Shows
The Conscious Clinician PodcastEpisode 38: Physical Therapist Growth SpurtsIn this episode, we share our growth-spurt experiences as physical therapists. We realized during mentoring that ALL physical therapists experience growth spurts. It’s how we evolve our clinical practice! So long as we keep learning, there will always be periods of change followed by periods that are more steady as we integrate the new information into our practice. We also share our signs of being in a growth spurt and tips for navigating these with less overwhelm!
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a re...2021-11-2114 minThe Conscious Clinician PodcastEpisode 37: When PT Is Not The AnswerWe have spent 36 episodes exploring how to work with someone, build better rapport, collaborate, move past our own and the patient's roadblocks to improving our quality of care and work. We realized that we haven't talked about when PT is not the answer and how we know we need to end care.
In this episode, we explore the reasons why you may choose to recommend discharge, including what we say and examples of how we handle these conversations. We can practice within our ethics AND support the patient to get the care that’s best for them.
2021-11-0139 minThe Conscious Clinician PodcastEpisode 36: Fear Avoidance in Patients & ProvidersIn this episode, we explore fear avoidance. As humans, we all experience fear and some of us exhibit fear avoidance behaviors. As people exhibit more fear avoidance, they also report higher pain intensity levels. This has consistently shown up in pelvic pain, pelvic girdle pain, and persistent musculoskeletal conditions.
We talk through Sammy’s patient who exhibited high fear avoidance and how they began confronting it. We also explore how fear-avoidance influenced Monika’s clinical practice and how often we see this with healthcare providers. It’s not just patients who demonstrate fear-avoidance! In order to do no harm...2021-10-1827 minThe Conscious Clinician PodcastEpisode 35: Telehealth Tips for Physical TherapistsOne of the few positives from the pandemic was the widespread access to telehealth medical services. Our bet is that it’s here to stay. We have been providing telehealth PT since March 2021. We recognize that while it’s convenient for patients and providers, it does change the way we interact with our patients. Additionally, providing telehealth from your own home creates unique challenges for providers.
In this episode, we focus on how to prepare and care for yourself to provide telehealth. We explore the way that communication changes when it’s virtual and we offer tips that ha...2021-10-1036 minThe Conscious Clinician PodcastEpisode 34: Managing Your Time In a VisitPicture this: It's a long day. You're behind on notes. You're running late to see the next person and it just feels like the whole day is slipping away from you. And you're thinking, “What happened here and how am I going to dig myself out of this hole?”
In this episode, we focus on time management and the self-reflection required to identify strategies for change. We need to take a hard look at what factors are causing us to run behind, because it's not as simple as like, ‘Oh, I'm just running late all the time.” If you'v...2021-10-0329 minThe Conscious Clinician PodcastEpisode 33: Providing Patient-Centered Care with Students & ObserversPicture this, you’re working with a new student or have someone shadowing you. They are eager to learn about your field and have tons of questions to ask you AND the patient. While you love their desire to learn, it’s also affecting the flow of the session.
We’ve certainly been there, so in this episode, we dissect why and how having another person in the room affects patient-centered communication and care. This applies to observers, interns, students, mentors, and anyone else who might be a third body in the treatment space.
We discuss ...2021-09-2632 minThe Conscious Clinician PodcastEpisode 32: Empowering Folks During Pregnancy, Birth, & Beyond with Dr. Tasha Darden, DPT, DoulaIn this episode, we examine pregnancy, birth, race, and consent through Dr. Tasha Darden’s unique lens of pelvic physical therapist and doula. During her pregnancy, she realized “that it was really hard to find a doula that looked like me” and since has become the provider she needed. She shares all you need to know about doulas and how they support people in birth. But we can’t talk about improving birth outcomes without talking about consent and obstetric violence. Tasha shares the Planned Parenthood model of consent: FRIES along with tips for discussing birth trauma postpartum. Finally, we dive deep...2021-09-2057 minThe Conscious Clinician PodcastEpisode 31: Patient Centered Plan of Care Development (SOAP Series #4)In this episode, we finish with part 4 of the SOAP note series: Plan of Care & Prognosis. Often the plan of care is an afterthought, something we consider when documenting or perhaps the last 5 minutes of the evaluation when we schedule follow-up visits. So we asked ourselves “How do we form a mutually agreed-upon plan, which is realistic and considerate of the patient and the provider?”
We share the tips which have helped us create more collaborative plans with patients and the assumptions and fears which have gotten in the way. Our own fears and psychosocial factors can affec...2021-09-1325 minThe Conscious Clinician PodcastEpisode 30: Empowering Assessments (SOAP Series #3)In this episode, we continue with part 3 of the SOAP series: The Assessment. We have broken this section out into three key considerations:
What is our assessment of the patient?
What information do we share with the patient?
How do we keep reassessing throughout the plan of care?
In addition, we also discuss examining our own biases in assessment, practicing new conversations with peers/mentors, focusing on solutions rather than impairments, and how to fold in biomechanical explanations in an empowering way. Tune in next week for Plan of Care tips!
Highlights from our conversation in E...2021-09-0522 minThe Conscious Clinician PodcastEpisode 29: Performing A Conscious Clinical Exam (SOAP Series #2)In this episode, we continue with part 2 of the SOAP series: the Objective Exam. Most of us learned explicitly and implicitly from our training that the purpose of the exam is for us (the provider) to learn about the patient's body in order to create an appropriate plan of care. However, we’ve realized that the patient is actually learning about their body during the exam as well!
Everything that we do during the exam process is teaching the patient something about their body. They are internalizing our language and reactions - for better or worse! So in...2021-08-2928 minThe Conscious Clinician PodcastEpisode 28: Taking a Patient-Centered History (SOAP Series #1)We are kicking off a 4 part series to explore patient-centered care from where it all begins - the evaluation. We break it into sections using the SOAP note model: Subjective, Objective, Assessment, and Plan. We discuss what we could do to improve rapport with our patients, our efficiency and accuracy in getting to the root of a problem while partnering with our patients as active collaborators.
In this episode, we focus on the subjective including building rapport, understanding the patient’s experience, and wrapping the subjective up into the objective. How do we learn their story and ho...2021-08-2235 minThe Conscious Clinician PodcastEpisode 27: Evolving Pelvic Physical Therapy Practice with Meryl Alapattu, DPT, Ph.D.In this episode, Dr. Meryl Alapattu, DPT, Ph.D. shares with us her experience in assessing psychosocial factors and developing “soft skills” as a researcher and faculty member at the University of Florida.
“I think we were a little bit late to the game in pelvic health, thinking about psychological factors” including fear avoidance. “A lot of these persistent pain conditions have similar factors that contribute to the pain experience…. [When] we look at people with pelvic pain compared to people with knee pain, for example, the types of things that they're fearful of, or the activities that they may...2021-08-1635 minThe Conscious Clinician PodcastEpisode 26: Supporting New Parents’ Health with Catherine O’Brien, MA, LMFTIn this episode, we have the pleasure of dissecting maternal and paternal mental health with Catherine O’Brien, MA, LMFT. She shares the common issues that new parents experience which contribute to pelvic floor conditions like dyspareunia. While postpartum is a time of massive changes, we need to listen to our patients when they feel like something just isn’t right.
Catherine helps soon-to-be parents create a postpartum plan because “there’s usually a lot of prep for a birth plan… but nobody's like, well then what happens after we bring the baby home?... Your partner is not your p...2021-07-2634 minThe Conscious Clinician PodcastEpisode 25: Physiatry in Pelvic Health with Dr. Allyson Shrikhande, MDIn this episode, we discuss pelvic health from the lens of physiatry with Dr. Allyson Shrikhande, MD. She is the medical director and founder of Pelvic Rehabilitation Medicine (PMR), offering true multidisciplinary care for people with pelvic floor dysfunction.
Allyson shares what a pelvic health physiatrist does, saying “we're trained really to look at the interplay between the organ systems with each other, as well as the organ systems with the fascia, the muscles, and the nervous system.” Physiatrists can serve as the quarterback for people with pelvic floor dysfunction, referring them to the various specialties. She also...2021-07-1829 minThe Conscious Clinician PodcastEpisode 24: How to Thrive, Not Just Survive with Yolanda Johnson, MD, FAAPIn this episode, we unpack overwhelm and burnout with Dr. Yolanda Johnson, MD, FAAP. As a pediatrician, mom, and coach for women in healthcare, Yolanda knows that doing it all means burning out. She shares practical tips to start shifting out of survival mode and begin discovering who you are, how you want to work, and what needs to change.
For the first time, Dr. Yolanda shares her experience of impostor syndrome during residency and how that led to her passion for coaching. We dive deep into the counterintuitive need to slow down and do less when...2021-07-1152 minThe Conscious Clinician PodcastEpisode 23: Inclusive Pelvic Health Practice with Dr. Brian Stirling, DPT, OCSIn this episode, we have the pleasure of speaking with Dr. Brian Stirling, DPT, OCS who treats male pelvic health and orthopedics. Brian shares the barriers he’s encountered as a male specializing in pelvic health as he wants to expand to treating all genders of patients. We discuss inclusive care, which develops when we have the courage to face our biases, remove educational barriers, and support a variety of providers joining the specialty!
We explore how our own fears (for our license, saying the wrong thing, avoiding litigation) have influenced our practice patterns. Brian leads us in...2021-07-0454 minThe Conscious Clinician PodcastEpisode 22: Preventative Pain Science with Josh Bellingham, MPTIn this episode, we dive deep into pain science how-to’s with Josh Bellingham, MPT. As a physio, Josh is passionate about providing accessible resources to people with persistent pain. He believes that the relationship between a patient and provider is the vehicle for changing limiting beliefs, which ultimately are the reason people make progress.
Josh is an advocate for using current pain science with ALL people experiencing pain, at any point along their journey. We explore how this looks for different populations and how to tell if someone is willing to "go there". He shares how the...2021-06-271h 00The Conscious Clinician PodcastEpisode 21: Intersections of Sexuality, Racism, and Healthcare with Dr. Uchenna "UC" Ossai, DPT, WCS, CLTIn this episode, we discuss how you can’t separate racism from healthcare with Dr. Uchenna “UC” Ossai, PT, DPT, WCS, CLT. As the only Black pelvic health physical therapist certified in Sexuality Counseling, UC has been empowering people to embrace their sexuality with their whole selves - and in spite of what society may be telling them.
This leads us into discussing the spectrums of pleasure, joy, race, sexuality, and how these factors all affect a person’s experience of sex. We explore the archetypes which affect black women’s health and sexual wellbeing, in the context of...2021-06-2050 minThe Conscious Clinician PodcastEpisode 20: A Patient's Perspective of Conscious PT Practice with KatieIn this episode, we have a special guest, Katie, joining us. Katie is actually the patient from Episode 19: Putting It All Together: A Case Study of Conscious Clinical Practice. This is a unique opportunity for a former patient and provider to reflect upon their experience working together. Be sure to listen to Episode 19 first for context!
Katie shares his first reaction to E:19. In his words “It was fascinating to hear the two of you talk together and to learn what does it sound like when practitioners are talking to each other and what are some of the...2021-06-131h 00The Conscious Clinician PodcastEpisode 19: Putting It All Together: A Case Study of Conscious Clinical PracticeIn this episode, Monika shares a case study to illustrate integrating the principles of emotional intelligence, trauma-informed, and patient-centered care. It's a story we're all familiar with: a man with chronic low back pain.
He was in the midst of a prolonged flare-up when they started working together and had seen many physical therapists before. She realized that she would have to do something different if they wanted a new result.
With this in mind, we discuss how Monika:
Prepared herself mentally and emotionally for a different approach
Shifted her focus from “fixing” to collab...2021-05-2344 minThe Conscious Clinician PodcastEpisode 18: Impostor Syndrome in Healthcare ProvidersIn this episode, we shed light on impostor syndrome in healthcare. This all too common phenomenon is an isolating experience. Providers who feel like impostors are constantly striving to earn the acceptance they cannot give to themselves. This is most common in marginalized groups including people of color, first-generation college students, and women in male-dominated fields. If not addressed it worsens as people attain more prestige/higher positions and is associated with burnout.
We share our experiences with impostor syndrome and how this has affected us in the clinic. Feeling inadequate or like a fraud definitely influences h...2021-05-1633 minThe Conscious Clinician PodcastEpisode 17: Providing Patient-Centered EducationHave you ever had a moment where you realize that a patient did not understand what you thought you educated them on? We have!
In this episode, we share our strategies for providing patient-centered education rather than lecturing. We’ve developed a checklist to follow:
Assess their current understanding
Ask permission to share your knowledge or perspective
Identify their skepticism and response
Break it down into chunks
Check their interpretation
We explain each step, how we do it, and why we do so. We’ve learned that patient-centered education is an ongoing process, especially when we're wo...2021-05-0928 minThe Conscious Clinician PodcastEpisode 16: Defining Patient-Provider Relationship BoundariesIn this episode, we explore how to establish healthy patient-provider boundaries around discussing personal matters. Sammy describes a patient experience that started as a discussion of pain-related stress and evolved into the patient sharing personal conflicts, relational issues, and more.
Sammy felt uncomfortable and realized that the patient was seeking emotional support that exceeded her scope of practice. After multiple attempts to redirect and focus on PT, she had a direct conversation with the patient.
These types of situations can challenge our personal and professional boundaries. Each of our definitions of “oversharing” varies, however, practicing with e...2021-05-0223 minThe Conscious Clinician PodcastEpisode 15: The Power of Understanding Patient Beliefs with Dr. Mike Nelson, DPTIn this episode, we have the pleasure of interviewing Mike Nelson, DPT about patient-centered care. We’ve both worked with Mike and admire his dedication to building a relationship with patients that helps facilitate change. After reflecting on moments of tough interactions, he began a quest to create more structure in his communication and found motivational interviewing. Since then he’s been passionate about connecting closely, integrating evidence, and sharing a message of hope with his patients.
Together we unpack buzzwords like: shared decision making, patient-centered care, motivational interviewing, and program adherence. What do these terms mean and h...2021-04-2546 minThe Conscious Clinician PodcastEpisode 14: Enhancing Your Emotional IntelligenceIn this episode, we are so excited to bring you part 2 of emotional intelligence (EQ). First, check out Part 1: EQ for Healthcare Providers (Episode 13).
Emotional intelligence affects both patient and provider outcomes. A staggering 80% of medical errors are due to miscommunication (2014). Logically, improving our EQ will help us connect with people of different backgrounds, communicate clearly, and thus improve patient outcomes. However, we were surprised to find that there is relatively little research exploring EQ and patient outcomes.
The link between EQ, burnout, and resilience has received more empirical attention. Emotional intelligence is inversely correlated w...2021-04-1833 minThe Conscious Clinician PodcastEpisode 13: Emotional Intelligence for Healthcare ProvidersIn part 1 of a two-part series, we break down emotional intelligence (EQ), what it is, and how it shows up in clinical practice. We have discussed several of the skills of EQ in our previous episodes, so it’s about time we focus specifically on this skill!
Emotional intelligence is the ability to monitor your own and others' feelings, to discriminate amongst them, and use this information to guide your thinking and action. EQ is a skill that can be developed, the cornerstone of those elusive yet important “soft skills.” We discuss the skills which make up EQ, bas...2021-04-1141 minThe Conscious Clinician PodcastEpisode 12: Our Words Have the Power to Heal and HarmIn this episode, we focus on the power of language in clinical practice. We’ve all seen patients who are hypervigilant or scared of movement because they’ve heard their pelvis is unstable, their pelvic floor muscles are too weak, they have disc degeneration, etc.
These biomechanical and kinesiopathological explanations of pain paint an image that their body is broken and they must rely on our help to fix it. So we have to consider every statement that we're making and have an intent behind it.
How does this sound to someone who doesn’t know muc...2021-04-0445 minThe Conscious Clinician PodcastEpisode 11: Authentic Evidence Based Practice with Dr. Annemarie Everett, DPT, WCSIn this episode, we dive deep into PT practice, what it is and what it could be, with Annemarie Everett, DPT, WCS. She shares how she co-founded POPUp and the humbling lessons she learned to approach patients who have prolapse with dignity, honesty, and autonomy.
This patient-centered approach to practice was shaped by her personal growth. At a low point, Annemarie realized that she had to stop assuming responsibility for other people’s happiness, fulfillment, and ability to achieve their goals. Something had to give. She started asking “what can I create for people and what can I see...2021-03-281h 05The Conscious Clinician PodcastEpisode 10: Grounding Techniques for Patients and ProvidersIn this episode, we explore the concept of grounding in pelvic health. Grounding is “directing attention toward what is happening in the present moment.” It has many benefits for patients AND providers including improved bodily awareness, improved focus, and better problem-solving.
In our experience, grounding can also reduce sympathetic nervous system activation and help regulate emotional reactions. Oftentimes people in pelvic PT feel betrayed by their body or try to avoid bodily signals as a way of adapting to pain. When people are disconnected from their bodies it can affect their progress. Helping people feel safe is a pre...2021-03-2138 minThe Conscious Clinician PodcastEpisode 9: Vicarious Trauma in Healthcare with Dr. Brie Robertori, PsyDEpisode Summary
Our special guest in this episode is Dr. Brie Robertori, PsyD, a clinical psychologist who specializes in family therapy, trauma-informed care, and multicultural practice. After experiencing vicarious traumatization through her training, she developed a passion for trauma-informed practice. This passion led her to complete her dissertation as a program evaluation for a trauma recovery clinic, with a goal of ensuring that clients were receiving trauma-informed care and that treating clinicians were receiving support for vicarious trauma exposure.
Brie shares best practices when screening for abuse and trauma, including how we can respond with compassion and...2021-03-141h 06The Conscious Clinician PodcastEpisode 8: Trauma Informed Pelvic Health Practice with Dr. Krystyna Holland, DPTWe are so excited to bring you this interview with Dr. Krystyna Holland, DPT!! She specializes in trauma-informed pelvic health practice for people across the gender identity spectrum. Her practice philosophy centers around intentionally minimizing our risk of perpetuating harm. We explore how this carries over into patient interactions including co-regulating, obtaining informed consent, and empowering patient autonomy.
We also discuss the equally important need to self-reflect, self regulate and modify our workload so that we can do no harm because providing trauma-informed care is more than just being nice. Dr. Krystyna also sheds light on shame...2021-03-0747 minThe Conscious Clinician PodcastEpisode 7: Cultivating Resilience for Pelvic PTsIn this episode, we explore resilience, professionally and personally. Well-being is a constant journey and resilience is like the health gauge of our coping skills at any given time. We each share examples of times we have been resilient and times we have struggled. Monika shares how her family upbringing affected her beliefs about work, rest, and vacation. Sammy shares how she thrived in graduate school for PT and how she can apply that to her life currently.
Each of us realized that when we are resilient, we've found a way to keep the essence of ourselves f...2021-02-2859 minThe Conscious Clinician PodcastEpisode 6: History Taking Pearls & PitfallsIn this episode hosts Monika and Sammy hone in on history taking. The beauty of the subjective is that each question is planting a seed in the patient’s mind. Sometimes we will harvest several sessions later, once the patient has had time to reflect. We can use questions to invite their curiosity, create an individualized blueprint for their care, and increase their engagement with treatment. We share our common pitfalls including:
Asking leading questions
Making assumptions
Asking vague questions
And offer suggestions for each pitfall and additional tips for an insightful subjective assessment.
Highlights from our...2021-02-2135 minThe Conscious Clinician PodcastEpisode 5: All About Pain CatastrophizingIn this episode hosts Monika and Sammy examine pain catastrophizing through the lens of a patient, Sarah, who is experiencing vaginismus. Sammy shares how she came to realize that Sarah presented with significant catastrophizing, how this affected the plan of care, and what changes she made in her PT practice as a result. Monika and Sammy define catastrophizing, how it may show up in patients, and share practical tips for working with similar patients who exhibit moderate/high catastrophizing.
Highlights from our conversation in Episode X
Case introduction: Sarah & vaginismus [0:33]
What is pain catastrophizing? [6:01]
How can you identify a...2021-02-1457 minThe Conscious Clinician PodcastEpisode 4: "The Fixer" Role of Healthcare ProvidersIn this episode, hosts Monika & Sammy explore “The Fixer” role that providers take on. They describe how being The Fixer shows up in clinical practice, signs and symptoms, origins and benefits, and tips for transitioning into The Guide role.
Sammy describes it as “feeling like you need to be someone's hero [like] you need to be the one that solves all of their problems.” With this mentality, a provider must focus on how and what to change so that the patient improves. This is a great deal of pressure to perform. Instead, providers can shift into The Guide by...2021-02-0748 minThe Conscious Clinician PodcastEpisode 3: Identifying Patient's Readiness to ChangeIn this episode we break down the myth of “non-compliance”, introduce the Transtheoretical Model (i.e. stages of change), and provide practical strategies for working with patients at each stage. The “non-compliance” myth propagates a hierarchical relationship between the Provider / patient and doesn’t take into account natural human ambivalence when it comes to change.
Instead, we’ve shifted to assessing all patients for their readiness to change. We briefly describe each stage from the Transtheoretical Model, how to listen for “stage talk”, and share our strategies for working with patients in each stage. We also explore common misconcept...2021-01-3129 minThe Conscious Clinician PodcastEpisode 2: The Mountain Metaphor for a Healing JourneyHosts Monika & Sammy break down the subliminal scripts and healthcare practices which set providers up to be the gatekeepers of wellness. In this medical model, “we are the gatekeepers of wellness” and patients must go through us to “receive” healing.
Using the mountain metaphor they redefine pelvic PT and patient roles. The healing journey is depicted as the “The Mountain.” Rather than dragging patients up the mountain, PTs are guides who walk the path alongside their patients, guiding them around common pitfalls, exploring new paths, and supporting the hiker (i.e. the patient) along their journey.
They share w...2021-01-2530 minThe Conscious Clinician PodcastEpisode 1: Welcome Conscious Clinicians!Hosts Dr. Monika Stefanowicz & Dr. Sammy Steele welcome us to The Conscious Clinician Podcast! Sammy introduces us to the origin story of the podcast when the pair worked closely together as mentee/mentor. Their vision for the podcast is “to help pelvic floor physical therapists create an enjoyable and sustainable practice through the lens of exploring relationships with patients/clients.”
Monika shares, “we think that relationships are at the very heart of healing.” However, most pelvic health therapists receive minimal training on the interpersonal aspects of patient care. These soft skills are essential in pelvic health, given the intim...2021-01-2519 min
The Masterful Art of Self CareEpisode 11: The Pelvic Chronicles: w/ Monika Stefanowicz of Lift.Laugh.KegelIn the first episode of the Pelvic Chronicles, we dive deep into the pelvic floor with Monika Stefanowicz of Lift.Laugh.Kegel and talk about the connection of the digestive system to the pelvic floor, how prevalent pelvic floor issues are (1 in 4 women suffer from some type of pelvic floor isssue!) and address the shame and stigma surrounding our pelvic floor and how women like Monika are bringing more education and awareness to the public on this topic.
---
Support this podcast: https://podcasters.spotify.com/pod/show/themasterfulartofselfcare/support2019-01-121h 14