate McKinnon? And I said, yes, the star, Kate McKinnon. I said, yes. And then he realized I was not her. And I said, well, I am, am I Speaker 1 (00:49): That's great. Speaker 2 (00:50): It's funny. And then my husband said, I'm going to start making dinner reservations, Speaker 1 (00:55): But that, but the thing is, she actually Speaker 2 (00:56): Spells her name. M C K I N N O N. And I spelled M a C K I N. So she's ruined the spelling, my name, but that's okay. I'm delighted to be the Kate McKinnon not the comedian. Speaker 1 (01:09): Absolutely. And, and, you know, you can probably get a table anywhere. Oh yeah. Oh yeah, absolutely. And when you show up, you're not lying. I think it's great. And now, but you are a star because you were on the TEDx stage and this month we are talking all about Ted X talks and how to get onto that stage. So, like I said, in the, in your bio that you were on TEDx Farmingdale stage in 2020. So talk about your experience. What was it like? Speaker 2 (01:44): My God, can I tell you a little history to it? I mean, it's, it's an amazing experience. It really is because I I've been wanting to do TEDx for a while, but to be honest, who I was not born a speaker and we met, we actually met with Tricia, Brooke at her speaker salon in 2018, the spring, I think it was 2018. And that was the first time I'd ever spoken on a stage in my life. And honestly, it was one of the most terrifying things I've ever done. I thought it was going to die. And it was the first time I'd done a talk that was even remotely like a TEDx. And what I did love was the power of being able to get up and be an authentic speaker and have a message that resonated for people on. And I just want to share that quick story because I S I talked about my two greatest losses being my two greatest gifts, and I lost my, I lost my hearing in my left ear at one and a half for meningitis. Speaker 2 (02:39): And then I lost my mother at four, and I talk about that and I couldn't even put it on line for a long time, but I finally did. I went to Spain. I was in a, at a Tapper's party in the mountains of Spain, and somebody came up to me and they said, I heard your talk. I'm deaf too. And they wanted to talk to me about it. And what I learned then was it doesn't really matter. You could speak to a hundred, you could speak to a million people, but we're really, we're really trying to get to that person that, that touches. And if it's only one we've made a difference in somebody's life. And so that just gave me the bug. And so I then did Trisha did another speaker salon in the spring of 2019, and then it wasn't. And so I did another talk. Speaker 2 (03:25): And then finally the third talk in the fall of 2019, I I was going to do at the speaker salon to talk about my business functions way, but Trisha had this masterclass on doing a TEDx talk. So I took it, and it was during that, where we went through the process of how do you actually create an application? So it starts with the whole process of, of an idea worth spreading. It's not like having an issue or a problem. It's like, you're creating an idea that's worth spreading. And, you know, we go through a whole exercise and she gives us questions that we answered to just kind of dig deeper to those things that are important to us, that we feel like we want to talk about. And in the process of going through the class we I dunno at one point I somehow got talking about women and how mentoring women and the importance of me, of women. Speaker 2 (04:18): And, you know, there were, there was sort of this topic around there. And somehow it got shaped where it was about me turning, you know, at that point it was, I was 62, I think, 62 or 63. And somehow it got shaped around what it means to be a woman aging in this society. Oh, and I know that was really the key. We were doing it with a TEDx in mind. So there was a TEDx on women. And so the topic became of that. I'm sorry. That's right. That's like talking about that and sort of digging deeper into that. And that just really resonated. And so there's that the idea where it's spreading, which ended up being for me that society deems women invisible after a certain age, and this is something we can change now and forever. So our younger sisters never feel they're like go out, which still makes good silica gives me chills. Speaker 2 (05:12): I mean, it just really still came so deep from with me. And then the next question is when you're doing the application, why are you the person to give this talk? And I was like, I don't know. And Trisha was really funny. She goes, can I answer that question for the church? He goes, because you've been doing this your entire life. So that, that it wasn't just like an intellectual thing. It was a thing that had been important to me for a long time, but I didn't really know it, but once these ideas come up and they come out, they sort of take on a life of their own. They really do. And so in that, that speaker salon, I had a chance to actually work on my talk in a workshop environment. So as you know, with the speaker salon, we have other speakers. Speaker 2 (05:57): So you get up on stage and you get to practice and get to write you get feedback and stuff like that. And it just, I could see from my fellow speakers that it was really resonating with them. So that was really powerful. Like I felt like there's something here that I really have to talk about. And so that idea then grew and grew and grew. And actually I had an opportunity to present it that, for that particular TEDx women's talk and I went there and the environment wasn't there, wasn't right. For me, I felt totally out of alignment. I didn't get support. It was like, I'd been with Trisha. We were so well taken care of. And, you know, you just show up, dressed up, made up, get on stage, you tech is taken care of. And it just wasn't that kind of event. Speaker 2 (06:43): And I felt like my talk deserved an event to really showcase it. So I actually had the talk a year before. So in December of 2019, it was ready to go. And that was really hard to walk away from. But by the time I did it for TEDx farming tale, it was just, it was in me, it was part of me. I probably can still do it with a little practice. It just came from me. So to me, that's a really powerful thing to say about doing TEDx talks. It's, it's an idea, but it's like, you end up, it's like, it comes out of you, you speak it. And then as you're speaking, you learn to embody it. Like, it's, it's a really interesting, like you talk it, but then it becomes part of you. So when you're actually presenting it for me, it was a full body experience. Speaker 2 (07:30): That's amazing. It just felt like it came from me. Yeah. Yeah. And it's so good. And, and don't worry everyone. We've got the link to it in the, in the show notes here. So you'll be able to watch her talk. But I love, I just want to circle back to something that you said when you were filling up the application, why should you be the one to do this? And you said, I don't know, had Trisha take that one. She does not like the, I don't know. She does it well that well, and that's, what's so funny because she goes, she goes, well, I do. And so she knows me. She knows me well enough to say that, but it was, it was funny. She was like right on it. She was right on it. And and I think a lot of people might hit that, that roadblock in the application process. I don't know why should I do this? Like, you know, those, that imposter syndrome creeps in and why shouldn't you be the person to give this talk? That's a really hard question to answer. So what advice do you have for people if they're filling out an application and they get stuck, they hit a roadblock. Speaker 3 (08:39): Yeah. Speaker 2 (08:41): Yeah. You know, I I'll tell you something. I I'm an, a big believer I get, I always get help. I, you know, I have a community of people that I can ask things and run things by. And I think it's really important for something like this, because you want to get a sense that does it land, does it resonate or like people even knowing what you're talking about? Do you know what I mean? I just, that, that has been my experience that I think it's really been important for me to be able to run it past people. And, and in this case because I was in that masterclass setting, the other thing I was going to say was really, there was an interesting part of that because as I was working on the idea and that's part of it, it's like, sort of, it's like, we're responding, but we're working on the idea that somebody said to me, I got up and I don't quite remember how I said it, but at one point, one of the women said to me somewhere we both know, she said to me, why would I like, you know, cause I looked pretty good for my age. Speaker 2 (09:41): Right? Like I'll say, yeah, I look. And so a lot of people don't realize how old I am and it's just, it just sort of, you know, I always say to my father, he looked, he looked young until he turned 70. So I have a few more years. And so she said, why would women, why would women believe or trust you if they, you look like you do? And I said, but it's not an outside thing. It's an inside thing. But that question was so important, right. To get that kind of response. And I think, you know, that's, the other thing is like, you know, for me, you know, of course since I've done it, but like even doing it where it resonates for men, like there was something about it. It was, it was more than just being a woman, even though the conversation was about being a woman. Speaker 2 (10:23): And I got that from testing it out. Right. And talking about it as I was writing it that it needed to resonate beyond like, yeah, why would I listen to her? Cause she looks great. What does she really know about? So my story tells how I know deeply about what that experience is. And I think that's that, that one question stayed with me the whole time. It's like, it's gotta be beyond like, just looking at me and saying, Oh yeah, like, you know cause that's not really what it's about our inside light. And it's interesting since I've done the talk and lots of people have talked me about it. Men, women, men have talked about how it's affected them. Men have talked to me about how they want their wives to listen and, you know, gay men have talked to me. I mean, like it's really kind of across the board. Speaker 2 (11:13): But there was Oh one woman. I was somewhere and she came up to me and she was you know, like a 32 year old Afro-American woman. And she goes, identify. She goes, I've been feeling that she said, not only because you know of my race, but also because as a woman that I feel like I don't get taken seriously and I'm invisible. And I thought, wow. And I said to her, this is why I'm doing the talk because I like it so that you, you women, your age never had this experience ever. And you know, we're in a society that values youth that values youthful looks that values, you know, the Speaker 1 (11:54): Up and comers, the Anji news, the et cetera, et cetera. Right. And so, you know, when you, it's, it's surprising to hear someone in their thirties say that, but I, I mean, I'm in my forties and I know I feel that way. Yeah. You know, and, and that's why listening to your talk is actually quite healing because you're like, Oh, well, wait a second. I'm not the only person that feels this way or wait a second. It doesn't, that doesn't matter. It matters. What would I, like you said, the light that I have on the inside and how is that B how am I sharing that is kind of like what I got out of it. So I found it to be like, really affirming that like, Hey, and I know this is so cliche age is just a number. But it is, but I get, I know so many women feel that way. So many women feel like they're not heard especially if they're over a certain age, they're passed over if they're over a certain age. And so I think that's why the talk resonates so much. Speaker 2 (13:05): Yeah. Yeah. Well, it's, it's also interesting, you know, it's like the, you know what they say, like, you know, you see your, you see a yellow VW car, you know, Volkswagen car, and then, then you only see them, right? Like, it's like once I started writing about this talk and then reading books and it just happened, right. Like it seemed, but it was very synchronistic. How many in the books, like women over 50 writing stories about when they turn 50, when you know people in you know, broadcasting, people consulting people, you know, high-level executive women. It was really it. I suddenly saw it everywhere. I said, wow, I didn't even realize that this is just in the water of the conversation. Like we don't even know it's existing. So when I started talking about it, it's been out there, but I think people heard it in a new way. Speaker 2 (14:00): And my conversation, I actually just had this happen the other day, a woman I haven't and a beautiful, beautiful young woman who I haven't seen for years. I met her at a workshop up in Syracuse. I met her mom and she's been, you know, we've been sort of tracking each other on social media all these years. And then she reached out to me because she wanted to do an interview on funkshway. And she told me, she'd heard my talk. And she said, and she started quoting it. But the thing that she said that really struck me is what I had said, but she really mirrored back was that we get better as we age. That's the thing. And that's the thing that we really need to get. And so my talk is looking at the hero, not looking at the women behind me, but looking at the women who are out there, I start with an Amash, if you will, to, you know, by time I did it. Speaker 2 (14:52): And, and Farmingdale, Ruth, Ruth Bader Ginsburg was the first woman. I mentioned queen Elizabeth, Jane Fonda, Lily, Tommy, Tommy, like they're in their eighties and nineties and they are living full out lives. That's the message. We, we don't need to stop at our fifties. And if we're turning our light on and we're excited about what we're doing and we're out there, you know we were alive and that is what people see. That's the beauty. I mean, to me, that's really the beauty. It's like, we're living, we're living our life. And I, you know, I talk about Jane Fonda. She had a movie you know, five at Jane Fonda in five acts. Speaker 1 (15:33): Like she's still out there. Like she continues. Speaker 2 (15:36): I used to be out there. And she's now, you know, climate change and, you know, getting arrested for protesting and stuff like that. I love her. I love her. Right. That's, that's what I want. That's where I want to be looking. That's what I want to be looking at. Yeah. Speaker 1 (15:52): And it reminds me too, of like Joan Rivers, who was at her prime when she was 81, she had four TV shows a best-selling line on QVC all over the place. I mean, this is a woman who didn't stop, talk about always looking forward. Right, right. Definitely one of those women. So obviously your TEDx talk was a talk and an idea worth spreading touch people's lives a hundred percent. What do you have any other tricks or tips for the listeners about applying for your talk? And then, so you gave one have people around you to bounce ideas off of, I want to circle back because I want to know if you have any others and then we'll talk about the prep, the preparation. So any other tips or tricks? I, I, Speaker 2 (16:48): I would say so. I, I honestly I'm not here to promote anybody, but I would say it helped to have a coach. It really helped to have somebody knowledgeable because I'll tell you what I did learn from her is you kind of, you want to vet, there are a lot of TEDx talks out there and you want to vet them. You want to find one that is going to be, you know, preferably find out about who's producing it cause they're independent and they have guidelines and they should be following them. But sometimes a first time producer may or may not be prepared, right. Fully prepare to really give the, the, the kind of support you need. And that was my experience. It was just, I was, I was spoiled by the kind of sport I've been getting, but I saw that I needed to not worry about anything other than getting myself on stage and speaking and letting everything else be taken care of. Speaker 2 (17:42): So you want to vet and and that's, again, through a coach, I have somebody who who's experienced, she's placed other TEDx she's up place, but helped other people get on the TEDx stage. So that, that, that certainly for me was true. And you know, now it really getting out and you can, I, now we have club, you know, clubhouse people, you know, clubhouse event with people talking about TEDx and, you know, being able to do that 90 minute pitch and stuff like that. And people talking about is this topic. And, you know, for me, it was gathering information about it sort of understanding really what it was, watching them, watching them learning, you know, seeing what worked, what didn't work. And you know, certainly that's a big part of it. And if you know people, I had somebody reach out to me on LinkedIn cause she was going to do TEDx. Speaker 2 (18:34): So she wants to just talk to me to find out more about it. I think it's, it's one of those things where you, there are ways you can find people to find out. One of the things that, you know, Trisha will recommend, like don't bother the TEDx producers, right. If you're like an apply, you're going to apply, they're not the ones to ask these questions. They're really not. They're like, so you need to find that information elsewhere, but there's enough. There's like, Oh, and then that's it. Chris Anderson who started ted.com, it's also, he has a good book out on that. There's a number of books on it. I mean, it really kind of guides to help you think the process through, think about what you're really talking about. What's the difference between a TEDx talk and doing a key note for instance, or, you know, a lot of people. Yeah. I, I did you know, I worked in corporate America for a long time and I did a lot of debt, you know PowerPoint presentations, it's not the same, right. Like really kind of begin to understand really what it is that distinguishes it from other kinds of talks. So those are some of my thoughts just off the top of my head. That's amazing. I love, I would never thought Speaker 1 (19:44): Reach out to pass TEDx speakers. That's such a great tip. Such a great tip. All right. So let's talk about preparing for at the talk. So you just don't say, Oh, practice it a couple of times and wallah I'm up on stage. So talk about your preparation. Yes. Speaker 2 (20:04): So when I, and I, and again, I had a little bit of a jumpstart because I was in and working on another talk and then I ended up practicing my talk and the speaker salon. But Speaker 1 (20:17): It it's it takes Speaker 2 (20:19): Time. I, you know, I think there maybe some, somebody who's a better speaker than I am, but like if you were to apply and it was three weeks from now, and by the way, P TEDx neuro doesn't work that way apply. And then it's several months out, but you really need time to write the talk if you haven't written it to practice it memorization as a whole process, by the way, this is one of the things about getting older. I was afraid I was not going to be able to memorize a talk longer than three minutes. And my talk was I think, nine minutes and I've done 18 minutes, but learning the technique of memorization because they are a memorized talk and, and you don't necessarily have a teleprompter as a whole process of like, how do you memorize? So you've written the talk now you Steve to memorize it. Speaker 2 (21:09): And so that's a really important part. And part of the memorization, again, I've, I've had a lot of coaching from Tricia where you know, ways of memorizing, how to break the script down, sort of, you know, learning a little bit at a time, learning a little bit of time and then starting to put it all together. But part of that practicing is, you know, for me practicing at least three times a day, at least three times a day. And ultimately you don't want to just be practicing in front of your cat. You're going to want to practice in front of other people. But part of that practice was I'd go out walking and I'd practice the talk I'd be driving. I practice the talk. I mean, really I have to, for me, I had to get to the point where it was. Speaker 2 (21:52): So it wasn't just up in my head. It kind of has, I don't know how to describe this, had to drop from my head into my body. Right. And also part of that was to choreograph it. So, you know, like sometimes people have a way of rocking and, you know, they walk around the stage. You have a little, as far as I know for TEDx, there's you have your red circle, which can be a small rug or big rug, but I think you're not supposed to go off the rug. I've seen some Ted dot coms where they do it's a different staging, but the idea is you kind of are in a small space. So you have to practice being able to really stand fairly still, or like move a little bit. But when you're moving, not just because you're rocking, but we actually, I actually choreographed what I was doing and I do it like a performance to be honest with you. Speaker 2 (22:40): And so I got helped with that performance and I got had, you know, somebody I trusted and, and, you know, ultimately Tricia, you know, have somebody see me perform, tell me how to move. You know, maybe I should say it this way. And so it was for me, it was, I had the opportunity to prepare my TEDx talk over three months for the one the one in December of 2019. Then I actually performed it again for speakers who day or another Patricia Ray, after the pandemic. And I had to learn how to do it into a video, looking at myself, that's a whole other technique. And then finally, actually on a stage for a TEDx Farmingdale, which was not, it was live stream, but it was, I did not have a lot live audience. And so each thing each time was something different. Speaker 2 (23:34): So there's a preparation for what you think it's going to be. And then you show up and you have the experience. So it's, it's practice, practice, practice, practicing in front of people. And the other thing we learned is, you know, and then if you're going to practice in front of people two weeks before the talk, don't ask them, you know, you can say, I want to practice. But don't ask, don't have them like start ripping your talk apart, like a certain point. You have to have a few trusted people where they're going to give you good feedback, but it's not about redoing. The talk is a certain point. That's the talk, right. It's very interesting. It's a very it's a, it's a lengthy process. I hope, I hope that answers it. It's like you know, Speaker 1 (24:18): Oh yes, absolutely. Absolutely. And I just, I, I love that you're giving the list, Speaker 2 (24:25): The insight into these things Speaker 1 (24:30): Talks like, Hey, like this takes time, this is months of preparation. This is months of memorization. There are techniques to it. You know, you can memorize one sentence and memorize a sentence, add another sentence at another, till you have a paragraph, right. It's not like you're just going up there trying to memorize a nine minute talk right off the bat, because that's so daunting. And I, I want the listeners to know that you do have time before these talks that it's not like you apply. And they say, okay, see, in Speaker 2 (25:01): A week, right. Speaker 1 (25:04): Yeah, no, they want to make sure you're ready to, yeah. Speaker 2 (25:07): Thanks about the application I forgot to say is very often they ask for video. And so you do like a one to two minute video of yourself. Partly because they want to see who you are, how you speak at a sense. So it's not like if they select your, you just sort of seeing your application and that's it. And so that's always interesting because you know, that was in writing a piece of my talk, not, it was a way of giving, giving the essence of my talk. Actually what I did was I wrote something that was the essence of the talk without like doing the talk. Right. But giving them an opportunity to see me on camera, to get a sense of how I am as a speaker is really important. And that is always a challenge, right? Like I still, I've been doing this for a while and I say this so people understand, like, you know, have, have a little hope because if I can do it, honestly, if I can do it, other people can do it because it, it was an area that I wanted to do, but it was a challenge for me. Speaker 2 (26:07): And I had to learn to do everything, everything, it was always learning something new, something new. And again, I could say at my age, you know, it was tough, but that's not really what it was just, I hadn't learned how to do it before. Right. Speaker 1 (26:19): Yeah. Don't, don't, don't get too overwhelmed by it because you can learn, Speaker 2 (26:24): You can learn and that's really the point you really can learn. But I, you know, I, I say this with all all respect to anyone who wants to try this, if there's a way that they can find, you know, if you, they can find someone to help them with this. For me I'm one of those people, I've done many things in my life. I like to have somebody help guide me because it does seem so daunting. And so the other way, it just feels like, okay, I'm shooting in the dark. I'm not sure because you may never hear from the people that you've applied to. Right. So you have no idea why they didn't accept you. And so it's helpful to get some feedback and guidance from somebody who, who has some experience or expertise in this area. Speaker 1 (27:11): Yeah, absolutely. I couldn't agree more. I mean, we have coaches, like if you want to get better at tennis, you hire a tennis coach. If you want to get better at golfing, you hire a golf coach, you know, it's the same thing you want to get better at speaking, you hire a coach that can teach you how to be a good public speaker, which is why I joined the speaker salon way back when, why you did and, and here we are. Right. Right. Exactly. Exactly. Yeah. I think that's great advice. Now, is there anything that we glossed over or any other points that you want to make about your experience on the TEDx Speaker 2 (27:50): Stage? Yeah, I just it it's I have to say if someone really wants to do it, I think that's half the battle. You really want to do it. You really, really there's something for me. It wasn't just like I did it halfway and said, Oh, this is too hard. There was something in me that felt like I had something I needed to say that, that, that, and that really is, it's something, it became something bigger than me. It wasn't just getting up and doing a talk. It had to be something for me to keep going, had to be something bigger that I felt like there was an important message that I needed to say. And I think that's part of it that that is part of what had me do it. And then go to a stage and say, this, this just wasn't the environment, like from a functional perspective, let alone, like, just that, for me, wasn't an alignment with what my talk was about. Speaker 2 (28:53): And I would rather not do it just to say I did it. I th there was a, there was a challenge in that for me, but ultimately I said, it wasn't about saying it just to say it and get it done. This was an important message. And I wanted to be on the stage that I can convey it to where I felt like it could get out. And so that desire that there's a bigger message and that desire for me if like that person in Spain, if there's one person out there that I can touch and make a difference, there's that ripple effect. So it's, it's, it's something that's bigger than us ultimately. And I think that's the important thing. And even like, starting with, you know, that, I don't know why am I the one to say it? Like we don't even know sometimes, but the more I worked on it, the more I realized it was something that had been for me to say for a long time, I just didn't know it. Speaker 2 (29:45): And so it grew and I grew, and there was something so beautiful for me when I finally got on that stage. I really, it really was, I was prepared. I was more than prepared, made up, dressed up a beautiful stage, great support. And and I, I have to say there was one moment where I was moved by my talk. Right. That's the other thing, you know, if you have emotion, but when you're doing your talk, you don't want other people to take care of you. Like they'll just fall apart on the stage. It's really like, you want them to have the experience. It's like, you're giving them a gift and you want them to have the experience. But there was a moment my husband even saw it where my eyes started watering up. I was so moved by what I was saying. It's like, every time I said it, it was new to me. Speaker 2 (30:37): It was new to me. That's the kind of talk. I think that we're looking for something that is so deeply important and satisfying and feel like I am the one to say the talk that, that, that is the thing that kept me going with all the challenges and all the new things to say I wanted to get there. And when I did it and walked off the circle is one of the most satisfying things. I, it really is a peak experience in my life. I've had a few of them. It's really, it's it probably at this point in my life feels like my greatest achievement, to be honest with you so strongly about it. Speaker 1 (31:15): Oh, that's so wonderful. Thank you for sharing that. And now Kate, where can people find you? Like I said, we will have the talk in the show notes for the, for this episode, but where can people find you if they want to do a Ted talk and they want to reach out to you for some advice and just where people can find you on on the regular, regular. Speaker 2 (31:38): Okay. I would say probably my, I am on LinkedIn, Kate McKinnon, spelled M a C K I N N O N. That's probably, you know, that's certainly a good place to reach out to me. I'm on Instagram. Funkshway K at funkshway Kate and Facebook I'm Kate McKinnon. But I also have a website at kate-mckinnon.com, M a C K I N, and r.com. M-Sci K I N N O N, that cog and you know, a place where you can send me an email that way as well. Also, I I'm reachable and you know, all of those are, you know, I check everything, so please feel free. I would be happy to, you know, people really want to talk with me about it, be my honor and pleasure. Really. That's awesome. Speaker 1 (32:30): Awesome. Thank you so much. And last question, knowing where you are now in your life and in your career, what would you give to Speaker 2 (32:40): Your younger self? Oh, I love this question. I, I would say, and I've said this to young women before, who kind of remind me of my younger self. Like I have an assistant working for me. It was like 23 years old. And I've had women like in their 1819 that I would say you have everything you need to be successful right now. The only difference between me and you is experience. I love it. That's great advice. Yeah. Excellent advice. Thank you so much, Kate. This was a great talk. And I think the listeners now have a better idea of what it takes to get on that TEDx stage. And we will regroup with you and Kaia and Trisha for the TEDx round table, which I'm really excited about. So thank you so much. Thank you, Karen. Thanks you so much for asking me to be on it's my honor, and privilege, and you know, to be able to talk about this, obviously I get really excited, but I, I really love sharing with people and I really hope that people really look to themselves to see where they might actually have that message that they want to do this. Speaker 2 (33:57): That would just mean the world to me. So, and I look forward to seeing you with Kaia and Tricia at the round table. Yes, I'm definitely looking forward to that one and everyone thanks so much for tuning in and listening. Have a great couple of days and stay healthy while at the, in smart.  

In this episode, Creator of The Magnetic Soul-Work Success System, Keiya Rayne, talks about her process from no talk to TEDx talk. Today, Keiya talks about leveraging the power of energy to land a TEDx talk, how to set yourself up for success, and how to achieve a calmness and confidence in the Red Circle. How did Keiya go from having no talk to stepping onto a TEDx stage? Hear about the secret sauce to creating, developing, and delivering an Influencial talk, find out how the TEDx talk has changed Keiya, and get her advice for her younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways "We have all these different experiences of our lives, and when we bring them together it makes the essence of our lives, and it gives us a message that we can impart to others and help them improve their lives." "The secret sauce is hiring a mentor." "When you're giving a TEDx talk, you want to appeal to a lot of people." "When you have an idea that's worth spreading, then it's universal." "The human energy is so powerful." Keiya's 1-minute energy reset tool: "Pivot, pause, smile." "The most important thing is to make the decision and have the intention to do so." "A lot of times we're so focused on doing. I want to introduce the idea of the beingness - the energy of lightness about what you desire." "People buy from you based on how you make them feel." "A lot of times we're afraid to even take that step. Set the intention to do that, apply, and go for it. If you have that desire, then the universe wants you to have it." "Nothing is ever going to replace rehearsing." "When you feel comfortable and confident, and you've embodied your talk, then you're free." "Be still, and trust that everything is going to be okay."   More about Keiya Rayne Influential TEDx Speaker, Keiya K. Rayne, is a Clarity Coach, Relationship Expert, Intuitive Healer, and the Creator of The Magnetic Soul-work Success System. Described by one of her clients as Yoda, but only cuter, for more than 15 years, she's helped her clients master their mindset and attraction energy, so they're able to achieve a higher level of success in the areas of Love, Business, and Purpose with unexpected ease. Keiya's been featured in the documentary, The Big Talk Over Dinner: Race and immigration, The Big Talk, Follow me Friday, Courage Up podcasts, as well as various online magazines publications. She's a recipient of The White House President's Volunteer Service Award for her humanitarian work domestically and globally.   Suggested Keywords TEDx, TED Talk, Speaking, Public Speaking, Talking, Experience, Energy, Determination, Confidence, Preparation, Pivot, Pause, Smile,   Keiya's TEDx talk: Being Taught to Form a Line is the Greatest Gift We Can Ever Receive   To learn more, follow Keiya at: Website:          https://www.keiyakrayne.com Facebook:       Keiya Rayne Instagram:       @keiyakrayne Twitter:            @keiyakrayne LinkedIn:         Keiya Rayne   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript:  Speaker 1 (00:01): Hey Caio, welcome to the podcast. I'm so excited to have you on, and it's so great to see you. Speaker 2 (00:08): Likewise, it's a pleasure to be here. It's like, you know, a family reunion side rail to be here Speaker 1 (00:14): This whole month. We're talking about how to get on a TEDx stage. And I was part of the speaker salon, which is by Tricia, Brooke, who is also a guest this month. And I met you and I met Kate and we're all getting together to talk about how to get on a TEDx stage and really just how to do a talk. Right? Yeah. So let's start. My first question is how did you go from having no talk to getting on the TEDx stage? I think Speaker 2 (00:45): Everybody wants to know. Yes, yes. That is, you know, it's a very fascinating story. I actually met Tricia Brooke at an event. And when I met her, there was something that was just in her energy that drew me to her and I just really fell in love with her. And of course she mentioned, she was, of course speaking about speaking. And I just casually mentioned to her, I'm like, you know, I'm going to get on your stage now. I did not really have an interest of getting on her stage. I, you know, I knew, you know, in my life like getting on a stage at some point in my life was going to happen. You know, I just, I just knew that, but at that particular time, I was really just kind of like, yeah, you know, that sounds good. Well, of course, two weeks later, I get this email from Trisha saying, Hey, I'm launching this week or salon and that's what happened. And so I did speak her salon and it was through the speaker salon. Now, when I arrived on the speaker salon, I had no talk whatsoever. And, you know, with Trisha, she really creates a safe space for you to just get up and share from your heart, from your soul. And I got up and whatever she was able to pull out of me you know, most people were like, wow. And so Speaker 1 (02:12): I can, yes, that is true. I will, I will agree with that. Speaker 2 (02:17): Right. And that's right, you were there. And and that was the making of my TEDx talk. And then later on I did another speaker salon and that was where one of the TEDx producers was in the audience. And that's how I landed my TEDx talk. Speaker 1 (02:36): Yes. And now let's talk about, so do you have, did you have a specific process by which you had your idea, you then took that idea and formulated your talk? Speaker 2 (02:53): Well, you know, thankfully the idea from my talk came from the speaker salon. And so for me, what was great about that was that I already had something. And so I was able to really just, and it's interesting because my TEDx talk had pieces of my speaker salon talk, and there's something that I will share later, but there's a little, the secret sauce that was, you know, really working with someone to help you do that. But it was really, you know, receiving the support, I believe from Tricia in working with that talk and being able to take it, it's fascinating because, you know, we was able to take all these different experiences that I've had and was able to bring them into this talk. And a lot of times, you know, we may think of ourselves like, well, you know, I don't really have a talk and not realizing that, you know, we have all these different experiences of our lives and when we bring them together and really makes the essence of our lives, and it really gives us something that we can a message that we can impart to others and, and, and help them improve their lives, inspire them in some way. Speaker 2 (04:17): So you don't have to reinvent the wheel to find these talks. You can look at your life experience, look at within yourself and say, Hey, wait, this happened to me and it might help someone else is abstinence kind of what I got. Yeah, exactly. Exactly. And just keep in mind though, you know, TEDx talk is a very different type of talk, so it's not like it's a keynote talk or write it. It's a very specific type of talk, which I'm sure, you know, Trisha will elaborate on that a lot more, but either way, right. There were still all these different pieces that came together to create that top. Yeah. Right. And now you alluded to this before, but the secret sauce to creating, developing and delivering this impactful TEDx talk, what is that secret sauce? You know, it's, it's, it's, it's a V it's, it's simple, but it's not. Speaker 2 (05:13): And I'm going to tell you, the secret sauce is hiring a mentor and they'll just, you know, just hire Patricia, Brooke, because I, I just believe, and she doesn't even know what I'm saying this, but I really believe she she's just the best. I mean, she knows this inside and out, but she is, you know, she has a hearing and I, and this is something that she's really masterful at helping other people share their story. And so when you're able to find that type of person who can really help you in all these pieces, right. And then, you know, because like I said again, right. Tedx talk is, is is, you know, we suspend the islands and they may say it in America too. Like, you know, a horse of a different color, you know? So when you're getting on, when you're dealing with the red circle, right. Speaker 2 (06:07): You, you really need to know if that's right. If you want it to be impactful right. And influential, then you want to get someone who knows how to make that happen for you. Yeah. And I should also say, I'm glad that you kind of said, it's, it's different than a keynote talk. Right. Because when you're at a keynote talk and you're at a conference or something like that, you're really directing that talk to a specific group of people. Right. So you really have narrowed down in each down to maybe what is probably your ideal audience, but when you're giving a TEDx talk, you want to appeal to a lot of people. Was that difficult? Speaker 2 (06:50): It wasn't. And I'm going to tell you why. I didn't think it was difficult. I think it was because of the message, right. The idea worth spreading. And so when you have an idea that's worth spreading, then it's universal. Yeah. That's very true. Hey, wait a second. What was your TEDx talk about? We didn't even mention that yet. I mean, we'll mention it to get at the end, but what was, what was your TEDx talk about? Give us the cliff notes and then of course we'll have a link to it in the podcast. Exactly. Exactly. Well, it, it's how being taught to form a line is the greatest gift you can ever receive. And so all I'm going to say about that is, you know, we all learn how to form, you know, like what we were like in grade school, learn how to form a line and not realizing the impact that something as simple as that has had, have had on our lives, as well as, you know, other people around the world who really don't know how to form lines. Speaker 2 (07:54): Right. And through my humanitarian work, you know, I did humanitarian work for many, many years traveling around the world. And that was a big thing. Just getting people to form a line. And so that's kind of, you know, a little, I don't want to give it all away. No, no, no. Don't give it all the way we want people to go and watch it and listen to your words. Yeah. So now let's take us to that moment of when it was your turn to give your talk, you have to go into the quote unquote red circle. So how do you set yourself up energetically for success? How do you stay calm? Cause I feel like if I was wearing my Garmin watch, my heart rate would be like 106. Like it would be off the charts. I would be so nervous. So how do you do this? Speaker 2 (08:42): Well, you know, the thing is, you know, the nerves are there, but energetically, you know, I started setting myself up and which is something I do every day. Right. So it is a, it is a non-negotiable practice for me to really set myself up energetically every day. And that is, you know, through meditation, through journaling, through you know, getting quiet and doing all those things that will enable me to really get into a calm state and, you know, the more you practice it right in, and you're in, you know, that right? So the more that, you know, so that is something that I've practiced for so long. And so that when it was time for me to get on the stage, I had that to reach back to. And so I, I really was able to kind of channel right. Being calm because it was, it was something that practice because when you're ready to go on that stage, it's just, I mean, you know, everything is happening. Speaker 2 (09:44): You're what am I going to remember my lines? And, and it wasn't the time for that. And, and just to get in the zone, but when you set yourself up for that, right, you, you are really working on your vibration on, on, on your nervous system and calming yourself down, you know, then that makes that that's a game changer, because that was one of the things that I heard quite a bit was you looked so calm when you gave your talk, you know, it was like, you just, you were just walking, like you were floating. It is like, Hey, you don't know how much, you know, right. It was all that meditation and breathing exercise that I did. Speaker 1 (10:23): I think that's a really great point for people to understand is that you're still nervous, but you had some tools to help mitigate that a little bit. Now, would you recommend, let's say someone they want to get on a TEDx stage and let's say they're accepted. We'll just throw that out there. Is this something that you would recommend someone to do in preparation for that or just something to do just because you're a human being Speaker 2 (10:49): Living in this world? Well, both, I think just, you know, just as a human being, living in this world, right. We have so much to deal with and I'm really, really big on, you know, mastering your energy and understanding, you know, the human and the human energy is so powerful. And I think it's one of those things that we as humans don't really give a lot of attention to, you know, like we just don't realize the power of, of our energy and, and of our vibration and how, when we learn to manage that, and we can also use, we can also learn to leverage that as well. So it's, you know, when you learn how to do the two, wow. Yeah. It really, it, it, it puts you in the center and it really assist you in every area of your life. Speaker 1 (11:43): And do you have for the listeners, if they're curious, like, what the heck is she talking about? How can I do that? Do you have like a quick example of how someone do that, or even where they can find out more information about how to do that? Speaker 2 (11:58): Well, you know, it's, that's a great question. And one of the things that I was going to that I'm offering the listeners is what I call a one minute energy reset tool. Right. And what that is. Right. And it's, it's a one minute tool that we can use to always bring ourselves back to the moment. And it's called pivot, pause, smile. Right. Very, very simple. But it's very powerful. Right. And so as, even as you're going through your day and you're like stressed out, and if we just think to pause and you think, okay, I'm going to pivot my energy in this moment. I'm just going to put a smile on my face. Right. In that moment, you can change it. But as well, there are tons of, you know, whether it be method, meditation, breathing exercises, there's quite a bit, but I think the most important thing, right. Because you can find it if you want, it is to make the decision and have the intention to do so. Yeah. And this Speaker 1 (13:04): Is the kind of stuff that I know you probably work with with your clients on the regular, right. Speaker 2 (13:10): Oh, 100% because it's not negotiable. Speaker 1 (13:15): Yeah. And, and now let's talk about, so we talked about how to kind of set yourself up for when you get into that red circle, but what about landing a Ted talk? I mean, that's stressful as well. Right. So can you walk us through your process of how you, like, how did you choose which one, how did you foster your energy toward landing that go ahead. Okay. So Speaker 2 (13:49): In my case, I was actually, you know, because I was, I was kind of recruited if you will. Right. It was like, I was auditioning without realizing I was auditioning for a TEDx talk. And, you know, at the end of Tisha speaker salon, she has people come in various influencers and producers come in. And so in that sense, I was fortunate that sort of the introduction was already made for me because he saw me and it was like, Hmm, I wanna meet her. However, I still needed to apply. And so this is, I feel like it's my secret sauce, right? W in, in terms of applying. So I actually want to go back to when I was giving my talk. Now I knew there were going to be produces influences in the audience. And so I actually had set myself up and a genetically from then to attract and land buy talk. Speaker 2 (15:02): It's really, really important. Right. And so would, that would look like was, again, in my morning practice eyes, you know, set the intention one that, Hey, wouldn't it be great to be chosen by one of the influences or one of the produces. So that was an intention that was already set, right? So there's, there's that energetic piece there sending myself up. This was even when I got on stage to do speaker salon, and again, just having the, what I call the universal law of detachment. And so I wasn't attached to whether I got chosen or not. It was just really important for me to, to give an impactful and inspirational and transformation, transformative talk, but I just want to plant the seed right. That it started. So the, the energy, the energy of everything that you do starts from the very beginning. Speaker 2 (16:11): And so I will tell you, I wasn't surprised by the fact that I was chosen in a way, because I had sort of said that intention, and there was an energy, right. That I was putting out there for that. And not to say that other people weren't doing it right. Because it's, everybody's like, they're putting out, I want to give a talk. Right. But there's something about when you understand and which I spoke about before, when you understand how to leverage energy and you really get to understand the power of attraction that we have to attract what we desire into our lives. Right. And so with all of that, all of that, knowing if you will, which is what my speaker salon talk was about, I think created that vibration within me. Right. So that whoever was in the audience, it made it possible. Right. For kind of, for them to define me. Does that, does that make sense? Speaker 1 (17:19): Yes. And I, I really love that. What was it? The universal law of detachment. Yes. I really I'm. I don't think I've ever heard that before, but I really like it because if you go, it, it sounds to me and correct me if I'm wrong, but you went into this talk with that sort of love detachment. So it wasn't like your whole being was, was predicated on this talk. Right. Is that right? That's exactly correct. Exactly. Speaker 2 (17:50): Correct. And it's also when you learn how to use universal laws and university and just energy. Right. And so these laws are set up to, to support us and we don't know about them. And so would that combination, right? That, that was sort of the, like the, the game, if you will. Right. I was playing, that was w that enabled me to create that sense of lightness. Right. And, and so, and I say that because now let's think about the person who's now applying. Right. So I, I still had to apply, but I was kind of like in, because he saw me. So let's say for the person that you know, is not in front of a producer, and now they're applying to a TEDx talk. And what I want to, what I'd love to invite that person to do is because everything is energy. Speaker 2 (18:47): And so even when you were filling out that application, if you're filling out that application with the energy of desperation, Oh my God, I really want to give this talk. And, and, and, but there's so many other, all of that, right. You're, you're going there is just like, you're going to block yourself from attracting that talk. Now I'll tell you something. I heard I was listening to two women speak about applying for TEDx talks and, and both women had already given TEDx talks. And so they were speaking of applying for other TEDx talks. And as I listened to both of them, I can hear the level of, sort of the level of, of stress and frustration in, in, in, in, in all that it takes right. To apply for the TEDx talk and right away, I was like, wow, just, just that alone, just that energy that you even, you know, coming to it from where you're coming from with it will impede the process. Speaker 1 (20:02): Yeah. That makes a lot of sense. And, and I think, I just want to make a clarification when you're talking about that universal law of detachment, it doesn't mean that you're filling it out and saying, Oh, whatever, if I get it, I don't really care. Is that right? Cause that was kind of coming, especially as you were speaking just now I was thinking, wait a second. That doesn't mean that you're like blahzay and like, whatever. Speaker 2 (20:27): Right. Not at all, not at all, not at all. It's, you know, it's, it's, it's kind of, you do your part and then you release it. Speaker 1 (20:36): That makes sense. Yeah. So you're still doing your part with the best intentions with all your, with your energy and your, this is the ASM. Yeah, exactly. Exactly. And, and I bring, and I Speaker 2 (20:48): Bring, you know, and I bring, I keep going. I, you know, I go back to the energy piece a lot because, you know, again, for the, let's say for the person who's applying for that top, right. W w w a lot of times we're so focused on doing yes, yes. Right. And so, and we do that with everything. Like, I want something I'm going to go after, what do I have to do to get it? Speaker 1 (21:09): We often say that in an email, what do I have to do? What, what are the next steps? What I have to do next? What do I, yeah, totally, Speaker 2 (21:16): Exactly. Right. And so I want to really introduce the idea of the beingness of that energy of lightness, about what you desire and what you want, be it a TEDx talk or anything else, because it's that sort of, that energy of likeness that, you know, I feel makes, makes you more of a magnet to that. And so you're not impeding it with your okay, I got to do. And, but also as well is that you're leveraging, right. You're leveraging energy in a way, instead of just, you know, all of the, like, what do I got to do? And you're trying to make this happen. Right. It's like, you kind of like, okay, because then the right person will be put in your path, your application, you know, the person that is reading your application that is watching your video. Right. They are going to feel you, they can feel right. So everything is, and so that's why it's so important to bring in, I feel the energetic piece. Yeah. Speaker 1 (22:30): And thank you for that. I think that's great advice for anyone out there that wants to with the, with the aspirations and the hopes of getting on a Ted ex or maybe even a Ted stage. Yes. At some point that will come, these live events will come back. I know it. And, and what has changed for you since you did your TEDx talk? Speaker 2 (22:57): Oh my God. So much, so much, so much in terms of, you know, I will say even my, my level, just my level of confidence that in and of itself, I think my, you know, the income, my clients, just my entire, just everywhere in, in all aspects of my life has really gone to a completely different level, you know, since doing the TEDx and more importantly, just me as a person. Right. I have evolved and grown since then. Yeah. Speaker 1 (23:30): Yeah. Cause oftentimes people, you know, if you're an entrepreneur, you have your own business, you may, part of going onto the TEDx stage is yes. Of course, to get your message out, but also like, will this help my business? Speaker 2 (23:43): Absolutely. Yeah. And it sounds Speaker 1 (23:46): Like people have found you, people have started to want to work with you, which is amazing. Absolutely. Absolutely. And, and that, that's, what's great about, I think just taking the stage in general, really, because people have an opportunity to to hear you. Right. And so as an entrepreneur, it makes it a little easier, right. In terms of you don't need to go looking for people because they've heard you, they've seen you and it, it kind of gives them an insight into who you are. They get to feel you, they get to connect with you. And you know, when people buy from you based on how you make them feel. Absolutely. Absolutely. I love it. Now. Is there anything during this talk, did we, did I gloss over anything? Did we miss anything? And if we did, let me know if we didn't, what's your best advice for someone wanting to get on a TEDx stage, Speaker 1 (24:45): You know, hire Tricia, Brooke. I could second that yes. You know what, we're not, we're not paid to do that. No, we're not right. I'm just going to keep it real, you know what I'm saying? Like, and, and I say that, and I'm gonna tell you why I say that. Right. and also you, right. First of all, if you have the, the, the desire and the intention to do so, go for it. Like just, you know, I think that's the most important, I think a lot of times we're afraid to even take that step. And sometimes someone might think, Hey, you know, a TEDx it's too big. Cause a lot of people will look at that TEDx talk or tend to be like, Oh my God. Right. Like I could never do that. Right. And so, you know, besides hiring Tricia had, you know, said that intention to do that apply and go for it because if you have that desire, then that the universe wants you to have it. Speaker 1 (25:44): Yeah. And, and, you know, working with Trisha or with any other coach, I think just really, really important. I remember during our speaker salon, like I remember people going up and speaking and I was sitting there thinking, I thought this was supposed to be for like, non-professional speakers. Why is everyone like a professional already? And I got up and I was like shrinking in my chair, like, Oh, this is amazing. This is not good. This is amazing. But having Trisha there, cause I remember my idea of doing my talk about my experience with pain. And I was speaking about it in the third person. And I remember a Trisha like, like I was, you know, just maybe a couple of minutes in and she was like that was really good. But let me ask you a question. Is this about you? And I was like, yeah, it's just like, why, why are you talking in the third person? And it's those and that, Speaker 2 (26:44): It's those simple things that we would never be aware of and never. And the other thing I want to say about that too, was that, you know, when I, when I was done with my talk, I was able to, with my TEDx talk, I was able to go into the audience and sit and you know, support and watch the other speakers as well. And there was there was a difference, it was a clear distinction and difference, right. Between the people that, you know, had, I'm able to Tricia speakers in particular because there was, I think two of them that went after me. Right. and the other speakers. And so it, it really Speaker 2 (27:29): Separates you. Yeah. And I would think, and this is, this will be the lab. Maybe we could talk forever, but I think practice, practice, practice. How much did you practice? Let's not gloss over this. Yes, that's right. That's right. Thank you so much. Because when you said was there something that we forgot that was it because in my mind I was like, I, I gotta remember that. So yes. Well all we got all the energy, right. You're, you're centered. You're, you know, you're you're you got your energy together. Nothing. And I mean, add absolutely nothing is going to replace Speaker 3 (28:19): Rehearsing. Yes. Speaker 2 (28:20): Memorizing. And so what gave me that confidence also, right. To be calm was the fact that I knew that talk inside and out and, you know, and, and, you know, Tricia taught us also how to memorize. And so that for me was, was really the key because then, you know, when you feel comfortable and confident and you've embodied your talk, then you free. So thank you for bringing that up because I really wanted to like, make sure that we said, Oh yeah, I can just use my energy. And then yes. Yes. And just to give the listeners some insight how, if you could even remember how many hours do you think you rehearsed? Cause it's not like five hours. It's not like you just did it a couple of times. No, no, no, man. You know, it's, it's kinda 24 seven almost really like I'm, I'm serious. Speaker 2 (29:31): Like I, you know, in the beginning, you know, and I think we kind of, I give myself like a little bit of a leeway, like kind of in the beginning I was like, okay, let me, you rehearse. I think for the last, and I didn't have a whole lot of time. I had, how much time did you have since, since you knew you were going to get the talk till the day you gave it. Exactly. And it was unusual, right. Because usually people can have, I think like up to six months, I think I found out, I think speaker salon was like July 20th and September 7th. Oh boy. Yeah. Okay. Right. I think it was either June, June, or July. And so I had very little time because I think I was the last person that came on board. Okay. Right. But, but I think we all, we all found out at the same time, but but I mean, because I didn't apply, so I didn't even kind of, I hadn't applied yet. Speaker 2 (30:26): So I kind of didn't even know that I would even be chosen. So it was a very, a very short period of time, which meant rehearsing, rehearsing, memorizing. Like I ate, slept, drank that talk so that I can embody it. So I didn't have to deal with the nerves. Right, right. Excellent. Well, this was great. Now Kaia, where can people find you on social media website, et cetera, et cetera. Awesome. Awesome. Thank you. Yes. People can find me@caiorain.com. Kaia K rain. Actually, I'm going to spell it for you even. I know you're going to have the link. It's K E I Y a K R a Y N e.com. And you can also find me on Instagram and if I'm making it easy for you, everything is Kaia K rain, Instagram, LinkedIn, all those good places. Excellent. Well, thank you so much. And I, Oh, I almost forgot. I have one last question. Knowing where, and I ask everyone this, but knowing where you are now in your life and in your career, what advice would you give to your younger self? Wow, that is, I love, love, love, love, love this question. Speaker 4 (31:46): Yeah. Speaker 2 (31:48): Be still and trust that everything is going to be okay. Fabulous advice. You know, because when I look back and if we all look back at our lives and we look at all the things that we stressed out about and we worried about it and we made ourselves crazy about like every little thing. If you real, if you knew that if I can just have a sense of trust and just chill, I was going to say, chill the hell out. Right. Things are going to work out. So that's, that would be my advice. Excellent advice. And I thank you again. And of course everyone, we will have links to everything Kaia, including her TEDx talk in the notes at podcast Speaker 1 (32:40): Dot healthy, wealthy, smart.com. Thank you so much for coming on this one. Speaker 2 (32:44): Wonderful. Thank you. Oh, this was great. Thank you so much for having me. It was fantastic. Speaker 1 (32:50): And I'll tell you listeners, thank you so much for listening. Have a great week and stay healthy, wealthy and smart.

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Tricia Brouk to talk about how to land a TEDx Talk. Tricia is an international award-winning director, author, speaking coach, and podcast coach.  In this episode, we discuss: What is a TED talk? How do you get chosen? Why do you need to vet organizers? What makes an exceptional TED talk? How do you prepare?   Resources: Round Table Talks   Tricia's Website: Tricia Brouk   www.TheBigTalkAcademy.com   www.speakersalonapplication.com   Tricia's Social Media:    LinkedIn   Facebook   Twitter   Instagram   YouTube   Podcast   More About Tricia:  Tricia Brouk is an international award-winning director. She has worked in theater, film, and television for three decades. Her work includes the writing of two musicals, both produced in New York City, a one-woman show, and four documentaries, two eligible for Academy of Motion Picture Arts and Sciences nominations. She had an extensive career as a dancer performing all over the world. In addition to her work in the entertainment industry, Tricia applies her expertise to the art of public speaking. Tricia founded The Big Talk Academy where she certifies speakers in the art of public speaking. She was the executive producer of Speakers Who Dare and TEDxLincolnSquare and now The Big Talk Live. She has shepherded more than fifty speakers onto more than fifteen TEDx stages in under three years. She is currently being featured in a new documentary called Big Stages, which highlights the transformation of her speakers. Tricia's commitment and devotion to inclusion is a priority as all of her shows, events, and communities are diverse. She curates and hosts the Speaker Salon in NYC, The Big Talk, an award-winning podcast on iTunes and YouTube. She directed and produced The Big Talk Over Dinner: Race and Immigration that premiered at the Be Your Best Self Expo in 2020. She was awarded Top Director of 2019 by the International Association of Top Professional and is relentless about her vision of amplifying voices all over the world. Her book, The Influential Voice: Saying What You Mean For Lasting Legacy was #1 New Release on Amazon in December 2020. Tricia lives in New York City with her husband, Joe Ricci, and their two cats, Lola and Bella. Their building faces the Alvin Ailey Dance Theater where she gets to watch young dancers realize their dreams every single day.   Subscribe to Healthy, Wealthy & Smart: Website:   https://podcast.healthywealthysmart.com Apple Podcasts:       https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                      https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher:  https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the full transcript here: Speaker 1 (00:01): Hi, Tricia. Welcome back to the podcast. Third time. Third time on I'm so excited to have you here. Speaker 2 (00:08): I am so excited to be birth. Third time, Karen, it's always awesome to talk with you. Speaker 1 (00:14): Agreed, agreed. Awesome to talk to you. Not to me. Now this month we're talking all about TEDx talks, how to get on that stage. We've spoken to, we're going to speak to a couple of TEDx speakers, which I'm really excited about and you help prepare speakers for the TEDx stage. So we've got a lot to talk about. My number one question is what is a Ted talk? Speaker 2 (00:43): This is such a great question. And for anybody out there who really wants to dig deep and go into the world of Ted Chris Anderson's book, the official guide to public speaking, Ted talks, the official guide to public speaking is really the place that you need to go. A Ted doc is an 18 minute or less talk. And Chris Anderson actually says, 12 is the new 18. It is a gift, not an anus. It is an idea, not an issue. And you want the audience to adopt your idea as their own. At the end of this talk, a Ted talk is an idea worth spreading, and it is really meant to get the audience to think differently. And there's very specific format and outline when it comes to what a Ted talk is. And I highly recommend you dig deeper with Chris Anderson's book. Speaker 1 (01:37): Yeah. And for those who are watching here, it is. I just happened to have it coincidentally right on my bookshelf next to me. So this is the book. Great. And, and because I do want to differentiate that a Ted talks, not a keynote talk, Speaker 2 (01:54): Right? A Ted talk is 18 minutes or less, and it's really all about getting the audience to think differently. A keynote is 45 to 60 minutes long, and the keynote is going to start out by you telling the audience why you're the credible expert to talk about this idea. You're going to share with us what you're going to cover. Then you're going to cover it. Then you're going to summarize what you covered. And then there's a very clear call to action, which is buy my book, sign up for my program, donate to a worthy cause. And when you're thinking about that in relationship to a Ted talk, it is so different because literally you can open a Ted style, talk with music. This is how I see the world though, through Spiaggia trickle lens, you can open with music with video, with compelling slides. And it's really about taking the audience on a journey from where you start. What is the idea worth spreading that you want the audience to think about, taking them on a personal journey, your personal story, or someone else's personal story, and then wrapping up so that they think differently and potentially walk out of that theater, adopting idea, adopting your way of thinking as their own and maybe even behaving differently in the world. Speaker 1 (03:06): Yeah. And I, a great example of that is a Ted talk from Ted X, Lincoln square that you produced on forgiveness. You know, the one, I mean, right. Speaker 2 (03:18): I do Sarah Montana, one of the most compelling speakers I've ever had on my stage, she applied to TEDx Lincoln square with a talk about forgiveness. The idea was about forgiveness and how do we teach people to forgive? We all know forgiveness is important. It's good for our health. It's really important, but nobody teaches you how to do it. So in her application, the written application, she submitted her talk about forgiveness with a personal story that her mother and brother were murdered on Christmas Eve. And I thought, how in the world is this woman going to be able to share an idea worth spreading from the stage where I don't feel bad, the audience doesn't feel bad. We are not just sad hearing her talk about this horrible tragedy in her life. So I gave myself the challenge Garren, I thought, okay, I'm going to challenge myself and ask her to submit a video because I could not imagine how this story could be shared in a way that was an idea we're spreading. Speaker 2 (04:22): That would get me to think differently. All I could focus on was the trauma. So she submitted this incredible video and what was wonderful about this, and this is really an important takeaway here. She was healed from the trauma. She did not share a vulnerable story before she was ready. And she was able to tell us the story. So she set up context and then take us on the journey of her journey of forgiveness and how she ended up forgiving so that we could potentially put into motion, her practices of forgiveness into our own lives. And that is an incredible example of someone who is sharing a powerful idea, worth spreading, also giving context and her personal journey so that we can observe as the audience member not feel bad, but observe and adopt this idea as our own. Speaker 1 (05:19): Yeah, I, it was such a powerful story. We'll have a link to it in the show notes. It was just so wonderful. And that actually leads perfectly into my next question is how does one get chosen? So you gave us a little bit of the backstory of how she was chosen, but for the listeners who are thinking, Oh, I really want to do a TEDx talk or a Ted talk one day, how does that happen? Speaker 2 (05:41): This is really great. You have a million search engines looking for Ted talks all the time. The best thing to do is start with cities, TEDx, Philadelphia, TEDx, New York, TEDx, Dallas, TEDx St. Louis TEDx, all cities. It doesn't have to be where you live, but there will be amazing Ted X events in major cities, TEDx, Los Angeles. That's where you want to start, because the reason you want to start there is that they will have been around for a while and they will know what they're doing. And we'll get into that leader of the next step is universities, TEDx, university of Nevada TEDx case Western reserve, university TEDx rush, you universities put on TEDx events all the time. And the other reason that's a great place to start is because they will have the support of the school. They will have the support of the, of the university. Speaker 2 (06:38): Tedx UCLA is an Epic event. It's really hard to get into that one. And it's wonderful. And that's because they've been around for awhile, they know what they're doing. So cities, universities, and then you can actually go to ted.com and they have a map of all the TEDx events in the world. So if you want to speak in Ghana, if you want to speak in the UK, if you want to speak in New Zealand, you can search the map and it will identify where those TEDx events are happening. And then you just get in touch with the organizer. So the next thing you want to do is subscribe to all of the TEDx events that you can get on their mailing list so that you are notified when the applications open applications are rolling for many events, meaning you can apply all year and many have a specific window. So you want to make sure that you don't miss that six, eight week window where their applications are open. And this happened to one of my clients. She lives in Chicago. I gave her the application information. We worked on her application for months, months so that it would be right. She knew the deadline and she missed the deadline Speaker 1 (07:55): For heartbreaking. It was Speaker 2 (07:57): So heartbreaking. There was a little bit of is this self sabotaging thing happening right now. So just know that they do close. So make sure that you understand if you're notified, get those dates on your calendar, create a spreadsheet for yourself. Because if you believe you're going to apply to one event and land that event, you're a unicorn. I Speaker 1 (08:18): Have had unicorns. Trust Speaker 2 (08:21): Me. I haven't had unicorns. I currently have a unicorn, Dr. Kristin Donnelley, we just started working together and her first application was accepted. So she's going to be speaking itself, Lake Tahoe in may, which is super exciting. It does happen. However, she'd got my support. So if you are working on applications, apply to as many as possible. And if you are chosen for more than one, guess what you can do more than one, or you can determine which one you actually prefer. And you can take that stage. So making sure that you start with cities, moved universities, go to ted.com and search that way. Google is not your friend here. There's a million million, million ways that you can go around that and find the actual events that you want to speak out. And Speaker 1 (09:07): Let's say, I, there are three TEDx events that I want to speak at. Can I submit the same talk to all three? Or should I have a different talk for each one? Speaker 2 (09:18): Submit the same idea. We're spreading to as many applications as possible. And when, and if you're chosen for more than one, you can determine with the organizer. When you want to switch your idea, most organizers, 99.9% organizers are not going to let you do the same talk at multiple stages. You can absolutely speak at multiple stages, but you want to speak with the organizer about, Hey, I just accepted TEDx South Lake Tahoe, and I'm talking about tolerance. Can I talk about empathy at your event? It's similar, but I want to talk about something different and you can have that conversation with the organizer. Speaker 1 (09:56): And when it comes to the applications themselves, is there, are there any tips or tricks or to make yourself stand out? Speaker 2 (10:08): Yes. Very, very important that you do not pitch your business. This is not about how to get sales. This is about an idea worth spreading. So if you have a business where you are connecting rescue animals, to people who need support and that's your business, that is not your idea. We're spreading. You have to dig deeper and find a reason to talk about why animals can serve us in humanity. The other thing is, if they're asking you a little bit about yourself, go, go above and beyond. Don't cut and paste your bio. Tell us who you are. Tell us that you love cooking. Tell us that you absolutely that you've been married. And then you have two cats or personal things. The reason that is going to make you stand out is because nobody else is doing it. I coach all of my speakers to incorporate who they are in that question. Speaker 2 (11:05): Tell us more about who you are. And that is because you want to be a human being. When producers are choosing their speakers, it starts with the idea worth spreading, and then it moves into do I want to work with this person for nine months? And if you are high maintenance or lazy by cutting and pasting a bio into the application, we take cues. We are looking for who you are in those applications, which means if I say, I want one line for your idea worth spreading, and you write three, you can't read directions. You're not going to follow the rules, which means you're going to be difficult to work with once I book you. So I'm not going to, I'm not going to choose you. If you submit a video. And I say, I want a two minute video and it's two minutes and three seconds. You just disqualified yourself because I have hundreds of other people who are actually following the rules. So it's really important when you apply to these events that you answer the questions they're asking, you do not pitch your business and do not cut and paste a bio because that tells us you're lazy or somebody else supplied for you. Not you. Speaker 1 (12:15): Ah, I love the rule following thing. I'm a rule follower, but it, you know, I think that's great for the listeners here because that's how specific TEDx talks are because hundreds of people are applying. So like you said, if I say one sentence, you give me three. They're not even, they're not, you're not going beyond that. It's a next Speaker 2 (12:38): That's right. That's how I do all of my operations. It, we don't have, but not brutal, but smart, efficient, efficient. Yeah. We don't have time to handhold. We want to work with speakers who we know are going to show up prepared. And if we say you have eight minutes that they're going to actually deliver eight minutes. Because ultimately, if you are working with an exceptional TEDx producer who knows how to produce a show, they are putting on a show. There is a journey here. There is an arc and a through-line to that performance, to that show, to that event, which means you're going to put you in specific orders as speakers so that the audience goes on a journey. And I say specifically, a good TEDx producer. And that's something that is really, really important to remember. Not all Ted TEDx events are created equally. Not all TEDx events are going to give you the support that you need. So it's really important that you understand that as well, when you're looking for events Speaker 1 (13:41): And how can you pick that out? Like if you're like a newbie to the TEDx world, this is your first time applying, how do you, how do you know who's good and who's not good. Speaker 2 (13:53): First thing you want to do is go to the YouTube channel and watch the videos from past events. If the sound is bad, if the set is wonky, if the lighting is terrible, you can't trust that event's going to be improved. If you decide you do want to speak, there, have a conversation with the organizer, making sure that they have the proper audio and video. That's the first place you want to start. The next thing you want to do is get in touch with people who have spoken at those events. And this is the thing that people are afraid of, or have not been given permission to do. Karen, it's reached out to other speakers who had the experience. They will tell you the truth. They, if it's a good event, they will tell you it's a good event. And they may even put you in touch with some of the organizers, some of the, the the volunteers, so that you can talk with them about the process. Speaker 2 (14:45): So make contact, reach out, ask all the questions you want to ask. Were the organizers micromanaging your script. If they were think about that, did they take your voice out of your talk and make it their voice? If they did, you need to think about that. You need to create boundaries immediately, which means I'm so excited that I'm going to be speaking at your event. I am very, very competent in terms of writing my script. I will absolutely take your feedback, but the final script is mine. Not yours, set boundaries right away. People are afraid to actually tell organizers what they want. And that's something that I want to invite you and all of you to give permission so that you take back the control. It's your talk. Now let's be real. You do not own that. Talk. Once you take a Ted stage, head owns it. It is forever there's you cannot do it anywhere else. So be, be mindful, your image and your script will belong to Ted for the rest of eternity, which is also why you do not want a bad video to end up on YouTube for the rest of your life, because you have zero control over it. You cannot take it down. So really important that you vet organizers and that you're clear on how they work, what the process is. And if it's something that you are willing to champion or risk. Yeah, I would be safe. Speaker 1 (16:15): So nervous to say that to a Ted organizer. I mean, just because that's my personality, as you know, I would be like, Oh, well, you know, I mean, this is, this is what I want to do. And if it's okay with you, I'd like to do it this way. So to be able to set those boundaries, but not be dismissive of them. Yeah. Speaker 2 (16:37): Right. Their event, you want to honor, it's their event and Bay. They are the producer of this particular TEDx event. And you can absolutely respect all of that. And I encourage you to take that very seriously. They're in charge and reminding them that it's your idea worth spreading. They chose you for a reason and they need to allow you to be your amazing self and not try to infuse you with something else in that moment. Speaker 1 (17:06): Yeah. And, and that makes perfect sense. And you just have to keep your, have your confidence in yourself Speaker 2 (17:12): And in what you're doing. Absolutely. And I've had speakers who are extremely seasoned that I've worked with, who have come back to me because the TEDx events will, will provide you with a speaker coach for free. And I've had clients come back to me and say, the speaker coach thinks we need to do it this way. And they want to take this out of our script. And I'm really freaking out right now. It's two weeks before the event and all these nerves. And like all this panic, my talk is terrible. All that happens until you say, thank you so much for your feedback. I really, really appreciate it. And I'm going to do the talk I've written and they all say, no problem, no problem. They all say no problem. Speaker 1 (17:53): Excellent. Well, that is great advice for, for those folks out there, like me who are like, Oh, I don't, you know, want to offend anyone. And so that is really, really good to know. And the other thing that you said earlier that I just want to circle back on is when you're vetting these TEDx producers, you said that this might be someone you're working with for nine months. What can you explain that Speaker 2 (18:20): If you are going to work with a TEDx producer or say yes to an event, it needs to be yes. To an event that is not two weeks from the day you're accepted my event applications, whether it was TEDx Lincoln square or speakers who dare applications opened up in September, I made the decision in December and then the event was in March. So January, February, there was three months of speakers preparing. Now. They were also submitting in September. So September, October, November, December, January, February, that's eight months where I was spending time with these speakers, watching their videos, reading their applications. So you will want to have at least three months no less to prepare for your event. If you're being asked to speak in an event that happens in less than four weeks, I would gracefully decline because you are not going to have enough time to write a powerful talk and memorize it so that you can be your best self on that stage. And trust me, it has happened many organizers. This is really important. The one question Ted X does not ask on the application to become a licensed holder and organizer is, do you know how to produce an event? Speaker 2 (19:52): Anyone can get a TEDx license if they go through the process and they're granted a license, not everyone knows how to produce an event. And that is why vetting is important. And it's also important for you to know that this is an opportunity for you to share a very important message that you care deeply about in order to serve in order to reach people. The Ted brand is a massive platform. You have an opportunity to end up on ted.com and reach millions of people, which is why you want to set yourself up for absolute success and have a runway so that you can write an amazing talk, get the coaching you need, and then perform it beautifully. And that leads Speaker 1 (20:39): Perfectly into my next question. You answered it a little bit just then, but what makes an exceptional Ted talk? Speaker 2 (20:48): If the talk is really truly an idea worth spreading, that's the audience to think differently. And if you are activating from the stage, which means, you know how to deliver this content in a way that is how is MADEC in control in command while also sharing the idea worth spreading. And it doesn't mean teaching. It means sharing the idea worth spreading gifting, this idea, making sure that it's not an issue. And it's truly an idea. For example, teachers in public schools do not get enough support financially. We all know that to be true. It is an issue. If we reframe that as teachers are the GPS of our children's future, that is an idea. So really be clear that you are sharing an idea worth spreading, that you were in command of the material that you care about it, and that you are gifting this material to the audience so that they adopted as their own. Speaker 1 (21:56): And that was a great example, just switching the, the framework of the title makes all the difference. And, and I like that. It's, it's an idea, not an issue, an idea worth spreading, not an issue that we all kind of know, or maybe take for granted or something, right? Yeah. And that makes a big difference. Okay. How do you prepare for a Ted talk or a TEDx talk? It seems so daunting. Speaker 2 (22:25): It's the same preparation. If you are a speaker for any kind of stage, you are about to take, you begin with the writing process. You write and you rewrite and you write and you rewrite and you edit and you kill your darlings and you end up hating your talk and you think it's terrible. And you get past that part of the process. And now you have your, your final talk, your script. Then you begin to memorize. There is nothing sexy about memorization. It is boring. It is wrote. It is hard work. It's bicep girls it's plays. It is over and over and over start with the first sentence, move to the second, finish that paragraph. If you cannot prevent yourself from glancing down at the script, you are not memorized in that first paragraph. Do not do not cheat yourself. You want to make sure that first paragraph is memorized before you move on to the next, once you have the next paragraph, go back to the burst and tie those two together with the transition. Speaker 2 (23:27): So the last sentence of the first paragraph with the first sentence of the second paragraph, connect those dots. Once you have that and you are in complete control of those two paragraphs, then move on once you've done that through the whole talk, start in the middle and go to the end. Then mistake speakers make again. And again is they have the first half memorized cause they keep starting at the beginning and then they get on stage and nerves happen and they can't remember the second half. Once you have it all memorized, go back to the middle and work on the middle to the end. Once you are truly memorized and you can also record yourself doing the talk and listen to it in the car and listen to it on the treadmill, listen to it outside. When you're walking, when we're listening to songs, we memorize them because we're doing it while we're doing something else. Same thing applies here. Listen to yourself, give the talk over and over and over and over once you're memorized and really memorized, then do what I call an Italian run through. And this is from the world of theater, fast as possible, no emotion at all. You just want to give the talk as fast as possible. So your synapses are firing and you know that, you know the words, the moment you don't know the words, that's the section you're not memorized. Speaker 1 (24:35): Yes. And I remember doing this in the speaker salon, and I will say everyone, all you people listening that what Tricia just said, how to prepare, how to memorize. It works. Like, don't think your way is better. It's probably not. This is what works. Trust me. I did this when I had to give a keynote talk a couple of years ago. And the other thing that you cannot just glance over is the writing process. Because Trisha, remember when I first came out and gave my talk and Trisha is so wonderful because she'll say, Oh, you know, I really thought this was very strong, but Mike, you think about, and then she'll give her feedback and it's such a gentle way to give feedback. And you can, you can expand on that in a second. But I remember giving my talk and you were like, is this about you? Speaker 1 (25:30): And I said, well, yeah, it is. And you were like, why are you doing it in the third person? So I have this clever talk. It was, I mean, it was all written out. I was ready to go. I was prepared. And like Trisha said, you're gonna edit, edit, edit. You're going to feel uncomfortable with it. And then you're going to do it. And that's exactly what happened. And it was all the better for it. So the other thing I would say is get feed back from a coach from a trusted person, because when you're in it, it's hard to see out of it. Speaker 2 (25:58): And we are not comfortable being vulnerable right away. We often need permission. We often need to have a safe place to become vulnerable. And that's what I witnessed with you. Karen, as you walked up on stage, super confident sharing the story, it was very compelling story and zero vulnerability. And the moment you told us it was about you and that it was about your chronic pain. We all leaned in and could not take our eyes off of you. It was the most powerful transformation. One of the most powerful transformations I've seen. And I've seen a lot when you're talking about feedback and this is really, I'm great. I'm really grateful that you brought this up. Karen feedback is paramount. And you also need to know when you're asking for feedback and from you. Many of my speakers in the past have asked for feedback one or two weeks before their Ted talk and we're not specific. Speaker 2 (26:58): And all of a sudden they're getting feedback from random people. I think you should change the beginning. I don't really like what you're doing with the choreography and the blocking is not good. And all of a sudden they have absolutely no confidence. And that's because they weren't specific in asking for feedback three months before the event ask for feedback from somebody you trust a coach, whomever, because you have time to make those adjustments two weeks or one week before your event. Let's say two weeks. I'd like to know if there's anything about this specific talk that you love week before. You're a warm body. I don't want you to say anything afterwards, except thank you for giving this talk. Right? So get really specific when you're asking for feedback so that you don't derail yourself a week or two before, you're about to deliver a talk that you have memorized and no longer have time to make adjustments. Speaker 2 (27:57): Yeah. And that is great advice. And it reminds me of advice that jazz, who we both know, lovely, lovely, jazz set on this podcast. She said, you know, cause we were talking about asking for feedback from people and she's like, you wouldn't leave your apartment to go get a cup of coffee and ask every person you passed on the street. What kind of coffee you should get? Because you're going to get a different answer. And it's just crazy-making. It is crazy-making and nobody needs crazy-making two weeks before they're set to give a Ted talk. No, that's the visualization making needs to be happening. You need to be visualizing what it looks like to walk out onto that stage. You need to be visualizing what it looks and feels like to be delivering perfect mandating, powerful idea, worth spreading. You need to be visualizing what it's going to feel like when they applaud and when they rise to their feet and give you a standing ovation, you need to be visualizing what it means to walk into an out of that red circle. Speaker 2 (29:01): And this is part of the deep preparation work that I do with my TEDx speakers and with my community and clients is it is a big deal to walk out onto that stage and deliver your powerful message. You can change and save lives by speaking, whether it's in the red circle or not. So taking the role of speaker seriously and understanding the magnitude of your responsibility requires you to go above and beyond. It's not just about memorizing and talk and going and doing performance. Think about how powerful it is when that person is going to be watching your video. And they're going to think differently. They're going to potentially behave in their lives and that ripple effect can reach every other person in their life. So it is a very big responsibility when you are speaking from any stage. So give yourself permission, set yourself up for success by going through the process. Speaker 2 (29:58): And that's why I say nine months, because you really want to give yourself enough time to identify that idea, cultivate that talk, frat that beautiful, powerful talk, memorize it in a way that is so solid. You, if the chandelier falls on your head, you could absolutely continue and then give yourself the success set up by visualizing, by knowing what you're going to eat. And at what time you're going to eat it before you take that stage so that your body is not using energy to digest, but it's using energy to support you as a performer. This is about being an athlete and any and everything that you can do. You want to shoot that ball into the, into that hoop over and over again so that your muscle memory is ready to go. It is game on and Kyrene did this so beautifully. We worked like an athlete, works repetition over and over mindset. Self-Sabotage we did every possible trick and, and practice in order to have her walk out onto that stage and own it. She got a standing ovation. Speaker 1 (31:06): Yeah, she's amazing. It was an amazing talk. And again, we'll have that in the show notes here as well. Well, you know, I was going to ask you, would you like to sort of wrap things up, but you already did it. That was a perfect way. Now, before we before we end the podcast where can people find you? And if you don't mind, can you talk about your new book? Speaker 2 (31:28): Oh my goodness. I would love to talk about my new book. I'm a new author and it is so exciting. It's all the influential voice saying what you mean for lasting legacy. And it is on presale now@theinfluentialvoicebook.com. And you can find me at Tricia, brooke.com. I'm on Instagram, LinkedIn, and the influential voice is really a book about how to be a good human being while also teaching you to effectively communicate on stage and off. And I wrote it in June of 2020 instead of going to Mexico for 10 days with my husband, because we were all quarantining inside. I decided to use that time to write a book about how to teach people, to communicate with dignity, respect, curiosity, and love. And it is my hope that it will teach people that their voice matters and how to use their voice for good in the world. Speaker 1 (32:25): Amazing. And what a great use of time during quarantine. Geez. I feel like I just like rearranged my apartment. You wrote a whole book. That's amazing. Amazing. Yeah. And so we'll have links to that as well. Now, Trisha, before we leave I've asked you this question a couple of times already, but you're going to get it again. At what advice would you give to your younger self knowing where you are in your life, Speaker 2 (32:51): In your career? You can not imagine what is waiting for you. So keep taking those forward steps, excellent Speaker 1 (32:59): And advice. And Tricia, thanks so much. This was fabulous. I think everyone here will be inspired. They will start looking up those TEDx stages and, and again, get your book, get Chris Anderson's book, Ted talks. I think there are two great resources to sort of set you up for success in your speaking career, regardless of you get on a Ted stage or not. So thank you so much for coming on. Thank you, Karen and everyone. Thanks so much for listening. Have a great week and stay healthy, wealthy and smart.  

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Jonas Sokolof, DO, a physician specializing in physical medicine and rehabilitation at NYU Langone's Rusk Rehabilitation to talk about the importance of exercise therapy in cancer care.    In this episode we discuss:  What is Oncological Physiatry Use of exercise in improving function and quality of life  Lifestyle Medicine in Oncology Dr. Sokolof's baseball diamond analogy for rehab  The importance of collaboration in the treatment of patients live with and through cancer  Common side effects from cancer treatments And more!    Resources from this episode:  Round Table Talk: Cancer Rehab and Survivorship  More info on Dr. Sokolof NYU Langone Oncology Rehabilitation Summit: Optimizing Rehabilitation Outcomes Through Exercise   More About Dr. Sokolof:  I am a physician specializing in physical medicine and rehabilitation at NYU Langone's Rusk Rehabilitation. After completing my residency training at Harvard Medical School, I subspecialized in musculoskeletal/sports medicine and interventional spine care. During this time, I acquired additional skills in the nonoperative treatment of various musculoskeletal conditions, including arthritis, lower back and neck pain, coccygodynia, neuropathy, dystonia, and tendinitis. As a physiatrist, my goal is to help my patients regain function through various nonoperative treatments, including rehabilitation, injections for spine and joint pain, and medication. Whenever possible, I try to avoid prescribing medications for long-term use and prefer a more holistic approach to patient care. For instance, I have expertise in osteopathic manipulative medicine treatment (OMT), also known as manual medicine. OMT is "hands-on care"; I use my hands to diagnose, treat, and prevent illness or injury, through stretching, applying gentle pressure, and using resistance. I often find this modality useful as a supplement to other treatments. If needed, I can also provide people with image-guided injections for the spine and peripheral joints. Additionally, I perform electrodiagnostic testing to diagnose and guide treatment of various neuromuscular disorders. A major focus of mine is the rehabilitation needs of cancer patients and survivors. My goal is to help individuals, from diagnosis to cure, improve overall function and quality of life. I have expertise in diagnosing and treating a variety of cancer treatment–related side effects, such as chemotherapy-induced peripheral neuropathy, radiation fibrosis, lymphedema, and post-mastectomy pain syndrome. As the need for physical rehabilitation grows in the field of oncology, I find it exciting and rewarding to help restore function in anyone who has experienced cancer. I'm also certified in sports medicine, so I'm experienced in treating sports-related injuries in cancer survivors and helping them return to sports and exercise routines. I am passionate about lifestyle medicine, an evolving field that focuses on lifestyle interventions, such as diet, exercise, stress reduction, and smoking cessation, to treat and prevent various chronic conditions and improve function. In my research, I explore lifestyle interventions to improve the lives of people who have had cancer. I also speak at the local and national level about rehabilitation programs for people with cancer. I am a co-chair of the lifestyle medicine counsel for the American Congress of Rehabilitation Medicine and a co-chair of the medical fitness working group for the American College of Lifestyle Medicine. Additionally, I sit on the executive committee for the American College of Sports Medicine's Task Force on Exercise Oncology.   Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts:      https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                   https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the full transcript here: Speaker 1 (00:07): Welcome to the healthy, wealthy, and smart podcast. Each week we interview the best and brightest in physical therapy, wellness, and entrepreneurship. We give you cutting edge information. You need to live your best life. Healthy, wealthy, and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now here's your host, Dr. Karen Litzy. Hey everyone. Speaker 2 (00:36): Welcome back to the podcast. I am your host, Karen Litzy and this month, which is the month of April, 2021. We have focused our attention on cancer, survivorship, and oncological rehabilitation. To that end. I am thrilled to announce that on May 11th at 8:00 PM Eastern standard time, this is a Tuesday evening. We will have our round table talk focused on that subject. Oncological rehabbing cancer survivorship. All of the guests from this month will be on that round table talk. So that includes Kristin Carol Jillian Schmidt, Dr. Lisa van Hoose, and our guest today, Dr. Jonas Sokoloff. This is your chance to ask these four amazing experts, any question you want. And I know being a physical therapist going to conferences, I always want to try and get the person's attention to ask them a question. Sometimes you never get the chance. This is your chance. So if you have questions on oncological rehab on cancer survivorship, whether you're a physiotherapist, a healthcare professional fitness, professional, learning more about how to treat this population is imperative because a hundred percent of us are probably going to see someone who has cancer, who has lived through cancer in their lifetime. Speaker 2 (01:55): So how do you sign up? Go to podcast dot healthy, wealthy, smart.com click on the link that says round table talks, and you can sign up right there. And again, it's going to be Tuesday, May 11th, 8:00 PM, Eastern standard time. Now onto today's episode, like I said, today's guest is Dr. Jonas Sokoloff. He is a physician specializing in physical medicine and rehabilitation at NYU Langone Rusk rehabilitation. After completing his residency training at Harvard medical school, he sub-specialized in musculoskeletal sports medicine and interventional spine care as a physiatrist. His goal is to help his patients regain function through various non-operative treatments. And he also has expertise in osteopathic manipulative medicine treatment. Also known as manual medicine it's hands-on care. So he does use his hands to diagnose, treat and prevent injury or illness through stretching, applying gentle pressure and using resistance. A major focus of his is the rehabilitation needs of cancer and survivors is goals to help individuals from diagnosis to cure, improve overall function and quality of life. Speaker 2 (03:06): He has expertise in diagnosing and treating a variety of cancer treatment related side effects, such as chemotherapy induced, peripheral neuropathy, radiation, fibrosis, lymphedema, and post-mastectomy pain syndrome. As the need for physical rehab grows in the field of oncology, he finds it exciting and rewarding to help restore function in anyone who has experienced cancer is also sort of certified in sports medicine. So he's experienced in treating sports related injuries in cancer survivors and helping them to return to sport exercise and routines. And he is also passionate about lifestyle medicine as am I and ever evolving field that focuses on lifestyle intervention, such as diet, exercise, stress reduction, and smoking cessation to treat and prevent various chronic conditions and improve function. And we talk about that in the podcast today. What else do we talk about? Well, we talk about exactly what a physiatrist is and how they work in the field of oncology. Speaker 2 (04:06): We talk about some common side effects that people may experience from cancer related treatments. We also talk about the, his baseball analogy on rehabilitation and getting people back to their sport or back to life, which I love because I'm a softball player. So I had anything with a baseball analogy I'm all in. And he also talks about the importance of lifestyle medicine and why that's important, especially with cancer patients. And he lets us know exactly why that's so important. So a huge thank you to Dr. Socolow for coming on the podcast. And everyone don't forget to sign up for our round table on May 11th, by going to podcast at healthy, wealthy, smart.com and clicking on the round table tab. Enjoy everyone. Speaker 3 (04:59): Hi, Dr. Sokoloff welcome to the podcast. I'm happy to have you here this month, where we're talking all about cancer survivorship. So thank you so much for coming on. Oh, thank you very much for having me. It's really great to be with you. Yeah, this is really exciting. I'm definitely familiar listening to your podcast or floor gray while you're doing and you guys, my pleasure. Awesome. Well, thank you so much for that. And like I said, in your bio, you're a physiatrist and you're here at NYU. And we'll talk about that a little bit later, cause you guys have an oncology summit coming up and we'll talk about how people can sign up for that, but they have to listen to the whole, they have to listen to this whole podcast to get all the goods. So before we get into the meat of the discussion today, can you tell the listeners what oncological physiatry is? So uncle logical desires, you, maybe I should start by what is desire? Speaker 4 (05:58): You know, there's, I'm sure most of your listeners are well aware of what the field of desire tree is all about, but there may be a few that aren't so desire tree also known as physical medicine rehabilitation is a sub-specialty of medicine that involves essentially working with patients to enhance quality of life and physical function for patients that may be suffering from whether it's a an illness or an injury traumatic brain injury, spinal cord injury, or musculoskeletal injury. And it's a, it's a very multi-disciplinary field that overlaps a lot with orthopedics neurology, internal medicine rheumatology sports medicine, and, you know, several others. So you kind of have to know a little bit of everything, but basically the main goal of [inaudible] is to enhance quality of life and physical function. Now in oncological, physiatry is, is sub specialty. Speaker 4 (06:57): So we are experts in neuromuscular and musculoskeletal and other functional impairments that directly affect you know, people living with the beyond cancer, whether it's from the actual cancer itself or from the treatment of cancer. So surgery, radiation, systemic therapies, chemotherapies, immunotherapies, targeted therapies, et cetera. So in a nutshell, that's, that's, that's essentially what the field is about and what drew you to this subspecialty. So I am a sports medicine trained physiatrist. I did three years of a physical medicine rehabilitation residency. Before that you have to do a, a year of a general internship. And then I went on to do a three-year residency in PMNR. And then after that I did another year long fellowship and what's called spine and sports care or spine and sports medicine. So I received training in sports medicine care. So sort of like non-surgical orthopedics, interventional spine psychiatry, injections under fluoroscopy and under ultrasound. Speaker 4 (07:59): And, you know, I thought I was going to, you know, treat, you know, weekend warriors and, you know, athletes and, you know, yoga moms and so forth. And you know, essentially non-surgical orthopedics. But for me, I learned kind of early on in my fellowship year that, you know, I, I tend to kinda get bored doing the same thing, you know, over, over and over. And I, I really liked the variety and really like the challenge. And there was an opportunity to major cancer center in New York where they were looking to hire another physiatrist. They already had two physiatrists and they were looking at another physiatrist who actually had more of a sports medicine, interventional background. And I ended up applying for the position and it was, I was so impressed with the institution, but more importantly, I was, I was really impressed with this opportunity to really make a big impact in the field of oncology and really help like enhance the quality of life for people living with and beyond cancer. Speaker 4 (09:03): I just felt for me, that was more meaningful because there's such a huge need. Unfortunately, people who have the disease of cancer and go through treatment through the whole continuum, they have a lot, a lot of problems with, you know, getting back to the way, the level of functioning and quality of life that they had prior to their diagnosis. There's just a tremendous need, but we've gotten so much better at treating a variety of different types of cancers keeping people alive longer. Unfortunately a lot of these treatments do have a lot of sequelae that, you know, the oncology field, it's just not, they're just not well equipped to deal with these issues. And that's where we really shine as rehabilitation professionals because we are the experts in physical function and quality of life, and we really can make a difference. And I liked that feeling of really being able to make a big difference in the lives of these people. Speaker 3 (09:59): And you had mentioned in there that a couple of things that stood out to me, one that there are more people living after and beyond cancer than before, because of I'm assuming better treatments, better detection. Correct. And you also mentioned that there are side effects from some of these treatments and interventions. And I think oftentimes people think physical therapists alike think, Oh, someone had cancer, they survived it, they must be fine. So what do you see as the most common side effects and where can rehabilitation physical rehabilitation make a difference with those side effects? Speaker 4 (10:44): I would say probably amongst the most common side effects that I see, for example. So I see a lot of breast cancer patients and survivors in my practice and a lot of head and neck cancer survivors, a lot of prostate survivors. I'd say, you know, sequentially after surgery, for example, after mastectomy, or even in breast conservation, surgery, lumpectomy, and so forth. Whereas like you're, you're right. Patients, essentially in many, in many cases they're diagnosed early. They are, you know, very high success rate. The achieved cure is very often, but unfortunately a lot of these people, these individuals are left with a lot of pain and dysfunction, everybody heals at their own pace or rate. So their ICL, I see a great deal of patients who, whereas it it's expected that they're going to sail through their, their treatments. And men, many instances, they have achieved the events they have achieved you know, complete remission, but yet in some way, they're, they're left kind of broken and they're not able to get back to their baseline level of functioning. Speaker 4 (11:50): They have, they may have prolonged pain that lasts longer than what would be expected. They may have more scar tissue. And there's there. These factors may be, are usually multifactorial lifestyle factors come into play. Underlying premorbid conditions come into play you know, whole host of factors. And in many instances they are not, they don't recover as fast and they need a lot of help. So I'd say the biggest, you know, impact. I think the, in my practice, I would say in our breast cancer patients, we see a lot of patients with post-mastectomy pain syndrome pain that lingers way past the recovery period with scar tissue that often results in shoulder dysfunction adhesive capsulitis rotator, cuff dysfunction and impingement, bicipital tendonitis, various other factors that really adversely affect people's abilities to get back to like their life. That's one example that comes to mind, radiation fibrosis. Speaker 4 (12:55): So, you know, chemotherapy, radiation being the cornerstone of treatment for head and neck cancers, a great deal of morbidity there, you know a lot of scar tissue that forms after radiation, that impairs neck range of motion, ability to open your mouth trismus swelling, lymphedema in the head and neck population. Nobody, nobody knows how to handle these types of issues, but as rehabilitation professionals are really well equipped in you know, are able to really make a big impact in the lives of these folks. So I'd say those, those two populations really stand out to me and they are, they do make up a majority of my practice. Speaker 3 (13:37): And one thing that rehabilitation professionals are really proficient as in is exercise. So how can exercise help with these patients to improve their function and quality of life? Speaker 4 (13:49): Right? So we do have very robust data in the form of randomized controlled trials that exercise both aerobic training and resistance chaining can actually help improve several different cancer-related health outcomes. And that includes overall physical functioning lymphedema, anxiety, depression, overall, quality of life and wellbeing. And this comes from, you know, a tremendous amount of rigorous, you know well-designed clinical trials. So we do have, we now have really great evidence supporting this. We actually know that it, that it can be used as medicine, and we all know, I'm sure your listeners are well aware that exercise is medicine and really in oncology, this is actually even more apparent. Speaker 3 (14:39): And when we think about these patients living with and living beyond and through cancer, one of the things at least that I've seen with a lot of my patients that I have seen is that fatigue is an issue. And so when we're thinking about exercise, so as physical therapists, you're sending your patients to us, fatigue is a big issue. Do we center our treatment approach around a graded approach to exercise or to a paced approach to exercise? Or is it one of those answers that it depends. Speaker 4 (15:11): So it's all it's should be a personalized approach, right? It's really not a one size fits all. And that's why, again, it helps to be, you know, it helps for a patient to work with a highly skilled trained rehabilitation professional so that they can really hone in, do a full comprehensive assessment and really understand, you know, what exactly that particularly low patients struggling with with the impairments may lie what their history has been and order to come up with a real, you know, comprehensive, structured, personalized program. Oftentimes we use in rehabilitation, we're using a therapeutic exercise program. So for example, patient has, let's say rotator cuff dysfunction, right? They have imbalance of their scapular scapular stabilizing muscles, right? And they may have altered glenohumeral mechanics that are promoting this condition of impingement, let's say of the supraspinatus tendon and that leads to pain, loss of range of motion. Speaker 4 (16:14): And then that then progresses to let's say, adhesive capsulitis or frozen shoulder, for example. So we would, we would construct a therapeutic exercise program specifically honing in on that specific dysfunction, right. The shoulder. But we can also use, you may say generic exercise. We could use aerobic training and strength and conditioning on top of the therapeutic program, all from a personalized standpoint for what meets the needs of that specific patient in conjunction with a therapeutic exercise program. And that's where I think really where the field is headed is really being able to the goal should not just be, to get the patient out of pain, would get them back to, you know, being able to do some of their life specific activities, but also getting them to an exercise program that should be one of the main goals of ecological rehabilitation program. Speaker 3 (17:10): And I think that's great advice for all the physical therapists and physiotherapists out there listening is that when these patients are coming to you, like we'll take the example of shoulder pain post-mastectomy or post some sort of treatment that we don't want to just focus on. Let's just do exercises and rehab around the shoulder, but let's take it broader and try and make this into like a lifestyle change for the patient. Speaker 4 (17:40): Exactly, exactly. There's a there is a diagram that I often use on a lot of my talks when I lecture on this subject. And it's Speaker 5 (17:50): The baseball diamond approach to rehabilitation is a approach that is utilized in sports medicine. It was it was passed on to me by some folks some physiatrists at the Mayo clinic. It's very simple way to think about it, but essentially your goal is to get, get to home plate, get back to return, to play, you know, so to speak or return to life, do advance through all the bases to get the first space you have to restore range of motion from first base to second base. And you have to start to work on strength from second base, third base. Now you're starting to work on the neuromuscular kinetic chain on the pitcher's mound. You really want to put an exercise program that they should be able to be able to do for the rest of their lives. Because what it's going to do is actually going to, it's going to improve survival. Speaker 5 (18:32): It's going to improve cancer related you know health outcomes. Okay. So it's gonna help them to improve. It's going to help to improve anxiety, fatigue, physical functioning. And this is another thing that I really love about the field of oncological rehabilitation, because not only are we helping to restore quality of life and overall physical function, but we actually have the opportunity to make an impact on the disease itself. We actually can, as rehabilitation professionals can actually change the course of the disease by getting our patients back to a safe and effective exercise program. So it really needs to be incorporated into rehabilitation. It really should be all part of what we're doing as rehab professionals. Speaker 3 (19:14): I really liked that baseball diamond analogy. And, and oftentimes when we think of that return to play, I know the first thing that comes to my mind is as an athlete. So you're getting them back to their sport, whether whatever that sport may be, but you're absolutely right, that that same framework can be used for all of our patients. They have to get back to, it may not be back to the soccer pitch or the baseball field, but they are getting back to returning to play, which is their life Speaker 5 (19:49): That's correct. And even back to their familial roles, there's societal roles, there are vocational roles really getting them back to the things that they want to be doing, the things that they need to be doing to live out the rest of their life. Speaker 3 (20:06): Yeah. I love that baseball diamond going to be using it all the time. I love it. Especially as a former softball player and a former pitcher, I can definitely relate to that. Now we've been saying this word a couple of times throughout the interview, and that is lifestyle. So there is this lifestyle medicine, branch of medicine. So how does that fit into the oncology patient in the world of oncology? Speaker 5 (20:34): So two thirds of the world's cancers, according to the world health organization can actually directly be linked to lifestyle, right? So smoking alcohol dietary intake lack of physical activity, increased stress levels and so forth. So we have as rehabilitation professionals, the opportunity to intervene to provide lifestyle interventions and again, help restore physical function, but also have a major impact on the, the course of the disease itself. So I believe that lifestyle medicine actually should be, is a very important aspect of what we offer in rehabilitative care, especially in on-call oncological rehab. So I try to incorporate it into my practice counseling patients and educating patients on proper nutrition, certainly exercise. We do a lot of cancer counseling and exercise. We offer stress reduction techniques. Certainly when, when patients are smoking we, you know, get them as soon as we can plugged in with smoking cessation programs and so forth and so on. So because there is such a direct relationships to lifestyle and cancer it, it has to be a key component of the rehab plan as well. Speaker 3 (21:51): Yeah. And that, that is all in our lane. Speaker 5 (21:54): Exactly, exactly. Yeah, I mean, you know, the F really up until, you know, recently the thought process, you know, cancer essentially had a very strong genetic component. But right. The it's the way the, the environment or lifestyle is affecting those genes, which we know that, that poor lifestyle can actually turn on a lot of those oncagenes and promote you know, promote cancer growth. So yeah. Speaker 3 (22:26): Yeah. And so what is it coming from you from your position as a physiatrist? What are some things that you really want physical therapists to know when it comes to treating patients that have, or have lived through cancer, Speaker 5 (22:43): Physical therapists that it's, it's safe to put these folks through an exercise program it's safe to put them on a resistance training program as long as it's, you know supervise and as long as, you know, if you're working with a physical medicine rehabilitation physician or a physiatrist, it's really great to partner up so that you can learn, you know, what would be a safe way to approach, for example, a patient with metastatic disease in the spine or metastatic disease somewhere else. You know, in the, in the skeleton, for example, cause I think a lot of therapists may be apprehensive. They don't want to, you know, cause a fracture, for example, they may not want to injure a patient and they're not sure what would be safe. Just know that it is safe when it's done, you know, under the supervision of someone who's as skilled, as trained as yourself, but also helpful if you have members of your oncology community that you can communicate with and determine you know, what would be the great, the best plan for that patient and what would be the safest plan? Speaker 5 (23:57): I mean, therapists were, we, we were in constant communication about the patients programs in our, in our at our site as to what, how you can progress them through an exercise program safely based on, you know, review of imaging and based how, and then how they present clinically. So yeah, I mean, I, I would, I would just say, I think, you know, a lot of these patients can tolerate probably a little bit more than what's been previously done in the past. Speaker 3 (24:29): Awesome. Well, thanks so much for that. And hopefully all the physical therapists and physios and even other healthcare professionals listening or taking notes on all of this, cause this was great. Let's talk about the NYU Rusk rehab. They have an oncology summit coming up. Is it in October, Speaker 5 (24:49): October 1st, it's going to be Speaker 3 (24:51): Featuring our very own Nicole Stout as a keynote. We love her here. Love her, love her so much. So go ahead and talk a little bit more about that. Speaker 5 (25:00): So we are having our first you know, annual uncle logical rehabilitation summit Ruskin suit, NYU school of medicine on it's gonna be October 1st, it's going to be a hundred percent virtual. Eventually as we come out of the pandemic, we will hopefully transition to an in-person program. But this year we're going to starting off as virtual. And the theme of this year's symposium is going to be exercise oncology. So we are going to have oncologists lecturing, certainly physical therapists, speech therapists, occupational therapists Dr. Katie Schmidts, the CSM round table leader in luminary in the field of exercise oncology as well as Nicole Stout, excited to have them are two keynote speakers are really looking forward to providing a robust program for anyone interested in how to implement exercise into a rehabilitative care plan for oncology patients. Speaker 3 (25:58): Yeah. And it's like total coincidence. I got the email for that. Like a couple of days ago, I was like, Oh, this is perfect because here we are doing this interview. So this worked out very, very well. And now where can people find you, if they want to ask you questions, they want to connect with you? Where can they find you? Speaker 5 (26:17): My email probably is the best. I'll definitely find putting it out there. It's my first and last name, so that's Jonas, J O N a S dot SoCal off that's S like Sam. Okay. O L like Larry off, likeFrank@nyulango.org, one word, NYU llangollen.org. Speaker 3 (26:37): Perfect. And we will have all of this links to sign up for the summit and your email in the show notes for this episode at podcast at healthy, wealthy, smart.com. And last question that I ask everyone, is that knowing where you are now in your life and in your career, what advice would you give to yourself as let's say, fresh out of medical school? Speaker 5 (27:05): What would the advice would I give myself fresh out of medical school? I would say, you know, I would say, probably go with your gut. Right. You know, there's a lot of pressure. I think when you're, when you're going through medical training and medical school you know, pulling in different directions on planning your career you have a lot of different factors, financial and I think, you know, I always had wanted to, into going to have a medical career that was going to make a big impact. I think I got a little bit sidetracked along the way, and I, I kinda may have been chasing a different dream, but then when I finally realized what I think what I was meant to be doing, it really kind of brought me back in line on my path. So I'd say, you know, just really follow your gut, you know, pursue your dreams. You know, really go with what you feel is right deep down in your heart, and now you really can't go wrong. So Speaker 3 (28:06): I love it. Great advice. And, and frequently heard advice here on this podcast. So it must be a good one. So, Dr. Sokoloff thank you so much for coming on today and look forward to seeing you at our round table discussion in a couple of weeks. So thank you for that as well. So thank you. Thank you. Thank you. Speaker 5 (28:26): Thank you. I'll look forward to the round table. Speaker 3 (28:28): Yeah. As in everyone for listening everyone out there listening. Thanks so much. Have a great couple of days and stay healthy. Speaker 1 (28:34): Be wealthy and smart. Thank you for listening. And please subscribe to the podcast at podcast dot healthy, wealthy, smart.com. And don't forget to follow us on social media.  

In this episode, Associate Professor and Program Director in the Physical Therapy Department at the University of Louisiana Monroe, Dr. Lisa VanHoose, talks about the provider role in cancer survivorship. Today, Lisa talks about implicit provider bias, survivorship as a concept, social determinants and healthcare access, and provider trust. How can physical therapists help lessen the overload? How do you determine whether or not you're a trustworthy provider? Hear about the effects of cancer on co-survivors, get some advice for screening when working with cancer survivors, and learn about the disease burden on marginalised communities, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways The definition of cancer survivor: "You become a survivor from the time of diagnosing." "When we talk about survivorship, it really is a conversation about how well are you able to live your life." "Cancer and its treatment is one of the top causes of bankruptcy in the US." "Cancer and Alzheimer's Disease are two chronic diseases where we're seeing the caregivers die earlier than the survivor because of the caregiver burden." "Medical access accounts for about 20% of someone's health outcomes." "Cancer survivors who have unmet social determinants of health are more likely to miss appointments." "If you want to know if you're a trustworthy provider, you should probably ask." "You can condition yourself to have less bias, but you have to actively do it." "100% of physical therapists are going to see someone who had cancer or has cancer." "Everyone needs to be doing a self-assessment of where they're at in regards to their own biases." "African American women were dying at rates 3 to 4 times higher than those of their Caucasian peers." "That difference in healthcare is avoidable if we would just stop and be intentional about the care and the way in which we deliver care to each other." "We're one decision away from someone having a different type of cancer survivorship journey." "Although we know cancer survivors are recording these side-effects to cancer and its treatment, only about 20-30% get referred to a provider to address them." "In our quest to provide care for others, we forget to refresh and replenish ourselves."   More about Lisa VanHoose Dr. Lisa VanHoose is an Associate Professor and Program Director in the Physical Therapy Department at the University of Louisiana Monroe. Dr. VanHoose received her PhD in Rehabilitation Science and MPH from the University of Kansas Medical Center. She completed fellowships at the University of Arkansas Medical Sciences Donald W. Reynolds Institute on Aging and the National Institute of Heart, Lung, and Blood Institute PRIDE Summer Institute with an emphasis in Cardiovascular Genetic Epidemiology. Her Bachelor of Science in Health Science and Master of Science in Physical Therapy were completed at the University of Central Arkansas. Dr. VanHoose has practiced oncologic physical therapy since 1996. She is a Board-Certified Clinical Specialist in Oncologic Physical Therapy. As a NIH, PCORI, and industry funded researcher, Dr. VanHoose investigates socioecological models of cancer related side effects with an emphasis on minority and rural cancer survivorship. She has been an advocate for movement of all persons, including the elimination of social policies and practices that are barriers to movement friendly environments. Dr. VanHoose served as the 2012-2016 President of the Academy of Oncologic Physical Therapy of the American Physical Therapy Association. She currently provides oncology rehabilitation services through the Ujima Institute, PLLC, as the owner and service provider.   Suggested Keywords Physiotherapy, Research, PT, Health, Therapy, Healthcare, Cancer, Oncology, Survivorship, Rehabilitation, Mental Health, Providers, Biases, Movement, Wellness,   To learn more, follow Lisa at: Website:          https://www.ujimainstitute.com                         ULM - Lisa VanHoose Facebook:       Ujima Institute Instagram:       @ujima_institute Twitter:            @LisaVanHoosePT                         @UjimaInstitute LinkedIn:         Lisa VanHoose   Subscribe to Healthy, Wealthy & Smart: Website:  https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:  https://soundcloud.com/healthywealthysmart Stitcher:  https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Transcript:  Speaker 1 (00:07): Welcome to the healthy, wealthy, and smart podcast. Each week we interview the best and brightest in physical therapy, wellness, and entrepreneurship. We give you cutting edge information. You need to live your best life. Healthy, wealthy, and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now here's your host, Dr. Karen Litzy. Speaker 2 (00:35): Hey everybody. Welcome back to the podcast. This month is all about cancer survivorship. So if you missed the episode two weeks ago with Christine Carol and Jillian's Schmidt, make sure you go back and listen to that episode. Lots of great information, especially for providers on how to treat people with cancer currently, or cancer survivors. Now today's episode is brought to you by net health and tomorrow, which is Tuesday, April 20th, net health has a three-part mini webinars series bet with best-selling author, Stacy Fitzsimmons and Kelly Castillo of net health. They'll be talking about the three T's of creating revenue ownership beyond just billing beyond just the billing department, training tools and transparency. Stacy and Kelly have over 25 years of combined experience helping private practices give the best possible care while increasing their revenue head over to net health.com/litzy. To sign up as a bonus. If you put Litzy in the comment section and show up, they've arranged for net health to buy lunch for your office. Speaker 2 (01:44): Once again, that's net health.com forward slash L I T Z Y. So head over and sign up now and moving on to today's episode again, following in our theme of the month, which is cancer survivorship. I'm thrilled to have on the program, Dr. Lisa van hus. She is an assistant professor and program director in the physical therapy department at the university of Louisiana Monroe, Dr. Van who's received her PhD in rehab science and MPH from the university of Kansas medical center. She completed fellowships at the university of Arkansas medical sciences, Donald W. Reynolds Institute on aging and the national Institute of heart lung and blood Institute pride summer Institute with an emphasis in cardiovascular, genetic epidemiology, her bachelor of science in health science and master of science and physical therapy were completed at the university of central Arkansas, Dr. Van, who says practiced oncologic physical therapy since 1996. Speaker 2 (02:40): She is a board certified clinical specialist in oncologic physical therapy as an NIH, P C O R I and industry funded researcher, Dr. Van who's investigate socioecological models of cancer related side effects with an emphasis on minority and rural cancer survivorship. She has been an advocate for movement of all persons, including the elimination of social policies and practices that are barriers to movement friendly environments. She served as a 2012 to 2016, president of the Academy of oncologic physical therapy of the APGA. She currently provides oncology rehab services through the Ujima Institute PLLC as the owner and service provider. So on today's episode, what do we talk about? Well, it's all about the provider. So in today's episode, Lisa talks about implicit provider bias, survivorship as a concept social determinants of, and the healthcare and healthcare access and provider trust. So how can physical therapists help lessen the overload? How do you determine whether or not you're a trustworthy provider we'll hear about effects of cancer on coast survivors, get some advice for screening when working with cancer survivors and learn about the disease burden on marginalized communities. So there's lots to dive in. This is a long episode but it is well worth it. I highly encourage you to listen to the very end because everything is so good and you will get so much information from Dr. Van who, so I want to thank her and thank net health and thank you for listening. Speaker 3 (04:20): Hey, Lisa, welcome to the podcast. I am very happy and honored to have you on, so thank you. Thank you. Hi, everyone. Super excited to be with you today. And now all this month, we are talking about cancer survivorship. This is your research. This is your wheelhouse. This is what you teach. So let's get to it. What we're going to talk about today is provider bias in that lens of cancer survivorship. So can you tell us how that works and what that is? Yes. So I think most of us are now familiar with the term implicit bias because of all the things going on in the social environment, right? So implicit bias is basically those preferences, attitudes, stereotypes that we might have towards a person or towards a specific group of people. And so when you talk about provider bias, it's that implicit bias, but it's something that is hailed by a provider that might then potentially impact have a interact with that patient or client, and even the decision-making process for that client and the research to just that it, a lot of times occurs either subconsciously or unconsciously. And so we're not even realizing how we might be negatively impacting somebody's care. And how can that provider bias affect outcomes affect treatment and affect the survivorship of these cancer Speaker 4 (05:58): Or patients with cancer. I don't want to say cancer patients. I want to say patients, people with cancer almost, almost, almost set it wrong. Speaker 3 (06:09): No worries. So when you think about provider bias so the research should just that most of us have a bias towards people that are a bigger body size or what we call obese, right? And so if you were a PT, a nurse, a physician, and you were talking with someone that is of a larger size, and they're trying to articulate to you that maybe their knees hurt, or maybe they've got, you know, some type of discomfort provider bias might make you minimize their complaint. It might make you not do a full assessment because you're like, ah, it's just related to their weight. Or you might just go, well, you know, it's part of their lived experience because they chose to be fat. And so there are things that instead of us doing the standard care, we actually will deviate from it because of our bias. Speaker 3 (07:04): And so where we see that happen, where that has an influence on cancer survivorship is we know that every cancer survivor will have at least one physical impairment and most of the time it's fatigue, but let's say that cancer survivors, someone who identifies as as a sexual orientation, that's not heterosexual. And you as a provider, you may believe that, you know, there's a moral or religious issue with that. So then when that person's talking to you about their fatigue, as it relates to maybe their sexual activity, or maybe just how it relates to their everyday life, you may decide consciously or unconsciously to not listen. Or you may decide that, you know what, that that's, God's answer to, you know, their, their lifestyle choice. So, sorry, y'all just, somebody is having a healthcare emergency right now. Speaker 4 (08:06): That's okay. Normally it's on my end because I'm right on Broadway. So there's always a siren going off. The listeners are used to it, please continue. Speaker 3 (08:14): So I think when we think about, you know, someone's care, we're all talking about, you know, high quality care and standardized care and trying to minimize variations. But a lot of the variations we see are related to our biases. Speaker 4 (08:29): And so let's talk for a minute about, so we know outcomes may be different because of this provider bias. And, you know, we are talking about cancer survivorship, but there's a difference between you're alive. You lived, you survived and the concept of survivor ship. So can you talk a little bit about that and how again, where that bias may play a role? Speaker 3 (09:01): Yes. So the new definition for cancer survivor is that you become a survivor from the time of diagnosis. And so often we think of that as binary, right? Are you alive or not alive? When we talk about cancer survivorship, it really is this conversation about how well are you able to live your life? Right? So regardless of the cancer diagnosis are, do you have the resources that you need to live the life that you choose at the best level that you so choose? And so when we talk about survivorship, now we want to know about all of your physical wellness. We want to know about your emotional wellness. We even talk about financial wellness because one of the side effects to cancer is financial toxicity cancer and his treatment is one of the number one causes of bankruptcy in the United States. So survivorship is really about how well are you able to live your life? Speaker 4 (10:05): And I would also have to assume that within that survivorship is the environment in which you're surviving. So can you talk a little bit about that as well? Speaker 3 (10:14): Beautifully stated. So the hot topic everywhere right now is social determinants of health. And I think that is also just as true for cancer survivors. And I also want to say their caregivers because when we talk about cancer survivorship, we want to also talk about the coast survivors, right? So a lot of times we'll focus in on the cancer survivor. But the work that we did in Arkansas, a couple of years back, we went throughout the state talking with cancer survivors and caregivers. And the thing that cancer survivors told us over and over again, was I'm more concerned about my loved one. I'm more concerned about my coast survivor because everyone's focused on me as a person with cancer, but no one is thinking about the lived experience of my of my caregiver. And I was at a conference once and they were talking about how that cancer and Alzheimer's diseases, Alzheimer's disease are two chronic diseases where we're actually seeing the caregivers die earlier than the actual survivor, right. Because of the caregiver burden. And so that's a trend that people are watching in the data. So, yeah. Speaker 4 (11:29): Yeah. So it's, it's more of, it's more than just the patient, it's the caregiver and it can also be their community. Do they have access to their treatments? Do they have access to the things they need to help them survive and survive? Well, if you're living perhaps in an area that you don't have access to a lot, these things might Speaker 3 (11:54): That also be something that can cause a bias in the provider, almost definitely. So I think you have to think about all of the social determinants of health. So in the, the literature suggests that the medical access, like the healthcare access, a counselor, about 20% of someone's health outcomes. Now we do know that your ability to get to a provider of choice is important. And we also know that people typically don't want to travel more than a 20 minute drive to get to care, but there are some areas where people are driving hours. I remember when I was in Kansas practicing, I had clients that would drive three to four hours one way to see me. And so when you think about cancer survivorship, and we know one of the number one complaints is fatigue. If you're driving three to four hours to get to therapy, then the expectation is you're going to work with a therapist for an hour, hour and a half. Speaker 3 (12:58): It's just not a realistic journey. So we have to figure out a way to improve access. Most definitely. We also have to think about the fact that, that it's not just can someone access care, but can they access high quality care? So there is a time and a place for generalists. I totally love my generalist, right. Shout out to you. But then there also Toms for specialists. And so there are certain geographical areas where it would be really difficult to find a specialist in cancer, be it an oncologist, be it a PTB in an OT, be it a dentist. So we have to think about those issues when we talk about healthcare access. But then you talk about the 80% and the 80% are going to be the things like what is the environment that that person with cancer has to live in. Speaker 3 (13:50): So like I'm here in Louisiana and Louisiana has a stretch of highway that's known as the cancer corridor, right? Because we have hundreds of production, meals and industries that have a lot of waste products. And so because of that, we see this uptake in cancer prevalence, we see a different survivorship experience for those cancer survivors because they're constantly exposed to these environmental exposures. So I think, you know, that's one thing when you think about cancer, survivorship is what is the environment in which they're living right now? We're talking to everybody about, you know, physical activity, the, the APA has just launched a physical activity campaign, but then you have to think about, okay, what, what is their green space availability? Is it safe for them to be out and walking, right? Then you have to think about how are they going to fuel that movement. So are they close to grocery stores, right? Or, you know, community gardens. So I think when we think about cancer, survivorship, healthcare is one piece, but then we also have to think about all those other determinants of health as well. Speaker 4 (15:02): And it's does it not seem overwhelming? I mean, gosh, to me it sounds, seems so overwhelming. So how can as providers, let's say, as physical therapists, healthcare providers, what can we do to help lessen that? What that Speaker 3 (15:19): Overload? Yeah. So I think if we, number one, just all can agree that we have some level of implicit bias because we're all animals. So therefore we are slightly tribal in animalistic, which means that you're naturally going to have a preference towards people who look like you or people who act like you or think like you, so you have to engineer the system to combat that. And the best way to do that is with screening tools, right? So could you introduce a screening tool that asks that client about their cultural beliefs and their lived experience? Right. so then that way you can incorporate that into their care because I was pulling up some articles that looked at the lived experience of black or African-American and Hispanic or Latino X cancer survivors. And one of the things that they talk about is the fact that their provider, who is often, you know, someone who identifies as white, doesn't really ask them about their life. Speaker 3 (16:27): They might give them instructions, but doesn't ask them about the context right. In which they're supposed to implement this. And they're like, that's part of the reason why I don't follow those instructions and then they get dinged for noncompliance, right. Or, or non-adherence, and they're like, that person never asked me anything about me. So could you potentially introduce that as a screen in regards to kind of getting some information about their cultural values and beliefs, and then introduce a social determinant of health screen. So then you can find out kind of what their needs are because one of the articles I pulled up was talking about how that cancer survivors who have unmet social determinants of health are more likely to miss appointments. And so how often do we all get frustrated at that patient? That's a no show. Well, have you asked them about what's going on in their life and then help to align them or connect them with some community resources, because that might be the root of a no-show right. So I would say start off with some screening. Speaker 4 (17:37): Yeah, that's great. And you know, we had a conversation last night on clubhouse with a group of physical therapists and it was about the female athlete, but one of things that Speaker 2 (17:50): Was very clear is, are we asking the right questions? And I think that completely aligns with what you just said. So what is your food security? Like, what is your home security like, right. Do you have children? And this is another one, do you have pets? But if you have, what is your responsibility in your home life? If you have a dog, if you live alone or do you have to walk this dog? We just talked about fatigue being one of the major aspects. So what if they have to walk their dog three times a day and they have physical therapy that day? Well, which one do you think is not going to happen? Speaker 3 (18:28): Exactly great points. You know, Speaker 2 (18:31): These are all great questions to ask. So it's, we're asking questions, but are we asking the right questions? And I think that was a solid point that you just made. Speaker 3 (18:41): I love that. Are you asking the right questions and then are you living? Speaker 2 (18:47): Hmm, well, even more important because like you just said, implicit bias can make us our brains be like, blah, blah, blah, blah, blah, blah, blah. Oh, were you saying something or, or, you know, Speaker 3 (19:01): Often someone will say something, someone will tell us what they value and then, because we don't value that we'll minimize it and that might've actually been the secret sauce to them being able to achieve their healthcare goals. Speaker 2 (19:15): Yeah. Yeah. Another and again, gosh, another great question that was brought up yesterday is, well, what kind of successes are you having right now? And then, like you said, that might be it, that might be the secret sauce. So if we're not tuned in, are we going to miss it? Speaker 3 (19:33): Great points. And then I think often as providers, we tend to ask all the questions about the negatives. And especially when you add in your provider bias your implicit bias, because we've been conditioned to think so many negative things about different subgroups. So we automatically start asking them all these questions about all of these negative things that we think should be occurring in their life. So I love this concept of saying, well, what's going well, right? What are the successes? Because then it also changes the dynamic of the relationship, because then that helps you to understand what are the things that you could leverage. Right. And expand. So I, I really think, you know, the other hat I wear y'all is I'm an educator. And so when we talk about culturally responsive pedagogy, one of the core elements is are you coming into that exchange with the student from a positive lens? Speaker 3 (20:36): And I think we also have to think about that as a provider. Because anytime you interact with a human, it's an exchange of energy, and if the energy I'm putting to you as negative, that's going to impact you. So I think always kind of, you know, asking, you know, what's going on. Well also thinking the best of the person that's sitting in front of you. That's one thing that I've learned from the patients that I've been able to serve is they're like, there are some days that I just have to borrow the positivity from my providers. Right. And I think we have to recognize that that some days we are, we are that, that shining star, that good vibe for another human, but that requires us to actually believe in that other human and in their experience. So you got to see that human in front of you perfectly said, of course. And that leads me to the next topic. Is, is, are you a trustworthy provider? And how do you determine that? Because is, is trust normally determined by the person in front of you? They feel you're a trustworthy provider. If you feel you, are, are you biased towards yourself? Like, yeah, I'm awesome. Right. So can you expand on that? And on that note, we'll take a quick break to hear from our sponsor and be right back Speaker 2 (22:03): Tomorrow, April 20th, as part of net health, three part webinars series bestselling author, Stacy Fitzsimmons, and Kelly Casio of net health. We'll be talking about the three T's of creating revenue ownership beyond just the billing department, training tools and transparency, head over to net health.com/lindsey to sign up as a bonus. If you put Lindsey in the comment section in the registration page, sign up and show up net help, we'll buy lunch for your office. Once again, that's net health.com forward slash L I T Z Y. Sign up today. Speaker 3 (22:39): Oh, that's a good one. So there are two dynamics that occur in the therapeutic Alliance. There is the trust that the patient or the client, or maybe their caregiving unit, the stove's on us as providers, right? So that's the gift. And I think often as providers, we feel like we're entitled to trust and you're not, it's no different than any other relationship. It is something that someone is gifting to you, if they're dressed. And then for us as providers, we have to prove to be trustworthy and trustworthy is reliable and honest, right. And authentic. And so how do you know if you're trustworthy is that patient or client is actually the judge of that. It's not you. And so the definition of trustworthy may slightly vary for different patients, right. Because they are actually the judge and the jury in that. So if you want to know if you're a trustworthy provider you should ask, or maybe it should be part of your customer satisfaction survey, but I think, you know, when you think about provider bias or even implicit bias most of us can sense when the person that we're interacting with is not being authentic. Speaker 3 (24:03): Right? And so your bias thing can impact your ability to be, to be perceived as trustworthy as a provider or even just as a human. And so that's why it's really important for us to do the self work, to really kind of sit with ourselves, know what our triggers are. So, you know, who is it that we have these really negative perceptions of, or thoughts about, and then really questioning that. So Eckhart totally talks a lot about watching your mind. And so my challenge to providers is even in that interaction with the client or the patient in front of you, you know, always kind of paying attention to what are the voices in your head saying, you know, as you're doing that interview, listening to that client what, what is really S what else is going on? You know, like when that patient says, you know, no, I've not been able to, you know, take my blood pressure medicine, are you like, yeah, it's probably because, you know, you're doing X, Y, and Z with your money, or, you know, you're always telling a lie, but could you say to yourself, is that true? Speaker 3 (25:12): Cause Bernay Brown talks a lot about asking yourself is that the story is, you know, what's the story I'm telling myself. So could you really question that and then push back on, push back on that a little bit, cause you can condition yourself to have less bias, but you have to actively do it Speaker 4 (25:32): And it takes work and it can be uncomfortable. Yeah. Speaker 3 (25:35): It takes a lot of work, takes a lot of work. Because it's easier just to believe your own little echo chamber that you've created. Speaker 4 (25:44): My next question is what is your advice to providers when it comes to dealing with cancer survivors? Because as I spoke about in another podcast with Kristin is a hundred percent of physical therapists are going to see someone who had cancer or has cancer, the numbers are there. So what is your advice to providers when working with this population and kind of checking themselves? Quote unquote, Speaker 3 (26:15): Great question. So I'm, I'm going to say, first of all, we're going to go with your statement of ask the questions. Because I have actually seen therapists, physicians care for a client and never know that they had cancer because we didn't do a complete history. Right. and so you, you want to ask people that because the data says that one in two men will have cancer in their lifetime, one in three women. So just like you said, the odds are, is that you're going to care for someone that has had cancer or currently has cancer. So ask the question, number two is ask some details about it. So now the standard is, is most cancer survivors will have, what's known as a cancer survivorship plan that outlines the details of their tumor and also the treatment of it. And that's really beneficial to you as a provider because it'll help you be able to explain maybe some of the symptoms that they're reporting and also potentially anticipate some of the symptoms that they might have in the future. Speaker 3 (27:23): And there are things you could do to prevent that so that they have a better survivorship journey. Then number three, just listen and listen with a beginner's eye and beginner ears. Right? So be really curious about what that person is saying. Everything doesn't have to be judged because I always remind people, there are 8 billion people on the planet, so there are 8 billion ways of doing this thing. There's no rights or wrongs. And then the fourth thing is a screen, right? Because I have to recognize as a provider that I'm going to ask the questions, I'm going to do the things that are often comfortable for me because you get in this routine. And then, because this is a human sitting in front of me and everyone is diverse. I have to have some screening so that I don't miss anything. Right. Because often my pattern is based on what I like and the things that I do with the community that I'm, you know, most accustomed to. Speaker 3 (28:28): And so when I'm treating someone that might be different from me and everybody's different from me, then it's always good to have a screen that way you make sure you're not missing anything. And then I would say the last thing is ask that person what is important to them because often as providers will create a whole plan of care and never really asked people to rank or prioritize, what's really important to them. We often make judgements for people and that's not our jobs as providers, we're, we're part of their team. So those would be the things that I would say to remind people love. And then, you know, I think everyone needs to kind of be doing a self assessment of where they're at in regards to their own biases. And then just getting curious about it, be okay with talking with someone who doesn't think like you or who doesn't look like you. Speaker 4 (29:23): Yeah. Every point. Excellent. And hopefully people were taking notes on that. And now Lisa, where can people find you if they want to learn more about you and what you're up to and what you're doing. Speaker 3 (29:35): Awesome. so you can typically find me at the university of Louisiana Monroe. So I am the associate I'm associate professor and program director of the physical therapy program there. Or you can find me through Jima Institute. So the Ujima Institute is a grassroots organization that we started to primarily look at ways in which we could collectively come together to address the health and wellness of black communities. Because one of the things we didn't even talk about was health disparities as it relates to minority or marginalized communities. So when you think about black and Brown cancer survivors, when you think about cancer survivors from LGBTQ communities their disease burden is significantly different than the majority group. And even things like just their mortality rates are significantly different. That was some of the work that we did early on in Kansas city where we found that, you know, African-American women were dying at rates three to four times higher than those of their more of Caucasian peers. So yeah. Of white peers. Speaker 4 (30:47): And is that because of lack of access, was it because of lack of belief that they were ill or what, what did you, what did your findings Speaker 3 (30:59): So some of it was an access issue. So when you think about where the mammography centers located also the quality of the equipment at different sister centers varies as well. I think people often don't think about that. Then also the providers. So there's often a difference in which providers are available to which subgroups then also, and this is one thing that even, I think PTs and healthcare providers should think about in general is our typical office hours, right? So we tend to do eight to five. Well, if I'm a second or third shift worker that might not work for me, or if I work in an industry where I do a 12 hour shift that may not work for me. And those are often jobs that black and Brown community members are holding down. And so the very nature of how we deliver care often introduces some inequities. And I love that Def to my favorite definition of inequities talks about how they are avoidable, right? So that difference in healthcare is actually avoidable. If we would just stop and be intentional about the care and the way in which we deliver care to each other. Speaker 4 (32:18): Mm gosh, it's so multifactorial. But changeable Speaker 3 (32:25): Very changeable. I often say we're just one decision away. We're one decision away from someone having a different type of cancer survivorship journey because for your audience, fatigue is the thing that we often talk about, but the other things are like pain. Most cancer survivors are also experiencing a high level of anxiety. And in the United States, we're actually going the opposite direction in regards to our mental health resources, right. And cancer survivors need that support. Other things that bother them are things like neuropathy and even like itching. Like I cannot tell you how many cancer survivors are like, can you just make the itching stop? And people are like, well, who is it that big of a deal, but if I have a job and if my job is customer service and my receptionist is scratching, I'm like that impacts employment. So I'm like all of these things are, are part of the cancer journey where there are things we could do to prevent that or to attenuate it, even things like weight management, there are so many parts of this cancer sequella that we could adjust address early on. The other thing that has always been really interesting to me in the data is although we know cancer survivors are reporting these side effects to cancer and it's treatment only about 20 to 30% of them actually get referred to a provider to address them. So there are a lot of people live in a life that has less quality that really, that doesn't have to be right. And to me, that's not kind that is not con no. Speaker 4 (34:14): So you survived then what? Speaker 3 (34:19): Yes. Yeah. So, yeah. Yeah. So, and especially when we know that there are clinicians and providers out there that could be helping. Speaker 4 (34:30): Absolutely. And you know, I think don't you think that this is such an opportunity for the world of physical therapy? You know, we can be a conduit to other providers. Yeah. So, so if they, the cancer survivor is only spending 10 minutes with the doctor, but Hey, maybe they are coming to us maybe. Well, now it's like an automatic PT referral at the time of diagnosis. At least that's what the guidelines say. Am I correct in that Speaker 3 (34:59): Is the preferred guidelines. So that's kind of the pre rehab standards, right? That you get that diagnosis, you get a PT a Val, so we can get some baseline data. Speaker 4 (35:10): Right, right. Exactly. So might we also be the person to have the time to listen? And like I said, be that conduit and that super connector to people they need. So something to think about for the PT profession, you know, it's a huge opportunity for us to expand our reach, to be helpful and to make a difference in people's lives. And that's what we're supposed to be doing anyway. I totally agree. Because early Speaker 3 (35:38): On in my career I went through patient navigation certification and I remember people going, why would a PTB here? But it's a great place for us to be as a, as a rehab professional and especially as movement specialists, right? Because movement is the key to life. And so if I can help a cancer survivor, figure out the resources, they need to be able to keep their movement and function. That's a game changer in regards to health and wellness, even cancer outcomes. Some of the data even suggest in regards to mortality recurrence rate. So PT might, you know, often we talk about nurse navigation, but actually having a PTs, a navigator is not a bad idea. Speaker 4 (36:28): Absolutely. Well, I have to say, I thoroughly enjoyed this conversation, Lisa, and as always, and last question is knowing where you are now in your life and in your career, what advice would you give to your younger self, maybe that fresh face gal right out of PT school. Speaker 3 (36:47): Yeah. If I could talk to her, I would tell her to put herself first. Cause I think there is a reason why that the triple aim moved to the quadruped blame, right? To include burnout of providers because often in our quest to provide care for others, we forget that we need to refresh and replenish cash sales have. That is really, really important. We take better care of the equipment in our clinics and our hospitals that we do of our providers. Speaker 4 (37:20): And if it's, if we can't take care of ourselves, we are the most important piece of equipment. Speaker 3 (37:26): Yes we are. So we are the most important piece of equipment as it. If you wanted to talk about resources and I think also in regards to, when we think about our patient you know, client interactions, cause I often ask therapists nowadays, are you causing harm to the client that you're serving because of who you are. And maybe that's because you've not done yourself care, maybe it's due to your provider bias. Maybe it's due to, you need to re upskill in regards to your clinical skills. But I think it's always good for us to ask ourselves, are we doing somebody harm and why? Speaker 4 (38:04): Excellent. And on that we will end. So I will thank you so much for coming on, Lisa. Thank you. Speaker 3 (38:10): Thank you so much for having me. It's always a blessing to be in your space. Speaker 4 (38:15): Thank you so much mutual mutual and everyone. Thank you so much for listening. Have a great week and stay healthy. Well, the in smart, a huge thing. Speaker 2 (38:23): Thank you to Dr. Lisa van who's. And of course, to our sponsor for today's episode net health, again, sign up for their webinar, which is out tomorrow, April 20th, as part of their three-part mini webinars series, bestselling author, Stacy Fitzsimmons and Kelly Casio of net health. We'll be talking about the three T's of creating revenue ownership beyond just the billing department, training tools and transparency, head over to net health.com/lessee to sign up. And remember if you put Litzy in the registration page, sign up and show up net health. We'll buy lunch for your office once again. That's net health.com forward slash L I T. Speaker 1 (38:59): Why thank you for listening and please subscribe to the podcast at podcast dot healthy, wealthy, smart.com. And don't forget to follow us on social media.  

In this episode, Net Health's Daniel Folsom talks about how to use Google ads and how to boost your SEO to drive more potential clients to your business.  In this episode we discuss:  - How to use online directories to boost your SEO - The importance of online reviews  - The ins and outs of running a Google Ad - Are Facebook ads worth it?  - How to prepare to run an ad on either Google or facebook - and much more!    More about Daniel:  My Name is Daniel Folsom the account executive for the Digital Marketing Group at Net Health.  I have 20+ years' experience in the healthcare world through sales and practice development. I live in the beautiful state of Georgia and have two kids (four-legged) Jon Jon and Oliver. I have a passion for helping private practices find ways to grow their brand and sustain a healthy level of consistent revenue through patient engagement.   Resources:  Rehab Therapy Outpatient Services 101: How to Expand into the Home or Assisted Living Facility. Free Market Scan Daniel's LinkedIn   Subscribe to Healthy, Wealthy & Smart: Website:                   https://podcast.healthywealthysmart.com Apple Podcasts:        https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                       https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:              https://soundcloud.com/healthywealthysmart Stitcher:                      https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:              https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Transcript: Speaker 1 (00:07): Welcome to the healthy, wealthy, and smart podcast. Each week we interview the best and brightest in physical therapy, wellness, and entrepreneurship. We give you cutting edge information. You need to live your best life. Healthy, wealthy, and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now here's your host, Dr. Karen Litzy. Speaker 2 (00:35): Hey everybody. Welcome back to the podcast. I'm your host. Karen Lindsay and today's episode is brought to you by net health. So net health has a great new webinar coming up tomorrow, April 13th at 2:00 PM. Eastern standard time with Ellen Strunk. She is a physical therapist, owner of rehab resources and consulting, and his net health guest panelists discussing rehab therapy, outpatient services. One-On-One how to expand into the home or assisted living facility. Ellen lectures nationally on the topics of pharmacology for rehab professionals, exercise and wellness for older adults, coding billing, documentation for therapy services, and the importance of functional outcomes to value based payment, head over to net health.com/litzy to sign up as a bonus. When you sign up for the webinar type, Litzy in the comments section of the registration show up to the webinar and net house. We'll buy lunch for your office. Once again, that's net health.com forward slash L I T Z Y. Speaker 2 (01:32): To sign up now on today's podcast, we are talking all about S E O for people who aren't familiar. That means search engine optimization. And my guest is Daniel Folsom. He is an account executive for the digital marketing group at net health. He has 20 plus years experience in the healthcare world through sales and practical development. He lives in the beautiful state of Georgia has two kids, four legged, John, John, and Oliver. And he has a passion for helping private practices, find ways to grow their brand and sustain a healthy level of consistent revenue through patient engagement, which is something we all want if we own our own practice. So today we talk about digital marketing. We talk about search engine optimization. What it is, is it dead? Is it alive? How can you make your website more SEO friendly? We talk about Google and Facebook ads and are they really worth the cost? Speaker 2 (02:30): And guys, this is a deep dive. This is really talking about Google ads and definitely Google ads more than Facebook ads. But boy did I learn a lot and Daniel is very generous. He is offering a free market scan, covering all online directories, which there's like, guys are so many. I had no idea all these online directories that will make a difference in where your podcast is ranked on Google. And so what the folks at net health are, is a free market scan, covering all those online directories to see if you're in there or not tedious work folks. You don't want to do this yourself. So Daniel talks about how you can get that free scan in today's podcast. So everyone enjoy, Speaker 3 (03:16): Hey Daniel, welcome to the podcast. I'm happy to have you on the show this week. Thank you very much. Happy to be here. Great. And today we're talking about, I think something that can affect every single physical therapist that has a website, every company, every individual therapist, and that is looking at SEO or search engine engine optimization. And we're also gonna touch on online ads, Facebook ads, Google ads, things like that, but let's start out with SEO. So here's the question is the title of the episode is SEO dead. Absolutely not. That's the biggest question that we have to answer today, right? How are you found online when you're found, what does that online reputation look like for your Google ads? So when I find you, what does it look like? Funny, kind of a funny story. I was working with a physical therapist group last week and we've looked at their Google listing and they actually had a picture of chilies. Speaker 3 (04:22): So what happens is, and I thought, well, Hey, if you're cracking backs in ribs, I think I want to make an appointment, right? That would be a win-win yet what Google does. If we don't actually create that directory and clean it up is they take the Google earth pictures that attached to your address and they put those images on. So if you haven't looked at it, definitely take a peek at that Google listing anyway, yes. With our SEO, try to get back to that. We want to know what you look like across these search directories. Can people find you with your address and they call you from your phone number. If they look at these directories, are these directories actually clean with reviews? Are you getting good reviews? Are you responding to the negative reviews? So all of this goes into making up that SEO. Speaker 3 (05:12): You know, I always say, if people ask me, you know, when, when should we start SEO? And, and as I mentioned, you should have started 20 years ago. And when you say looking at all these different directories how many directories are there? And can you give some examples? Because I just think, well, Google, what are the other directories? So there are 72 plus directories. And when we talk about directory management, we talk about 72 different directories. The reason we talk about 72 is those are what massage, Google analytics to make Google happy. So Google actually sends these small bots out across all of these different directories to make sure they're consistent across internet. And that affects your Google analytics. Of course. So these bots also work in tandem with Google because they want to be the next game on the net. They want to be the next big game on the street, right? So they're sending bots out to find information. So when we run what we call a business scan here at net help, we are running that business scan to look at how accurate all of these directories look for you. You will find if you've had a practice purchase, if you have gone by a different name, if you've moved locations, a lot of these directories are going to be out of line. So if anyone's using those, they're either going to go to the wrong address. They're going to see the wrong name so forth. Speaker 4 (06:37): And what, so aside from Google, what are some of these directories? Is that like Yelp or is it, is that one or no, Speaker 3 (06:46): We, we have Yelp, we have yellow pages. We have Google business, we have Facebook and using a service, you know, a service we'll actually go in and create those directories so that they're all consistent. More importantly, they go in after that and lock those directories for you, which means they can never be changed or modified unless we go in and actually change your modified those directories for you. You know, some of the other search directories, we talk about Yahoo four square city search MapQuest, local database, a few more just to add on. Speaker 4 (07:21): Yeah, that's a lot. Okay. So what you guys do is you scan all of these directories to make sure that it lines up with what your, what and where your business is, and then absolutely. And then you make it so that people can't hack into it, or can people still hack into it and kind of screw that up. Or Speaker 3 (07:45): Nope. Once these directories are locked, we actually claimed the directories. We clean up that directory management and cleaning up that directory management. We're going to make sure that we've got consistent pictures of the practice. We've got pictures of the team, maybe of the owner with a nice blurb there. So all of these directories are going to look consistent. And of course the goal here is to create a beautiful story, right? So if I search physical therapy near me, I go to your Google ad, your Google ads, beautiful with pictures and reviews and things that click on your website. It then translates the story over to your website. So it's a nice flow from the original organic search all the way to your website. Speaker 4 (08:26): When, what else goes into SEO, because I know people talk about SEO and we always just think, Oh, it's just maybe cleaning up these directories, but I know that what's on your website and maybe the backend of your website also counts for SEO. So can you talk a little bit about that? Speaker 3 (08:49): Sure. So when we talk about your website, we want to talk about keywords that drive to your website. So in using a vendor for your website, you want to make sure that you keep those keywords accurate and you also keep them fresh. For example, when microneedle and came out, we wanted to make sure that we added any of the search words for microneedling in, into those keywords to drive traffic. So we look at the meta tags, we look at the data tags, we look at the backend of what that website is there for, because again, that organic search with Google is the happiest that Google analytics, that it makes it the happiest there. So that's what we're really doing when we drive that traffic with those back keywords. You know, I think a lot of people too, when we talk about websites, miss the opportunity to blog and blogging is huge in having searchable content. You know, let's say you just came back from a wonderful conference and you learned all these cool new techniques or, or services that you can offer going in and creating a blog about that makes it searchable content. Again, we're driving that organic traffic directly over to your website. Speaker 4 (10:06): And if you can drive more organic traffic, does that bump you up in the Google search? Because everybody's like, Oh, you want to be on the first page of Google. Speaker 3 (10:15): Right. Right, right. Where do you hide a dead body, the second page of Google. Speaker 4 (10:20): Right. So how do we, how do we, so obviously adding a blog, making tree of these keywords, making sure all of these directories are up-to-date and locked in. Is there any other tips or tricks that can bump you up in the Google in the eyes of Google without having to pay for it? Cause we'll get into ads in a little, Speaker 3 (10:42): Right. You know, that Karen is a beautiful equation that deals with how old is your domain? Are you garnering reviews? Are your directories established and consistent? So there is a really long equation that goes into making that very, very happy. Of course, you know, running ads can potentially puts you on the first page. And when we talk about ads, we'll talk about what that looks like. But putting you on the first page, it's just a lot of consistency and it's a lot of work to check the right boxes as far as what SEO means and what makes Google happy for you. Okay. Speaker 4 (11:20): Right. So doing all these things that we just discussed, obviously very helpful. Right, right, right. And the more you update your website, does that help to boost it up? Speaker 3 (11:32): Absolutely pleased fresh content every month, whether it's an e-book, whether it's a newsletter, whether it's a blog post, whether you're just changing staff names, we want to keep that website fresh. You know, part of what we, we pride ourselves on at net health is every month and account manager is actually going to go with the customer. We're going to make sure that we're pushing out those blogs. We're pushing out those eBooks. We actually set up cadences for the month ahead of us just to make sure that we're tackling maybe seasonal issues as well. So let's say it's winter time, everybody's slipping and falling. How are we addressing that type of searchable content as well, pulling that organic traffic over to your site. Speaker 4 (12:17): So now let's move on to ads, right? So you've got Google ads, Facebook ads. The big question everyone wants to know is where can I get the most bang for my buck, Speaker 3 (12:30): Bang for your buck. Here's what we need to do everybody. Before we dive into ads, we need to make sure running an ad for you even makes sense. If you just take money and put it into a pay-per-click ad, it's probably not going to work. You know, one of the things that we do at net health with our customers is we do a forecasting call. That forecasting call looks at your geographic area, longitude latitude within 30 miles, because that's generally the driving distance. People are going to come to see your location. And then we type in keywords. I want to see if enough people are searching for those keywords. You know, you could put $2,000 into an ad, but if you have 20 people searching for the keywords that are relative to your services, it's probably not going to be a good return on your investment. Speaker 3 (13:17): So with that forecasting call, we look at those keywords and we also see how much they cost. You know, as we kind of spoke about earlier, those keywords could literally drive your ad budget way out of socket. I've seen people who have run ads in the past that it did make sense to run ads, but they had an ad budget of $400. When we look at that ad budget, we have to tie it into what does a conversion look like? And a conversion is when someone searches for your words goes over to your ad, clicks on that ad and fills it out. So that's somebody that converts over. Now we call that a lead. So this is someone that has engaged. They're looking for your services, they're in your target area, they're searching for your keywords. And they said, Hey, we are looking for you. Speaker 3 (14:12): Now, the other thing when we run these ads to care is which is very, very important is we need a really good call to action. And what does that call to action mean? You know, I think for everyone, this can be unique to the practice, with their call to action. It's something that's going to engage them to take the next step. You know, I have some people who use eBooks and toolkits and things that, you know, fill this out and get the free toolkit or ebook. We generally find that people generally just want the ebook. They really don't want an appointment. So when we really look at a conversion here, we really want to something unique. You know, the cool part of forecasting is we can actually look at what other ads are running, what their calls to action are. So we can really kind of create a unique structure to walk that practice through having an amazing call to action and filling out the form to have that conversion into the lead. I have to say some of the more successful physical therapy practices that are using any type of ads right now, last month, we had someone who ran a targeted ad that gave away a free 30 minute back massage. He had well over 50 participants fill out his lead form, which was huge. I didn't always, I mean, I didn't know that many people needed they're bankrupt, but obviously they do. Speaker 4 (15:36): Right. And what other call to actions have you seen that have been really successful? Like I know a lot of people will say, you know, a free, you know, 20 or 30 minutes call or, or screen or something like that. But what, what else have you seen that has really worked? Speaker 3 (15:59): Usually you want to tie it to something within your services that keeps the person engaged or will engage them. For example a physical therapist was really focused on their, their dry needling and they actually did this hot patch. It was almost a massage machine as well. So after the dry needling, you literally sat on this like hyperbaric type chamber chair and got this warm back massage. That was a part of it as well. Now that was after the third visit. So of course at that point they've got the patient engaged with it. Again, we usually find toolkits eBooks and things really aren't that effective, but something tangible that the patient can actually use or have you know, we've even had people tie them around Starbucks gift card with, we all have our Starbucks. Speaker 4 (16:56): Right, right, right. So really taking some Liberty here to be quite creative, correct? Correct. Okay. And you had mentioned something in talking about the ads about the price of keywords. Can you talk about that a little bit more? Because I know it's definitely something I don't understand. I'm sure it's a lot something, a lot of the listeners don't understand. So go ahead. Speaker 3 (17:20): Sure. So when we, when we look at the forecast, we actually look at the keywords of course, for the services that are offered there at the practice, those keywords, and what Google will tell us is, is what people were paying for those keywords. So the funny part about keywords is in certain areas, some lawyers may be bidding on those keywords as well. So we generally want to keep the costs, the cost per click below $3. If it's above dollars, we really want to see if it makes sense for our practice with their budget. And of course, what outcome they're looking for. Does it really make sense for you to run these ads? Sometimes it does. Sometimes we can have a great return conversion level. Other times we may want to look at some other keywords and other prices just to make sure that, you know, again, this is going to be affordable for the practice and we're going to bring the number of conversions that they need to make this profit. Speaker 4 (18:17): And so for example a keyword like low back pain might be worth, I'm just going to make this up here for $4. Whereas shoulder pain might be worth $3. Like, is that how that works? Speaker 3 (18:33): You got it. Yep. Yep. The biggest trend difference that you see right now is physical therapy. Of course, near me. Where, of course that's an extremely popular keyword search. I've seen it cost 58 cents in certain areas. Right now in Seattle, it's $58 for late work. Speaker 4 (18:56): Okay. So if you're running a Google ad and you have back pain in your ad, it costs $58 per day, Speaker 3 (19:06): $58 for someone to search for that in your area, click on your ad, just click on your ad. Speaker 4 (19:15): Wait. So if five people click on your ad in one day, it costs you like $300. Speaker 3 (19:24): Correct. Do you see what ads can fail for people who aren't doing proper form? Speaker 4 (19:28): I see. Yes I do. Now. Okay. Now this is making much more sense, much more sense. So you really want to know how much those keywords cost to see, like, if it's worth it or can you put in a different keyword and still get that demographic and okay. Speaker 3 (19:47): Absolutely. So some of the things and part of the service of net health that we provide is we provide weekly checks. So we actually go in and you can bid on words every week. So some of those higher dollar words for our customers, there's no guarantee that you're going to win, but if you're paying $10 for physical therapy near me and you bid three 50 on it, you win the bid. Guess what? For the week you actually get $3 and 50 cents. You save $7 for every click for that. We also go into the ad. We look at stale keywords. So if all of the keywords that we have, and you can have up to 50 plus keywords here that we're talking about in a plan we look at what words really are stale. We want to pull those words out because they're just kinda sitting there doing nothing in our, in our campaign. Speaker 3 (20:34): And then we want to put in those active words. So we want to look at what new words may have come up within the week. Also Google gives us a ad score. So if your ad is not running at a hundred percent, we want to make sure that it is running at a hundred percent. So we look at what Google tells us of why it isn't. And we go in and repair that for you. We also, every two weeks make sure that we have a call with our clients just to make sure the ads are running correctly. We're making sure that they understand the keywords because as you can envision, we're bringing the horse to water. It's up to them to teach them how to have that horse drink the water. So we really have to do a lot of sales training on, on what that conversion looks like. You know a few weeks ago we had our podcast on purpose, the profit, and you know, the big comp topic of conversation was, you know, how well trained is your, your front desk staff and answering the phone. So, you know, I really depend a lot on that when we talk about these, these ads, because of course these are hot leads, ready to schedule an appointment. What does that look like when they're actually called for that follow-up Speaker 4 (21:45): And where are these Google ads showing up? So are these the things like if I go onto a website and I see a banner ad or something, is that a Google ad? Or is it only like when you go into Google and you type in physical therapy near me and you see those ones above the fold, the T ad, is that the only place? Right? Speaker 3 (22:08): So, so, so it can be a banner ad. It can be the ladder, as you mentioned, that says, ad generally it's the ladder that says add there, it pushes it to the top, you know? And I think a lot of people get really confused with that because they think, Oh, if I run an ad, I'm going to be at the top of Google. What they don't understand is Google only a lot certain ad spaces on each page, you can have two to three at the top. You can have two to three at the bottom. And that is all based upon the number of people that you actually have in that search criteria. So you could easily pour $2,000 into an ad and be on the top of page two, which again, who's going to look for you there. So one of the things that we really dive into when we run these ads is where are you going to be on that page placement? And where are we going to be able to put you? Because of course it's very important. Speaker 4 (22:58): And in these ads, I mean, are, is, are there photos, are there videos or is it just texts? There is Speaker 3 (23:07): Absolutely. So when we talk about the Google ad, it actually is, it looks like a landing page. So when I click on physical therapy near me and I see Karen physical therapy, I'm going to click on that. It's going to take you to the landing page. Now that landing page again, as we go back to create this beautiful digital marketing story should look just like your website, which should look like your Google directory, which creates this beautiful flow over. Now, that landing page is going to have graphics on it. It could have videos on it. Of course this is where we were going to have your call to generally we ask for name, email address, phone number, and maybe some other information that you want to gather. For example, you know, tell us how we can help you. You know, when would you like to be contacted? Speaker 3 (24:00): Those types of things are important on there as well. The beautiful part of filling out that ad for us is that it actually goes into a lead database. So from that lead database, we can actually nurture that lead for our customers, with eBooks, with personal letters. I love the nurture campaigns to be very personal. You know, let's get to know who the physical therapist are there. Let's get to know who the front desk staff is. So let's send out some really good tailored, personal messages, say, Hey, thanks for clicking on our ad. We'd love to help you. This is Megan she's at the front desk. She can help with that. This is Dr. Smith. He's going to be able to help with it really puts the face and the name together, which creates again that beautiful story and a lot of familiar nurse with the ad. Yeah. Okay. All right. Well, this is so much more robust than I had originally thought. This is great. Now let's talk about Facebook ads because with this, I would think, well, if your ideal, customer's not on Facebook, obviously you're not going to be running a Facebook ad. So how effective are these Facebook ads? Speaker 2 (25:12): And on that note, we'll take a quick break and be right back, be sure to sign up for net health next webinar, which will be Tuesday, April 13th at 2:00 PM, entitled rehab therapy, outpatient services, one Oh one. How to expand into the home or assisted living facility. Their guest panelists will be Ellen Strunk, owner of rehab resources and consulting head over to net health.com/glitzy to sign up as a bonus. When you sign up for the webinar type Lindsay in the comment section or the registration show up with a webinar and net health, we'll buy lunch for your office. Once again, that's net health.com forward slash L I T Z Y Speaker 3 (25:54): Facebook ads can be really effective. You know, where we win with Facebook ads is target marketing. So with our ads that we're running they're actually going to be slow creep ads. So they're not kind of those, those strange ads over on the right that nobody hardly ever looks at. These are actually in the feed. So as you're looking at Sonia's wedding photo and Katie's baby picture, you're actually going to see the ad. Now, when we talk target marketing for Facebook, we're really talking about who you want to attract as your patient. So if you're looking to grow your 30 to 45 year old demographics within a certain zip code with Facebook, we can really, really target out who sees that ad to make sure that we're achieving your key goals are to grow the market within that targeted area. Speaker 4 (26:49): So yeah, you can really get like drill down to really your ideal patients. Speaker 3 (26:59): Absolutely, absolutely. You know, the good part about running Facebook ads is it's fairly inexpensive. I will say the rate, the return on Facebook ads, isn't near what it would be running Google ads. Big only because you've got to think with Google, we have 200,000 people searching for physical therapy near me with Facebook. We've taken that and we've really targeted down to kind of a small pocket of people that are going to be looking for that ad. Again, the Facebook ad is going to be like the Google ad. It's going to be beautiful pictures. It's going to be a nice call to action. It's going to be something that's going to engage them and want them to click on that ad to fill out that call to action form. Speaker 4 (27:41): Got it. And what are some big no-nos if you have big no-nos for, for Google ads or big no-nos for Facebook ads? Speaker 3 (27:51): You know, I think some of the big no-nos are over promising and under delivering on your ad. You know, when we talk about these ads, we really want to make sure that they don't go stale. So that's another big no-no that people don't really understand. So, and when we talk about an ad going stale, we actually talking about keeping some of those higher dollar keywords that aren't really searchable right now and taking them out if people really aren't looking for them, because as you pointed out in the example, if you've got a $58 per click and you've got 30 people or three people clicking on it, it's a stale keyword. It's still taking a lot of money from your ad dollars. So we really got, I think that's the biggest no-no here. And a lot of that is just us making sure that we're doing that for the customer. Speaker 4 (28:43): And what about Facebook ads? Any big no-nos there? Speaker 3 (28:47): You know, I think with Facebook ads, again, you just want to keep them simple. I think in this philosophy of life kiss, keep it simple. You know, with Facebook ads, a lot of our customers really want to get involved, almost tell a complete story in that Facebook ad. And you really, really want to use that ad as if I'm looking at this for two to three seconds, what am I going to get out of it? So I think a lot of people over-complicate their Facebook ads. And of course you lose your audience at that point, they should be able to in literally two seconds, scroll your ad, see your good call to action, who you are, what you're trying to accomplish and send that right over again, all of the aesthetics for either Google or Facebook should match your website. It should match your landing page. It should be that beautiful story that just carries over. Speaker 4 (29:38): Got it, got it. Well, this has been very, very informative and super helpful. Is there anything that we missed, anything that was on your list of, of talking points that we, Speaker 3 (29:53): I don't think so. You know, I think some of the things too, when people are looking at ads that I just wanted to mention here, because this is the biggest oversight I think is when we talk about running those Google ads, we talk about, of course, how much your cost per click is, how many conversions you're going to have a big number that people really overlook is what we call the impression. And the impression is people who actually went to your ad, but never filled out the ad form. And I think a lot of customers and, and, and practices overlook this number, but it's super important because this is part of your paid ads. That's pushing your brand. I've seen where I've been able to give for example, 10 leads, 10 plus leads to a particular practice, but they had 32,000 impressions. So if you could imagine 32,000 impressions of just looking at your ad or just looking at that Google directory that displays your ad, that's a huge number. So I think that's the biggest thing I just kind of wanted to touch on. When we look at running these ads, let's look at the impressions as well, because again, that's promoting your brand, Speaker 4 (31:07): Right? And like the way I look at it, and this may be completely wrong. Now that you said those well, 32,000 people looked at it, but only 10 people clicked. So do I have to change something? Is something not landing correctly? How do you, how do you interpret that? Speaker 3 (31:25): So we definitely want to, we, that's a great observation. So we definitely want to look generally their extra call to action. Was your call to action, not engaging enough. Was it not? I guess salesy that's, you know, I hate that word, but was it, was it not catchy enough that people were like, wait a minute, this is actually something that I want to look into. Speaker 4 (31:50): Got it. Okay. That makes sense. That makes sense. Cause I would think, Oh, why am I running these Google ads? Speaker 3 (31:56): Yeah. And of course we don't want to give up. Right, right. Yet the good thing is of course of the people that click on that ad, we then get to look at what that return on investment is. So of course, in physical therapy, you know, we look at, if we add five patients with 10 visits per patient, you've definitely reaped what you've paid for your ad service plus. So we definitely look at what that conversion rate is for you as well. Speaker 4 (32:27): What is this ad bringing back to us? So again, you're looking at how much you spent on the ad, how many people came in for initial eval and how many of those followed with their plan of care, whatever that plan of care may be. If it's, if you average six visits per patient, you know how much each visit costs, you can multiply that by however many patients you got from the ad. And if it made you profit great. If it didn't, I think you have to do some rejiggering there. Speaker 3 (33:00): Yep. Yep. We definitely need to either run a different campaign. We need to look at what, I guess why the wheel didn't spin properly here. One of the beautiful things of net health is that we tie certain KPIs. And if, if anyone isn't familiar key performance indicators to our ad module. So for example, Karen, if I told you, I'm going to bring you 10 patients every month and I don't meet that criteria for you, you're actually able to stop running ads with us. So we really put our feet to the fire to make sure that we're doing the right job. We're also doing what we said we were going to do in making sure that you're getting that return on investment for what you're giving us. Cause it's expensive, you know, act, I mean, add packages right now started a thousand dollars. So it's a lot of money. That's a lot of money. Are you getting that back? Speaker 4 (33:53): Absolutely. And that makes perfect sense. And now before we wrap things up, I have another question in a second, but I want people to find out where they can get more information on what you do, how they can get on board. So what is your call to action? Speaker 3 (34:12): Sure. So we're offering for anyone that's interested what we call that free business scan. So I'm going to go in for the practice. I'm going to run that free business scan. That's going to look at all of those search directories that we talked about earlier. I'm also going to look at, in that business scan, it shows how that practice compares to their competition. When we talk about reviews. So I'm offering a free business scan for anyone that is interested. I'd love to dive into that. Of course after that, I would definitely email that over. I would also love to offer a free forecasting call for any practices interested in running ads. Let's look at it, let's see if it even makes sense for you to run ads. I have to tell you, last month we walked away from three different practices where it just didn't make sense for us to run ads. So want to make sure that it's a good fit for both of us, Speaker 4 (35:03): Right? Well, that is awesome. And where can people get all of this? How can they yeah. Speaker 3 (35:09): Www.Net health.com and click on the digital marketing page. Perfect. Speaker 4 (35:16): Perfect. Well, that's great. I mean, yeah. Sign me up free. I would love that. So now last question is something that I ask everyone and knowing where you are now in your life and in your career, what advice would you give to your younger self? Speaker 3 (35:34): Oh, you know, Karen, that's such a good Speaker 4 (35:38): Question. I think it would just be slow down. Enjoy the martinis, enjoy the dog. Walks spend more time with your mom and dad. It's just literally just stopped going. And fifth years shifted down to second and learn how to live on cruise control for just a little while and be calm. Lovely advice. Thank you so, so much for coming on and talking to us about SEO and ads and for all of you PT entrepreneurs out there, head over to www.net health.com. Click on the marketing, digital marketing, digital marketing tab and get this free business scan free forecasting calling me. And that's huge for people to see, Hey, should I be, should I be running ads? Or if you are running ads, EEGs, are they working? Yikes. Well, Daniel, thank you so much. This was great. I really appreciate it. Thank you and everyone. Thanks so much for listening. Have a great week and stay healthy, wealthy and smart. Speaker 2 (36:43): Thanks to Daniel. And of course, things to net health for sponsoring today's episode again tomorrow, Tuesday, April 13th, 2:00 PM. Eastern standard time. Sign up for rehab therapy, outpatient services one Oh one. How to expand into home or assisted living facility with Ellen Strunk. And in order to do that head over to net health.com/lindsey to sign up type in Lindsay in the comment section net health, we'll buy lunch for your office once again. That's net health.com forward slash L I T Z Y. Sign up now. Speaker 1 (37:16): Thank you for listening and please subscribe to the podcast at podcast dot healthy, wealthy, smart.com. And don't forget to follow us on social media.