Podcasts about PRN

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  • 122PODCASTS
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Best podcasts about PRN

Latest podcast episodes about PRN

Nailed It Ortho
OITE Review: Basic Science 3- Bone grafting, osteoinductive properties, etc

Nailed It Ortho

Play Episode Listen Later Oct 20, 2021 34:54


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

Nailed It Ortho
OITE Review: Sports 18- Shoulder + Elbow

Nailed It Ortho

Play Episode Listen Later Oct 13, 2021 30:37


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

Nailed It Ortho
OITE Review: Sports 16- Labrum + More Shoulder

Nailed It Ortho

Play Episode Listen Later Oct 7, 2021 32:15


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

PRN - The Pit Reporters Podcast
EP 2141: Talladega Delivers a Piece of NASCAR History

PRN - The Pit Reporters Podcast

Play Episode Listen Later Oct 6, 2021


Three first-time winners, a piece of NASCAR history and an absolute free-for-all in the playoffs. After Talladega, what more could you ask for?! Brett McMillan is joined by PRN turn announcer Rob Albright and Adam Stern of the Sports Business Journal to break down the significance of Bubba Wallace's win, the future of 23XI with Kurt Busch mentoring Bubba and what's sure to be an exciting weekend at Charlotte's Roval as we trim the playoff field again.

Healthy Wealthy & Smart
560: Dr. F Scot Feil: Eliminating Student Loan Debt with Multiple Revenue Streams

Healthy Wealthy & Smart

Play Episode Listen Later Oct 5, 2021 39:50


In this episode, Physical Therapist and Educator, F Scot Feil, talks about understanding and eliminating student loan debt. Today, F Scot talks about the different kinds of student loans, his different revenue streams, and the value of having a diverse set of skills. How does the debt-to-income ratio affect student loans? Hear about eliminating student loans, managing multiple revenue streams, and get F Scot's most important piece of advice for students with debt, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways “The debt-to-income ratio is the amount of student loan debt you have over your current income.” “The best way to learn about this stuff, and what's right for you, is to talk to a certified financial planner that knows about student loans.” “The biggest thing to try to do, if possible, is not to privatise your loans. Try to keep as many of your loans federal as possible.” “You make your own luck. You have to work hard, and you have to network and leverage with the right people at the right times about the right things, and then you'll start to see those opportunities open up.” “The one key takeaway that I've had with all these revenue streams is you've got to do one at a time, and you've got to get it flowing, and then you can step on to the next stream of revenue.” “The money is nice, but the time-freedom is really what you're looking for.” “You don't have to work as hard, you can scale back, charge what you're worth, and make a lot more money in a lot less time.” “Your career just has to be the tip of your iceberg.” “There's a whole lot more out there than just going to an outpatient clinic every day and seeing your patients.” “Don't worry as much. Just leverage the heck out of your career and your degrees. Use them to do what you want to do and what you enjoy doing.”   More about F. Scot Feil Dr F Scott Feil is a husband, a father, a physical therapist, a professor, and, most recently, an amazon best-selling author. F Scott is also a business coach and mentor, despite starting his journey as an English major before landing as a Physical Therapist. He is one of three co-hosts of the Healthcare Education Transformation Podcast, which aims at breaking down the silos between healthcare professions and trying to find best practices in teaching and learning throughout healthcare academia. His goal is to help at least 222 professors (one from every PT School at the time of publication of his book) and clinicians pay off their student loans quicker by using multiple revenue streams. If he helps some others with terminal degrees, or other healthcare clinicians, along the way, then it's a bonus!   Suggested Keywords Student Loans, Student Debt, Financial Planning, Education, Skills, Income, Revenue, Profit, Opportunities, Physiotherapy, Healthy, Wealthy, Smart   Resources: FREE PT Educator's Revenue Idea Generator Professors Of Profit Facebook Group PT Educator's Student Debt Eliminator: Multiple Streams of Revenue for Healthcare Clinicians and Academicians   To learn more, follow F. Scot at: Website:          https://pteducator.com Podcast:          Healthcare Education Transformation Podcast Facebook:       PT Educator Twitter:            @FScottFeil_DPT Instagram:       @PTEducator LinkedIn:         F Scott Feil YouTube:        PT Educator   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:  00:02 Hey, Scott, welcome to the podcast. I'm happy to have you on. It's great to see you and to speak with you.   00:09 Yeah, Karen, thank you so much for having me. I'm a longtime listener, first time caller here. So this is exciting. I've been waiting to do this for quite some time now.   00:17 Yeah. And I'm happy to have you on. And today we're talking about a topic that is near and dear to many, many physical therapists. And that is we're talking about student loan debt, and not only talking about it, but how to maybe understand it a little bit better, and how to eliminate it. So let's start with some definitions. And what is the debt to income ratio? And how does that affect your student loans.   00:50 So, you know, I'm not a student loan expert, by any means. I'm more of an elimination expert. That's that's where, you know, my specialty comes in. So I've had to learn this stuff, too. And, you know, one of the best ways that I've gone about doing this is going to certified financial planners, especially once you understand student loans, and talking through, you know, where I'm at what what plan looks like, it's going to work for me, what are my plans in the future? What is, you know, my vision look like? You know, do I want to start a family, buy a house, buy a car, all those things kind of factor in to your big plan. And then from there, you've got to come up with a foundational blueprint or a roadmap that you're going to follow based on what your student loans are. So the debt to income ratio is very simple, you know, it's the amount of student loan debt that you have, right? over your current income, and you just, you know, do the math and divide, right? So, realistically, the highest that you would want your debt to income ratio to be is approximately 1.01. To one, right. So if you had $100,000 worth of student loan debt, you're making $100,000 salary. That's not a terrible debt to income ratio, right? Unfortunately, especially in the field of physical therapy, we're finding that students are graduating with 150 175 200,000 plus worth of student loans, and they're coming out and they're getting jobs at 65 75,000 a year. And those are some pretty risky debt to income ratios, right? those, those get a little heavy, because, you know, if you don't know anything about it, and you you have all this debt, and you've accrued this debt, that's just massive, your payments are going to be massive, right, your student loan payments, if you just do the standard repayment, mine started out at 1700 a month, right. And I only had 140,000, when I graduated, that was with two doctoral degrees. So you know, it was one of those things where I got a little nervous at one point, because I didn't even know that I wanted to use the doctoral degrees, the way they were kind of meant to be used. But then I kind of settled down talk to a couple people both both on the business side of things, and on the Certified Financial Planner side of things, and created that roadmap, I went from the generic, you know, repayment plan at 1700 a month down to the income driven repayment plan, which for me, looked like about 700 a month. And then again, after really doing a deeper dive with the Certified Financial Planner, where I was at in my life and how I was planning on attacking my student loans, we've finally got it down on the repay plan or the revised Pay As You earn plan. And that's about $135 a month. And that stretches it out over 20 years now. So the difference that I'm making between the, you know, 135 a month and the 700, I was paying, I can now take that and have more liquid assets to do something with right I can have more cash in hand to invest or to start a new project or, you know, to make payments on other stuff, you know, so it's taken me some time to kind of learn this stuff. And again, like I said, I'm by no means a student loan expert, but I am learning through the bumps and the bruises and going through it and being in the thick of things there. And realistically, like I said, the best way to learn about this stuff and what's right for you, because it's going to be different for everybody is to talk to a certified financial planner that knows about student loans. So that would be my first recommendation.   04:15 Yeah, and that is great advice. Great advice. I've been working with a certified financial planner myself. And it really, it's really great to have an outside view of your finances and everything that surrounds them by a professional who can go in and not be emotional about it, and not have biases built in because we all have emotions around our money and around our debt and our loans. And so it's great to have that outside perspective. Yeah, you   04:45 hit the nail on the head there, you know, especially when it comes to business and money. We tend to be very emotional beings and you really have to be objective when it comes to that. And that was that was you know, a big takeaway that I found when when starting up businesses and you know, figuring things out. I've had a bunch of deals in the last couple months kind of crumble and fall through and it's like, Man, that's a bummer. But at the end of the day, you realize it's just business like, it's not a big deal. Not personal, that, you know, can't get emotional beat up over, you just got to move on it's business, you know?   05:15 Absolutely. It's it. But I mean, it does suck.   05:20 It does. It does. And it's okay to kind of recognize that, you know, you know, exactly, but at the end of the day, okay, it's business. What's my next step? How do I pivot? How do I recover? What comes next? You know, I think that's really what entrepreneurs are doing these days is trying to figure it out, you know, just keep rolling with the punches until they, they get it right. Yeah,   05:38 absolutely. And now, you spoke a little bit about those different kinds of student loans. And so I'm assuming there are different approaches one can take, can you speak to that?   05:50 Yeah. So you know, again, like I said, I'm not exactly a student loan expert, there's several different kinds of student loans out there, the biggest thing to try to do, if possible, is not to privatized your loans, right, try to keep as many of your loans federal as possible, because the federal plans are the ones that work with you a little bit more, there's a little bit more give to them, right? You can restructure them a little bit. Like I said, I went from just basic repayment plan to income driven repayment plan, which is based on, you know, the amount of income that I would make as a new grad, down into the revised Pay As You earn plan, which, like I said, that one kind of starts you at a lower bracket. And year over year, as you make a little bit more, it creeps up a little bit, you know, but it also, again, it stretches it out over a longer period of time. So you know, they're their differences are time dependence, you know, how quick you have to pay him back. But you know, things happen, like COVID, right, and all of a sudden, the Federal plans have all kind of stopped, they put a, you know, a pause on them until the new year. So, you know, that's one of the ways that they can give you grace, you can go into a deferment plan, if you need a month or two, you know, though, they'll work it out with you, and they'll tack it on to the end or whatever, you know, there's just a lot of forgiveness. And then at the end, there's a big forgiveness. But with federal loans, you just have a lot more grace, right? Once you privatized the loans, you're stuck, that's it, they are what they are, and you've got to pay him back, there's, there's no getting rid of them, right. Because, you know, student loans are loans that we just, we can't go bankrupt on we can't, you know, get out of there just gonna be there forever until you pay them off. So, you know, it's super important to recognize the difference between a private loan and you know, a federal loan. So big takeaway there is try to keep as many of your loans federal as possible for as long as possible, because those will have the most options for payoff and forgiveness and forgetting, you know, you know, any sort of programs that are available that may come and go, right, there's the one program where if you work for a nonprofit for 10 years, right, X amount is forgiven. Now, there's been kickback on that saying that, like 99% of people don't get approved for it at the end, they cross the finish line, then all of a sudden, the finish lines moved, right. So you know, there's some fine, fine print, you've got to read there with all these. But you know, at the end of the day, most of the federal loans will give you a certain time period. And as long as you make your payments all along that time period, at the very end, there will be some form of forgiveness. Now, the only caveat with that is the way you're forgiving those loans is you get taxed on the amount of forgiveness as if you made that income that year. So, you know, for me, it'll probably be a 20 year repayment plan, at the end of those 20 years, I'll have $100,000 left, it'll be forgiven. And then it'll be like I made that extra 100,000 on my salary that year, so I get taxed on it. So in those 20 years, I have to come up with some sort of plan to save up and to make money to repay that one year, when I have that influx in salary, even though it wasn't there. It was a loan forgiveness. So just something to think about there, too, when you're planning out your loans and your repayment plan.   09:04 Yeah, yeah, I don't think people realize that you have to pay taxes on that loan that is left. So each year, you want to make sure that you're putting money aside and putting money aside so that you're in an account that maybe you can't touch so that when it comes you're not like, Oh my gosh, where am I gonna get this money from, but you're like, Oh, I know exactly where I'm gonna get it from. Because I have this account of money I haven't touched for 20 years, you can pull it out from there. And that can be like, it doesn't have to be a savings account at the bank. Exactly. That could be an account that is actually generating, maybe, you know, 4% or something like that, right? So you're making money on it, especially if your loan is only like 2.3%. So you could take that money that you would be paying toward that loan, put it into an account that's maybe making even if you're making 4% You're still making money on on that money in there so that when the time comes to pull it out to pay your taxes, is number one, you're not penalized. So it's not like you're putting into a 401k plan or an IRA or something like that, but just putting it into some sort of an account that can make you some money on the way.   10:12 Exactly. And that's where a certified financial planner comes in, because they can set you up with a savings plan over those 20 years that can get 810 12%. So you're actually saving a ton more money, and you're paying way less when it comes to it. And the you know, the rate the APR is, is even lower. So I don't, I don't want to throw out a bunch of like, you know, terms and, you know, definitions and stuff that are just kind of boring and not very sexy, to be honest with you. But we do have to kind of know a little bit about this stuff. You don't have to be an expert. Again, I'm not. But I know enough. Now I'm educated enough, because I took the time to talk to that certified financial planner and figure this out and sit there, it only took maybe an hour or two, to sit there with them and go through the plan and look at it and say, Alright, here's where I am. Here's my goals and plans. Which program is best for me. Okay, great. Let's get on that program. And then you know what, now let's figure out how we're going to pay it out. You know, and there's several different ways to do that, too. Right? You just have to come up with that number at the end of those 20 years. So how do you want to do that? And, you know, that's where my expertise kind of comes in? Is the elimination part of it? Yeah.   11:17 Yep. So let's talk about that. Let's talk about how do you eliminate that debt. And I know one thing that you speak about is having multiple income streams, I'm sure that's part of this conversation, but I'll throw the mic over to you. So you can talk about the elimination part. What does that mean? Yeah, so   11:33 originally, when I wrote my book, right, peak educator, student debt eliminator, I thought I could just start a side business or to write and make a bunch of money, and then throw all that money that I made toward the student loans and pay them off in a year or two and be done. That was my plan. And realistically, I probably could have done that, I probably could have knocked them out in about three to five years total, and been done. But that's kind of what the banks want you to do. Right? That's what these loans, processors wants you to do. They want you to pay all your loan off as quick as possible. So they get all the money and make all the interest, right? Well, after talking to the Certified Financial Planner, I said, Okay, well, if my loans are gonna go down from you know, 700 a month and 135 a month, that leaves me a good extra chunk of money that I can do stuff with, right? And he's like, Yeah, absolutely. He's like, in truth be told, as long as you're putting your a lot of money every month into your savings plan, or whatever, you know, investment plan, if you will, to pay off that 20th year, you can do anything with the money, right? So I figured, okay, well, could I invest it in stocks? And he's like, yeah, you could do that. I said, What about crypto? And he said, you could do that? What about real estate? Can I do that? Yeah, absolutely. So that's been kind of my plan is like, Okay, let me start a couple of side businesses that generate income and revenue for now. So that I can put it toward investments that don't kind of take me on the long term. Right. And I think realistically, you know, I think almost every millionaire has several different streams of revenue, right. And I think that we need to start thinking about that, as soon as we either enter grad school, or immediately after we finish grad school, you know, what is our plan for long term wealth? Right? How are we going to take care of ourselves, as well as our family, you know, that might not even exist yet. As well, as, you know, future generations, you know, we're talking generational wealth here. And it's not like, you've got to be a millionaire, right? But you know, a couple of six figure incomes, that can help a lot of people, right? I mean, you can take care of a family, or two or three down the line, even, you know, making several six figures over the course of many, many years, you know, and then if you invest it, right, you can put it in places, like we talked about, like rental properties, or something like that, where, you know, once those pay off, the mortgages are done on those in 15 or 20 years? Well, now you're going from making two or $300 a month in rent, up to, you know, 18 or 2000 a month, per per house, right? And that's where you get into that generational wealth. So, you know, for me, it started out as a simple mobile PT practice, right? I was by myself in a car with a table and some sheets and a bag with some equipment in it. And I was just driving around, you know, Waco, Texas, just kind of helping people in their homes or their offices or the gyms. Because I knew I could do that. I knew I could start that business, right? I had enough expertise in the physical therapy world to be able to run a small practice on my own. And I didn't really want to be tied down to the brick and mortar. I didn't want to have a high overhead. I didn't want to do any of that, you know, so I just started my own little business. And it started out with a crossfitter, too, you know, and that was not my demographic. It was just people in the community that I knew that asked if I can help, and so I did. And then Luckily, one of the women that I worked with, her husband had some shoulder and elbow issues and he was a big tennis player. So she said, You treat the arm in the elbow and choice it. Yeah, absolutely, I can do that. So once I started talking with him, he's a CEO of a small business in Waco there. We got him better, we got him back in the tennis court, he was feeling great. And so then he started referring me to all his other CEO buddies, and the CEO buddies and C suite level execs, right, and all these busy businessmen and business women. And it was great because I was I was selling them time, right, it wasn't so much about the physical therapy, or whatever it was, it was, I was buying them back time because I could come to their home or their office or their gym, and they love that. So it was just the right niche for me in the right, you know, they had expendable income, most of them because they were, you know, own their own business. So it was a really good group to get into, and a really good niche to break into. And, you know, word of mouth spread. And that kind of took off? Well, once that kind of happened, I really started having to figure out how to like market myself better, and how to do some, like digital marketing, you know, Facebook ads, Google ads, stuff like that. And I just didn't know that I didn't have that skill set, you know. And so I had to take a course in that and learn from it and kind of invest in myself. But once I did get better at that, you know, I even took a copywriting course and read a bunch of copywriting books as well. And once I started getting better at that a bunch of my buddies that I graduated PT school with saw what I was doing with Facebook ads, and they said, Hey, could you do that for our business? And I was like, yeah, I'm sure I could probably figure it out. They said, We'll pay you and I was like, Okay, great. That sounds awesome. You know, and that's where my agency kind of started, right. But one of the second pillars of revenue for me. You know, I kind of started a little bit of a digital marketing agency unintentionally. And so I did that for you know, that a year or so. And that even brought me outside of the field of physical therapy as well. I did it for a couple local businesses, some home renovations, some roofers, pool builders, stuff like that. And it was really working pretty well.   16:58 And then, you know, COVID, started hitting and things kind of got a little crazy. And I was still working full time in the clinic, too. And so with my wife being a type one diabetic, and already being immunocompromised, I had to kind of step back from that a little. And I stepped away from the clinical side of things. And that same week, the head of the program at university, St. Augustine emailed me and said, Hey, are you still interested in teaching because I spoken to him at the ETD graduation in 2018. And, you know, I said I wasn't, but now it's actually looking like a pretty good option. So I stepped out of clinical work, I headed into academia. And while I was doing that, you know, it really became a good fit for me, because, you know, I talked online most of the time, and then I had to go up and be there for labs. But it also gave me a lot of free time to work on my side hustles, and my side businesses, you know, and that's kind of how I fell into the consulting gig as well, like, that wasn't something I ever thought I'd be doing either. But I worked for workman's comp company as well up there in Waco. And I said, Hey, we should be educating these businesses to injury prevention and wellness and how to properly lift and ergonomics and all that. They said, Oh, no, we're not going to do that, you know, that's gonna eat into our PT numbers. And I said, No, it won't. Because I can't stop somebody from running over someone's foot with a forklift, it's gonna happen, accidents are gonna happen, you know? And they said, Well, no, we're not going to do that. So I said, Alright, fine. I'll do it myself, you know. And so I just went around to all the companies locally there that were sending us workman's comp people. And I said, Hey, would you like to lower your workman's comp numbers? And they were like, Yeah, sure. And so I go in, and I educate the workforce. And, you know, you can charge good money for consulting. I mean, I was able to charge you know, 1000 bucks to 1500 bucks an hour for two hours worth of work. So now it becomes a matter of, Okay, do I want to see patients at $200 an hour, which is a pretty fair rate for physical therapy, right? Cash pay at a network? Or do I want to work two hours and just, you know, educate these people and use my add my education background combined with my PT background, to kind of help them with injury prevention and wellness. Right. So again, it just kind of one of those things that fell into my lap, that wasn't ever something I thought I would do it just the opportunities were there. And I just kind of sees, you know, it was like, seeing like these opportunities out there and just realizing that holy cow, this is where I knew I was fine. Having a PT, you know, DPT and an add, not necessarily wanting to use them even though now I am, you know, more traditionally. But being able to leverage those degrees into other opportunities. You know, I'm not a huge believer in luck, I kind of feel like you make your own luck, you have to work hard and you have to network and leverage, you know, with the right people at the right times about the right things. And then you'll start seeing those opportunities, you know, kind of open up and you have to be ready to jump on those opportunities when they present themselves. So, you know, that's, that's kind of where a lot of these streams of revenue started from. It just kind of happened, you know, and I fell into them and I got better and better and better at it. I went, and then I was able to help more people with them as well.   20:04 Yeah, it sounds like you've gone from one to the next to the next to the next, which is, which is good. You're sort of keeping yourself open and you're learning and, and understanding like, Hey, I don't know how to do this. So I'm going to educate myself and learn a little bit more, and be able to do things that may not be at face value, what you went to, quote unquote, school for, but yet they are.   20:32 Yeah, I mean, we learn so many amazing skill sets throughout grad school, you know, whether it be the DPT program, or the ed d program, systems, right processes, standard operating procedures, things like that, like clinical development, and, you know, clinical thinking skills, critical thinking skills, all these things that we learn, are a lot higher level than a lot of the general public already know and deal with. So we can help by kind of bringing those things down and simplifying them, just like we would talk to a patient, right, if you're using layman's terms, you know, and I think the key here is to realize that we have a lot of these skills already, you can keep one foot in the healthcare boat already. Or you can diverged and go a different route. And you know, some of these skill sets, you're gonna have to learn because not everybody's, you know, born a natural with a lot of these skill sets. And that's okay, I've done that. But it's a good combination of taking as much as you already know, and pushing in on that. And then adding and supplementing a little bit here and there, when you find that you need it. You know, and that's where I think taking courses and paying for mentors, and doing all that stuff speeds up your timeline a little bit. You know, and that's why I'm a big believer in that I've had many coaches, many mentors over the last couple years, and they've totally sped up my timeline and showed me mistakes that they made and made sure I didn't make the right, you're still gonna make your own mistakes, there are a lot of them are going to be different than what your mentors went through, right? That's totally normal. But it's, it's realizing that they're not failures, they're just learning opportunities, you know, and I think we as pts are really good at being lifelong learners. And so it really shouldn't be a problem to dive into a skill set you're not familiar with, and just, you know, put your ego aside and being like, Alright, I don't know this, I need to learn it, here's a good resource, here we go, you know, just keep kind of attacking it until you get it right. You know, and I think at the end of the day, these multiple revenue streams now that are kind of growing are great, I love them, I'm very passionate and energized about them. They're definitely like passion projects for me, you know, and zones of genius for me, but it's a good way for me to get an outlet of creativity, I think, because I was an English major before I was a PT, right. So, you know, that to me was was a big transition in itself. But that's also helped me monetize blogs, monetize my book, right? monetize, SEO, and email sequences and copywriting. So, you know, again, all those things kind of fall into that consulting, revenue stream. But, you know, I had to learn how to adapt that English major into copywriting or into email marketing, or whatever it may be, you know, and I think the one key takeaway that I've had with all these revenue streams, is you've got to do one at a time, and you've got to get it flowing. And then you can step on to the next stream of revenue, then get that up and running, then get that flowing. And then step onto the next one. And again, you know, if you don't do that, you're going to fall for that shiny object syndrome, right, and you're going to be kind of chasing around, Ooh, that looks cool, that looks cool. I could do that, oh, I could do that, oh, that person's doing that, Oh, that looks really good. They all work. And you can do all of them, for sure. But you've got to get one down first, and then move on to the next and there's going to be you know, arguments and debates over what number is the right number to walk away from the first one and go on to the second one. I don't think it matters, I really don't just get it up and running, make sure it's making you some money, make sure it's profitable. And then when you're ready to step on to the next project, you're still gonna go back to the first one, you know, you're still who knows, you may even hire somebody to take over that portion for you. You know, but just knowing that there's multiple opportunities out there for physical therapists for healthcare providers, I think it's a great stepping stone for you to kind of open your mind a little and get out of that nine to five clock in clock out clinician mindset, you know,   24:15 and where are you now with? How many streams of revenue Do you have at the moment? And if you could put it in a pie chart, what is what makes up what? Because I think people would really be curious as Jeff, you mentioned a whole bunch. So where are you now? And what does it look like?   24:32 So I essentially what I teach, you know, all my students, I have what's called the feelgood method, right? Which is not just a clever play on my last name. It's also you know, how I make my students feel good about staying organized with their streams of revenue, right. So there's an umbrella on top and that's your holding company, right? For me, it's feelgood industries. pllc. Texas recommends if you have a professional license that you get a pllc it's different for every state. But, you know, doctors, lawyers, dentists, they all have pllc Alright, so since I started as a mobile clinic, I started as a pllc. then underneath that I had about four or five different revenue streams or tubes of revenue, that each of those was a DBA, or doing business as underneath the pllc. Eventually, I'm probably gonna have to turn some of those into their own individual LLC and make the pllc an actual holding company, but I'm not there yet. So, you know, with each stream of revenue, like I said, I have a couple little numbers next to each stream. And those are the checklists, things that you have to get done in order for that stream to start running. So I made a shift recently, because of my changing career, you know, like I said, the goal is to try to, you know, kick the bucket of the nine to five and do your own thing, you know, and go all in on entrepreneurship and your own business eventually, right? That's the hope. For me, my story's a little bit different, because my wife is a type one diabetic. And we need not just medical benefits, but good medical benefits, right? My nine to five might always be there. And I'm okay with that. I've learned how to kind of find the best possible job with the best possible benefits. and academia has afforded me that right now. So I'm able to do that, you know, at a little bit lower rate of like 32 hours a week instead of maybe 40. And that gives me more time then to work on the businesses. So while I was doing a lot of the mobile PT at first, that's kind of decrease now, because like I said, it's like, do I want to treat patients for $200 an hour do I want to do consulting at 1500? An hour, right. So I would say overall, you know, I've got the mobile business, I've got my online business and PT educator Comm. And then I've got my consulting, business, FTI consulting, and those are kind of the three main revenue streams. Now in those revenue streams. There's probably, I don't know, three or four different services, if you will, that are offered. You know, the consulting can be anything like injury prevention and wellness, because I've got that systemized. And I've got templates for that now where I can just come in, do the tour, see what's what, and then put together a presentation overnight. And then that also will have my copywriting little digital marketing. It'll have you know, Facebook ads, Google ads, it'll have copywriting, email, all that stuff underneath the consulting. And those I can charge, you know, for just one little piece, or put together a package where I'm like, Hey, here's what you need, here's what I recommend, you can go ahead and do it based on my outline, or if you need my help, here's my price, right, my fees. And then PT educator comm is just like I said, my online site where I do a lot of my blogs, I have a lot of the courses for sale and stuff like that. And that's just really to kind of keep me up to date on my writing. And, you know, my blogging skills and stuff like that just recently passed them the mark for 1000 subscribers and 4000, watch hours for YouTube. So I cannot monetize that as well. So the vlog cast, which I do one episode a week of an interview with somebody who's done that particular side, hustler side gig, starts out on YouTube, and then eventually makes it to the podcast in audio form. And that actually, the podcast hasn't even come out, that'll start September 1. With the first few episodes, I'll probably release three or four and the first one, and then do one a week after that. So if you want the new fresh content, you go to YouTube and watch the video if you want to catch up, you go to the podcasts. But if we're if we're giving it a breakdown, you know, I would say we're probably at about 60% of consulting at this point. And coaching, I kind of put coaching underneath that as well. And then I would say, you know, the the online business is probably about 30% at this point. And then treatment is just at this point, word of mouth, close family and friends here in the Wimberley area, you know, 10%? If that?   28:54 Yeah, got it? Yeah, I think that's really helpful for people to hear so that they're like, wait, I don't understand how, how is someone doing all of this at one time? Do you know what I mean?   29:03 Yeah, and let me make this clear, too. So 32 hours a week is still dedicated to my full time job and Right, right. So that gives me maybe eight hours extra to get to a 40 hour week, and then I work 50 or 60 hours a week, there's you know, I love that stuff, though. I would do that for free if I could all day every day, because that's what gets me excited, you know, the passion projects, helping people figure out a business model. So you're, you know, figure out what they can do for side hustles and side gigs. Even if it's just making an extra 500 bucks, you know, a week or something like that, you know that that could be huge for somebody who's having to pay 2000 bucks a month for student loans, right or 1500 bucks a month for student loans. So if we can figure out a side hustle or side business to get you started, at least, maybe you grow it big enough to the point where you can walk away from that nine to five and that's great if that's what you want to do. You know, but but I'm also to the point where I was working 60 or 70 hours a week for someone else and trading time for money and just wasn't cutting it. So I've scaled back, I've been able to, you know, increase my value on certain things and, you know, raise the prices on things enough to where I'm working less time and making more money. So it's like PRN rates don't even, you know, don't even cut it for me anymore. It's not even something I would look at. It's just not worth my time, because the money's nice, right. But the time freedom is really what you're looking for, I think, you know, I think people are, are looking to claim back a lot of that time with their family, not having to work weekends, not having to stay, you know, all hours at night at an outpatient clinic, doing notes and trying to, you know, stay on top of things. So, I know I've been there, man, it's a grind. And, you know, it's nice to be able to use my add and teach and to use my DPT and use that knowledge toward you know, something as trivial as a fantasy football injury course, right? That was one of the first courses I ever made. And then, you know, video gamers eSports, I did an Esports ebook on injury prevention for gamers, right? Like, that stuff is just fun to me, you know, I love that stuff. And we can use our knowledge to help those people and solve those problems. So why not do that? Right? Why not find a hobby or something you like? And just go all in on it, you know, and use your knowledge to help people. You know, so that's been a big a big finding for me over the last year or two, it's just that, you know, you don't have to work as hard. You know, you can scale back, you know, charge what you're worth, and make a lot more money in a lot less time. You know?   31:29 Yeah, that all makes sense to me. And what would be your says, we kind of come come to a close here, what, what is your biggest, your most important piece of advice for people listening, if they could take one, if you were like, oh, man, if you just took one thing away from this talk, this would be it.   31:51 Yeah, I think physical therapy or your profession, your career just has to be the tip of your iceberg, right? I mean, again, like I said, we as physical therapists can do so many things, we can help so many people, and it's like, if I go and treat a patient, you know, one on one, that's great, that one person gets better in that hour, maybe times eight hours a day, there's eight people, right? If you want to have a bigger impact, and you want to affect more people, right? Then maybe you coach somebody or teach somebody, you know how to start their own business. And now that person's treating, you know, 50 people a week. So now you're impacting 50 there, and the few that you were teaching, then you coach somebody else on something else, and they're helping, you know, 20 businesses, you know, with their patient intake model, and they're, you know, they're doing things, you know, at a higher rate. So now you're helping 20 businesses with 50 patients each, right. And so I think more impact can come if we realize that we're more than just a physical therapist that goes in and treats eight people a day, or 20 people a day, or 30 people a day, or whatever you're treating, right? Like we can do so much more. And we just need to think outside the box a little bit, you know, and be a little bit more than that nine to five clinician that clock in and clock out, you know, and then again, by having a bigger impact by helping more people, right, and then coming at it with a servant's heart. Money is just a byproduct, you can then take that money and pay off your student loans quicker if you want or invest in things that are going to make you more money down the line so that you can pay off the student loans, should you want to do it over a longer period of time. Either way, you know, it's just about opening your eyes and seeing that there's a whole lot more out there than just you know, going to outpatient clinic every day and seeing your patients.   33:29 Excellent, excellent advice and great takeaway. Now, where can people find you if they want to learn more about you what you're doing and how to get in touch with you?   33:37 Yeah, sure. So all of my tags are pretty much at p key educator on all the social medias. And then the book is on Amazon. It's available in softcover. And in Kindle, it's called PT educator, student debt eliminator, multiple streams of revenue for healthcare, academicians and clinicians. definitely have a second edition coming out pretty soon. So check it out, out while you can. You know, I'd love to see people hop on the second edition as well, because there are a couple of key changes with all the stuff that's going on nowadays, with cryptocurrencies and, you know, all sorts of investing strategies and stuff like that. So I'm still learning, you know, lifelong learner for sure.   34:13 Absolutely. And last question, what advice would you give to your younger self, knowing where you are now in your life and in your career? Yeah.   34:22 Don't Don't worry, as much, you know, just leverage the heck out of your, your career and your degrees. You know, use them to do what you want to do and what you enjoy doing, you know, leverage the heck out of it, you'll be fine.   34:37 Excellent, great advice. I've heard that many times on this show. So, Scott, thanks so much for coming on. This was great. I think you really gave people a lot to think about and some inspiration on maybe how they can use their passions and and think outside the box a little bit. So thanks for coming on.   34:57 Absolutely. Thank you, Karen. It's been a pleasure.   35:00 Absolutely and everyone, thanks so much for listening. Have a great couple of days and stay healthy, wealthy and smart.

PRN - Fast Talk Podcast
EP 2141: Bubba Wallace Gets Historic Win in Talladega

PRN - Fast Talk Podcast

Play Episode Listen Later Oct 4, 2021


Bubba Wallace battles his way to the front in Talladega, just ahead of the rain, and takes his first win. Doug Rice welcomes PRN's Brett McMillan and special guest host Kyle Petty to the panel on Fast Talk.

Nailed It Ortho
OITE Review: Sports- 10: Lower Extremity Contd

Nailed It Ortho

Play Episode Listen Later Sep 20, 2021 40:41


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

Leid Stories
Leid Stories - 09.17.21

Leid Stories

Play Episode Listen Later Sep 17, 2021 54:36


Keep it right here on PRN, the Progressive Radio Network.   We keep you in the know.

PRN - Fast Talk Podcast
EP 2138: Truex Wins Richmond; High Banks of Bristol Next

PRN - Fast Talk Podcast

Play Episode Listen Later Sep 13, 2021


Martin Truex Jr. scored a playoff win at Richmond and next up is the high banks of Bristol for an elimination race! Doug Rice is joined by PRN's Alexis Erickson and Brad Gillie, as well as former NASCAR driver Hermie Sadler as we look ahead to the first cutoff race of 2021! Which drivers should feel good heading to Thunder Valley, and who needs a win just to have a chance? Plus, Hermie explains why Ross Chastain could be the super sleeper of the playoff run.

The Racing Writer's Podcast
Ep. 188 | Doug Rice (PRN)

The Racing Writer's Podcast

Play Episode Listen Later Sep 13, 2021 47:51


You've probably heard Doug Rice's voice calling a NASCAR race for Performance Racing Network (PRN), but if you don't know much about him, you will after this episode. Rice explains how long he's been with the company and his role as president of PRN and the responsibilities; first hearing about NASCAR; memories from broadcasting in college and working at the campus radio station; the impact of participating in speech and debate club; getting his foot in the door with PRN; early lessons and snafus; the importance of painting a picture; the most important thing about broadcasting; regrets about not saving things through the years; working alongside Humpy Wheeler; his top broadcasting moment; what PRN races remain this season. Music created by Tony Monge. Please support my work through Patreon: www.patreon.com/KellyCrandall

Nailed It Ortho
OITE Review: Sports 7- ACL

Nailed It Ortho

Play Episode Listen Later Sep 10, 2021 29:34


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors. From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card. Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

Nailed It Ortho
OITE Review: Sports 6- Knee Imaging

Nailed It Ortho

Play Episode Listen Later Sep 8, 2021 35:14


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking with no ATM fees nationwide, 24/7 customer service, and loan options just for physicians including their PRN personal loan that gives you up to $75,000 to use as needed at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no cosigners or maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today and mention NAILED IT ORTHO, to learn how you can join the physicians nationwide who expect more from their bank.    Panacea Financial is a division of Primis member FDIC.

PRN - Fast Talk Podcast
EP 2137: Hamlin Wins Darlington - On to Richmond

PRN - Fast Talk Podcast

Play Episode Listen Later Sep 6, 2021


The playoffs kicked off at Darlington and Denny Hamlin punched his ticket to the next round with his first win of the year! Doug Rice is joined by PRN's Alexis Erickson and Brad Gillie, plus Hermie Sadler is our special guest. Hermie explains what makes Hamlin so good at Darlington and tells us why it truly is NASCAR's toughest test. Many playoff contenders had trouble during the Southern 500, but whose misfortune was the biggest setback? We debate that and a whole lot more on this week's show!

Healthcare Entrepreneur Academy Podcast
#206: Tactical Tuesday: Stop Making Excuses & Start Working Towards Financial Freedom

Healthcare Entrepreneur Academy Podcast

Play Episode Listen Later Aug 24, 2021 19:34


OVERVIEW: Jason A. Duprat, Entrepreneur, Healthcare Practitioner, and Host of the Healthcare Entrepreneur Academy podcast weighs in on some of the most common excuses people make for not starting their own business. He provides solutions to the top objections and gives examples for overcoming the hurdles you may face when it comes to launching a startup.     EPISODE HIGHLIGHTS: The top excuse Jason hears when it comes to leaving a W2 job to launch a new business - I need my income to pay the bills.  In addition to income, he also hears - My full-time job requires 50-60 hours of work per week.  If this is the case, then maybe you're not in the right job. Entrepreneurs find solutions. Excuses, objections, and hurdles can all be overcome.  You have to put the work in yourself. If you can't do that, you don't want it bad enough.  One option is simple. Look for another job that doesn't require so much of your time.   Another option is to communicate with your employer. Ask if you can split your full-time position with somebody else so you can work part-time.  This is a popular model that's growing, especially in healthcare due to hospital and corporate medicine burnout. Another solution Jason offers is finding a flexible position or working as a 1099 employee. When you do this, you can work part-time, as a PRN, or even full-time and then take extended time off.    Jason also suggests leveraging your license to provide services for patients or other businesses remotely. This saves commute time which you can put towards working on your business.  You will have to pay your dues. Don't quit your job to start a business. Instead, start lean and part-time to get the kinks worked out. And when your business is making good money, then take the leap.  In the end, the choices are yours to make. You are in complete control. You can make money on your terms and have financial freedom.  3 KEY POINTS: If your excuse for not starting a business is that you do not have the time, find a more flexible position or work on a part-time basis. If you're thinking of becoming an independent contractor, explore remote options. There's a tremendous amount of opportunity for remote work.  You don't have to restrict yourself to working in a hospital or a clinic just because you're a healthcare practitioner. TWEETABLE QUOTES: “If you want to get anywhere in life... you're going to have to put in some of the work yourself.” - Jason Duprat “All the choices are yours.” - Jason Duprat   RESOURCES: Alesia Quante Facebook Group - 1099 CRNA Success Community - https://www.facebook.com/groups/1099crna/ If you enjoy the podcast, please leave us a rating and review - https://lovethepodcast.com/hea Want to know when the next episode goes live? Subscribe and follow the podcast - https://followthepodcast.com/hea   #HealthcareEntrepreneurAcademy #healthcare #entrepreneur #entrepreneurship #podcast #stopmakingexcuses #overcominghurdles #startup #businesslaunch #1099employee #remotework  

Southern Race Week
SRW Podcast Season 2 Episode 30

Southern Race Week

Play Episode Listen Later Aug 24, 2021 31:38


On this episode of #SRWPodcast - Mike Bagley of Motor Racing Network & SiriusXM NASCAR Radio breakdowns #CupSeries playoff picture, Lenny Batycki of PRN's At the Track delivers #ShortTrackNews, and #ShortTrackDriver Jake Garcia talks about his first #SuperLateModel win at Crisp Motorsports Park from weekend of August 20th, 2021

Nailed It Ortho
OITE Review: Sports- 3: Hip

Nailed It Ortho

Play Episode Listen Later Aug 23, 2021 30:40


Get on the list for our early access to podcast OITE companion book  + time stamps for OITE Reviews: Click here for access Sponsor our show: www.naileditortho.com/sponsor or email us at naileditortho@gmail.com    Our episode today is sponsored by Panacea Financial, a digital bank built for doctors by doctors.   From medical student to attending, Panacea offers free checking and loan options just for physicians including their PRN personal loan that gives you up to $75,000  at an interest rate less than half of a credit card.   Panacea Financial can also refinance your medical school debt with no maximums or help you with commercial needs such as practice or surgery center buy-ins.   Visit panaceafinancial.com today to learn how you can join the physicians nationwide who expect more from their bank.  Mention: "Nailed It Ortho" in the how did you hear about us section!   Panacea Financial is a division of Primis member FDIC.

The Personal Computer Radio Show
The Personal Computer Radio Show - 08.18.21

The Personal Computer Radio Show

Play Episode Listen Later Aug 18, 2021 55:00


" The Personal Computer Show Wednesday August 18th 2021 PRN.fm Streaming On the Internet 6:00 PM Eastern Time IN THE NEWS o Hackers Return $600 Million They Stole in one of the Biggest Crypto Heists o Cyber Attackers Threatened to Release Gigabyte Hacked Documents o Google Rolls Out ‘Pay Calculator' Work-from-Home Salary Cuts o Apple CSAM or Child Sexual Abuse Materials Controversy Update o Half of US Hospitals Shut Down Networks Due to Ransomware o Apple Orders Account for Over 20% of TSMC Total Revenue IT Pro Series with Benjamin Rockwell o Most Critical Information Tech in Companies From the Tech Corner o Semi Conductor Shortage Update o What is the Global Navigation Satellite System "

I Need (Travel) Therapy
Travel Therapy as a New Grad & Advice for Traveling with a Pet - Morgan Lauchnor, OTR/L

I Need (Travel) Therapy

Play Episode Listen Later Aug 9, 2021 47:00


On this episode, we had a fun and informative conversation with a travel OT who has been accompanied on the road by her furry friend! Special guest, Morgan Lauchnor, OTR/L, looked back to the beginning of her travel career and brought us through her journey, sharing her experience traveling as a new grad in Ashland, Oregon, her decision to bring her puppy, Zoe, into her life, pet advice for other travelers to keep in mind, and more.This show is made possible by Med Travelers. If you're interested in exploring a career in allied travel, visit: https://www.medtravelers.com/getting-started/become-an-allied-traveler/to learn more about the nationwide opportunities they have to offer!We Discuss(0:00) Show introduction and Morgan's career background(8:42) Morgan's first travel therapy assignment (10:47) Advice for new grads to know before their first assignment (15:32) Establishing travel therapy career goals (19:43) Traveling in Ashland, Oregon(24:15) Deciding to get a dog as a travel therapist (27:58) Raising a new puppy as a travel therapist (34:04) Making pet arrangements for each travel therapy assignment (39:26) Additional advice for travel therapy with pets About Morgan Lauchnor, OTR/LMorgan has been a traveling occupational therapist for just under 2 years, starting right as a new grad and moving from PA to the west coast so she could live out her dream of seeing the country and all that it has to offer while working her dream job. She's been on 5 assignments in SNFs, from OR to CA, to TX, and NC and is planting some temporary roots in Asheville so she can get some inpatient/outpatient/home health experience working PRN for a hospital network. She travels with her mini-Aussie pup Zoey who has been the best adventure buddy. To continue following along on their adventures, make sure to check out her Instagram!About the ShowProducer – Jonathan Cary Assistant Producer – Katie SchraubenShow Notes – Sam MacKay Music & Editing – Aidan Dykes Powered by Med Travelers

Southern Race Week
SRW Podcast Season 2 Episode 28

Southern Race Week

Play Episode Listen Later Aug 9, 2021 33:20


On this episode of #SRWPodcast - EVP & GM of Atlanta Motor Speedway Brandon Hutchison talks progress of track work, Lenny Batycki of PRN's At the Track has #ShortTrackNews, and Brad Gillie of Performance Racing Network talks NASCAR from weekend of August 6th, 2021

Leid Stories
Leid Stories - 08.06.21

Leid Stories

Play Episode Listen Later Aug 6, 2021 54:18


Keep it right here on PRN, the Progressive Radio Network.  

Pri-Med Podcasts
Nasal Steroids for Perennial Allergic Rhinitis: Is PRN Use Enough? - Frankly Speaking Ep 235

Pri-Med Podcasts

Play Episode Listen Later Aug 2, 2021 8:43


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-235   Overview: Perennial allergic rhinitis affects both children and adults, and management includes both allergy avoidance as well as medication management. Intranasal steroids are the mainstay of treatment and have traditionally required consistent use, but new data are emerging. Find out the results of a new study evaluating PRN use as an alternative approach.   Episode resource links: Thongngarm T, Wongsa C, Phinyo P, Assanasen P, Tantilipikorn P, Sompornrattanaphan M. As-Needed Versus Regular Use of Fluticasone Furoate Nasal Spray in Patients with Moderate to Severe, Persistent, Perennial Allergic Rhinitis: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2021 Mar;9(3):1365-1373   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

Frankly Speaking About Family Medicine
Nasal Steroids for Perennial Allergic Rhinitis: Is PRN Use Enough? - Frankly Speaking Ep 235

Frankly Speaking About Family Medicine

Play Episode Listen Later Aug 2, 2021 8:43


Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-235   Overview: Perennial allergic rhinitis affects both children and adults, and management includes both allergy avoidance as well as medication management. Intranasal steroids are the mainstay of treatment and have traditionally required consistent use, but new data are emerging. Find out the results of a new study evaluating PRN use as an alternative approach.   Episode resource links: Thongngarm T, Wongsa C, Phinyo P, Assanasen P, Tantilipikorn P, Sompornrattanaphan M. As-Needed Versus Regular Use of Fluticasone Furoate Nasal Spray in Patients with Moderate to Severe, Persistent, Perennial Allergic Rhinitis: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2021 Mar;9(3):1365-1373 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

Astro Awani
AWANI Pagi: Berita tumpuan & kemas kini COVID-19 [27 Julai 2021]

Astro Awani

Play Episode Listen Later Jul 27, 2021 28:10


Ketahui berita yang perlu anda tahu hari ini bersama Hakim Rahman dan Nursyazwani Saiful Sham dalam #AWANIpagi 27 Julai 2021. Antara fokus berita pagi ini merangkumi:   Ini 10 tumpuan utama Mesyuarat Khas Dewan Rakyat hari ini  Laksana Darurat di Sarawak agar PRN tidak diadakan dalam masa terdekat #JomCucukVaksin #HapusCOVID19

PRN - Fast Talk Podcast
EP 2130: Almirola Wins Shortened New Hampshire Race

PRN - Fast Talk Podcast

Play Episode Listen Later Jul 19, 2021


Doug Rice and Alexis Erickson welcome PRN's Mark Garrow and Brett McMillan to break down the Foxwoods Resort Casino 301, shorted by rain and darkness Sunday. Aric Almirola took the victory, becoming the 13th different winner this season.

Eye on the Triangle
EOT 328 - Santisha Walker

Eye on the Triangle

Play Episode Listen Later Jul 4, 2021 21:51


FULL TRANSCRIPT OF EPISODEProvided by Otter.aiEoin Trainor  0:00  The views and opinions expressed in Eye on the Triangle do not represent WKNC or student media.Eoin Trainor  0:45  Good evening Raleigh and welcome to this week's Eye on the Triangle an NC State student produced new show on WKNC 88.1 FM HD one Raleigh, I am Eoin Trainor. On tonight's episode, Elizabeth Esser interviews Santisha Walker, a registered nurse, entrepreneur, author and speaker based in Durham they talk about her fitness apparel and wellness brand, the I am experience. But first you have some stories from the North Carolina News Service enjoy.Nadia Ramlagan  1:12  A state environmental committee is considering a proposal to set a process in motion to reduce carbon emissions from power plants. It involves North Carolina joining the Regional Greenhouse Gas Initiative or “RGGI,” a collaborative effort to shrink emissions by a group of East Coast states. RGGI requires companies to purchase an allowance for each ton of carbon-dioxide pollution they produce. The petition now heads to a second commission for a vote. Joel Porter with Clean Air Carolina says environmental groups are pleased the state is taking the impact of carbon pollution seriously.Joel Porter  1:44  So that was a big step forward for us on a long journey through the regulatory process, but we are encouraged that they approve of our petition and regulating greenhouse gases in North Carolina.Nadia Ramlagan  1:57  He says states already part of RGGI have seen carbon-dioxide emissions from power plants drop 47-percent over the last decade. With that dip in fossil-fuel generation came cleaner air, fewer hospital visits, and fewer lost work or school days from asthma and other respiratory illnesses. But an energy bill being debated by state lawmakers could complicate the effort to join RGGI. Porter says House Bill 951 would enshrine natural gas and fossil-fuel use in the state for the next decade, and limit the amount of renewable energy that can be used.Joel Porter  2:30  All and all, we're glad that we're supporting a petition to get the state in RGGI, because this bill closes the state's energy market to clean energy.Nadia Ramlagan  2:41  Derb Carter with the Southern Environmental Law Center says joining RGGI would put North Carolina on a path to reduce carbon emissions from 2005 levels by 70-percent before 2030, and become carbon neutral by 2050.Derb Carter  2:55  Which generally aligns with what the scientists are telling us we really need to do to avoid the worst impacts of climate change.Nadia Ramlagan  3:04  Carter notes North Carolinians already feel the effects of climate change from extreme weather. He says unless the course is shifted, the state's residents and economy will see more consequences. For North Carolina News Service, I'm Nadia Ramlagan.Nadia Ramlagan  3:23  New survey data offer a clear picture of how North Carolina kids and families are faring, both before and after the pandemic. The Tarheel State ranks 34th in the nation for overall child well-being in the 2021 Kids Count Data Book from the Annie E. Casey Foundation. Vikki Crouse with N-C Child says before the pandemic, one in five kids lived in households with incomes below the poverty line. And then, massive job losses meant thousands of parents suddenly had no or reduced income and few options for child care.Vikki Crouse  3:53  So we know that the pandemic took a toll on everyone, but especially parents and caregivers.Nadia Ramlagan  3:59  According to the report, the percentage of adults in households with kids experiencing symptoms of depression rose from 19-percent last year, to 22-percent in March of this year. The data also reveal in 2020, 22-percent of households with children experienced housing insecurity, reporting "little or no confidence" in their ability to pay their next rent or mortgage payment. In March 2021, that figure has dipped to 17-percent. However, Crouse says affordable housing continues to be a pressing issue.Vikki Crouse  4:29  And now he's really constrained because certainly families and kids don't fare well if they don't have a stable place to live.Nadia Ramlagan  4:36  But she notes the expanded Child Tax Credit will likely lift more than 140-thousand North Carolina children out of poverty.  Leslie Boissiere with the Casey Foundation explains both state and federal Child Tax Credit programs are critical to eliminating structural inequities in the tax code.Leslie Boissiere  4:53  We are excited and grateful that lawmakers passed the expansion, and we're calling on them to make that expansion permanent. We'd like to ensure that we don't have the largest-ever one-year reduction in the number of children who live in poverty, followed immediately by the largest-ever one-year increase.Nadia Ramlagan  5:10  She adds more than half of Black children have historically been ineligible for the full Child Tax Credit because their household incomes are too low, compared with 25-percent of white children. For North Carolina News Service, I'm Nadia Ramlagan.Lily Bohlke  5:30  Groups advocating for clean energy say Governor Roy Cooper's recent commitment to expanding North Carolina's offshore wind capacity will bring economic benefits to the state. North Carolina has among the highest offshore wind-energy potential in the nation, with its long coastline and shallow outer-continental shelf. Jaime Simmons, with the Southeastern Wind Coalition, says in addition to being a carbon-free source of power, expanding offshore wind could create tens of thousands of new jobs.Jamie Simmons  6:00  Some of these major location decisions are being driven in large part by the states or regions with anticipated projects. So these development goals set by Gov. Cooper make a much stronger case for these manufacturers to locate and invest in North Carolina.Lily Bohlke  6:16  North Carolina is facing a 10-year moratorium on all offshore energy leasing starting in July of 2022. Simmons says pending legislation would exempt offshore wind from the ban. In the meantime, she says there's work to do to get existing wind-energy areas ready for leasing – Wilmington East and West in the southern part of the state – and prepare for development of new projects to start immediately when the moratorium ends. Simmons says offshore wind will be an essential part of the move toward a carbon-free grid – and that it marries well with solar energy. When solar starts to produce less in the day, around early evening, offshore wind usually is blowing the strongest. She adds that the high generation capacity of individual offshore wind projects is key.Jamie Simmons  7:04  You're really talking about rethinking what baseload power means. Offshore wind is really the only renewable energy that could replace the capacity from a coal facility or natural-gas facility.Lily Bohlke  7:19  Cooper's proclamation outlines targets for offshore wind energy of 28-hundred megawatts by 2030 and 8-thousand megawatts by 2040. His administration notes 8-thousand megawatts could power more than 2-million homes. The order also aligns with the state's clean-energy plan signed in 2018, which aims to reduce power-sector greenhouse gases 70-percent by 2030 and to achieve carbon neutrality by 2050. For North Carolina News Service, I'm Lily Bohlke, reporting.Elizabeth Esser  7:54  I'm Elizabeth Esser with WKNC 88.1 Eye on the Triangle. Joining us today is Santisha Walker, a certified nurse, entrepreneur, speaker and author based in Durham, North Carolina. We discussed her fitness apparel and wellness brand, the I Am experience. Santisha, thank you so much for joining us on Eye on the Triangle. Santisha Walker  8:13  You're welcome. Thank you for having me, Elizabeth. I'm excited to be here.Elizabeth Esser  8:18  So you wear many hats. You're a certified nurse and entrepreneur an author, speaker. Would you mind telling our listeners a bit about your professional background and how you got to where you are today? Santisha Walker  8:29  Sure. So yes, I am a registered nurse. I've been a nurse for seven years, I actually received my nursing degree from Wake Technical Community College here in Raleigh. And then I went on to get my master's in nursing from Gardner Webb University. And so as far as my nursing background, I have worked at Wake med, I was a cardiac nurse on intermediate step down unit, I worked at a private practice in Raleigh for neurology, I've done homecare, supervisory visits, I've worked in assisted living, long term care and rehab. So I have a really broad knowledge of nursing. And as you know, I'm not your typical traditional conventional nurse, I believe in stepping outside of the box and using my nursing knowledge to help others outside of the bedside setting. I'm also a wellness coach. And so I thought it would be great to pair wellness knowledge with my nursing health care information that I have and then make you know the best of that and be able to help others outside of that setting. I am here from the Raleigh Durham area and I reside here at RTP. And so I try to reach out to the community and partner with others who are making a difference in the lives of others as well in the healthcare wellness setting. So I have a broad range of knowledge. Elizabeth Esser  9:43  So what is the I Am experience and and what inspired you to create it?Santisha Walker  9:48  Sure, so the I am experience. So my mission with that is to basically offer individuals a fitness and wellness experience that's going to empower them to intentionally cultivate the best version of themselves and reflect it out to the world. And so my vision was to offer a fitness apparel from a quality brand that everyone can trust. And then also tag on to that wellness products that they can use while they are actually working on their physical body. And so where this idea came from, I actually came to me during the pandemic, right, everyone was home, we were all going through a lot. myself as a nurse, I was still actually helping in the bedside setting, doing what we call PRN, helping in different COVID units in the area. But when I was home, I actually decided to focus more on my actual fitness and physical fit as far as my physical body. And so I began working out more. Before the pandemic, I would go to the boxing gym and try to work on my body, but I got really lazy with it. So I decided to incorporate more physical activity for myself. But also I want it to center myself emotionally, spiritually and mentally, right. And so with every, at every news station, every time we turned around, there was something negative being mentioned or or new breaking news, I should say about Coronavirus, and about COVID and about the number of deaths and so it was taking a toll on everyone, including myself. And so what I wanted to do was become very still very centered. And so I begin positive self talk, I begin to incorporate heavily, I was doing it before, but I really want to focus on positive affirmations. And so during my workout sessions, which I would work out early in the morning, go ahead and get it done for the day, I began playing affirmations in the background. So while I was doing my HIIT Workout, I had affirmations going. And that really helped me during that vulnerable time when I was working out to center my mind and to speak to myself in my body. And I just took it from there. So I thought you know, what, if this is helping me Who else could this actually help? You know, because when we working out that's a very, it's empowering, but it's also very vulnerable, right? Because you're questioning yourself, can I do this, I have to reach this goal, I have to feel better. So you're vulnerable, but you're also empowering yourself to keep going and push past that threshold. And so that that's when it came to me, you know, it would be really cool to you know, come up with an apparel that people could actually put on when they can actually when they see themselves in that apparel, they will be empowered, right. But then also add products or add something to that, that would allow them to continue with the empowerment, mind body, soul and spirit. And so that's where it came from my husband's nonprofit organization, Carolina united flag football club, they actually had access to Nike apparel, and so I tapped into his resource and I was able to get great you know, quality apparel and use you know, use the I Am brand to go ahead and put something great out there for individuals.Elizabeth Esser  13:03  And so I understand that the brand is not just a fitness apparel brand. What all does it offer?Santisha Walker  13:10  Yeah, great, great. Okay. So this is this is the fun part right because there are several fitness apparel you know, you can athleisure is everywhere. But the thing that says that I am experienced a part is we offer an I am fitness wellness kit, right so that I Am exclusive wellness kit is basically 10 subjects that those who purchase the apparel can choose from it's complimentary. And so you choose one of those subjects with your apparel purchase. And I'm actually sending you information based on my nursing and wellness knowledge that will help you to incorporate that into your life. So there are daily practical guides, they're invaluable resources that are reputable that you can you can believe and trust in, there's evidence based information that's provided on that particular topic. So each time you purchase an apparel, you can choose a new topic to go along with your apparel. So that I am exclusive wellness kit will be included with your package with your actual apparel that you receive at your doorstep. Okay, so another product that I included was the I Am energy workout mix. This was this was a really fun project. And again, like I mentioned before I was working out right but what I wanted to do was put I am affirmations on top of energizing beats So when we work out we want something that's just going to keep us going and especially when we reach that peak, right, we have to push to that threshold. And so what I wanted to do was incorporate Im affirmations with energizing beats so that you can actually listen to it for while you're working out. So it is a 30 minute audio. And so these are professionally engineered beats that are done by the professionals. I know nothing about studio work. So I reached out to Hatton Brandon CO and they were able to reach out to their resources their team and put together the I am energy work out there. And so again, that's complimentary. It comes with your apparel, you can only get it once you purchase your apparel. But that's actually to help your mind stay in that positive mindset while you're working out. And I actually had some someone reach out to me and she said, You know what, I actually listened to it after I finished my workout. And so that you can carry it into your everyday activities. And the other, the other, this is not really a product. But the other thing that I offer is I am empowered private group. And so that is a private Facebook group, you have to have an entry code, you have to answer questions to be able to get in. But once you purchase your apparel, then you actually get access to that group to be held accountable, and to be empowered on a daily and weekly basis. And so it's not just me posting information as a healthcare professional. But it's those that are in the group, were asking questions, Hey, what are you guys doing about this? How are you guys being empowered this week? This is what I'm doing. Right. One of the things I posted yesterday was Hey, guys, like I had a little bit too much sugar last week, and, and I didn't really take in as much water this week, I am, you know, being held accountable to drinking more water. And so they hold me accountable to that. So yeah, I wanted to definitely partner wellness products,Elizabeth Esser  16:15  and you have a background in healthcare and business. And you've been able to successfully merge these two passions in your career. Was creating a brand like the I am experience always a goal of yours? Or is that something that just happened along the way?Santisha Walker  16:31  Great question. So it happened along the way. You know, if you do a little bit of research and background on me, I am a true like, nurse entrepreneur, what we call nursepreneur. And so I consider myself a serial entrepreneur, because I love taking ideas, I love taking things and my creativities and bringing them to a full finished work and bringing them to fruition. And so no, I it's so funny, I had never envisioned myself, even launching a fitness line, right. But I have a business degree. And I always tell this story. I have a business degree. And I concentrated in marketing. But I never envisioned that I would be an entrepreneur. And I know that's like an oxymoron it's contradictory. But when I went to college back in 2001, you know, I didn't know what I wanted to do what to major is I said, Hey, if I get a business degree, I could always use it at some point in life. And then after graduating I in college, I kind of had an idea. I wanted to be a nurse, but I was close to graduating. So I graduated. But becoming a nurse, I didn't become a nurse to even partner the two worlds. It wasn't until later I realized, oh my god, I have all of this knowledge, I have a business degree. And my husband actually brought that idea of, you know, going into consulting and starting my own business. And so eventually I'm merged the two. So I did not set out to be a serial nursepreneur, I did not set out to launch, you know, a fitness line, I do believe in submitting my mind, my body and my will to the will of God, my Creator. And I do believe in allowing him to order my steps. And so throughout life, life is very secure. You know, very, you know, it's a windy road. And so I just believe in just following him and doing what he's telling me to do. And it's been a success so far. Success, meaning I have empowered a lot of people along the way. That's how I measure my level of success. So, you know, no, I didn't set out to do it. But I did. I do believe in not being boxed in and just you know, submitting myself to God and letting him use me in that way.Elizabeth Esser  18:38  And as a registered nurse yourself, you have a specific passion of empowering nurses professionally and in life. How have nurses and other health care professionals responded to the I am experience?Santisha Walker  18:51  Yeah, so they responded great. I actually had a giveaway I launched actually the day like nurses week was my first inaugural launch of the brand. And so I had nurses like reach out to me that was actually a giveaway that I offered. And one of the one of the nurses won, but they've responded positively. I will say just in general, nurses are amazing. We're the powerhouse of healthcare. And I'm happy to see that we are moving along and becoming used to nurses operating outside of that traditional setting. But it's it is still a pool every once in a while to get nurses to see another nurse operating outside of just having all scrubs and starting IVs and running to codes. And so I have had a positive response. But I think as nurses hear more about this and realize, Hey, you know, this is something you guys can tap into as well. I think there will be even more a better response but so far it's been it's been good. I actually have a nurse who was a part of our inaugural launch. And so she has actually been putting it she's a she's an ER nurse at Wake med and she's actually been she's an ambassador. And she's been putting helped me get the brand out to other nurses as well. Elizabeth Esser  20:05  When is your next release?Santisha Walker  20:07  Yeah, so my next release is actually, this Friday, June the 25th. I'm not sure when this will air, but it is June the 25th. And so I release the fourth Friday of every month. And so if you missed the first release, or the most previous release, you can also always subscribe and then you'll get a heads up with that next release is coming. So the 25th of June is my next release. And the releases are available only for one week. And so you have to almost get in there why you can you know, while the getting is good. And then once that, that that seven day is over, then the next release is not until another three or four weeks.Elizabeth Esser  20:44  And finally, where can listeners find your merchandise? Santisha Walker  20:47  Yeah, so they can find it at WWW.theIAMexperience.shop So that is the I am experienced dot shop. And then once they go there, they can see all of the amazing information and yeah, all the good stuff.Elizabeth Esser  21:04  Santisha, thank you so much for joining us.Santisha Walker  21:07  You're welcome Elizabeth, thank you so much for having me.Eoin Trainor  21:11  And that is it for this episode of Eye on the Triangle. Thanks for tuning in. If you have any questions, comments, ideas or would like to get involved, shoot us an email at public affairs@wknc.org. We'd love to hear from you. Stay tuned for usual programming. We'll see you next time.

Eye on the Triangle
EOT 328 - Santisha Walker

Eye on the Triangle

Play Episode Listen Later Jul 4, 2021 21:51


FULL TRANSCRIPT OF EPISODEProvided by Otter.aiEoin Trainor  0:00  The views and opinions expressed in Eye on the Triangle do not represent WKNC or student media.Eoin Trainor  0:45  Good evening Raleigh and welcome to this week's Eye on the Triangle an NC State student produced new show on WKNC 88.1 FM HD one Raleigh, I am Eoin Trainor. On tonight's episode, Elizabeth Esser interviews Santisha Walker, a registered nurse, entrepreneur, author and speaker based in Durham they talk about her fitness apparel and wellness brand, the I am experience. But first you have some stories from the North Carolina News Service enjoy.Nadia Ramlagan  1:12  A state environmental committee is considering a proposal to set a process in motion to reduce carbon emissions from power plants. It involves North Carolina joining the Regional Greenhouse Gas Initiative or “RGGI,” a collaborative effort to shrink emissions by a group of East Coast states. RGGI requires companies to purchase an allowance for each ton of carbon-dioxide pollution they produce. The petition now heads to a second commission for a vote. Joel Porter with Clean Air Carolina says environmental groups are pleased the state is taking the impact of carbon pollution seriously.Joel Porter  1:44  So that was a big step forward for us on a long journey through the regulatory process, but we are encouraged that they approve of our petition and regulating greenhouse gases in North Carolina.Nadia Ramlagan  1:57  He says states already part of RGGI have seen carbon-dioxide emissions from power plants drop 47-percent over the last decade. With that dip in fossil-fuel generation came cleaner air, fewer hospital visits, and fewer lost work or school days from asthma and other respiratory illnesses. But an energy bill being debated by state lawmakers could complicate the effort to join RGGI. Porter says House Bill 951 would enshrine natural gas and fossil-fuel use in the state for the next decade, and limit the amount of renewable energy that can be used.Joel Porter  2:30  All and all, we're glad that we're supporting a petition to get the state in RGGI, because this bill closes the state's energy market to clean energy.Nadia Ramlagan  2:41  Derb Carter with the Southern Environmental Law Center says joining RGGI would put North Carolina on a path to reduce carbon emissions from 2005 levels by 70-percent before 2030, and become carbon neutral by 2050.Derb Carter  2:55  Which generally aligns with what the scientists are telling us we really need to do to avoid the worst impacts of climate change.Nadia Ramlagan  3:04  Carter notes North Carolinians already feel the effects of climate change from extreme weather. He says unless the course is shifted, the state's residents and economy will see more consequences. For North Carolina News Service, I'm Nadia Ramlagan.Nadia Ramlagan  3:23  New survey data offer a clear picture of how North Carolina kids and families are faring, both before and after the pandemic. The Tarheel State ranks 34th in the nation for overall child well-being in the 2021 Kids Count Data Book from the Annie E. Casey Foundation. Vikki Crouse with N-C Child says before the pandemic, one in five kids lived in households with incomes below the poverty line. And then, massive job losses meant thousands of parents suddenly had no or reduced income and few options for child care.Vikki Crouse  3:53  So we know that the pandemic took a toll on everyone, but especially parents and caregivers.Nadia Ramlagan  3:59  According to the report, the percentage of adults in households with kids experiencing symptoms of depression rose from 19-percent last year, to 22-percent in March of this year. The data also reveal in 2020, 22-percent of households with children experienced housing insecurity, reporting "little or no confidence" in their ability to pay their next rent or mortgage payment. In March 2021, that figure has dipped to 17-percent. However, Crouse says affordable housing continues to be a pressing issue.Vikki Crouse  4:29  And now he's really constrained because certainly families and kids don't fare well if they don't have a stable place to live.Nadia Ramlagan  4:36  But she notes the expanded Child Tax Credit will likely lift more than 140-thousand North Carolina children out of poverty.  Leslie Boissiere with the Casey Foundation explains both state and federal Child Tax Credit programs are critical to eliminating structural inequities in the tax code.Leslie Boissiere  4:53  We are excited and grateful that lawmakers passed the expansion, and we're calling on them to make that expansion permanent. We'd like to ensure that we don't have the largest-ever one-year reduction in the number of children who live in poverty, followed immediately by the largest-ever one-year increase.Nadia Ramlagan  5:10  She adds more than half of Black children have historically been ineligible for the full Child Tax Credit because their household incomes are too low, compared with 25-percent of white children. For North Carolina News Service, I'm Nadia Ramlagan.Lily Bohlke  5:30  Groups advocating for clean energy say Governor Roy Cooper's recent commitment to expanding North Carolina's offshore wind capacity will bring economic benefits to the state. North Carolina has among the highest offshore wind-energy potential in the nation, with its long coastline and shallow outer-continental shelf. Jaime Simmons, with the Southeastern Wind Coalition, says in addition to being a carbon-free source of power, expanding offshore wind could create tens of thousands of new jobs.Jamie Simmons  6:00  Some of these major location decisions are being driven in large part by the states or regions with anticipated projects. So these development goals set by Gov. Cooper make a much stronger case for these manufacturers to locate and invest in North Carolina.Lily Bohlke  6:16  North Carolina is facing a 10-year moratorium on all offshore energy leasing starting in July of 2022. Simmons says pending legislation would exempt offshore wind from the ban. In the meantime, she says there's work to do to get existing wind-energy areas ready for leasing – Wilmington East and West in the southern part of the state – and prepare for development of new projects to start immediately when the moratorium ends. Simmons says offshore wind will be an essential part of the move toward a carbon-free grid – and that it marries well with solar energy. When solar starts to produce less in the day, around early evening, offshore wind usually is blowing the strongest. She adds that the high generation capacity of individual offshore wind projects is key.Jamie Simmons  7:04  You're really talking about rethinking what baseload power means. Offshore wind is really the only renewable energy that could replace the capacity from a coal facility or natural-gas facility.Lily Bohlke  7:19  Cooper's proclamation outlines targets for offshore wind energy of 28-hundred megawatts by 2030 and 8-thousand megawatts by 2040. His administration notes 8-thousand megawatts could power more than 2-million homes. The order also aligns with the state's clean-energy plan signed in 2018, which aims to reduce power-sector greenhouse gases 70-percent by 2030 and to achieve carbon neutrality by 2050. For North Carolina News Service, I'm Lily Bohlke, reporting.Elizabeth Esser  7:54  I'm Elizabeth Esser with WKNC 88.1 Eye on the Triangle. Joining us today is Santisha Walker, a certified nurse, entrepreneur, speaker and author based in Durham, North Carolina. We discussed her fitness apparel and wellness brand, the I Am experience. Santisha, thank you so much for joining us on Eye on the Triangle. Santisha Walker  8:13  You're welcome. Thank you for having me, Elizabeth. I'm excited to be here.Elizabeth Esser  8:18  So you wear many hats. You're a certified nurse and entrepreneur an author, speaker. Would you mind telling our listeners a bit about your professional background and how you got to where you are today? Santisha Walker  8:29  Sure. So yes, I am a registered nurse. I've been a nurse for seven years, I actually received my nursing degree from Wake Technical Community College here in Raleigh. And then I went on to get my master's in nursing from Gardner Webb University. And so as far as my nursing background, I have worked at Wake med, I was a cardiac nurse on intermediate step down unit, I worked at a private practice in Raleigh for neurology, I've done homecare, supervisory visits, I've worked in assisted living, long term care and rehab. So I have a really broad knowledge of nursing. And as you know, I'm not your typical traditional conventional nurse, I believe in stepping outside of the box and using my nursing knowledge to help others outside of the bedside setting. I'm also a wellness coach. And so I thought it would be great to pair wellness knowledge with my nursing health care information that I have and then make you know the best of that and be able to help others outside of that setting. I am here from the Raleigh Durham area and I reside here at RTP. And so I try to reach out to the community and partner with others who are making a difference in the lives of others as well in the healthcare wellness setting. So I have a broad range of knowledge. Elizabeth Esser  9:43  So what is the I Am experience and and what inspired you to create it?Santisha Walker  9:48  Sure, so the I am experience. So my mission with that is to basically offer individuals a fitness and wellness experience that's going to empower them to intentionally cultivate the best version of themselves and reflect it out to the world. And so my vision was to offer a fitness apparel from a quality brand that everyone can trust. And then also tag on to that wellness products that they can use while they are actually working on their physical body. And so where this idea came from, I actually came to me during the pandemic, right, everyone was home, we were all going through a lot. myself as a nurse, I was still actually helping in the bedside setting, doing what we call PRN, helping in different COVID units in the area. But when I was home, I actually decided to focus more on my actual fitness and physical fit as far as my physical body. And so I began working out more. Before the pandemic, I would go to the boxing gym and try to work on my body, but I got really lazy with it. So I decided to incorporate more physical activity for myself. But also I want it to center myself emotionally, spiritually and mentally, right. And so with every, at every news station, every time we turned around, there was something negative being mentioned or or new breaking news, I should say about Coronavirus, and about COVID and about the number of deaths and so it was taking a toll on everyone, including myself. And so what I wanted to do was become very still very centered. And so I begin positive self talk, I begin to incorporate heavily, I was doing it before, but I really want to focus on positive affirmations. And so during my workout sessions, which I would work out early in the morning, go ahead and get it done for the day, I began playing affirmations in the background. So while I was doing my HIIT Workout, I had affirmations going. And that really helped me during that vulnerable time when I was working out to center my mind and to speak to myself in my body. And I just took it from there. So I thought you know, what, if this is helping me Who else could this actually help? You know, because when we working out that's a very, it's empowering, but it's also very vulnerable, right? Because you're questioning yourself, can I do this, I have to reach this goal, I have to feel better. So you're vulnerable, but you're also empowering yourself to keep going and push past that threshold. And so that that's when it came to me, you know, it would be really cool to you know, come up with an apparel that people could actually put on when they can actually when they see themselves in that apparel, they will be empowered, right. But then also add products or add something to that, that would allow them to continue with the empowerment, mind body, soul and spirit. And so that's where it came from my husband's nonprofit organization, Carolina united flag football club, they actually had access to Nike apparel, and so I tapped into his resource and I was able to get great you know, quality apparel and use you know, use the I Am brand to go ahead and put something great out there for individuals.Elizabeth Esser  13:03  And so I understand that the brand is not just a fitness apparel brand. What all does it offer?Santisha Walker  13:10  Yeah, great, great. Okay. So this is this is the fun part right because there are several fitness apparel you know, you can athleisure is everywhere. But the thing that says that I am experienced a part is we offer an I am fitness wellness kit, right so that I Am exclusive wellness kit is basically 10 subjects that those who purchase the apparel can choose from it's complimentary. And so you choose one of those subjects with your apparel purchase. And I'm actually sending you information based on my nursing and wellness knowledge that will help you to incorporate that into your life. So there are daily practical guides, they're invaluable resources that are reputable that you can you can believe and trust in, there's evidence based information that's provided on that particular topic. So each time you purchase an apparel, you can choose a new topic to go along with your apparel. So that I am exclusive wellness kit will be included with your package with your actual apparel that you receive at your doorstep. Okay, so another product that I included was the I Am energy workout mix. This was this was a really fun project. And again, like I mentioned before I was working out right but what I wanted to do was put I am affirmations on top of energizing beats So when we work out we want something that's just going to keep us going and especially when we reach that peak, right, we have to push to that threshold. And so what I wanted to do was incorporate Im affirmations with energizing beats so that you can actually listen to it for while you're working out. So it is a 30 minute audio. And so these are professionally engineered beats that are done by the professionals. I know nothing about studio work. So I reached out to Hatton Brandon CO and they were able to reach out to their resources their team and put together the I am energy work out there. And so again, that's complimentary. It comes with your apparel, you can only get it once you purchase your apparel. But that's actually to help your mind stay in that positive mindset while you're working out. And I actually had some someone reach out to me and she said, You know what, I actually listened to it after I finished my workout. And so that you can carry it into your everyday activities. And the other, the other, this is not really a product. But the other thing that I offer is I am empowered private group. And so that is a private Facebook group, you have to have an entry code, you have to answer questions to be able to get in. But once you purchase your apparel, then you actually get access to that group to be held accountable, and to be empowered on a daily and weekly basis. And so it's not just me posting information as a healthcare professional. But it's those that are in the group, were asking questions, Hey, what are you guys doing about this? How are you guys being empowered this week? This is what I'm doing. Right. One of the things I posted yesterday was Hey, guys, like I had a little bit too much sugar last week, and, and I didn't really take in as much water this week, I am, you know, being held accountable to drinking more water. And so they hold me accountable to that. So yeah, I wanted to definitely partner wellness products,Elizabeth Esser  16:15  and you have a background in healthcare and business. And you've been able to successfully merge these two passions in your career. Was creating a brand like the I am experience always a goal of yours? Or is that something that just happened along the way?Santisha Walker  16:31  Great question. So it happened along the way. You know, if you do a little bit of research and background on me, I am a true like, nurse entrepreneur, what we call nursepreneur. And so I consider myself a serial entrepreneur, because I love taking ideas, I love taking things and my creativities and bringing them to a full finished work and bringing them to fruition. And so no, I it's so funny, I had never envisioned myself, even launching a fitness line, right. But I have a business degree. And I always tell this story. I have a business degree. And I concentrated in marketing. But I never envisioned that I would be an entrepreneur. And I know that's like an oxymoron it's contradictory. But when I went to college back in 2001, you know, I didn't know what I wanted to do what to major is I said, Hey, if I get a business degree, I could always use it at some point in life. And then after graduating I in college, I kind of had an idea. I wanted to be a nurse, but I was close to graduating. So I graduated. But becoming a nurse, I didn't become a nurse to even partner the two worlds. It wasn't until later I realized, oh my god, I have all of this knowledge, I have a business degree. And my husband actually brought that idea of, you know, going into consulting and starting my own business. And so eventually I'm merged the two. So I did not set out to be a serial nursepreneur, I did not set out to launch, you know, a fitness line, I do believe in submitting my mind, my body and my will to the will of God, my Creator. And I do believe in allowing him to order my steps. And so throughout life, life is very secure. You know, very, you know, it's a windy road. And so I just believe in just following him and doing what he's telling me to do. And it's been a success so far. Success, meaning I have empowered a lot of people along the way. That's how I measure my level of success. So, you know, no, I didn't set out to do it. But I did. I do believe in not being boxed in and just you know, submitting myself to God and letting him use me in that way.Elizabeth Esser  18:38  And as a registered nurse yourself, you have a specific passion of empowering nurses professionally and in life. How have nurses and other health care professionals responded to the I am experience?Santisha Walker  18:51  Yeah, so they responded great. I actually had a giveaway I launched actually the day like nurses week was my first inaugural launch of the brand. And so I had nurses like reach out to me that was actually a giveaway that I offered. And one of the one of the nurses won, but they've responded positively. I will say just in general, nurses are amazing. We're the powerhouse of healthcare. And I'm happy to see that we are moving along and becoming used to nurses operating outside of that traditional setting. But it's it is still a pool every once in a while to get nurses to see another nurse operating outside of just having all scrubs and starting IVs and running to codes. And so I have had a positive response. But I think as nurses hear more about this and realize, Hey, you know, this is something you guys can tap into as well. I think there will be even more a better response but so far it's been it's been good. I actually have a nurse who was a part of our inaugural launch. And so she has actually been putting it she's a she's an ER nurse at Wake med and she's actually been she's an ambassador. And she's been putting helped me get the brand out to other nurses as well. Elizabeth Esser  20:05  When is your next release?Santisha Walker  20:07  Yeah, so my next release is actually, this Friday, June the 25th. I'm not sure when this will air, but it is June the 25th. And so I release the fourth Friday of every month. And so if you missed the first release, or the most previous release, you can also always subscribe and then you'll get a heads up with that next release is coming. So the 25th of June is my next release. And the releases are available only for one week. And so you have to almost get in there why you can you know, while the getting is good. And then once that, that that seven day is over, then the next release is not until another three or four weeks.Elizabeth Esser  20:44  And finally, where can listeners find your merchandise? Santisha Walker  20:47  Yeah, so they can find it at WWW.theIAMexperience.shop So that is the I am experienced dot shop. And then once they go there, they can see all of the amazing information and yeah, all the good stuff.Elizabeth Esser  21:04  Santisha, thank you so much for joining us.Santisha Walker  21:07  You're welcome Elizabeth, thank you so much for having me.Eoin Trainor  21:11  And that is it for this episode of Eye on the Triangle. Thanks for tuning in. If you have any questions, comments, ideas or would like to get involved, shoot us an email at public affairs@wknc.org. We'd love to hear from you. Stay tuned for usual programming. We'll see you next time.

Healthy Wealthy & Smart
547: Dee Kornetti & Cindy Krafft: Maintenance Therapy in the Home

Healthy Wealthy & Smart

Play Episode Listen Later Jul 1, 2021 53:01


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.  

The Personal Computer Radio Show
The Personal Computer Radio Show - 06.30.21

The Personal Computer Radio Show

Play Episode Listen Later Jun 30, 2021 54:00


The Personal Computer Show Wednesday June 30, 2021 PRN.fm Streaming On the Internet 6:00 PM Eastern Time IN THE NEWS o John McAfee Died Hours after Spanish Court Authorized Extradition o Windows 11 Minimum Hardware Requirements o Windows 11 Requires Use of TPM 2.0 Chip o Windows 10 vs Windows 11 Differences o Microsoft Windows 11 Frequently Asked Questions IT Pro Series by Benjamin Rockwell o Ranking People, Info, Infotech From the Tech Corner o The Pentagon's UFO Report to Congress

PRN - Fast Talk Podcast
EP 2127: Bowman and Busch take victories in Pocono

PRN - Fast Talk Podcast

Play Episode Listen Later Jun 28, 2021


The Pocono doubleheader is in the books and the winners were Alex Bowman and Kyle Busch! Doug Rice is joined by PRN's Alexis Erickson and Brad Gillie, plus it's the in-studio return of NBC's Kyle Petty! After a miserable few weeks, Kyle Busch overcame a lot to win on Sunday, while Kyle Larson's remarkable winning streak crashed and burned in Pocono's Turn 3. And speaking of Hendrick Motorsports, where is Chase Elliott these days? We also preview the Quaker State 400 at Atlanta and Kyle shares the story about how he played the Grand Ole Opry.

The Personal Computer Radio Show
The Personal Computer Radio Show - 06.23.21

The Personal Computer Radio Show

Play Episode Listen Later Jun 23, 2021 55:00


The Personal Computer Show Wednesday June 23rd 2021 PRN.fm Streaming On the Internet 6:00 PM Eastern Time IN THE NEWS o Drought-Stricken Communities Push Back Against Data Centers o Gaming is a Serious $159 Billion Industry o Texas Power Companies are Remotely Raising Temperatures on Residents' Smart Thermostats o 65% of Americans Have a Smart Home Device o What Happened to Curved TVs? IT Pro Series by Benjamin Rockwell o Stay Out of Work Politics From the Tech Corner o Should You Buy Refurbished Electronics? o Winners and Losers of the Work-From-Home Revolution

DIY Writer Podcast
Madilyn Dale #109

DIY Writer Podcast

Play Episode Listen Later Jun 22, 2021 43:46


About Madilynn Dale Madilynn Dale is an author based out of Oklahoma City, Oklahoma, U.S. She writes fantasy, romance, and paranormal pieces primarily. She spends most of her day with her son, tending to her pets, and writing. Madilynn holds degrees in several areas. She has a Bachelor's Degree in Kinesiology from Southern Nazarene University, located in Oklahoma. She also has an Associates of Science degree in Physical Therapy Assistant Sciences from Oklahoma City Community College. She is licensed as a Physical Therapy Assistant in Oklahoma and works as a PRN therapist. Madilynn has enjoyed reading various forms of fiction and the occasional non-fiction story since she began reading as a young girl. Writing seemed to be another piece of this addiction to books, and she embraced it after becoming a mother. Writing is now a piece of her soul to be bared to the world. Madilynn's hobbies, when not writing, include reading, baking, crafting, hiking, and horseback riding. She loves to travel and explore. One day she hopes to expand her travels and see the world, but in the meantime, you will find her working on her next novel. She will most likely have coffee and some form of chocolate with her as she writes. Madilynn's work can be found at her website www.thechaptergoddess.com. She has published work on various sites, including Amazon, Smashwords, Barnes & Noble, iBooks, and Lulu. She can be found on Bookbub and Goodreads. She may also be found on various social media forms, including Instagram, Facebook, Twitter, Snapchat, and TikTok. Newsletter signup: https://mailchi.mp/fc8a19b1f915/the-chapter-goddess-email-sign-up

SLP Full Disclosure
Tech Ideas for On-Site & Teletherapy – Katie Walters MA, CCC-SLP

SLP Full Disclosure

Play Episode Listen Later Jun 21, 2021 51:21


On this episode, we had a very informative conversation about teletherapy resources for the major platforms—Google Meet and Zoom—along with some alternative options. Our special guest, Katie Walters MA, CCC-SLP, used her wide-ranging speech therapy experience to share her favorite activities, websites, and extensions, including Web Paint for Google Meet, Boom Cards for Zoom, Universal Design for Learning (UDL), and more. This show is made possible by Med Travelers. If you're interested in exploring a career in allied travel, visit: https://www.medtravelers.com/getting-started/become-an-allied-traveler/to learn more about the nationwide opportunities they have to offer!We Discuss(0:00) Show introduction and Katie's background(12:10) The basics of using Google Meet as a teletherapy platform (24:41) Using Google Meet with a Chrome Remote Desktop(27:13) The Web Paint extension on Google Meet(29:47) The Annotate Meet extension on Google Meet(32:46) Ultimate SLP for Zoom teletherapy(34:51) Boom Cards for Zoom teletherapy (37:34) Simply Speaking for Zoom teletherapy(40:05) Epic Books for Zoom teletherapy(42:55) Universal Design for Learning (UDL) resources(46:36) Jam BoardsAbout Katie Walters MA, CCC-SLPAfter leaving her previous career in theater, Katie got her CF in both a school setting and a private clinic in Florida. She knew she wanted to experience as many different areas as possible in the field to find her niche, so she sought out work in every setting afterward. She did PRN work at an inpatient rehab hospital, worked at an SNF, worked on the assistive technology team with a school district and with self-contained classrooms at the high school, PRN work in acute care, SLP for elementary students, SLP for self-contained medically fragile classrooms and Autism support classrooms, teletherapy for elementary, middle, and high school students, and on—everything but Home Health. Her therapy areas of interest are working with students who are Deaf or Hard of Hearing, Assistive Technology, and Neuro-Cognitive impairments (congenital or acquired), but she loves it all. Katie currently lives in Knoxville, TN with her husband and two pups, Rosie, and Gracie. She loves hiking, walking/playing with the dogs, digging in the dirt, and planting flowers; just being outside. She hopes to travel again, soon!To learn more about Katie's amazing resources, explore these websites and tutorials:Web PaintUltimate SLPEpic BooksPear DeckGoogle SlidesJam Board TutorialChrome Remote DesktopSnap&Read, CoWriter, and Word BankSimply SpeakingAutism Internet ModulesBoom CardsAnnotate MeetFind Us On Website - https://www.medtravelers.com/slpfulldisclosure/Instagram - https://www.instagram.com/slpfulldisclosure/YouTube - https://www.youtube.com/slpfulldisclosure/Apple Podcasts – http://bit.ly/slpfulldisclosureappleSpotify – http://bit.ly/slpfulldisclosurespotifyAbout the ShowProducer – Jonathan Cary Assistant Producer – Katie SchraubenShow Notes – Sam MacKay Music & Editing – Aidan Dykes Powered by Med Travelers

Southern Race Week
SRW Podcast Season 2 Episode 21

Southern Race Week

Play Episode Listen Later Jun 21, 2021 31:43


On this episode of #SRWPodcast - #ShortTrack driver JoJo Wilkinson talks how Instacoat Premium Products is helping her continue at #BMRRacingAcademy, NASCAR #CupSeries Driver for Stewart-Haas Racing Cole Custer talks how he got into racing, and PRN's At the Track's Lenny Batycki has #ShortTrackNews from weekend of June 18th, 2021

The Personal Computer Radio Show
The Personal Computer Radio Show - 06.16.21

The Personal Computer Radio Show

Play Episode Listen Later Jun 16, 2021 54:00


The Personal Computer Show Wednesday June 16th 2021 PRN.fm Streaming On the Internet 6:00 PM Eastern Time IN THE NEWS o Google Makes Workspace Free for Everyone o Federal Judge Puts NY State $15-A-Month Internet Law on Hold o Verizon Expands Return Policy to 30 Days o Apple's Tightly Controlled App Store is Teeming with Scams o Apple Admits Why its Own Files App was Ranked First o JBS says it Paid $11 Million Ransom after Cyberattack o Nikon to End Camera Production in Japan o eBay and PayPal Finally Break Up for Good IT Pro Series by Benjamin Rockwell o A Lifetime of Learning From the Tech Corner o Amazon Prime Day June 21-22 o ATT Donates $2 Billion to Help Bridge the Digital Divide

Organic Gardener Podcast
364. Replay of Brandon Youst's interview from the Bootstrap Farmer

Organic Gardener Podcast

Play Episode Listen Later Jun 14, 2021 86:12


So I was checking out the recording of this interview to post to PRN and realized there's about a 2 minute blank spot at the beginning of the interview so I'm reloading it here. Sorry!!!! Brandon was Season 3's teaser released on New Year's Day and what a game changer this was for me this winter. If you've ever thought of starting a value added product business or any kind of garden business Brandon's got courses to help you succeed. I'm still trying to perfect my salad in a jar lunch club and I feel this is a great time to be re-releasing this because one of the most impactful things you can do for climate change in Joan Gregerson's book is create a food waste lunch club. Thanks always for listening everyone. For more info check out the show notes here: https://organicgardenerpodcast.com/podcast-2/362-bootstrap-farmer-podcast-brandon-youst/ (https://organicgardenerpodcast.com/podcast-2/362-bootstrap-farmer-podcast-brandon-youst/) Support this podcast

PRN - The Pit Reporters Podcast
EP 2124: Kelly Crandall of Racer.com, and Rob Albright of PRN

PRN - The Pit Reporters Podcast

Play Episode Listen Later Jun 9, 2021


Larson stages another rout at Sonoma, and will Texas make the All Star Race bigger? Kelly Crandall of Racer.com, and Rob Albright of PRN join host Brett McMillan.

Southern Race Week
SRW Podcast Season 2 Episode 19

Southern Race Week

Play Episode Listen Later Jun 7, 2021 32:00


On this episode of #SRWPodcast - Kevin Lee of NBC Sports covering NTT IndyCar Series recaps #Indy500, Host of PRN's At the Track Lenny Batycki has the latest #ShortTrackNew, and #Promoter of Oglethorpe Speedway Park Randall Jenkins discusses the closing of the track from weekend of June 4th, 2021

I Need (Travel) Therapy
Everything to Know About Traveling for Your Clinical Fellowship – Jennifer Martin MS, CCC-SLP

I Need (Travel) Therapy

Play Episode Listen Later Jun 1, 2021 59:04


Notes (Time Stamped):This show is made possible by Med Travelers. If you’re interested in exploring a career in allied travel, visit: https://www.medtravelers.com/getting-started/become-an-allied-traveler/to learn more about the nationwide opportunities they have to offer!We Discuss(0:00) Show introduction—Information on our re-brand and social media accounts(1:14) Introduction to Jennifer and a brief overview of her SLP career(2:05) The difference between working as a contractor vs. as a permanent employee(3:39) The process for doing your CF with a travel therapy company(6:40) A look at the current CF job market(11:22) Doing your CF in a medical setting(16:35) Doing your CF in a school setting(19:01) Why starting your CF in a school setting can be beneficial(24:45) PRN side work during a school setting CF year(30:37) A typical day in the life of a school CF(39:43) What supervision looks like in the school and medical settings(48:52) The Med Travelers CF Program(53:56) Advice for current and future CFsAbout Jennifer Martin MS, CCC-SLPJennifer Martin is currently the Senior Director of Teletherapy at AMN Healthcare and is the host of the SLP Full Disclosure podcast. Before becoming an SLP, she got her bachelor’s degree in Speech-Language Pathology at the University of New Mexico and her masters of Audiology and Speech-Language Pathology at Northern Arizona University. About the ShowProducer – Jonathan Cary Assistant Producer – Katie SchraubenShow Notes – Sam MacKay Music & Editing – Aidan Dykes Powered by Med Travelers

PRN: Pause, Renew, Next
Change, Culture, and Calling: with Melissa Lewis

PRN: Pause, Renew, Next

Play Episode Listen Later Jun 1, 2021 31:08


This is the last episode of Season 3, and PRN is ending this season with a fantastic guest, Melissa Lewis. In this episode, Melissa and I talk about her nine-year career working in Costa Rica. She shares about culture, food, missions, and life change. Recently, Melissa moved back to the U.S. and has begun a […]

The P.T. Entrepreneur Podcast
Ep402 | The Top 2 Reasons People Are Opening Cash Practices

The P.T. Entrepreneur Podcast

Play Episode Listen Later Jun 1, 2021 53:37


Overwhelmingly, we have seen 2 main reasons why people are opening cash practices. 1. They are frustrated that they can't use their skill set the way they want to. 2. They can't make over 100k without working home health, PRN, being a clinic director or working multiple jobs. Ultimately, these two reasons lead to what we think is the biggest reason people continue to run their businesses.....Freedom. Freedom to win. Freedom to fail. Freedom to take their life whatever direction they want. Yves and I take a deep dive on this topic and hopefully it helps you gain some clarity.

PRN - Fast Talk Podcast
EP 2123: Larson Wins Coca-Cola 600. Doug Rice, Alexis Erickson, Mark Garrow

PRN - Fast Talk Podcast

Play Episode Listen Later May 31, 2021


The Coca-Cola 600 saw Kyle Larson and well, that's about it, as he dominated to win his second race of 2021 and first crown jewel event in his career! Doug Rice is joined by PRN's Alexis Erickson and Mark Garrow to recap NASCAR's longest race that saw Hendrick Motorsports make history. Speaking of HMS, which team is best in class behind the Hendrick gang? Plus, we have highlights from the 600, recap a thrilling Indy 500 that saw Helio Castroneves join the four-time club and discuss the legacy that Rick Hendrick has made since winning his first race on a shoestring budget in 1984.

Sports Medicine Broadcast
David Silverstein saved a life

Sports Medicine Broadcast

Play Episode Listen Later May 26, 2021 51:55


David Silverstein has been an Athletic Trainer for 12 years and has yet to need his CPR skills. That all changed in an instant as his actions helped "Z" survive long enough for the EMS to arrive and take over. David, you just recently saved a life.  Tell us the story. SCA leading cause of death in exercising athletes typically caused by underlying structural or electrical conditions. 75% of deaths occur in football, basketball and soccer. Male and African Americans are at highest risk. Survival declines 10% each minute waiting for defibrillation. Early defibrillator increases survival chances by 80%Eyes rolled back, brief seizure-like activity and agonal breathing was distracting and those were all the signs pointed out in the video.   Differentiated from EHS or sickle cell in that SCA is sudden without signs of struggling or exhaustionAny athlete who has collapsed and is unresponsive should be assumed to be in SCA until proven otherwise or another cause of the collapse clearly is identified. What is your prior experience using CPR? None other than teaching and getting certified. I first took the class when I was in undergrad. Tell us some more of your Athletic Trainer Story. Graduated from MSU during the internship era. GA @ CCF Got out of Athletic Training and came back to it after 5 years. Served mostly in high school settings but working at a DC office now while doing a lot of PRN coverage. How did you process the situation afterward? Didn’t want to be there Replayed events in my head to see if I performed up to par What are you going to change because of this event? EAPs 1E. Every school or organization that sponsors athletics should develop an EAP specifically for managing serious and/or potentially life-threatening sport-related injuries (athletic EAP) 2E. The athletic EAP should be developed and coordinated with local EMS, school public safety officials, on-site medical personnel or school medical staff, and school administrators 3E. Every school should distribute the athletic EAP to all athletic staff members 4E. The athletic EAP should be specific to each venue (including maps, directions, etc) 5E. On-site emergency equipment that may be needed in an emergency situation should be listed 6E. The athletic EAP should identify personnel and their responsibilities to carry out the plan of action with a designated chain of command 7E. Appropriate contact information for EMS 8E. The athletic EAP should specify documentation actions that need to be taken after an emergency  9E. The athletic EAP should be reviewed and rehearsed annually by all parties involved 10E. Health care professionals who will provide medical coverage during games, practices, or other events should be included Call to action: Drill EAPs more often TUFSS AT Cares More consistent hours at Shaw Resources from David Silverstein: https://uwsportscardiology.org/ Contact Us:

Southern Race Week
SRW Podcast Season 2 Episode 17

Southern Race Week

Play Episode Listen Later May 24, 2021 32:16


On this episode of #SRWPodcast - EVP & GM of Charlotte Motor Speedway Greg Walter talks #CocaCola600, Host of PRN's At the Track Lenny Batycki has the latest in #ShortTrackNews, and #ShortTrack driver Grant Thompson recaps his #LateModelRacing debut at Wisconsin International Raceway from weekend of May 21st, 2021

Doctor Me First
285: How to Start a Super Crazy Business and Go PRN Clinically - Part 6

Doctor Me First

Play Episode Listen Later May 24, 2021 23:26


This has truly been an amazing series. We started out talking about how to go about creating your business, now let’s get into the nitty gritty. Contracts, taxes, and making sure that you’re setting yourself up for financial and mental success.    First things first, taxes. I know. It seems super scary to have to step out and handle your own taxes rather than being paid through a W2 and just having them taken out. But here’s the deal, if you create a financial plan and remember to simply put back money for taxes, you’ll be fine.    In fact, knowing that you need to take out money for taxes and insurance, use this information going into your contract negotiations. Don’t short yourself and later realize that you didn’t think of those expenses. Before you ever leave your current job, ask for the information on what you and your employer pay and then factor that into your contract rate.    Also, don’t be afraid to have someone who is well-versed in medical contracts go over yours before you sign. You have the right to have the contract reviewed to make sure it says and covers exactly what you think it does. Protect yourself and know your rights.    The only person who is negotiating for your life and career is you. Know what you want in both and make sure that you only settle on things that aren’t non-negotiables.    Listen in to hear all of my tips and advice as well as my responses to questions I’ve received as this series has progressed! If you want to change your life, then listen to the whole series and really think about whether or not this is the right route for you!   “If you don’t ask, it’s an automatic no.” Dr. Errin Weisman In this episode: [02:12] Welcome to the last installment of this series! [02:38] I want to talk about taxes first, the differences between being an employee with a W2 and a contractor with a 1099 form. [06:30] Use this information as a tool when you go into negotiations. [08:08] Now let’s talk about contract reviews. [08:31] Make sure you ask for what you want. The worst thing that can happen is that they will say no. [09:14] Find someone who specializes in contracts to go over your contracts. [10:16] When it comes to negotiations, the only person who is going to negotiate your contracts is you. [11:38] Marketing strategies are a very important part when looking for PRN work. [12:01] Get on LinkedIn when looking for PRN work. [12:44] If you are thinking about coaching, come over to Physicians Coaching Alliance. [13:19] Listen as I share the two different timelines you need to make. [14:35] Diana wants to know how you balance clinical PRN work with starting your new business? [15:35] Delegation and outsourcing is an important component when you are working PRN, launching a new business and spending time with your family. [16:38] It’s so important to minimize the parent's guilt when you are making this transition. [18:23] If this series has been helpful, let me know. [18:52] Thank you for listening!   Links and Resources Physician Financial Services  Physicians Coaching Alliance Episode 273 Quitting Your Job Almost Guilt Free Episode 178 Empowerment with Anu Murthy   3 WAYS TO GET INCREDIBLE HELP AT LOW-COST!!! Buy my Kindle Book, Doctor Me First, on Amazon Join us for our Monthly Burnout Masterclass Series. Sit with me in my Slack Channel. Schedule a call with Errin HERE Find out more about sponsoring an episode HERE Email Errin HERE

Financial Residency
Why You Should Get Clear on How to Pay for Your House

Financial Residency

Play Episode Listen Later May 21, 2021 30:22


Wall-E and Eve (or EV-A), two amazing community members, are focused on getting a house as soon as possible. However, Ryan and Kayse don't understand why they can't already buy a house now based on all the money they have in savings!  They could honestly have every bank clawing to lend them money!    Reach out to Panacea Financial for your banking needs as a physician. Panacea’s PRN personal loan was designed specifically for physicians and physicians in training. Go to https://panaceafinancial.com/ and open your new account today. Panacea Financial is a division of Primis, Member FDIC.

BS Free MD with Drs. May and Tim Hindmarsh
#20: The Doctor As Patient: Widowmaker

BS Free MD with Drs. May and Tim Hindmarsh

Play Episode Listen Later May 20, 2021 45:02


What if you were walking to work in the morning and your life suddenly changed? Do you have everything in place to protect your assets, your family, your future plans? Sometimes physicians are taken by surprise when they become the patient, and denial is something we are all vulnerable to  This weeks continuation of the Doctor as Patient series is a wild ride of how we can  instantly be facing our own mortality. Our special guest this week is also our own family member, Tim's brother in law, Dr. Larry Adam.  Dr. Adam is a retired Family Practice physician with over 35 years serving his patients and community in British Columbia, Canada area. He graciously shares with us his story and how his faith was his key in dealing with his imminent heart attack,and struggles post MI. You will be touched by his moving story of life, faith and survival.  Thanks to our sponsor this week! Check out Panacea Financial for a great banking options for physicians.  Panacea's PRN personal loan was designed specifically for physicians and physicians in training. Go to panaceafinancial.com and open your new account today. Disclaimer All opinions expressed by the guest in this episode are solely the guest's opinions and do not reflect the opinions of May or Tim Hindmarsh MD or BS Free MD, LLC  or any affiliates thereof. The guest's opinions are based upon information they consider reliable, but May and Tim HIndmarsh, MD, BS Free MD  LLC, nor any affiliates thereof warrant its completeness or accuracy. The guest, May and Tim HIndmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Stay in the loop with us: Thanks for joining us! You are the reason we are here.  If you have questions, reach out to us at doc@bsfreemd.com or find Tim and I on Facebook and IG. Please check out our every growing website as well at : bsfreemd.com (no www) GET SOCIAL WITH US! Instagram:: https://www.instagram.com/bsfreemd/ Facebook: https://www.facebook.com/bsfree If you prefer to listen on Spotify → Click here! If you are an Apple Podcast listener → This link is for you! Don't forget to Rate & Review on Apple Podcasts!

Financial Residency
The Closest Thing to Passive Income in Real Estate with Dr. Cathy Carroll MD, CFA

Financial Residency

Play Episode Listen Later May 18, 2021 35:12


Ryan invited on physician and real estate syndicator Dr Cathy Carroll to do a deep dive in the pros and cons of investing in real estate via syndications. By the end of this show you will know if real estate investing belongs in your portfolio or not. Comment in the community chat www.financialresidency.com/community with your real estate plans! Reach out to Panacea Financial for your banking needs as a physician. Panacea’s PRN personal loan was designed specifically for physicians and physicians in training. Go to www.panaceafinancial.com and open your new account today. Panacea Financial is a division of Primis, Member FDIC.

Doctors Unbound
Sleep, Nutrition, and Exercise: Medicine Redefined

Doctors Unbound

Play Episode Listen Later May 17, 2021 26:41


Taking physical medicine and rehabilitation to the next level these former athletes, Dr. Altamash Raja and Dr. Darsh Shah, are reaching new heights with their podcast Medicine Redefined. Fellow members of Doctor Podcast Network, these two residents are making big waves in the world of physician podcasting helping to educate their listeners on everything from sleep to nutrition. They share their ‘unbound’ journey from sports to medicine to podcasting. Reach out to Panacea Financial for your banking needs as a physician. Panacea’s PRN personal loan was designed specifically for physicians and physicians in training. Go to https://www.panaceafinancial.com and open your new account today. Panacea Financial is a division of Primis, Member FDIC.  Get an in-depth, actionable plan for your website, marketing, and SEO. Get ahold of Baker https://www.bakerlabs.co/doctorsunbound

Doctor Me First
283: How to Start a Super Crazy Business and Go PRN Clinically - Part 5 with Dr. Dena George

Doctor Me First

Play Episode Listen Later May 17, 2021 49:24


It’s time. It’s time to bring another amazing doctor into this discussion on how to go PRN clinically and start your own super crazy business, and I could think of no one better than Dr. Dena George. Listen as we chat about why it’s very possible for you and what you should be focused on to make this dream happen!   Dr. George is an amazing physician but she’s also a coach for physicians. We’ve worked together in the past and there is nothing but love all around because we’ve both seen a new way to act on our passion and our calling.    Since I started this amazing series, I’ve had several people write in and ask questions about how to get started, how to market, and where to find clients. Dr. George is here to help me answer them.    You know how so often people ask about getting started and the answer is just to start? While that’s true, it helps to have mentors in the space who can help guide you in this. That said, when it comes down to it, you have to have the confidence to start doing the work.    You don’t need extra certifications. You don’t need a website. You don’t need fancy software and a built out sales funnel. You need to figure out what you want to do in your business, learn all that you can about the online space, and network your butt off.    Where can you find clients? EVERYWHERE!   This was truly an amazing conversation. Dr. George even shares the five roadblocks she sees so many physician entrepreneurs stumble into. Listen in to hear those as well as how to avoid them. If you have questions for us, send them on in!   “I firmly believe that clear and focused physicians change the world.” Dr. Dena George In this episode: [02:20] Welcome to the show Dr. Dena George! [03:32] We are going to answer some questions that have been asked since the series started. [03:48] The first question is ‘how do you get started in coaching and where do you get started?’ [04:12] Dr. George says the way you get started is get started. [08:19] You don’t need extra certifications or an extra degree because nobody ever asks. [10:45] Another question is from someone new in business and they want to know how to put themselves out there. [14:44] You do not have to have a website to put yourselves out there. [16:06] The only requirement for marketing is to tell people what you know and how you can help them and then offer to help them. [17:44] “Where are the clients?” [20:44] Hear Dr. George’s five stumbling blocks for entrepreneurs. [21:04] #1 Trying to speak to everyone. [23:57] #2 Judgement. [27:06] #3 Comparison. [31:32] #4 Hustle. [36:18] Listen as we discuss PCA, Physicians Coaching Alliance. [37:39] #5 Overcomplicating. [42:52] When it comes to entrepreneurship, it’s not failure, it's feedback. [44:06] Thank you so much for being on the show! [44:50] Here is your kick of encouragement.   Links and Resources Panacea Financial Physician Coaching Alliance   Find Dr. Dena George Dena George MD, Coaching Create An Unstoppable Life Podcast Facebook | Instagram    3 WAYS TO GET INCREDIBLE HELP AT LOW-COST!!! Buy my Kindle Book, Doctor Me First, on Amazon Join us for our Monthly Burnout Masterclass Series. Sit with me in my Slack Channel. Schedule a call with Errin HERE Find out more about sponsoring an episode HERE Email Errin HERE

Doctor Me First
281: How to Start a Super Crazy Business and Go PRN Clinically - Part 4

Doctor Me First

Play Episode Listen Later May 10, 2021 29:27


First, let me say how happy I am that you all have liked this series. If you’re thinking about changing how you work in medicine, then this really is the series for you. Now, the next part is once you have your baby business up and running and taking some of the load of your income, how do you actually start practicing PRN?    There are several things you should consider, but before you do ANYTHING you need to tackle your mindset. Fear is what holds us back from building our businesses and fear is what will keep you stuck.    This same thing applies when you go to talk to your organization about a change in how you work with them. So before you have that conversation, start thinking about what you want your work life to look like.    What are your non-negotiables? Do you need a specific schedule? Need to stop being on call? What do you have to have to make ongoing practice work for you and your family?    Then listen in as we talk about the different negotiation buckets! I’m also tackling malpractice insurance and ways that you can be paid. The thing about being PRN clinically is that you really get to call the shots in a lot of ways.   What specific questions do you have about PRN clinical work?    “Why are we so bad at talking to other humans? If you think about networking as trying to communicate with someone, just try to be interested in someone and try to have a conversation with them, it’s so much easier to make a personal connection with them.” Dr. Errin Weisman In this episode: [02:57] I answer a question from a listener. If you have a question email me at hello@burntouttobadass.com [06:01] Fear is what is keeping you from starting a business. [06:43] Content is any way for which you are spreading your message. [08:30] Are you ready for part 4? [08:54] We are talking about clinical logistics but first mindset stuff. [10:48] Take the time to advocate for what you really want to do. [13:52] The first bucket to look at are your must haves, your non negotiables. [14:54] Next figure out what you would like to have but might be negotiable. [15:30] The third bucket is what would be nice to have. [16:51] You then must think about your malpractice insurance. [20:08] When it comes to you getting paid, the best way is whatever works for you. [23:37] You get to decide how you want to get paid when you do clinical PRN work. [24:51] Thank you for listening and I’ll see you next week for part 5.   Links and Resources MR Insurance Doctor Me First Workbook   3 WAYS TO GET INCREDIBLE HELP AT LOW-COST!!! Buy my Kindle Book, Doctor Me First, on Amazon Join us for our Monthly Burnout Masterclass Series. Sit with me in my Slack Channel. Schedule a call with Errin HERE Find out more about sponsoring an episode HERE Email Errin HERE