So thanks to Alex for coming onto the podcast, Alex is a physio, he’s just started his own practice with Origin Physiotherapy – do you want to tell us a little bit more about that first of all Alex?

Yeah so brand new, I’ve been trading for 2 weeks. I was ready to start my own practice about April this year after going on the mentorship. I wanted the name to represent a couple of things, first of all, the origin of my own practice but also highlight that we go after the origin or the cause of somebody’s problem and not just treat their symptoms.

That’s cool, and going back to April of this year when you finished the Mentorship Live, what were your main frustrations or roadblocks clinically at that time?

So, my main experience was based in the NHS. So we get a lot of people coming through the door and you don’t really get a lot of time to go through a very systematic approach. You stick to what you know, or what you were thought – even if that was 5-6 years ago. So you do go on courses, you do treat above and below a joint, but I was definitely kind of stuck and that’s why I signed up.

And at that point, did you have any reservations or any doubts?

Yeah, I mean you’re always going to have reservations or doubts with people that you don’t really know. At the time I hadn’t really heard of Dave or ProSport so of course you think about credentials, who’s going to be leading the course, and that kind of thing. But once I was up that that was soon resolved.

And you came up and did Mentorship Live which was an event we ran this year where we went fairly intensely through the Mentorship in 3 days. How was that experience?

Yeah, I mean you’re always going to have reservations or doubts with people that you don’t really know. At the time I hadn’t really heard of Dave or ProSport so of course you think about credentials, who’s going to be leading the course, and that kind of thing. But once I was up that that was soon resolved.

It was very intense, because although it’s not new stuff it’s a way of approaching things slightly differently. So you’re completely changing your thought process of how you assess and treat the person in front of you. So it was hard to take that and go away and implement it all straight away – and I actually don’t recommend that. I think taking a few key people and start with those and gradually introducing it as a system. So the 3 days were very intense but they were brilliant.

I think what’s helped me the most though was the recent refresher. Because after the 3 day course I went straight back into the NHS, and although I was implementing some of it it’s hard to implement it completely as a system in that environment.

That’s a good point. We’ve actually not done a Mentorship Live since as I think it’s a bit of information overload. When the information is drip fed week by week, focusing on implementing one piece at a time, I think people are more successful. And THEN coming onto the refresher courses that we run twice a year, as you said that helps people a lot once they’ve already gone through the system.

So in that NHS environment, what difference did what you were able to implement make to your practice at that time?

It was pretty useful from a coordinative testing point of view to be able to then offer some really good and useful exercises. That’s something I did quite a lot after doing the mentorship and started to get some really good results. But I hadn’t used the progressions after that enough to the point of when someone improves at that, where to go next. So I did take bits away but the refresher has really helped to cement some of that stuff.

How often do you typically see people in the NHS?

My diary is pretty solid. I do have some urgent slots, so I can see people a week later if needed but generally it’s about 2-3 weeks for a follow up, some people once a month, and then trying to utilise our group sessions more to free up the 1-1 diary.

Nice, yeah I’m just thinking from a patient adherence perspective that’s a bit of an obstacle isn’t it if you can’t see them for 2-3 weeks sometimes?

That’s a good point. That’s probably the biggest thing, people coming back in and not doing their exercises, or having filmed it on their phone but their not doing it correctly. It’s frustrating from that point of view sometimes, but that could be my coaching. So it’s a good learning point and I now make sure I have my good coaching points in the video when I’m recording it on their phone

For sure, it’s one of the ways to overcome that problem. Is there anything in the mentorship that has helped you in that regard?

I think just having the confidence to prescribe the exercises. Because then I can coach verbally and record videos of them doing it. In the NHS you do slip back into your old ways sometimes though. I saw two NPs in my new private clinic today and it’s miles apart. I’m confident that they’ll come back having done their exercises properly.

Cool, it’s an interesting topic. Even in private practice we’ve had issues in our own clinic recently where there had been a few more cancellations than normal, and when we delved a bit deeper to figure out why, our analysis showed that we were getting lazy with our ‘effective explanation’ – not coming back to this at the end of every session so that the patient knows why the exercises are important. And once we started doing this again, the cancellations stopped. It’s really interesting how much of a difference it can make.

That is interesting, I’ve been doing the effective explanation solidly with my own private clients, but I’ve probably only done it twice with NHS clients. And I honestly can’t tell you why. Partly it’s probably because of the NHS paperwork we have to do a ‘style’ of effective explanation anyway so it would probably be a bit like repeating myself.

Yeah it’s interesting! So thinking back now over your journey from April to now, how has your journey been?

Yeah it’s been huge. So thinking now with clinical reasoning thinking about the patient’s injury, looking at their history, identifying the contributing factors, and then getting your ‘top 3’ tissues, and “what is my hypothesis?” – what am I trying to confirm or reject? And then just treating and reassessing. And it’s that reassessing every time that’s something that’s new for me after the refresher. I was probably doing it before but after treating 2-3 tissues then re-checking. So if you got a positive change you’re not sure exactly what tissue got the result!

Yeah it’s a bit like purposeful practice isn’t it. You probably do it as routine, but doing it specifically after each intervention to check if it’s successful makes a massive difference. And even the confirming for denying your hypothesis. I think that’s important, from the subjective you have an idea but until you see them move you don’t know. Then with each layer of the assessment you’re either building more confidence, or your thought process changes “well I initially thought this, but now this makes more sense”. And it’s not that you’re proven wrong, you’re just using your clinical reasoning skills to form a better hypothesis based on the new information…

Yeah and it’s confidence with being OK rejecting your hypothesis. It doesn’t mean you’re wrong or even that you’re in the wrong place. You just might have to look at it in a slightly different way. So having the confidence in the system and the approach to think okay let’s look at it this way instead.

100% that’s a great point, and even now myself years in when I come to a problem, it’s having the confidence in your system to not jump and try something different. Instead, take a step back and reason why you’ve come to this roadblock. What other tissues are involved that you maybe hadn’t considered before, etc. Always asking “Why?” and “What Else?”..

So setting up your own practice now, is it fair to say the mentorship has given you the confidence to set up your own practice?

Yeah definitely. My old manager actually wasn’t that happy that I came on the mentorship, only from the point of view that it gave me the confidence to make me want to do my own thing. I want to do this 100% by myself, for myself. Because I think I can now. I had 7 ½ years experience, but it was that course that flicked a switch and finally gave met the confidence to go for it.

And I’m sure you’ll be very successful with it. So you’re two weeks into trading now you said?

Yeah I’ve had a few referrals from my old gym. I also treated someone today who’s quite key in the area for running clubs and they’re singing the praises already so hopefully the word of mouth referrals will keep coming in!

You can’t go wrong with runners that’s how we started – above a running shop! And my last question is always the plans for the future, so I imagine for you it’s all about growing the new business?

Definitely, there’s two treatment rooms in the place I’ve got so I want to get this place up and running take someone else on and get them on the mentorship. There’s no point someone coming in using a different approach as I want to build the reputation of this place about the system and approach.

Really good, thanks for your time Alex appreciate you coming onto the podcast!

Thanks Shane