Happy holidays and gratitude to the Healthy, Wealthy and Smart family! This is a special episode where all the amazing women behind the show come together to discuss 2019 and what’s to come in 2020. Thank you for supporting us and we hope to continue to provide great conversations in the new year!

In this episode, we discuss:

-Why you should enlist a team to help grow your business

-How to gracefully ride the ebbs and flows of entrepreneurship

-Prioritizing your mental health to avoid burnout

-New year intentions from the team

-And so much more!


A big thank you to Net Health for sponsoring this episode!

Check out Optima’s Top Trends For Outpatient Therapy In 2020!

 For more information on Jenna:

Gratitude Jenna KantorJenna Kantor, PT, DPT, is a bubbly and energetic woman who was born and raised in Petaluma, California. She trained intensively at Petaluma City Ballet, Houston Ballet, BalletMet, Central Pennsylvania Youth Ballet, RDA Choreography Conference, and Regional Dance America. Over time, the injuries added up and she knew she would not have a lasting career in ballet. This lead her to the University of California, Irvine, where she discovered a passion for musical theatre.

Upon graduating, Jenna Kantor worked professionally in musical theatre for 15+ years then found herself ready to move onto a new chapter in her life. Jenna was teaching ballet to kids ages 4 through 17 and group fitness classes to adults. Through teaching, she discovered she had a deep interest in the human body and a desire to help others on a higher level. She was fortunate to get accepted into the DPT program at Columbia.

During her education, she co-founded Fairytale Physical Therapy which brings musical theatre shows to children in hospitals, started a podcast titled Physiotherapy Performance Perspectives, was the NYPTA SSIG Advocacy Chair, was part of the NYC Conclave 2017 committee, and co-founded the NYPTA SSIG. In 2017, Jenna was the NYPTA Public Policy Student Liaison, a candidate for the APTASA Communications Chair, won the APTA PPS Business Concept Contest, and made the top 40 List for an Up and Coming Physical Therapy with UpDoc Media.

Jenna Kantor currently holds the position of the NYPTA Social Media Committee, APTA PPS Key Contact, and NYPTA Legislative Task Force. She provides complimentary, regularly online content that advocates for the physical therapy profession. Jenna runs her own private practice, Jenna Kantor Physical Therapy, PLLC, and an online course for performing artists called Powerful Performer that will launch late 2019.

Jenna continues to perform in musical theatre and lives in Queens, New York with her husband and two cats.

For more information on Julie:

Gratitude Julie SiasDr. Julie Sias, PT, DPT is the Producer of the Healthy, Wealthy and Smart Podcast. Julie received her Doctor of Physical Therapy degree from Chapman University. Julie loves to gain new insights and inspiration from the guests of the show in order to enhance her physical therapy private practice in Newport Beach, California.


For more information on Lex:

Gratitude Lex Lancaster Alexis Lancaster is a student intern on the Healthy Wealthy and Smart podcast. She earned her Bachelor of Science degree in Biology, a Graduate Certificate in Healthcare Advocacy and Navigation, and is currently in her final year of the Doctor of Physical Therapy program at Utica College in Utica, NY. Lex would love to begin her career as a traveling physical therapist and hopes to eventually settle down in New Hampshire, where she aspires to open her own gym-based clinic and become a professor at a local college. She loves working with the pediatric population and has a passion for prevention and wellness across the lifespan. Lex also enjoys hiking, CrossFit, photography, traveling, and spending time with her close family and friends. She recently started her own graphic design business and would love to work with you if you have any design needs. Visit www.lexlancaster.com to connect with Lex.

For more information on Shannon:

Gratitude Shannon SepulvedaDr Shannon Sepulveda, DPT, M.Ed., CSCS, WCS is the owner and Physical Therapist at Shannon Sepulveda, DPT, PLLC. She is an Orthopedic and Women’s Health Physical Therapist and is currently the only Board-Certified Women’s Health Physical Therapist (WCS) in Montana. Shannon received her undergraduate degree from Dartmouth College, Masters in Education from Harvard University (M.Ed.) and Doctorate of Physical Therapy (DPT) from the University of Montana. She is also a Certified Strength and Conditioning Specialist (CSCS). She has been a practicing Physical Therapist in Bozeman, Montana for over 6 years. In her free time, she enjoys running, biking, skiing, hunting and spending time with her husband, son and daughter.

Read the full transcript below:

Karen Litzy:                   00:00:07           Hey everybody. Welcome to the last live podcast of 2019 I am your host, Karen. Let’s see, and today’s episode is brought to you by Optima, a net health company. Optima therapy for outpatient is a software solution enabling therapists and staff to do their jobs efficiently and accurately. Their software provides anytime, anywhere access to documentation, even while disconnected, which is huge, and workflows that streamline patient care and save valuable time. You can check out Optima’s new on demand video to learn what’s in store for outpatient therapy practices in 2020 with some of the biggest industry trends along with tips and best practices to successfully navigate these changes.

Karen Litzy:                   00:01:14           Learn about these trends for the new year at go.Optimahcs.com/healthywealthy2020 and we will of course have a link to this in the show notes under today’s episode. And I also want to thank net health not only for today, but for being such an amazing sponsor to this podcast. We couldn’t do what we do every week without their help. So a huge thanks to net health. So definitely check them out. And notice I said we now it’s because of course I cannot do this podcast alone by any means. And today I am so excited to have the powerhouse team behind this podcast for amazing physical therapy entrepreneurs for strong, amazing women who help bring this podcast to life every single week. So in this episode, I’m happy to have on doctors. So they’re all doctors, Julie Sias, Jenna Kantor, Shannon Sepulveda, and Lex Lancaster. And what we did was I had a conversation with Jenna and Julia.

Karen Litzy:                   00:02:18           You’ll hear that in the first half of the podcast. And then in the second half of the podcast with Lex and Shannon and we talked about what our sort of our year in review, what 2019 did for us as people and as women and as entrepreneurs and physical therapists. And one theme that came across was that we’re all doing things that make us happy and that in 2020 we want to continue that and we want to sort of construct the life that we want to see us leading. So that’s in our personal lives and also in our life as physical therapists. So the amazing thing is Lex, Jenna and Julie are new grad physical therapists. Jenna and Julie have started their own practices. Lex has her own business outside of physical therapy, helping people with websites and graphics. Shannon, has an amazing practice in Bozeman, Montana.

Karen Litzy:                   00:03:20           She has started her practice about two years ago. It has grown exponentially. So she talks about how she did that. And it’s amazing. We talk about what I have coming up in 2020 including an online course to help all those physical therapists or occupational therapists out there who want to start their own practice in a way that feels good to them in a way that’s going to make them happy, bring them joy. And also the most important thing as physical therapists is our job is to get people better. And in our conversations in this podcast, we talk about how what we do as individuals not only affects us, but it’s exponential. It affects everyone around us, our communities, our friends, our families, and of course the patients that we serve. And we’re so grateful to that. And of course, as the host of the podcast and creator of the podcast, I just want to thank all of these women because without them I wouldn’t be able to do this.

Karen Litzy:                   00:04:14           There’s no way I can do this on my own. Like one of my guests said, Stephanie Nickolich and we mentioned this in the podcast is if you try and do it all, it’ll keep you small. And when I was trying to do it all with this podcast, it was keeping me small. I wasn’t able to upcycle this as much as I have with the help of these four women. So I just want to tell all of them and I say it in the podcast as well as that I appreciate them. I think they’re amazing and I wouldn’t be able to do what I do without them. And I just want them to know that my gratitude for this past year of 2019 is so immense and looking forward into 2020. I’m so excited to see what we all come up with. So I hope you guys really take in this episode because I think it’s really special and of course to the audience thank you so much for another great year of listening and interacting with the podcast and being able to meet so many listeners all over the world has been a real joy to me in this past year. So everyone, thank you so much. Have a very, very happy new year and we’ll be back with brand new episodes in 2020.

Karen Litzy:                   00:05:24           Hey Jenna and Julie, welcome to the podcast. Welcome back to the podcast. Since you’ve both been on several times. The reason being is because we all work together on the podcast to make it what it is. So well, welcome, welcome. So we’re wrapping things up for 2019 and I thought, well, what better way to do that then with the people who make this podcast happen every year and who I’m eternally grateful for and appreciate so much for all of your hard work and your dedication and your fun and your being you. So, thank you guys for everything that you do. And now let’s talk about 2019. Right? So we have January, 2019 to now. So a lot of things have happened within that year. So Jenna, we’ll start with you. What are some highlights for you that’s happened over the past year that you can kind of share with all the listeners?

Jenna Kantor:                00:06:34           Why hello listeners! Good, good evening and sun salutations. For me, I started my own practice literally on January 1st and we were driving back and I got my first patient that day. So literally my practice started this year. That was a big one for me. I also very quickly left all my PRN for those who don’t know, that’s working as needed, like a substitute teacher at a bunch of mills and I very quickly left all of them and I have been working for myself and it was the best decision I ever made. I have that musical theater background, which I’m sure listeners are quite familiar with, but if you don’t know not, you know, and I was really not meant as a physical therapist to be sitting in one spot from nine to five. I really am not built that way and I love that I can make my own schedule, my own life and not feel like I’m really stuck in a location. It’s a very, very big deal for me. That was something that was very concerned about as a performer. So I’m grateful to have made that move for myself.

Karen Litzy:                   00:07:49           Awesome. And Julie, how about you? So what’s happened from January till now?

Julie Sias:                      00:07:54           So having been kind of mentored by Karen for the past three years, it was nice cause I also actually started my own practice and Karen was helping me along the way and everything. And January 1st yes, had my first patient and everything and it’s been going really well, I haven’t left my PRN jobs, but I do manage my concierge outpatient practice. And then I also see kiddos as like a consultation kind of gig. And then I work at a skilled nursing facility, PRN right now to supplement all that. But it’s been a really exciting year because I finally have had a lot of control over all of my hours and it’s been nice being out of school as a new grad.

Karen Litzy:                   00:08:44           Yeah. And Julie, when did you graduate? What was your graduation?

Julie Sias:                      00:08:49           So I graduated in the summer last year and then I took the licensing exam in November.

Karen Litzy:                   00:08:56           Right, cause you had to wait that extra long time to take your licensing exam.

Julie Sias:                      00:09:01           Yeah, so that was when I was just like a licensed applicant in California and I was working at the skilled nursing facility that I did a clinical rotation at. And then after I finally got my license, I was able to do all the paperwork to get a corporation and everything.

Karen Litzy:                   00:09:16           Right, right. And Jenna, when did you graduate?

Jenna Kantor:                00:09:19           That is so cool, Julie. I graduated in May 2018, took my boards in August and then I had a baby. No idea. I felt like, I think it was the rule of threes and I didn’t have a three so I made up one.

Karen Litzy:                   00:09:48           That’s so funny. Can you imagine now people probably be like, Oh my God, if they get like just a little clip.

Julie Sias:                      00:09:54           That’s Jenna’s one liner for the episode. We should make a graphic. I had a baby.

Karen Litzy:                   00:10:06           So great that the two of you were able to have a good idea of what you wanted to do and then we’re able to execute on that and take action on that because it’s certainly not an easy thing to do, especially when you’ve just graduated and you’re trying to, you know, sort of make your Mark and kind of find your way. So to be able to know that before you even graduated I think is is amazing. And do you have any advice? Let’s say there are some new grads listening or some students who are getting ready to graduate on what they can do to get some clarity around maybe where they would want to start their career at. And I’ll have either one of you can jump in. Julie, do you want to jump in?

Julie Sias:                      00:10:56           Yeah, I’m ready to rock. So it was good to have accountability from you Karen because I kept telling you every year that I was going to do this. So then when it finally came to the time I couldn’t really back down. So that was good. Cause then I had told everybody so if I ended up backing down that wasn’t really going to look very good. And then I was also really clear with how I wanted my life to be. And going this route is definitely more of like a, it’s tough, it’s been tough kind of cause it’s feast or famine sometimes and that’s kind of like the ugly side of being an entrepreneur. But I have to like pause and just be grateful when I think about like my day and I just go, you know what, this is actually my ideal day. I got to go for a walk in the morning.

Julie Sias:                      00:11:54           I saw two patients. Maybe it’s not like whether I want to be for like a full time job eventually, but I just have to like take a second and just be grateful. So it’s good to have a clear vision about what you want your days to look like and then just know that when you put in the hard work eventually it will pay off.

Jenna Kantor:                00:12:41           Yes.  Amen, this is Jenna. I could not agree with you more. I think that is such a good point with any new practice owner is to stop and essentially smell the roses because it’s easy to be, Oh my God, this is where I’m at. Oh my gosh. You know, living sometimes paycheck by paycheck and yes, you’re not going to be rolling in the dough right away. It takes time. It takes patience, it takes persistence, all that stuff. But exactly what you said I think is a great way to approach it. I think a big thing, well there’s a lot of big things for somebody. Big things when you graduate and you’re trying to find a job, but there really is, from what I have seen, I know there’s always an exception to the rule. There’s really no help with the idea of graduating and getting a job from your school. They are focusing on teaching you what you need to know. You’ve got to pass those boards, boom, bada Bing. So if you’re not going to continue and try to teach at the school that you were just at, you’re not going to really get that guidance. The big thing now unfortunately as most of the jobs are at mills, there are places where people don’t want to work for a long period of time. That’s why they’re always hiring. It just is what it is. And you could have this idea similar to me where you want to work with performing artists or say you want to work with tennis players. Say you want to work with geriatric patients only, but not by the hair of the chinny chin, Medicare, chin.  So you have a different vision on how you want to treat your patients. It’s not easy to fully see that through when you graduate because you see this number of what you owe.

Jenna Kantor:                00:13:50           So you’re in this like fantasy world. You’re in school, you’re learning like, Oh that’s what I’m going to do. You graduate, you see your debt, that number and that number changes everything for everyone you’ve finished. You’re like I need to get a job now. And it’s just ah, and then you start work and then I’ve heard from some people, cause I spoke to a lot of new grads since then, I’m coming to me and I’ve only been out for a year and four months, you know, since taking the boards and then coming to me, just so fearful of

Jenna Kantor:                00:14:26           what if I quit? And that makes me look like a bad physical therapist. I always say the same thing. I don’t care if it’s your fourth, your fifth or 10th job that you’re quitting. This is your life. None of us are living your life. So you got to make sure you are happy every time. You may get promises that, that they may not keep. And you need to keep track of that so you’re not putting it on yourself. When you’re not enjoying the job and you feel like you need to suck it up, you’re not supposed to suck up life you’re supposed to enjoy life. You can’t find that working for someone. You might be happy working at a mill. I’m not saying you wouldn’t be, you wouldn’t be, but most people aren’t, unfortunately. So you’re going to go through a journey most likely, unfortunately as a new grad of really having a hard time finding that fully right place for you to work long term.

Karen Litzy:                   00:15:14           And I usually tell people to kind of when you’re trying to figure out, well what do I want to do or where might I fit? I usually have people do a couple of different exercises and I mentioned this on the podcast before, but one is like, just make three columns. I’m a big column person, right? So you make three columns in the first, just put like what you love to do and the second column is what you’re good at because they could be two different things. Just cause you’d love to do something doesn’t mean you’re good at it. Like I love to do graphics doesn’t mean I’m good at it, but I love to do it but I’m not good at it. And then the third is what will someone pay you for? So if you can kind of find a through line there, I think it helps you to sort of drill into maybe what are your strengths, what are you good at? What do you love? What will someone pay you for? So I always say like, I’m really good at crocheting. I really love crocheting, but no one’s going to pay me for it. So it’s a hobby. See the difference, right? So you want to make sure that

Karen Litzy:                   00:16:30           you’re excluding your hobbies as being your full time job. But you know, for me, I some examples of what I’m good. Like I love curiosity, I love asking questions. I love, you know, networking and being with people and meeting new people. Those are things I really love and those are also things I’m good at. And so I was able to parlay that into a podcast and then parlay that into, through the podcasts and through networking into public speaking and into being asked to different conferences and stuff like that. So just know that not everything has to come from one singular job. You know like, and I think we can all say that here cause we’ve all got a couple of different things in the fire, stokes in the fire. Is that how you say it? I’m not really sure.

Karen Litzy:                   00:17:22           At any rate I would say to new grads is to certainly find the job that’s going to put food on your table and feed your family and feed yourself and feed your pets and feed your kids and feed whoever else is depending on you. But don’t discount that this one thing is the only thing you’re allowed to do. You’re allowed to do a whole bunch of other stuff, you have to give yourself that permission to do that and then you never know where that’s going to lead you. Because if I only stuck just to patient care, well I wouldn’t have this podcast and I wouldn’t be going all over the world speaking and I wouldn’t be asked to coordinate social media for conferences around the world. I mean just wouldn’t be a thing. But instead I just decided to do what I love and do it well and get paid for it. It’s awesome.

Julie Sias:                      00:18:28           Actually I have like a counter to that and that sometimes it’s also good not to do what you love as a job cause it can be something that is your me time sort of thing. Oh that’s like another counter to that. I was thinking about that maybe if you monetize something, it takes away the fun from it and then it becomes something where like I have to do this to make money versus I get to do this because I want to do it.

Karen Litzy:                   00:18:59           Right. And I think when you reach that point,

Jenna Kantor:                00:19:03           Yeah, I agree. Cut the cord if you don’t like it’s for me with performing I did. That was before me professionally for many years in musical theater. And I started to, I got into an eating disorder and I had to take a backstep cause it felt like a nine to five job going to these different States and I started doing community theater again to refine and which I did. And then I started working professionally again. So really was just, I realized I was just working at the wrong places. It’s not that they were bad places, just not right for me. So yeah, I definitely agree with it’s just assigned to cut the cord

Karen Litzy:                   00:19:41           Like Julie said, when you get to that point where I love doing this thing, but now it feels like a chore. I think you have to really do some self reflection and kind of see like, boy this is not, maybe, maybe I made a misstep here, so I need to take a step back and reexamine what I’m doing and let it go. Or you can see are there ways that I can make it even better if I give up some of the controls. Hmm, nice. Right? So I felt what Julie just said is what I felt about the podcast a couple of years ago. This very podcast, I was like, Aw man, I have to do another podcast. But then, and I was like pissed about it cause I was like, Oh, but I have to do this and this and this and Oh now I have to make time for this.

Karen Litzy:                   00:20:37           And I thought, all right, let me take a step back and kind of re-examine what I’m doing here. Cause there’s gotta be a way that I can make this better and that I can make it bigger. And the thing for me was asking for help. So once I ask for help and let the control go, now all of a sudden it’s, you know, more enjoyable and it’s something that I continue to be very proud of, but that I’m not like, Oh no, not again, damn you podcast. You know, so it’s instead of cutting the cord, I just tried, I took a step back and tried to look at ways that I can improve upon it and the improvement came with bringing people on board. So that’s, you know, another all very valid kind of ways to look at things.

Julie Sias:                      00:21:49           Yeah. Another way to look at it too is that when you were under a lot of pressure, that allowed you to kind of be more creative too, to look for solutions and sometimes you go in directions that you wouldn’t have thought you were going to go just because you were under that pressure and boom. That’s where sometimes magic happens too.

Karen Litzy:                   00:22:09           That’s right. Yeah. I think what Ryan Estis who was on the podcast a couple of weeks ago, what did he say? Like, when you’re comfortable it breeds laziness or something like that, I’m really butchering his statement. I was like, boy, I really butchered that one up pretty well. But I remember when you said that, I was like, yes, that’s so true. And yeah, it was something to the effect of like if he was looking at it from the point of view of an entrepreneur, that when you get to the level where you know you’re consistently making money and you’re consistently successful and then does that then breed complacency and does that take away your creativity a little bit?

Julie Sias:                      00:22:58           Yeah. That’s not really the magic zone for growing.

Karen Litzy:                   00:23:01           Right, right, right. Yeah. And that’s when you need some outside eyes to kind of take a look and see, and like Steve Anderson said last week, what is the role of a coach? And he said to give you those external eyes and ears that opens you up to things that you’re just not seeing. And that’s for everyone.

Julie Sias:                      00:23:27           Yeah. I actually have a perfect example of this and it was when I was just graduated and I was a licensed applicant and I had gone to all of my clinicals and asked for a job because I needed to make money while I was studying for the boards and stuff. And so ended calling Karen up and I was just like, you know, this one job offer, I got sure, like I’ll have guaranteed money and guaranteed hours and stuff, but I just, it’s not sitting with me well, I didn’t really enjoy that experience as much as I could have. And then you were just like, Oh well maybe that’s not the right fit for you. And then I got really creative and asked for referral for another clinic and ended up getting a job that better suited me at that time. So it was kind of nice having you there cause I was in the trenches like, Oh I need to make money right now. And you were just like, no, just take a step back. And then I had all these other opportunities present themselves.

Karen Litzy:                   00:24:24           Right. Right. And Jenna, that’s kind of what you were saying. Right. When you graduate, like you said, all you’re seeing is like, I’ve got debt, I need to make money. So you just take what you can. And so, you know, we don’t always want to take just what we can, but you know, we want in an ideal world, we want to take what fits from all perspectives, what fits for the employer, what fits for you as a potential employee, what fits for you, whether you want to be an entrepreneur or you know, a part time entrepreneur, full time, whatever. But I think as a healthcare provider, if you find that job that fits, it just allows you to help more people.

Karen Litzy:                   00:25:19           Right? And in the end, we’re in the business of making people better. And if you’re not in the job that allows you to do that or you’re not in the head space that allows you to do that, then the people who ultimately suffer are not you. I mean, you do a little bit, but it’s the people that we’re out there to help. We’re there to help people. That’s what our job title is. And so if you can’t, you’re not in a good head space to do that or in a good physical space to do that. Then I think it becomes very difficult. Like Julie said, well, I had a great day. I was able to do the things I want to do that keep me sane. So that when you show up for your patients, your clients, you’re showing up fully for them. That’s where I think the PT profession can Excel for sure.

Jenna Kantor:                00:26:24           When I was filling in for PRN work, I would come in energized, positive. I would walk in and go, let’s do some physical therapy. We’re going to heal. And like people loved me, or at least I believe they did. I had the patients even though I was a substitute teacher, which is how I introduce myself.

Jenna Kantor:                00:26:45           Like I really bonded with these people, you know, and I have that energy, but Oh yeah. If I had one full day or Oh my gosh, forgot it, two or three, Oh, can maybe have at once. Oh my God. Full days in a row, I would need days to recover, days to recover. Like I was like, I was gone, I was gone. I was like sleeping, like just feeling so tired throughout the day and it really made it so apparent to me that everyone else is doing this six days a week, maybe five, you know, I don’t know, depending on there schedule, but I was just, Oh my God, I can’t, you know, hence here we are a private practice owners on this call. Yeah, exactly.

Karen Litzy:                                           Now let’s talk about what’s in store for 2020 new decade. New year.

Jenna Kantor:                00:27:44           It’s my birthday. I’m turning 40 years old. That means I’m going to be so mature. February 16th. I like flowers, see’s candies and cats and Disney for anyone who wants to know. Yeah, we’re getting a dog. But like I’m more of a cat person so, but it has to be cute cats cause there are those presents. But 2020 is going to be awesome. I’m sorry, I just jumped in. But I’m theater people love talking about themselves being the center of attention. It’s great. So I am so excited about fairytale physical therapy. For those who don’t know, Fairytale Physical therapy is where we bring musical theater shows to children in hospitals and teach choreography that’s secretly composed of therapeutic exercises. This whole past year we’ve been working on paperwork back and forth with the lawyers to get it done right.

Jenna Kantor:                00:28:42           And we’re like almost there every time. Like people ask, it was just us liberal almost there. Right now we’re trying to get the right legal name because it’s not as simple as you would think. So we’re trying to figure out that legal name where they’re not straying too far from what we are. And so that’s going to exciting. And then for me, I am doing a lot of one-on-one beta tests with performers, for one course an online course for performers to essentially, those are going to be mini courses like say you have, hip tendonitis. All right? Now the majority of non-union musical theater performers do not have health insurance. And if they do, they have extremely high deductibles. So they usually just don’t get help. So this is creating a wellness program that will be on that boundary of like, Oh my God, you doing like physical therapy stuff, but y’all do.

Jenna Kantor:                00:29:42           It’s about the patients. So I’m creating this for them. The people who don’t have that access, they don’t have the money, they don’t have all that, where it’s a program and right now I’m just testing it on people cause it’s physical therapy. You have to test on people and see if it works, if they stick with it. And so that’s really cool. So I’m literally doing it, I’m doing three different types of injuries, right? No, five injuries right now. And taking different people. They’re essentially like patients where I’m talking to them every week and like upping the game and figuring out symptoms. So that’s great. Move that over. Now I’m also starting next week, just walking into the new year one on one work with physical therapists who want to work with dancers and figuring out what they want to know to make them the confident, accessible and go to dance PT in their area.

Jenna Kantor:                00:30:35           So I am working with now five, it was originally three 50 minutes ago, became five. I’m working with five and figuring out what they learned and basically giving, creating a course from this. So I’m very excited about two things cause it’s where I want my energy to go. I love doing, like we were saying, find what you like doing. I like doing the creation of online stuff. And I’ve just encountered so many people with limited access to performing arts, physical therapists who specifically know that. And if they do know that our hearts, they don’t have the insurance. You know, there’s a lot, a lot of people in this world who don’t get it. So I’m very excited to be bringing that help to performers at large. Whether it be giving that education to physical therapists or providing a program to them directly so that is exciting!

Julie Sias:                      00:31:36           Jenna, I was like, I’m going to bring like some California chill into the conversation because when I think about 2020 it’s more just like, okay, I got my income streams and their proportioned a certain way. I want my business to grow more than the other ones and slowly phase those out. So that’s like my intention for 2020 but then every other intention has nothing to do with physical therapy.

Karen Litzy:                   00:32:12           I love it. That’s good.

Julie Sias:                      00:32:16           I’ve just been spending too much time thinking about physical therapy this year too much time, so next year I’m just thinking about more time with family, more time exploring hobbies and stuff. Maybe then I’ll feel refreshed and have some inspiration to do more online type services and stuff like that, but just going into 2020, I have I don’t want to say low expectations, but just I don’t want to set too many things, just see where it goes.

Karen Litzy:                   00:32:40           You have sort of more relaxed expectations, so not that they’re low. I think phasing out your PRN jobs and increasing your income that’s a big job. And it’s awesome. So I think that’s a great thing to focus on. That’d be fabulous.

Julie Sias:                                              Karen, you haven’t told us about your 2020.

Karen Litzy:                   00:34:09           Why I am going to do nothing? No, I’m just kidding. I’m just stepping back and I’m going to live the life of Riley for the whole year. No, no, no. I am going to continue obviously with my concierge practice because I love it. I would like to take on another independent contractor onto the practice as well. Just to, even if it’s just one or two patients a week, you know, just something to kind of help offset the amount of time I’m spending with patients, which I love. But, it’s a lot. So oftentimes I get caught up working in the business instead of on the business. So that’s something that I’d like to kind of get a better balance of. And I am also in the final stages of putting together an online program. I know I said I was going to do this year, and I did it because I was too fearful and just was too afraid of like, no one’s gonna buy it. I’m going to look so stupid. And with that, you know, it’s clear that has been holding me back. But I’ve been working with Adrian Miranda also. So he helped me with some videos and worked with Joe Tata, to help me come up with a great plan. And I’ve been working with copywriters throughout the year and some business coaches. And so I have a program that I was calling strictly business mastermind, but now I think we’re might change it to the private practice mastermind, but that might be changed. I think someone else has a name that’s pretty similar.

Jenna Kantor:                00:35:20           You could do PP mastermind, so you could say pee pee like professionally, which would be funny. He’d be mad.

Karen Litzy:                                           Oh boy. I didn’t even think of that. Now that private practice mastermind PPM, I may need to rethink this. But we’re hoping for like an end of January launch and it’s not just me, there’s myself, there’s lawyers, there’s accountants, there’s PR professionals, marketing professionals, investment professionals, you know, investment 101 for entrepreneurs kind of thing. Got other successful physical therapists are going to come in and that’s just the six week part of the course. So six modules over three months, but then it’s a year long program. So each month I have new mentors coming into the group to talk about whatever the group is looking for. Whether that be, you know, practice succession or tax stuff, student loan stuff, whatever.

Karen Litzy:                   00:36:38           So we’ll have monthly webinars for the whole year. And then the best part is I’m doing the Marie Forleo model. So Marie Forleo started a B school, which is an online kind of business school, like abbreviated business school that she started several years ago. And once you purchase it once, that’s it. So if we do it again and there are things added to it, you’re always in the Facebook group. You don’t get shut out of the Facebook group after a year. You don’t have to pay for upgrades and all that kind of bullshit cause I think that’s so stupid. So I’m going with the Marie Forleo model and it seemed to serve her well since she’s made millions and millions of dollars and she’s just helped so many people. And I think they just know that like, Hey, this is the deal. And so once you buy the program, once you’re in it for life and you’ll get the benefits of that for as long as you need or want said benefits.

Karen Litzy:                   00:37:41           So I love it. I kind of liked that model. I just think it’s, I dunno, it just fits my personality a little bit better, you know? So, we’ll come up with a name, and then we’ll unroll it hopefully at the end of January.

Jenna Kantor:                                        Karen Litzy’s LIT program. Karen Litzy’s Master class cause you could do lit in LITzy. So that’ll be like the fire. Oh, I see what you mean. That’s a topless pizza delivery man. I dunno. I just, I was thinking lit. That’s red fire color and nothing. What else is fire color? Oh, pepperoni. And then I went to pizza and that’s where we got.

Karen Litzy:                                           Well, I thought it was because I am from the pizza capital of the world, which I guess would make sense. That would be amazing. I love that. Yeah. Yeah. Old forge, Pennsylvania. Plug for my hometown, pizza capital of the world. But yeah, so, but that’s pretty much. And then, I also am going to take a vacation.

Julie Sias:                                              Where are you going?

Karen Litzy:                   00:39:08           I don’t care, but I’m doing it. I don’t know where I’m going yet,

Julie Sias:                                              You should go to Hawaii.

Karen Litzy:                                           I love Hawaii. It’s so nice.

Jenna Kantor:                                        This morning you, I don’t know what it is, but one, I have a friend that’s gone on vacation that is when I decided to contact you. So it’s not on purpose. It’s just so when I’m contacting you I’ll be like, wait a second. She’s probably obvious. She’s in Hawaii. She’s in Hawaii.

Karen Litzy:                                           So we’ll see. I don’t know, but 2020. I am definitely, cause I have not had like proper vacation in a long time. So my goal, one of my biggest goals, and this is not PT related, kind of like what Julie said, but is take a vacation and love that with Brett. He just doesn’t know it yet.

Karen Litzy:                   00:40:03           We just have to be after June. He worked for a state Senator in New York, so he’s in session until in Albany, you know, you gotta, you gotta do what you gotta do. And then the other thing that I want to do, and Jenna can probably help me with this, is get a little more involved on the legislative side of things.

Jenna Kantor:                                        Love that stuff, man. You want, it’s that be the change you want to see in the world.

Karen Litzy:                   00:40:50           That’s another thing that I’d like to do, whether it’s PT related or not PT related, but just try and push for things that I believe in that should be happening.

Jenna Kantor:                                        So I think this has been the best podcast ever. I think for all of us were overjoyed to have us have cats. Julie, where’s your pet?

Julie Sias:                                              She’s outside.

Jenna Kantor:                                        There’s that dog, a dog and two cats walk into a bar. Thank you so much for having us on Karen.

Karen Litzy:                                           Yeah, this was great. And I’m just so happy to wrap up the year and I’m looking forward to lots of great stuff from everyone and with the podcasts and just kind of keep moving forward and trying to innovate and do some fun stuff. So that’s the goal and I thank both of you. So Jenna, Julie, thank you again. Like I said in the beginning, I appreciate you guys so much for all of your hard work and help and making the podcast much better than it ever was. So thank you so much. And everyone we’re going to take a quick break to hear from our sponsor and we’ll be right back.

Karen Litzy:                   00:42:20           This episode is brought to you by Optima, a net health company. Optima therapy for outpatient is a software solution enabling therapists and staff to do their jobs efficiently and accurately. Their software provides anytime, anywhere access to documentation, even while disconnected and workflows that streamline patient care and save valuable time. You can check out, optimize new on demand video to learn what’s in store for outpatient therapy practices in 2020 with some of the biggest industry trends along with tips and best practices to successfully navigate these changes. Learn about these trends for the new year at gooptimahcs.com/healthywealthy2020.

Karen Litzy:                   00:43:00           Hey Lex and Shannon, welcome to the podcast for our year end wrap up our year in review. So thank you so much for coming on and being on the other end of things for Shannon and the other end of things for Lex too. So thanks so much. So I spoke with Jenna and Julie the other day and now I have you guys here and I’ll say the same thing to you guys that I said to them is that I’m so thankful and appreciative of both of you for being part of the podcast and really elevating it to a new level this year. Cause I really do feel like without your help and without your contributions that it just wouldn’t have been what it was. So I just want to thank both of you and know that I appreciate both of you for your work in front and behind the scenes. So thank you so much. And now let’s talk about 2019 because now is the time of year that everyone looks back on the year. So I’ll ask the same question of both of you.

Karen Litzy:                   00:44:14           Where were you at January of 2019 versus kind of where you are now. So Lex, why don’t I have you start kind of what big things happened in your year? Where are you now? So it’s way different than where you were in January.

Lex Lancaster:               00:44:32           Yeah. It’s pretty crazy to be honest. I was thinking about it last night. This time last year, I was preparing for my last clinical physical therapy school, so I was actually going to New Hampshire. Mmm. I was going to be in an outpatient clinic for 13 weeks. I was super excited because it was my last one, but I was also getting that full 13 weeks in outpatient clinics. I was like my powerful clinical, so super pumped. So I finished that and then I went to graduation and I actually got engaged on white coat night. So that was really, it was awesome. Kyle did a really good job. And then I graduated PT school, it was so awesome. I was so happy. And then the NPTE came around and that was a different experience altogether. I will say that I underestimated that completely. Just the preparation for it as a whole, but then I passed. So that was great. And then now, so I had this dream of being a travel PT.

Lex Lancaster:               00:45:42           So, this past year, you know, I decided I was going to explore that. So right after I passed the NPTE, I accepted a contract with my fiance in Alaska. So we moved 3,500 miles away from home to an Island of 1200 people in Alaska. So now we’re in Ketchikan where it’s like the rain capital of the world. So I don’t look at rain as like, let’s keep me inside anymore. It’s okay. It’s always raining. It’s never not raining. And it’s pretty dark here. It’s pitch black still right now. So we’re currently in Alaska and an outpatient clinic. And to be honest, it’s been a whirlwind transitioning from student to kind of a PT, but you’re just studying for your exam to a full blown PT. It’s been hard just because I didn’t expect it. You know, I’ve done clinicals, I’m like, Oh, it’s no big deal. It’s totally different when you’re the person. So I’ve spent a lot of time in the last 13 weeks just kind of getting used to that and getting the groove and I’m excited. I’m excited to see what the next year will bring because this year was just really, really awesome and I’m really excited for, you know, to see what’s next.

Karen Litzy:                   00:46:52           And you also, not to, I don’t want to leave this out, but you also have an entrepreneurial streak in you. You have a company that you started this year as well. Am I correct?

Lex Lancaster:               00:47:05           Yeah, yeah. And I shouldn’t, you’re right. So I guess I initially launched it in like the end of 2018 but this past year has just skyrocketed. I just went from, I mean, I guess word of mouth is kind of the way that it really worked out. And I get to design websites and graphics and I am a virtual assistant, so I get to work with people all over the country and all different professions. I have so much fun doing that and I started it in PT school as I admit. I used to do it when I was bored in class. And then, you know, it got to the point where that was how I took study breaks. So that was the way I decompressed and I found that that was a big stress reliever for me.

Lex Lancaster:               00:47:56           So I explored that option and then I was kind of talking to Shante, movement Maestro and she was like, you know, you could really do something with this because I approached her at RockTape course and I was like, Hey, do you need an assistant? And that was right after I started working for you Karen. So like I was feeling pretty good. I was like, this is fun. I love doing this. And then I decided to do the whole web design business too and big changes for that coming next year. So yeah, it’s been, it’s been really, really cool. I’ve learned a lot about a lot of different people and I get to explore that all the time and I love it.

Karen Litzy:                                           Yeah, I think that’s great. What would you say to a physical therapy student right now? Who is set to graduate in, whether it be, maybe they’re graduating now or maybe it’s spring of 2020 given the huge changes that happened in your life over the past year. What would you say to them as they prepare to graduate or maybe they just graduated?

Lex Lancaster:               00:48:48           A couple things I would say I would say really explore your mental health. I think that I didn’t take that route when, as I was graduating, preparing for the NPTE and I feel like I truly drained myself to the point where if I could go back, I would invest in, you know, even a coach just to get me out of that sympathetic drive because I feel like my life just kind of, I just devoted all of my time and energy to the NPTE and it really did drain me. And, it was just a lot to manage. So let’s say explore your mental health, get that in check and you know, really be prepared to learn a lot and find yourself in whether you’re in your last clinical or just starting your job, you know, if you’re the smartest person in the room, try not, you know, try not to be that.

Lex Lancaster:               00:49:50           Like there’s always something to learn and it’s hard to go back to be in the clinic and be by yourself and not have someone to bounce ideas off of that’s in your room. Like your CI. It’s hard. And I truthfully would say get involved in Twitter. I’ve found that I’ve met the most incredible PTs on Twitter and I get so much good advice from them and I’m able to contact, you know, people have specialties that come into the clinic and I’m just like, wow, they could use some opinions on, you know, the vascular aspect and I’ll find somebody on Twitter and they are more than willing to help me. I would say just reach out if you have any questions about patients because there are so many PTs on Twitter and social media in general that would help you. So I would say just keep your network huge.

Karen Litzy:                   00:50:36           That’s great advice. And you know, I feel like this, the first time I heard someone say take care of your mental health. I mean Shannon, like we’ve been the NPTE or the boards and on through to our career. Have you ever gotten that? I never got that advice to kind of take care of your mental health. I think it’s great.

Shannon Sepulveda:      00:51:00           Yeah. I mean I think it’s super important. I mean, one thing like when I was a runner and an athlete and so I always made sure that like I worked out every day cause that really helped. But I remember like, just wait until you take your specialized board exam because then you don’t get your results for three months. So it’s like three months of like, okay, like is it June yet? You know? And so you don’t even like, and like when I took my women’s health board exams also I was postpartum so that like added a whole new mental health aspect to it. But I mean I studied for, you know, probably six months, probably pretty intensely for three months. And then you take the exam and it’s very similar to the NPTE where you’re like, I don’t know if I pass this because the questions are similar where you’re just like, ah, yeah, I don’t really know.

Shannon Sepulveda:      00:51:55           And then you have to wait three months to know if you pass. And so that’s really hard.

Lex Lancaster:                                       I’ll say a week was really hard. So I give you a lot of credit. Yeah, I know it was a hard, and you walk out and you’re like, then I have never felt like I have completely bombed a test, but I feel like I just bombed that and then everyone’s like, don’t worry, this is normal.

Shannon Sepulveda:                              Oh, it was sort of like, even with like my women’s health exam and then I was like, I think I failed that. And then I ended up getting like in the top 10 or 25 it was something like I did really well on it, but I thought I failed it.

Lex Lancaster:                                       It’s so odd that our brains do that, that all we remember all of the negative questions. We forget how many good ones there were and then we just kind of wrap around that.

Karen Litzy:                   00:52:51           Yeah. And that’s life, right? That’s why people always say to like, keep a gratitude journal at night. So then you remember the good things that happen to you every day and you don’t get wrapped up in the negative because I think that’s, like you said, it’s kind of where our brains tend to go. We remember those negative aspects before we’ll remember the positive ones. It is amazing.

Shannon Sepulveda:      00:53:15           Yeah. It’s the same thing with patients. Like who do you go home and think about the one patient that didn’t get better, not the six that you made better.

Karen Litzy:                   00:53:27           Totally. And now, Shannon, speaking of changing lives, so going from January till now, what’s been going on? What were your highs and lows and just so everyone knows, I mean they can go on the website, but you’re a business owner. You’re in Bozeman, Montana. And one of the only women health specialists in the state of Montana?

Shannon Sepulveda:      00:53:53           I’m the only one that’s taking the board exam. A couple women in Montana who have done the Herman and Wallace pelvic floor and they’re super highly trained and there’s other people in Bozeman that are women’s health physical therapists, but I’m the only one that’s taken the plunge to take the exam. But yeah, so 2018 so I know, I was thinking about this question. So I’ve been in my own practice for a little over two years. And so I was thinking, I’m like, where was I in January? And so since I take insurance, January is always like dead pretty much, but December is always nuts. I think I was still building my business like last January. I didn’t really like have a full schedule. I had been in business for a little over a year.

Shannon Sepulveda:      00:54:45           I changed my last name when I left my old clinic, just kind of to make a clean break with insurance and everything. And so I was still trying to get like name recognition and I do women’s health also getting into like the Perinatal community in Montana. And so this year I’m finally like, like doctors know who I am and patients come in, they’re like, I got referred by, you’re like so-and-so. They said you’re awesome. And so I’m getting like all of these women, especially postpartum women, that’s generally who I see, who were like, Hey, so and so like saw you, you changed their lives and I’m here. And so I would say like probably well over 50% if not 80% of my patients are direct access word of mouth. And I’m just like, Oh, this is so nice because I don’t have to like network anymore.

Shannon Sepulveda:      00:55:49           I don’t have to like spend my nights at like local networking events and which I was doing just to get some name recognition and now I feel like I can, I don’t want to like totally rely on word of mouth. I still think I need to get out into the community but it’s really nice just to like check my phone. I do online scheduling and be like someone’s requesting an appointment and another person’s requesting an appointment and know that like the patients are coming without me having to like really go out and spend a lot of time, which, and I think doing that really helped me now. I think I had to do that but now it’s nice where like it’s almost like an exponential growth cause moms tend to talk, which is really nice. And so the word of mouth has gotten really great for me.

Karen Litzy:                   00:56:37           That’s awesome. And you know, I think you bring up a really good point that you were in business for a year and you had a patient flow but it wasn’t like you were overwhelmed and you know, you didn’t have this full, full schedule. And I think for people starting out in business that is so important to realize that you don’t start your business and in two months, it’s rare it could happen. Yes. You’re not usually on a full schedule within a month or two.

Shannon Sepulveda:      00:57:09           No. And I think what was really important was like the time that I wasn’t seeing patients, like I took that time to either like have lunch with somebody, like have lunch with a prenatal yoga instructor or like have lunch with, you know, really anybody, a doula and midwife, like whatever. And so I really like had a lot of lunches and coffees just to like meet people. So when I wasn’t seeing patients, I was trying to meet people in the community. And I feel like those like one-on-one rather than like the big networking events were really important. And I sent like, it was great for me too because like I want to know who to send to for prenatal and postnatal yoga and I want to know who the good doulas are and who the good midwives and OBs are because I send people their way and who the good like trainers are that understand pregnancy and postpartum because I’m not a trainer. Like I get people to not pee their pants so they can go to the gym and see the trainer.

Karen Litzy:                   00:58:10           Correct. It could be your slogan. And you know something that would work.

Shannon Sepulveda:      00:58:19           Yeah, it was funny cause Shayla, the one that I did the podcast on with the hats she wanted, I got a bunch of my hats embroidered and she wanted me to put on the back leak-free thanks to my PT and I was like, that’s awesome. You know, I don’t know if people will wear that, but that’s a really good slogan.

Karen Litzy:                   00:58:39           That’s great. I mean, you’re really good at what you do. No, I mean that’s great because what do people want? They don’t, like you said, like I get them to not pee their pants so they can do other things. It’s that simple. You don’t have to overcomplicate things. Yeah, but I love that you’re still kind of doing business. I call it like business generating activities, you’re not getting paid for it, but it’s business generating activities, so it’s still like a moneymaking activity. And you’re right, the bigger, like Lex said, the bigger network you have, whether that be virtual in your case, because your business is in Bozeman, the bigger network you have a Bozeman, the more people are going to come your way. And so you did all of that work and now you’re really starting to see the benefits of it and it’s really exciting.

Shannon Sepulveda:      00:59:28           Yeah.

Karen Litzy:                   00:59:29           It’s also good that you know the cycles of your business. So you know there’s going to be really bit busy but January, not so much. You’d be like, okay, so January I’m going to set aside this time to do X, Y, and Z for my business. And if you know that those are the ebbs and flows because every business has an ebb and flow, then you know you can rely on that. And like I remember for me, my downtime is now around Christmas, new years, not a lot of people around. So that this would be the time where I would take a vacation or I would work on business plans for next year or I would, you know, just get things together. So, so to speak. So I think it’s great that you brought up all those points. And Shannon, what would you tell a new business owner, regardless of what kind of PT business you have, whether it’s a cash based business or your insurance or a hybrid, what have you learned that you’re like, Oh man, I would tell everyone this.

Shannon Sepulveda:      01:00:29           Yeah, I’ve learned that if you’re good at what you do and you get patients better, they will tell other people. And so I don’t want to say think of every patient as a referral source, cause that sounds like you’re, you know, it sounds like you’re categorizing them. But think of every patient as like, this person is very important. It’s very important for me to get them better because that’s what I do and what I’m good at. But it’s also very important for my business because if you get them better and you treat them well with respect and you do everything, they’re going to tell other people, especially in a small town. And so like I am very, like sometimes I come home and like after seeing like patients for an hour, so like I see like seven patients and that’s a big day for me.

Shannon Sepulveda:      01:01:22           And I am just like compassion fatigue is like full on set in because like I am so engaged for that period of time and with my population it’s really important because it’s really important for, they just need someone to listen to them. But if you think of every patient that way, it pays back. And every word that you use with the patient is very important. Because they come from like sometimes doctors that say things that I wouldn’t necessarily say to a patient and they come in with, you know, thought viruses. Thank you Lorimer Mosley and you know, just talking to them but being really compassionate, you know, with all for your patients. Yes. Really in the end. And sometimes it’s hard at like four o’clock at the end of the day, but it’s really important.

Karen Litzy:                   01:02:16           Yeah. And I always think of your patients instead of like you said, referral source, cause that is a little, that’s, I don’t know how to like how would you, I described them as ambassadors.

Karen Litzy:                   01:02:30           So they become ambassadors for my practice. And that’s the way that I don’t treat them as a referral source. I treat them as an ambassador. So someone who chose because of the care you gave to them, you know, I would love for you to see this friend of mine or my daughter or my cousin or my, you know, X, Y, Z person, my coworker. Because like you said, you’re listening to them, you’re treating them with respect and kindness and compassion. And so to reduce that to a referral source is, I don’t know, I agree with you. I like to use ambassador because they’re new, that they want to be part of what you’re doing. You pulling them in and saying, Hey, I’ll give you a free X, Y, Z. If you refer me to five of your friends.

Shannon Sepulveda:      01:03:24           But because they’re choosing to represent you and they’re so excited to tell people like that’s what is so awesome about what I do is like, like I’ll see people and be like, thank you so much for referring your friend. They’re like, Oh my gosh, I am telling everybody because like we don’t have to pee our pants anymore and we don’t have to have painful sex anymore and this is just so great. And I’m like, yeah, it’s great.

Karen Litzy:                                           And Lex, you’ll get more of that as you practice more, you know, you’ll get people coming to the clinic you’re in specifically to see you, which you might’ve already gotten so far is you’re in this small town, right?

Lex Lancaster:               01:04:07           Yeah. I actually wanted to say that because you used a word Shannon, you said, or a phrase, compassion fatigue. And I find that as a new grad, I’m learning how, cause that’s me every day I do that. And you know, my patients come in and on the Island we don’t, there’s not a lot of doctors. The practitioners here, you know, they have to go down to Washington to see a specialist. So oftentimes people will come in with, you know, a lot of comorbid conditions and we have to sift through all of that and make sure they’ve seen the correct people. So there’s nothing I love more than getting on the phone with four doctors for one patient. So, and I’ve found that like, that’s caring about them and I’m like, Hey, look, I’m going to reach out to your doctor. And they love that. And, but I do find at the end of the day that I’m exhausted. And so I’m trying to find that balance where I’m giving, giving, giving, but also saving a little bit for myself at the end of the day. But yeah, there’s been patients that are like that, Karen, they just, they’re like, Oh, I’ve told my friend. And then that friend comes in and then they come see me and it’s just like, this is amazing. And that’s why I could see why having your own business, why that’s so important. Because that word of mouth aspect, you really can’t replace that.

Karen Litzy:                   01:05:24           Yeah. Yeah. And you know, I think most PTs have that kind of compassion fatigue. And one thing that has helped me is, I remember it was at, Oh, I dunno, it might’ve been Jason silvernail might’ve mentioned it on Twitter. I’m not a hundred percent sure, but I remember. So I think it was him saying that the thing that helped him the most and he’s in the army, the thing that helped him the most is, is finally realizing that somewhat he is not responsible for a patient’s outcome, that the patient’s responsible for their outcome. So and that’s hard because you’re investing your time and your compassion and your emotions into this patient and your skills. But once I realized once I was able to kind of separate myself from like I am not the fixer, I’m there to guide and to coach and to diagnose and treat but not to fix and can separate the fact that I’m not responsible for this person’s outcomes, that the person needs to embody that.

Karen Litzy:                   01:06:32           Then the compassion fatigue is less, it’s still there because we’re all humans, but it’s much, much less. And when you instill that into your patients, it’s really fun. Like I had a patient who had chronic neck pain for five plus years and came in and he had stopped running, working out, doing this, doing good, going to CrossFit, doing everything. And I said, well, why, why, why do you think that is? And I understand I was the same way. And so we got him back to doing things and I would see him once a week, once every other week now, just once a month. And he’s like, yeah, so I had like a week. I was like, I really didn’t have any pain. He’s like, and you know, it’s because he’s like, I work out like almost every day now. He’s like, so you’re here but it’s not like what you’re doing to me. He’s like, I’m working out and that’s what’s making me feel better. I’m like, yeah, exactly. He was like, what? You gave me permission to work out again? I was like, yeah, I can do this. And I was like, I was like, you got like, that’s exactly what you hope to hear is like, yeah, got it. It clicked. And you can tell it like clicked for him at some point that week. Like, I’m helping myself get better. Oh, I see how it works. Got it.

Shannon Sepulveda:      01:07:51           Yeah. And that’s, I think really like, it’s hard. Like I try really hard not to make my patients dependent on me. Like I try really hard. I was like, my job is to empower you to get yourself better. Like I give you the tools to get yourself better and I don’t tend to do a lot of like if someone’s in like acute pain, I’ll do some manual therapy, but I don’t tend to do a lot of manual therapy because aye I can see like sometimes they’ll become dependent and my job is to be like, no, you can do this. Like you, you can do this. It’s all you.

Karen Litzy:                   01:08:29           Yeah. And all the research that like Lex, I feel like, and I don’t know Shannon, you could probably agree with me here, but I feel like Lex and like you guys and your new grads, like you guys are starting out on like second base. I started out, I didn’t even start out in the dugout. Like when I started, I feel like I started out in like the showers. Like I didn’t even get to the dug out yet.

Karen Litzy:                   01:08:50           You know, with all of this sort of patient forward care and you know, the science behind pain and all this stuff that’s this new research that has come out in the last 10 to 15 years. I feel like as a physical therapist it really gives us a headstart if you’re keeping up with it. So like you’re light years ahead of where I was.

Lex Lancaster:               01:09:14           And I would say a lot of it too is because of people that share things. Because you know, even like on social media, you see something and someone shares, whether it’s at a snippet of an article or something, you’re like, where did they see that? And then you go read that and you’re like, Oh wow, that was awesome. So you know, people post the books that Lorimer Moseley’s books and you know, you see those posts, you’re like, Oh, I should read that. And you read it and you just gain all this knowledge. And like I said, I feel like a lot of it is dependent on people that share things. So, you know, all the podcasts that are out, especially, I mean, especially yours, Karen, to be honest, I’ll say, I look at all yours and I’m like, Oh my God, that’s so amazing. So yeah, I feel like we do have an advantage, I would say, especially with the pain science literature, new curriculums like that, that like just the education piece that I give for pain, people just are like, Oh, okay. And then it’s like immediate buy-in and it’s so easy to just get people to, like you said, get ready to help themselves

Lex Lancaster:               01:10:13           We’re very ahead of the pain science literature.

Karen Litzy:                   01:10:19           I know I looked back and I’m like, Oh man, I’m grateful. I’m so grateful. I’m better with these people.

Shannon Sepulveda:      01:10:22           Oh yeah. I mean, I graduated in 2011 and there was nothing really, Oh yeah. I mean, well, in my PT education there was, yeah. I started learning some stuff after that, but there was nothing in my PT education about pain sciences and that was like, so I would have had like didactic until about 2010 early, you know, so I know it’s like 10 years ago.

Karen Litzy:                   01:10:59           I know. And like David Butler first published on sort of pain science stuff in 1996. Wow. You guys look it up. It was 96 or 97. And so, you know, we have, they say research to practice takes like 15 years.

Shannon Sepulveda:      01:11:18           There it is. There it is.

Karen Litzy:                   01:11:20           It’s amazing. It’s astounding to me. And, I find that if you stay engaged as a newer grad, that you really do have such an advantage, and advantage with your patients and I hope that people really no that and can appreciate that. Then new, newer ish grads can really appreciate how lucky they are coming up. As far as information, the information pipeline is so much easier. Now. I won’t even tell you, like I had to do the Dewey decimals system. I’m so old.

Shannon Sepulveda:      01:11:56           We were cleaning my house and I had all of my PT books and like my husband, so he works for the US geological survey and he has a PhD and I had all my PT books, what are you doing with these? I was like, he’s like, have you looked at these in 10 years? And I was like, no. And he’s like, everything’s online now Shannon, you can get rid of these. Yeah, yeah. And like everything.

Karen Litzy:                                           I got rid of my mind a couple of years ago. I’m like, what did I doing? And even if it’s all these journals, like physical journals in my apartment, I’m limited space here in New York. I’m like, I gotta get rid of these journals. They’re taking too much space.

Karen Litzy:                   01:12:52           So let’s talk about what’s coming up in 2020. So what are you looking forward to? Do you have any goals or expectations or plans, whether Lex, I’m assuming you’re going to get married.

Lex Lancaster:               01:13:07           Yeah. So we finally set a date. The wedding has been interesting. So I didn’t really want a wedding just because it is, it’s overwhelming. It’s a lot of stuff to plan. But then, you know, family, they’re like, Oh, well you’re the only girl. You really should do it. So we set a date for October 17th of next year, so we’re going to get married in New York. I’ve done minimal stuff. I’ve gotten the venue, really making very slow progress.

Lex Lancaster:               01:13:36           So working on that and then you know, for 2020, you know, I’m really looking at bringing, I just applied for a trade name for my business so I could take my name off it and just make it a new name. So I’m really excited to launch that eventually once I get that all set in stone and really trying to bump that side gig up just because I have found the value in the last couple months of doing things you like to do more often. So Kyle and I were actually talking the other day and you know, we’re seeing the value of providers that have their cash based or insurance businesses and these small towns in their hometown. And we’re seeing the value here. Like you get to know people, you get to know doctors. I love travel PT, I do, but I’m very far from home so I’m hoping I get closer back to home and we kind of want to land in a spot where we can kind of start our own thing.

Lex Lancaster:               01:14:34           We were those people like we care, we want to reach out to people out. People know us back home. And we really wanted to start our own thing. So we’re trying to get back toward, well and try to do that just because I see people, you know, as they have their own business, they make so many decisions that they get to see patients when they want to see for how long they want to see them. And sometimes, you know, I’m very jealous of that right now. You know, there are patients that I’d love to spend an hour and a half way, then I just can’t. And so I think that’s a major goal right now. It’s just to get to that spot. And I understand as a new grad it’s very hard. Yeah. I mean, I don’t, and Julie did it, so I should probably reach out to her because, you know, everyone says like, it’s really hard to do a business on your own as a new grad.

Lex Lancaster:               01:15:21           I should reach out to her because that’s what we want to do. And you know, we understand that will probably be hard, especially with student loans and whatnot, but at the same rate, like we’re trying to define, you know, what’s your happiness worth? And we just kind of find that right now the quality of care that we want to provide is sometimes limited by you know, whether it’s because of insurance, a lot of dancers and we’re finding it hard to justify their care even though they need it with insurance and people can’t afford to do X, Y, and Z out of pocket. So we’re trying to find, navigate all of that. So, I dunno, trying to, that’s a goal just to get to a place where we can build our own, you know, set of patients.

Karen Litzy:                   01:16:04           Awesome. And you’re in upstate New York?

Lex Lancaster:               01:16:08           That’s where I’m originally from, but we’re probably going to end up back in New Hampshire. Yeah, we both really love it there. And I don’t think my parents will be in New York forever, so I think we’re just going to go back to New Hampshire area. So we’re close to Boston.

Karen Litzy:                   01:16:23           Yeah, I think that’s a great goal. And you should definitely talk to Julie about that. And the good thing is you have each other to give each other support. You and Kyle have each other so you can, you have that support from each other. And I think being able to do that with the two of you I think would be really exciting.

Karen Litzy:                   01:16:42           If you build up your side gig, then you can slowly build up your practice. You know, you just to know where you have those income streams coming from. But I think that’s cool.

Lex Lancaster:               01:16:52           I’ll say after reading Danny McTay’s book, it kind of gave us both a little hope of just that you can do it. It’s just you have to decide if you’re going to burn the ship or do it as a side gig for a little bit. And I think we’re more or less thinking side gig for a little bit, even if it’s just something, something to let us treat, you know, the high level athletes that we can’t justify insurance-based for right now.

Karen Litzy:                   01:17:18           Yeah. Basically. Yeah. You should talk to Julie cause that’s what she’s doing. She’s sort of building it up slowly. We talked about it for this podcast. So. Perfect. And how about you Shannon? What’s coming up for 2020?

Shannon Sepulveda:      01:17:31           I was thinking about this, I’m like, what are my goals? So business is really good, which is awesome. I think one of my goals I need to try. So I really don’t want to hire anybody. I do all my own billing, all my own scheduling. I see my patients. I need to try to figure out time management a little more. Because like I’ll be in like I take Fridays off and I’m with my daughter and sometimes my son has off kindergarten on Fridays and I’ll be like in the target parking lot. And now they know when I stopped the car and I like sit in the parking lot space, I’m like checking my email. They’re like, mommy, don’t check your email. We need to go into the store. And I’m like, like accepting patient appointments or just like, you know, I need to try to figure out how to do that because I want to do everything.

Shannon Sepulveda:      01:18:26           But for myself. And so it may just be like saying no, it may just be having a wait list and trying to figure out like the feast or famine of owning your own business, like these ebbs and flows where like this month is like just absolutely nuts. Like I had five people call me in the last week trying to get in before their deductible resets. And so like I have like, I’m taking next week off and I’m not seeing anybody but like the 30th and the 31st, I think I’m like seven patients a day or something like that. 31st I have patients to like five 30 on new year’s Eve because like, they’re like, Oh please. And I’m like, okay, okay. You know, and because I know January is going to be really slow. And it’s really hard. I’m staying up till 11 o’clock at night to finish my notes. And so I think either I just have to accept that that’s the way it’s going to be or do a little bit more time management.

Karen Litzy:                   01:19:26           Or even sounds like maybe just setting your boundaries or boundaries for yourself and something that you’re comfortable with. I think that that is something I will say that really helped me is saying, you know, listen, the last patient I’m going to see at night is seven o’clock at night. Like I’m not going to go later than that or I’m going to take at least one day off. Yeah. It may not be, may not be a Saturday or Sunday, but I’m going to take one day off during the week and this past what I’ve done is that I’m going to take five hours or four hour chunk of time and have that just dealing with business kind of stuff. You not teaching care. So I think if you look at your schedule and kind of set your boundaries, then I think you’ll find that your time management just flows within that. Or you can get a virtual assistant.

Shannon Sepulveda:      01:20:19           I know I could do that. Yeah. It’s funny cause like for some reason my boundaries…

Karen Litzy:                   01:20:24           Cause you’re like me Shannon. I’m the same way. Like, I love to like keep everything close to me, but the moment you can like let just one little bit go.

Karen Litzy:                   01:20:46           You’ll be like, what the hell was I thinking? What would be the sooner? But you have to do it on your own timeline and when you feel like you can, you can let go of that. A little bit of control. Like I let go of like a smidge at a time. Yeah. And then for me it was easier then.

Shannon Sepulveda:      01:21:03           It’s really interesting because I think about, I’m like, okay, as a business owner it is not worth my time to spend. Like I tried to keep my Mondays as admin days like that is not worth my time to do. It’s worth my time to pay someone to do the admin stuff, but I keep holding it in.

Karen Litzy:                   01:21:20           Yeah. Yeah. That’s a good way to look at it. If you have whatever your fee is, let’s say your fee is, I don’t know, I’m going to make this up $200 an hour.

Karen Litzy:                   01:21:31           Right. The task you’re doing as an admin at $200 an hour task, $25 an hour task, or maybe it’s a $20 an hour task. So, and when you look at it that way, it’s like what am I doing? Like I could pay someone to do four hours of work and what I get paid in one hour. Do you know what I mean? So when you look at it that way, the financial offset makes a lot of sense because your time is money. And like you said that that four hours could be an hour that you get to spend with your kids having lunch. So it doesn’t necessarily mean it has to be with your business, but or it could mean that’s your time for, you can go to the gym or you can do X, Y and you can meet with a doctor or doula or whatever. So you know like that is $200 an hour time spent when you’re having lunch with like a possible referral source doing like weird admin stuff that you don’t need to do is not $200 an hour work.

Karen Litzy:                   01:22:35           That’s what I did and just really like looked at everything, wrote down everything I do and you can attach sort of a monetary value to it. And then once it’s down on paper you’re like, Oh my God, okay.

Shannon Sepulveda:      01:22:52           I know, I know and I haven’t like it’s interesting cause I hadn’t gotten to that point until this December because like I’m still growing and so that’s one of the things that I think I’m going to need to think about like, and I’m just going to see how like the ebbs and flows, like if it is still as nuts as it is right now, then like I got the, because the worst is, and honestly like the billing’s not that hard. It’s verifying the insurance benefits. And sometimes I can do it online and it’s really easy. And then sometimes the online just tells me what their deductible is, not how much they’ve met. And so then I’m on hold with blue cross blue shield for like an hour while I’m trying to do other notes.

Karen Litzy:                   01:23:40           And what you’ll find is like you will grow, maybe not exponentially, but you will grow bringing help on, you know, I did an interview with this woman Stephanie Nicholitch, she’s like a high performance coach and she said, you’re trying to do it all. Keeps you small. Yeah. And, it’s true, but you have to feel ready for it. So it’s in your time and you’ll know.

Shannon Sepulveda:                              Yeah, I think I’ll know. And the other thing is like one day, the other Monday I just like sat in front of my computer and I did my QuickBooks and my billing and I came home and I was like, I don’t even feel like I’ve worked today. Yeah. He’s like, I hadn’t seen patient, I hadn’t had that compassion fatigue. So some of it’s like, can I actually handle that many patients? You know, can I give good care when I see my caseload.

Karen Litzy:                   01:24:26           Yeah. And these are the growing pains that you have to deal with and it’s a good growing pains, growing pains. So hopefully you’ll continue with those growing pains. We hear it out in 2020. I think you will. Thank you. I want to thank you guys because like I said, if you do it all, it’ll keep you small. There’s no way I could do everything that is required of this podcast to keep it of good quality and to have good guests and good interviews and good graphics and good everything and make the guests feel like we’re on their side, you know, and that there putting their best foot forward on the podcast. And I think that’s what both of you and Julie and Jenna do is creates a good experience, really positive experience for the people who are on it.

Karen Litzy:                   01:25:28           Like Shannon, we were saying like, people bought those hats and Carol and which I think is amazing. But you just never know how far the podcast is going to go. And you know, yesterday I was with some friends and we were talking about the podcasts and what’s it on and you know, it’s on Spotify and it’s on, well iTunes is no longer a thing. So now it’s just Apple podcasts and I looked up under medicine and it’s like 52 out of all podcasts. For this fully female run podcasts. That is pretty good I think. Awesome. Yeah, it was really cool to see.

Shannon Sepulveda:                              One of my PT friends in Bozeman. He like just moved to Bozeman a couple of years ago and he referred a patient to me and this was about a year ago and I called him and he was like, yeah, I was like listening to healthy, wealthy, smart. And you were on it. And I was like, Oh my gosh, she’s in Bozeman. You were like randomly listening to the podcast and then you were like happy that it wasn’t because I was in Bozeman, you were listening to it. He’s like, no. And I was like, wow, that was awesome. It was a great moment.

Karen Litzy:                   01:26:38           Yeah. And never know who’s out there listening and you never know where, again, the podcast becomes a referral generator. We can call a referral generating. This we could say generates referrals, but it does and you never know who’s listening and where it’s going to kind of take you. So I think that’s so good to hear. And like I was talking with a coach that I had on a couple of years ago and she’s like, Oh yeah, I got two clients from you. And she referred one of her clients to be on my podcast, the one who was talking about poop. She ended up getting like three clients from being a guest. Whoa. All right. So I was like, Oh, that makes me feel so good that that’s the case. So, you know, keep up the hard work and you know how much that I am thankful and appreciate it and wish both of you have very happy 2020 new decade so thanks again so much. And everyone out there listening. Thank you so much for listening all year and we all wish you a very happy new year and hopefully stay healthy, wealthy, and smart.

Karen Litzy:                   01:27:58           And again, a big thanks to Jenna, Julie, Shannon and Lex for all of their work all year. And of course a big thanks to net health. This episode is brought to you by Optima net health company Optima therapy for outpatient is a software solution enabling therapists and staff to do their jobs efficiently and accurately. Their software provides anytime, anywhere access to documentation, even while disconnected and workflows that streamline patient care and save valuable time. Check out their new on demand video to learn what’s in store for outpatient therapy in 2020 you can go to go.Optimahcs.com/healthywealthy2020.


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©2019 Karen Litzy Physical Therapy PLLC.
©2019 Karen Litzy Physical Therapy PLLC.