Redefining Recovery: Uniting Physical Therapy and Mental Resilience

[00:00:19] Hi everyone, welcome to episode 2 of The Rehab Revolution with our host Dr. Gariffo. I'm happy to have you here today and kind of go through all of the things that The Rehab Revolution redefines.

[00:00:35] I know this is the second episode for Rehab Revolution really focusing on where rehab meets revolution, bridging the body and mind, redefining recovery by bridging the connection between physical therapy and mental clarity. Each one of these episodes of the series of 12 will kind of go through groundbreaking approaches like hyperbariatric oxygen therapy, dry needling and telehealth,

[00:01:03] which I know you did talk about a bit on episode 1, so happy to get in a little deeper today. And then also going back to telehealth while also sharing some of your transformative patient stories and experiences and debunking some rehab myths and really going through how healing becomes revolutionary.

[00:01:26] And the specific episode, episode 2, we will focus a little bit on physical healing meets mental strength and understanding more about how physiological challenges of recovering, of recovery rather, and how addressing mental resilience can accelerate physical rehabilitation. So, gonna just jump right in here with you and kind of start asking you some questions. Yeah, let's do it. Yeah, let's do it.

[00:01:53] So, Dr. Griffo, on the last episode I know that there was some talk about your journey into rehabilitation, but I wanted to go a little bit deeper today and really understand or find out a bit more from you about if there was ever a specific moment in your own life that you personally experienced the power of physical therapy yourself. Absolutely. Great question. I guess I want to start with when I was injured as an ice hockey player.

[00:02:22] So, I learned physical therapy two ways. One was not so good an experience. The other was a great experience. So, the first was an injury where I was injured playing ice hockey and I injured my shoulder. And I went to see a physical therapist. I loved the hands-on approach. I loved the camaraderie. And I loved how we were able to build a relationship, even around the shoulder and what I was doing that weekend or was I playing still hockey.

[00:02:50] And you see the physical therapist three times a week where you see your doctor or your surgeon or your neurologist maybe once every three months. So, I really developed a relationship with my physical therapist. I knew then that I wanted to become a physical therapist. However, Layla, my first job, I experienced everything that I didn't want to do or be as a physical therapist. And I learned a lot from that experience. So, I lasted there for two years.

[00:03:15] And what I uncovered from that first job is that I wanted to do the exact opposite of what that physical therapist did with his patients. Let me just give you an example. My paradigm shift was my first job where I learned, like, okay, how do I treat my patients better than he's treating his patients? And that's really simple. It comes down to alliteration of the three E's when I work with my patients.

[00:03:42] And the first E is evaluation. Is your evaluation comprehensive and personalized? And every one of my evaluations is comprehensive and personalized. Whereas, when I experienced that first job, you would see the physical therapist day one and day 30. So, day one was your evaluation and day 30 was your reevaluation. In between those days, you were treated by an aide, an unskilled, unlicensed aide. And I have no aides in my practice.

[00:04:12] So, the first one, most importantly, is, is the evaluation appropriate and is it comprehensive? The second E is evidence-based practice. My practice is not haphazard. It's not based on conjecture or it's based on literature. It's based on research and it's based on experience. 30 years as a physical therapist this June. I was celebrating 30 years in practice.

[00:04:36] So, I learned a lot in 30 years and I know that everything that I do to my patients and with my patients is evidence-based. And the last E, I think is the most important E, is engaged and empowered patients. My patients are educated on their diagnosis. They're educated on the rehab process. So, they're engaged in their own rehab.

[00:04:59] And they kind of like had the self-interest to do their own work, hard work in the gym as well as at home for their home life-size program. Also, collaboration in decision-making. Like, okay, you're in a lot of pain. I think we should pull back for the next couple days. And instead of coming and seeing you on Wednesday, let's push to Friday. So, that's what happens when you have empowered patients. They're able to communicate with you and not be intimidated by the communication.

[00:05:24] The first thing I do with every single patient every morning is I go in the room and I say, okay, how's it going? How's your shoulder doing? How was your weekend? What did you do? Did you play tennis? Did you go on to a wedding? I know exactly what they were supposed to be doing that weekend. And they really received that well because they're empowered and they're empowered for their own recovery journey. That's amazing. And also, 30 years is very impressive. So, congratulations on that. Thank you.

[00:05:51] I'm sure you have learned a lot and a lot of trial and error, I'm sure. You mentioned your first job. Was that your first job specifically as a physical therapist? Or what was the actual job it was? Yes, as a physical therapist. So, I went in fully blinded with the experience of I wanted to go set the world on fire. And I landed in this practice and I just, wow, it was not a good practice. But I stuck it out because I still was interacting with patients.

[00:06:21] I was still cutting my teeth with treating patients. But I knew my approach was going to be the polar opposite of his approach. And that's a powerline shift really is you learn a lot when you can just flip it 180 and do the exact opposite and succeed. Absolutely. I definitely agree that sometimes having an example of what you don't want can really, really make you realize what you do want, especially in healthcare. Absolutely.

[00:06:49] And then the three E's you mentioned, was that something that was your own approach? Is that something you created or is that it is? It is. Yes, absolutely. You know, the evaluation has to be spot on. You have to engage your patients. You have to empower your patients. You have to offer research driven interventions that are evidence-based because it can't, like if I'm ever, if the patient ever comes to me and says, why are you doing this exercise? And every one of my staff members know, my aides know why I'm doing what I'm doing.

[00:07:18] My patients know why I'm doing what I'm doing. I don't just stretch your shoulder out. I say, Layla, the reason why I'm flexing your shoulder is because you have adhesions and this is why we're doing this. So you know, okay, this makes sense versus you just, I guess he's, he's fixing me. He's just, he's just stretching my shoulder. And then when you empower your patients and you educate your patients, they're much more involved in their own treatment because you have their best interest at heart. And that really is crucial.

[00:07:47] The education is really crucial to rehab process. Absolutely. I definitely think that empowering and educating patients will definitely make them feel empowered on their own as well. So definitely, I think that's a wonderful approach that you have for your patients. And then I know oftentimes in physical therapy, I've heard the term like pushing through the pain is common in physical recovery. But what role do you think that mental resilience can also play in rehabilitation?

[00:08:16] You know, that's a fantastic question because what I see is with the patients that are resilient, mentally resilient, they adapt to setbacks. They really manage stress better. They maintain a positive outlook by being resilient. And with, by being resilient also had a really strong carryover for pain control because I then know this is why I'm doing this.

[00:08:43] And there's a big difference between, you know, good pain and bad pain, but mentally resilient patients can manage through the pain process and enhance their motivation as well as their engagement because they're able to better cope with setbacks. I mean, that's really important, having that resilience. You see it like you see it in many patients. You could see it in a 16 year old. You could see it in an 86 year old, but you know it when you see it.

[00:09:06] You know how successful a patient will be with their rehab in the first hour of the evaluation. I know it as soon as I see them, as soon as I evaluate them, and I know they're bought into the process. They're the resilient patients. They're the ones that will succeed in the rehab process. Is there something that you would say with those patients that you can like identify as resilient in them within that first hour?

[00:09:31] Is there like a common trait that you think they share or is it just kind of a gut intuition that you have with your experience? You know, I when I I guess 30 years of experience, I see it's a gut check definitely. But most often the patients had that dogged pursuit for their own best outcome, right? Like I come into it and I'm an elite athlete and I've dealt with many elite athletes or I'm an 86 year old with total hip replacement. And I want to go on my walks with my husband again.

[00:10:00] I'll know it based on the evaluation. It's not the evaluation, not the outcome of increased strength or increased range of motion or better balance. It's the outcome of I want to hold my grandkids in the air again. I want to play golf again. That's who are mentally resilient because they have their outcomes already lined up and they know where they want to go and how together we're going to get there. Absolutely. Their purpose, essentially, they have that driving force within them. Yeah.

[00:10:30] And then talking about the rehab process, is there something that you found where you find surprising about the rehab process that doctors don't always particularly talk about? Yes, there's there's there's this, you know, recovery is nonlinear. You know, I mentioned setbacks. I mentioned there's there's their value of setbacks because we have ebbs and flows. We have plateaus. We have temporary setbacks and they're unpredictable.

[00:10:56] And in those periods of rapid improvement, oftentimes the patient will say, wow, you know, this is really working well and it worked quickly. But the same exact patient, the same ACL patient a week later may not recover as quickly or they may not be in as good shape as the prior patient. So the value of setbacks most often docs miss that as well as.

[00:11:20] I call it the strategic use of controlled discomfort, having that therapeutic pain threshold and discussing that and communicating that with the patient, knowing what is good pain, what is bad pain, educating the patient and over educating the patient every single time you see that. Most most of the times when I talk to my patients, I already know what their abduction is. I already know what their shoulder range of motion is and their strength and their pain levels. I want to know how are we doing?

[00:11:49] Like, are you able to do more during the weekend when you're not with me? Are you able to do more with your wife, your husband or your kids when you're not with me? Are you back on the bike? Are you back golfing? That's most important to me. I want to make sure that we're on the same page as to what your outcome is. What is your purpose? Like you said, what is your purpose for rehab? And that's well-defined upon the evaluation. I go back to that and I reference that, you know, six visits in 10 visits in and say, Layla, you know what I saw you two weeks ago.

[00:12:17] Our goal was to have you golfing again, three weeks from now. How's it going? Oh, I'm absolutely back to golf and I feel fantastic. You work wonders and I see that a lot. You know, I'm not being pretentious, but I do see that a lot because again, this constant communication with me, not my aide, not my front desk, not my secretary. It's with me one-on-one the entire treatment. Absolutely.

[00:12:39] And I'm sure that encouraging them and educating them and empowering them also definitely ties into them doing the work themselves on the weekend as well. That's right. Yeah. You know, again, I think of, I think of a couple of diagnoses that I deal with a lot. And the first one is chronic pain.

[00:13:06] And the chronic pain patient has that instilled, embedded, if you will, depression and anxiety because of trauma. They've been dealing with pain for years and years and years. They've seen every specialist there is. They've seen the neurosurgeon and the surgeon. They had injections and they're on this medicine and they come to see me. And it's like, what can you do? What has not been done to me to date?

[00:13:33] Oftentimes that results in either dry needling or grassed in or hyperbolic option therapy, really unique differentiators that I provide that not many other physical therapists provide. There's nobody in my area that provides what I provide. And that's my kind of like coup de grace, if you will. My brand awareness is based on my experience, my knowledge and my expertise.

[00:13:53] And the second, I guess, diagnosis specific patient that really has that mental health, physical health, kind of like one, two punch dilemma is the cardiovascular patients. The patients that have CHF or they have heart disease or they have just labored breathing, they're after a witset. They've been dealing with cardiovascular issues for, again, like a chronic pain patient, 20, 30 years, 15 years.

[00:14:21] And they come in and oftentimes there's that cross referral between me and my psychologist where we can co-treat. So we can treat Layla's depression and anxiety in the same clinic. And I can treat her, her chronic low back pain or a chronic neck pain or her CHF status and her breathing training around those specific diagnoses. There are multiple diagnoses, but those two kind of like rise above all the others.

[00:14:47] Yeah, I can see how they definitely go hand in hand and definitely help balance that out for the patient. Is there, what would you say is the biggest myth about rehab and it drives you crazy? I got to smile, Layla, because I've been on this soapbox, I think, for the last 15 years.

[00:15:10] And what drives me absolutely crazy is that physical therapy is not a generic thing that people get, right? Because if that were the case, you can get it from anybody. You can get it from your primary care doctor. God forbid you get it from your chiropractor. You can get it from your hairdresser. If physical therapy was merely a service that you simply get, that drives me crazy.

[00:15:39] Because what happens is at that point, physical therapy becomes a commodity because a commodity is I can get that there, there, there or there. There's no differentiators. So how I differentiate that is my patients come to see Dr. Gariffo, not to physical therapy. They come to the profession of physical therapy. They don't go get a service of physical therapy. I know it's semantics, but it means a lot.

[00:16:04] It means a whole lot because our brand, my brand is what I do to my patients. It's not this faceless, generic, big box treatment plan that every other physical therapist can do. And because the doctor says, okay, go to physical therapy. You're like, okay, let me just pick a spot on the mat and I'll go into physical therapy. And physical therapy is physical therapy is physical therapy.

[00:16:27] So that's my kind of soapbox that drives me absolutely crazy is that other physical therapists that are friends of mine are okay with being a commodity. I am not a commodity. Absolutely. And then do you think definitely, I think not all physical therapy is created equal for sure. Right. Do you think that that myth itself is harmful? Absolutely. Yes, I do.

[00:16:53] Because what, like I said, you know, there's, there's a lot of, there's a lot of territorial grabs on behalf of athletic trainers, massage therapists, chiropractors, primary care doctors, offering quote unquote physical therapy, meaning physical therapy is a service that I can offer as a massage therapist, as an athletic trainer. No, you cannot. It's a profession. It's a profession that I went to school for a long time to become a physical therapist.

[00:17:21] So I think that if we continue down this path of being okay with being a commodity, there's definitely gonna be market share. Definitely gonna be market share taken from us. Absolutely. Not for me, not for my practice. I can tell you that as a matter of fact, but from other physical therapists, yes. Because I do that now. I, I am not a commodity, but I'm definitely more willing to take patients from another commodity down the street. That's a physical therapist. Absolutely. They go experience that. They come experience what I offer.

[00:17:49] And they're like, why did I ever even spend six weeks down there? Sign me up. I'm ready to go. Sounds like your practice definitely speaks for itself pretty quickly. Um, and I know with physical therapy, some people tend to believe quote unquote, if it works and must, if it hurts, it must be working. And others stop therapy too soon because they may not see results. What's your take on both ends of the spectrum? You know what the, if it hurts, it must be working.

[00:18:19] There's a fine line and that there, there lies the skill set of a good pain, bad pain. I mentioned that a couple of times. Right. 20 minutes. So I'll just give you an example. Like I'm working with a shoulder patient and I'm stretching them out. Right. Or they're saying I did my exercise this weekend and my pain is six out of 10. Okay. That doesn't mean anything. Is it a dull, achy pain? Is it a toothache pain? That's good. That's a good pain. Is it a sharp, stabbing, breathtaking pain?

[00:18:49] Bad pain. So therein lies the crux of having the knowledge and expertise and the skill set to differentiate good pain versus bad pain. And I do it every single day for every single joint in the body for all my patients. So I know that, okay, I am going to push you. A total knee replacement is a fantastic example. Oftentimes a total knee replacement will freeze in flexion, meaning they don't get the amount of mobility they need to bend their knee.

[00:19:17] So I have to literally crank on their knee through tears. Oftentimes they're crying saying stop doing that to my knee. I know they need a hundred degrees to be functioned. If they're stuck at 85 degrees, that's a problem. And that's a long standing problem with whenever they leave me. So oftentimes I'll be on the phone with the surgeon and say, doc, look, your patient's stuck at 80. I'm going to crank it on this knee. You're going to be really inflamed while they see you.

[00:19:46] But if I don't do that, Layla is not going to get her flexion back. And I educate the patients around that. And oftentimes I have them bite a bullet. No, I'm just kidding Layla. I just have them don't scream out loud. Just don't scream out loud. If you scream out loud, I got to put you in a private room. So there's the good pain, good pain, bad pain. And then also to having skill set to understand what is overexertion? What does that look like? What does that mean? That therein lies the thing like it must be good because I'm like, I'm winded. What's your RPE?

[00:20:15] What's your rate of perceived exertion? What is your number? How are you feeling right now? Can you talk to me right now? You're on the treadmill. It looks like your braving is really labor. Therein lies that kind of like expertise skillset to understand like, this is fine. You're okay. Let me take your blood pressure, but we're going to keep on doing what we're doing. We're not going to stop. There's that. There's the kind of like more is better. And then also, also the patient that comes in and says, wow, it's a slow process.

[00:20:41] I'm really not getting any better understanding, educating the patient on it is a slow process. This is surgery or this is a strain or sprain. I mean, the differentiation between the diagnosis of a fracture versus a post-op fracture versus a strain or sprain. Therein lies my education upon my evaluation. So you know exactly what's expected. I'm not going to go into an ACL patient and say, you'll be good in three weeks. Never.

[00:21:11] It's never going to happen. Six to eight weeks is a normal length of stay for that patient. So I have to under, have to educate them on the gradual nature of recovery. And that all happens upon the evaluation. So you know exactly what's going to happen over the next three to four weeks. Absolutely. I think helping patients manage the expectations and having realistic timelines must alleviate some of their stress for sure. And I'm sure, you know, good and bad pain difference, how to differentiate that.

[00:21:41] But patients might just think it's all bad pain. So lucky they have an expert to really know the difference between good and bad pain. You know, it's funny. So back, I don't, I don't tell my patients anymore, but back in the day, PT used to stand for pain and torture. I'm not sure if you're aware of that, but. I have not heard that one, but I can understand why. Yeah. Yeah. That's funny.

[00:22:07] Going a little bit deeper into the specifics of your practice. Within your practice. I know you've been doing some innovative techniques such like hyperbaric oxygen therapy, dry needling and tele-rehab. I'd like you to go into a little bit about each of those if you can. And then also what's one breakthrough treatment that's just blown you away in terms of the results? Yeah, that's great. So let me start with hyperbaric oxygen therapy.

[00:22:36] So really just the net net on that. What that is, is just if you think about it, it's pressurized oxygen in a controlled environment. So you're in a chamber and it's 100% oxygen. You have a cannula in. And then what that does is at the center level, it leads to rapid recovery. It's the reason why Justin Bieber sleeps in one every night. It's the reason why all the elite athletes, all the football players that I treated sleep in one every night because of the rapid recovery.

[00:23:02] Vocal cords, shoulder pain, knee pain, hip pain, it doesn't matter where the pain is. Hyperbarics is all about rapid recovery. So the analogy I like to say to my patients is the absence of oxygen is the presence of disease. Meaning if I have a sprain or a strain or surgery or a wound, if that's not oxygenated, I'm not going to recover as fast as I would if it were oxygenated.

[00:23:29] So there is the kind of the story around hyperbarics. Dry needling is more of a twofold. So upon palpation, you may find a knot like a patient knows what a knot means like a knot in your neck or your trapezius or your back or your knees, your quads. So I go in and I find that knot. So that knot might be three inches deep. I can't get to it where not for a needle.

[00:23:54] So I might put a needle in you that long, penetrate that muscle and then the muscle fibers that were like this because they're in a knot, then deflate and become like that. And I feel it under my fingers. So it's the rapid recovery upon patient upon palpation and penetration of a needle. And the last part of that would be the telehealth model. What the telehealth model has done for us with psychology as well as physical therapy is allow me to treat a patient.

[00:24:23] Let's say, Leila can't come in today because she has a cold or she's sick or she has to take care of her daughter. So I could do a telehealth visit with you and your daughter's right there next to you because she's sick in bed. And we could do your rehab right there. It's been gangbusters for us as well as psychology. So let's say our psychologist can't make it in to the office five days a week. She can only make it in three days a week.

[00:24:46] We could set up telehealth visit where Leila is in the clinic and we have a full monitor, full telehealth clinic set up in the office. And then you sit there and you have a private conversation with your psychologist in our clinic and she's home. So it's kind of vice versa of what you were, what's physical therapy. And I, I, there's so many stories and anecdotes about around like the wow factor around those modalities.

[00:25:11] But I think the most important one for me is hyperbaric as well as dry needling. So this one patient I had three years of chronic occipital headaches. So occipital is the back of your head. Oftentimes the muscles below your neck called the suboccipital muscles are in spasm. They squeeze a nerve that supplies the back of your head and you have headaches. So I treated her palpated suboccipital muscles, had a headache, dry needled her.

[00:25:41] Five minutes later, no headaches. Hasn't had headaches since. She had a headache for two years, two years, five minutes. So needless to say, she's my biggest cheerleader. She sent everybody to me for, for dry needling, for physical therapy, for hyperbaric. But there's many, many stories of patients. It's a, it's a, it's a bad business model because I heal the patient. Immediately versus, versus treating it for, you know, eight, 10 visits. But I'll take it for what it is.

[00:26:08] So, and then hyperbaric options there, we had a patient who came in post COVID. Post COVID symptoms are pretty severe. And those patients try everything and they'll, they'll pay anything to just not have these symptoms. So I had her in the hyperbaric chamber for four visits and she came out symptom free. She had, she had post COVID symptoms for three years and she came out four treatments later, no more symptoms.

[00:26:33] And then what that does is that really just drives the cycle of referrals because the best referral is a patient referral. And that's where I base my business on all my patients referring other patients. It's not about like going out and trying to take out this doc or this person to dinner and have drinks. That's not how I develop my business. My business is through treating you like royalty, because then you'll go back and tell your sister and your mother and your brother who I am and what I do.

[00:27:01] And that's how I base my, my practice awareness and my brand awareness on just my skill set and my, my experience. Absolutely. I think a word of mouth referral and most businesses, especially in healthcare definitely goes so far. Sounds like you definitely gave her a new lease on life. A two years of the headache does sound pretty miserable. So I'm sure she thanks you every single day. Okay.

[00:27:26] And going back to kind of talking about tele-rehab and how telehealth has actually really just changed the health and medical world so drastically, especially in the last few years. What role do you think technology plays in the future of rehab? And do you happen to see a day where AI or virtual reality can be a part of therapy or your therapy specifically? Yes, absolutely. I feel, I feel that it's a profession.

[00:27:55] It's a great profession because it's not one of those professions where AI will replace physical therapy because physical therapy by nature, by design, by definition is physical. If I'm not touching you and I tell all my new grads this, I kind of on a side here, side note here that I've been in physical therapy before. I've been in clinics before where I worked and I saw a patient and I saw a patient interact with a physical therapist that never ever touched that patient. And I'm like, that's not physical therapy.

[00:28:25] So every patient I see, I see and I touch. I palpate or I diagnose or I stretch out. So I, I, I will never replace that. I, I'm not, I'm not, I'm not, I'm not. I'm not.

[00:28:50] I'm not. I'm not. I'm not. I'm not. I'm not. But I am. I'm like, I don't like to emphasize any other plan that have electrodes on there.

[00:29:13] And I can diagnose that gate or say that there's a, there's a balance deficit based on the, the green screen behind the AI or behind the canvas. And I've done a lot of that research in the past 15 years. So I guess the, the long answer is that AI will absolutely compliment and supplement physical therapy, but it will never replace physical therapy. absolutely i think also it will never really there's no interaction quite like a human

[00:29:40] interaction so especially talking about empathy for sure and for those listening or for anyone you may know who may be struggling with rehab either physically or mentally what's one piece of advice that you would give them how about three pieces can i give you three pieces go right ahead you give me as many as you'd like to yeah i guess i guess the first would be just be patient

[00:30:08] just be patient and be kind to yourself just be appreciate the journey you know just really focus on the journey not on the destination we know based on the evaluation what that destination is what that outcome is but let's let's really enjoy the journey we're gonna be together for 10 visits 12 visits 15 visits so my piece of advice to the patient is be kind to yourself enjoy the journey

[00:30:34] and celebrate those small victories i guess that's the third point you know you come in and your pain level was an eight last week now it's a four that's a big big deficit let's celebrate that let's talk about that and i really i'm really proud of the celebration around the small victory so in my clinic it might sound a little corny but it really it really works so hear me out so in my clinic every

[00:31:00] discharge every single discharge is celebrated meaning if i'm with a patient in the room and i have 20 patients in my gym my aides know to come get me and say layla is being discharged today and i say all right guys everybody quiet down quiet down light is being discharged today and i embarrass layla i say layla okay give us a little story where were you six weeks ago i came in i saw dr griffel i

[00:31:27] couldn't move my arm now look at my arm arms great i feel great i'm playing tennis again and we all clap i give you a nice big clap i give you a t-shirt you put the t-shirt on and that's how we celebrate our patients you got to celebrate the victories you have to celebrate the victories no that's super exciting how do you think that the patients take to that do they tend to like that oh they love it i i always i always preface it with if i see this introverted patient i know like i'm not going to

[00:31:54] pull her out in the front of 20 patients i already planned that out so i just i have her in the back room i say here's a t-shirt congratulations and you know what also too is that oftentimes we may discharge a physical patient but you're still there for psychology or vice versa so we have those shared patients that are still coming in for psychology but may have been discharged from physical therapy and we have a lot of patients in this area that have this awesome logo on the back

[00:32:21] of their shirt that we have room that's awesome are you ever just out sometimes in philly and run into some of your patients or all the time all the time i wear my i wear my gear everywhere my wife yells at me all the time she says i wear it way too much but even in church like i'll leave church and they'll come out and say hey is that your practice yes it is oh my shoulders kill me can you take a look on my shoulder i said no i can't but you can give me a call and i can schedule something

[00:32:48] absolutely yeah yeah so it's great no i i don't think you could wear it enough that's your brand you should be proud of it and wear it wherever you go i know you're you're from south philly is that where your practice is based as well so it's 30 minutes from south philadelphia i'm in media in delaware county which is about 30 minutes from where i grew up all my schooling was in philadelphia uh i was the philadelphia eagles physical therapist back when i first graduated when i was in

[00:33:13] still in pt school um so yeah i'm a philly boy born and raised uh big celebration coming up this friday for the for the parade around that huge huge blowout of the chiefs which i was so excited about that was definitely a blowout of a game for sure do you think you're gonna make it to that parade on friday i don't think so i don't think so you know it's funny because my wife and i were still

[00:33:39] thinking about like they were supposed to have it tomorrow but we're getting bad storms here tomorrow so they moved it to friday last week knowing that we were in bad storms tomorrow so if it was tomorrow we were both going to go but now that it's friday we have dinner plans we're just gonna hang out and watch it on tv there you go yeah valentine's day gotta spend it with the wife right happy wife happy life that's right absolutely and i know um while we're on the topic of family i

[00:34:04] know in the first episode you did mention having three sons so are they how like what are their age ranges so i um i you know so let's see my proudest moment is i met i married my best friend 27 years ago and she's she's a nurse and and we have three beautiful beautiful sons my oldest son luca he's

[00:34:26] he'll be 25 in two weeks my middle son mateo uh is 23 and my youngest marcello just turned just turned 20 uh last month okay so they're all pretty grown around that college early adolescent early adult age range do you think any of them want to get into the medical field or following your footsteps as a

[00:34:51] physical therapist at all my youngest son is in school now he's a sophomore in college and he wants to become a psychologist he wants to take over the practice but he wants to do it down the psychology path okay maybe i can convert him over to physical therapy but we'll see or maybe you could say that you guys can work hand in hand yeah i'm not sure how that would work because i'm pretty stubborn with my patients i i can see that i understand why and then i guess i just have another question for you

[00:35:21] before we kind of wrap up episode two when you think about the future of rehabilitation and health care what particularly excites you the most we we need to i was just on a call last night with this neurosurgeon um and we were talking about this for like 30 minutes we are not good advocates for our own best interest meaning doctors typically don't fight the battle that needs to be fought for

[00:35:50] reimbursement meaning reimbursement goes down 10 every year and our costs go up 10 every year so you can't win if this is direction your head in every year so task-based practices like my practice is the future of medicine and definitely the future of physical therapy because in my practice i one-on-one see two patients an hour when i worked for the big box conglomerates commodity of physical therapy

[00:36:19] two years ago five years ago ten years ago before i sold my practice to them i was seeing six patients now eight patients an hour you cannot survive seeing four six patients an hour it's impossible because i can't give you the time that you deserve that you're paying for if you're there in the corner doing exercise with an aide you're there with me one-on-one for one hour that's how i want to run my practice and this neurosurgeon

[00:36:47] his 90 of his patients come from international because they're willing to pay the money to get treated because he only he only takes cash for his treatments so people see the benefit of one-on-one care and they're willing to pay for that people in pain want to be pain-free let me just tell you that and they're willing to say like okay i tried physical therapy the commodity of physical therapy it didn't

[00:37:14] work and i went over to dr griffo and he just worked miracles on me because he focused on me and he educated me and he was there engaged with me every single treatment that's how you succeed in health care absolutely definitely i think that one-on-one care goes so far especially having that entire time

[00:37:38] and not being with aids or being in the whole system of like you said earlier how a lot of practices are run between front desk and all of those different variables but just having that one-on-one time with you um and thinking about the future let's say five to ten years what would you what would be the best outcome for success for your practice with the rehab room yeah so we're already looking at uh

[00:38:07] number two so what happens in this world is that in the world of the space of physical therapies the first one is usually the toughest and i've done this before when i had seven practices sold then my goal is to have 10 of these practices cast-based practices that have the four pillars you know physical therapy psychology hyperbaric oxygen therapy and a full concussion clinic with diagnostics

[00:38:31] in all 10 of these facilities and the next five years that's my goal wow that's definitely a great goal i'm sure you will definitely accomplish it um and right now currently how many practices is it the one first practice yes first one yeah okay we've been building this practice for three years the the the model of care has been built for three years as to how do you treat a patient with psychology and physical therapy and also

[00:38:57] round it out with the hyperbarics and the concussion clinic so it's been a slow build but it's definitely more than worth it because the outcomes are just fantastic and i wouldn't be surprised if other physical therapists or other psychologists try to do what i'm doing in the near future but by that time they'll be uh kissing my heels because i'll be well ahead of them right now absolutely sounds like the groundwork has definitely been laid out just ready to hit the pavement and keep

[00:39:25] going and building and i think it's about all the questions that i have for you today on episode two so is there anything else you would like to wrap up with or tell the listeners any last words yes two two things uh i guess if you go to physical therapy and you go to physical therapy and you're not being touched don't go to that physical therapist turn around go somewhere else if you're not seeing your

[00:39:54] physical therapist every single day don't go back to that physical therapist you should be seeing your physical therapist not the aide not the front desk not the assistant you should be seeing your physical therapist and lastly physical therapy is hands-on health care that's what it is so if you're not being stretched out or having manuals or doing something with your physical therapist every single treatment go somewhere else go to the rehab room because i touch my patients every day

[00:40:20] absolutely and if for any of those listeners they can just look you up and find you for the rehab room um and i guess thank you so much for hosting this episode of um rehab revolution and episode two where physical healing meets mental strength um thank you again and we'll see you next week for episode three awesome thanks so much lela so nice thank you so much dr griffa