How John Achieved Great Success Transitioning From The NHS To Private Practice

Thanks John for coming onto the podcast, John is a physiotherapist in Ireland – is it Cavan where you’re working John?

Yeah we have a practice in Ballyconnell just on the edge of the border in county cavan.

And tell us a little bit more about yourself before you came onto the mentorship?

Yeah so I graduated in 2009 from Manchester Met, worked in the NHS there for a few years. Got a bit lost in terms of where I wanted to be in terms of a physio. In the NHS we were being driven towards classes and less hands on and my calling as a physio I suppose was to do more hands on and be more involved with the patient.

So I left the NHS and set up in Cavan and since I was on my own in the clinic I was looking for a mentor to help with direction when those tricky patients come along. That’s when I stumbled across Dave and I haven’t really looked back since – it was exactly what I needed at the time.

I think that will resonate with a lot of people. I started my career in respiratory in the NHS. I was learning a lot of new stuff and it was a challenging role, but in terms of what I wanted to do which was hands on MSK I felt I was almost becoming deskilled…

I wouldn’t change the NHS for the world it gave me an incredible background. But I do agree with you when it comes to deskilling, I cringe at the thought of some of the treatment I gave the first few patients who came to me when I started in private practice. That’s where the support network really helped me on the mentorship you know, no question was too stupid and it was great to be able to go for a bit of guidance when needed.

It’s funny you should say that about cringing about the treatments you might have given a few years ago. I had a patient email me a while ago and they actually replied to an email I sent about 5-6 years ago to them. When I read the rehab that I gave them I cringed!

I suppose we all have to go through that and it’s a good sign to look at your development and see where you’ve come from to where you are now.

Definitely, and at the end of the day people still got better. As long as you’re helping people it’s just part of developing! And then going back to when you first started – that lack of structure – what were the real world effects of that?

I was trying to implement a lot of different stuff from a lot of different courses and people were getting better, but there was no real structure and I suppose the more tricky cases – the high level runners and gaelic footballers who were breaking down a bit more – I might have been bringing them out on the pitch and doing some higher level RTP stuff, but then I wasn’t bringing my shoulder pain patient who wanted to lift their kids far enough. So I was probably under treating some of those patients.

Yeah, and going back to that email I spoke about previously I think I was in a similar boat where people still got better, but my rehab wasn’t good enough and people broke down again more often than I would have liked.

Yeah for sure

So I assume you followed Dave for a while on social media, what made you actually take action and sign up to the mentorship?

I think I had come across his info on Facebook then ended up on his email list, and I suppose at the start you know, setting up a new clinic, I was a bit hesitant financially to commit to something like this.

But I remember one patient in particular who now I would see as a straightforward lower back pain patient, but at the time I think they got worse after having a session, so after the patient had left I had a bit of self doubt and said you know what? I need to do something about this. And it wasn’t that I wasn’t busy, I was, but I wanted patients to get a bit more bang for their book.

So I emailed Dave, and he listened to me, told me to come in and sample it for a bit and he never really pushed me so I signed up and haven’t looked back since.

How did you find it initially in the first 3 months?

I definitely first thought “Holy God I know Nothing!” It was fantastic but it was intense and completely different to what I was doing at the time in some regards. At the time I wasn’t sure time wise if I could commit 100% but it raised my spirits and I got excited over it.

Yeah I agree that if you do a good effective explanation it saves you a lot of hassle down the line.

I was a little bit hesitant at the start you know thinking the patient is here for hands on are they going to be happy if I just speak to them for 20 minutes, but if they can leave understanding the plan and the structure. I’ve got to be okay with that now.

I think a lot of therapists, with the best intentions, spend as little time as possible on the subjective because they feel under pressure to give as much treatment as possible, but them knowing the plan is so important. So after the 3 months what results did you start to see first?

The majority of patients were moving better, even just from the effective explanation and the breathing especially with back pain – before you even touched them they were feeling better. Then because they knew the plan they were excited, they were making progress every week, and we were doing a lot more than just hands on.

And did you get that structure that you were looking for at the start?

Definitely, I’m completely on board with the Go To Mentorship system now I follow that to the letter of the law. That’s the way I treat my patients, it’s the way I treat my staff, they’ll learn those 7 steps – that’s my practice now. It’s clear, there’s clarity, and it works.

I think it’s important that, to have a good structure in place. When the tricky patients come along it can be easy to deviate but if you have a good structure it helps avoid that massively.

Previously I used to do that but I’m getting better at trusting the process, being a bit more of a detective with your subjective and objective and logically work it out 9 times out of ten you’ll get there.

Yeah that’s a good point. I had a patient in recently where she wasn’t progressing as fast as I’d like and when you get stuck it’s not the system, it’s your higher level clinical thinking. So when you get stuck it’s sticking to the system but stepping back and looking at the big picture you’ll usually get there.

Definitely.

So what’s next for O’Neill Physiotherapy?

Well I hope to come over for the refresher weekend next week, we’re just moving to a new location with the clinic, so all exciting times. I’m still developing you know keeping up with the research.

Great stuff, well thanks for coming onto the podcast and hopefully we’ll see you at the refresher next week!

Thanks again!