Interview with Dr. Erson Religioso III – Part 2 - March 2014

The following is not original material. This interview is reproduced with permission from Cinema, a former Twitter personality & blogger who left the social media world. The reproduction is intended to preserve & share Cinema's insightful interviews.

In Part 1 of the interview with Dr. Erson Religioso, III, DPT, MS, MTC, CertMDT, CFS, CSCS, FMT, FMS, FAAOMPT we explored Dr. Erson Religioso III‘s professional development. Now lets dive into a few of his current ventures. Enjoy!

Edge Mobility Systems is a growing contribution to the world of practicing physical therapists. What drove the development of these tools?

I was treating the son of a local chiropractor college faculty member. He saw myself and my co-workers doing tissue work and manipulation, and later brought in his very expensive set of stainless steel tools for me to use. I loved the way they felt against skin and the sensitivity they had, but for years, never wanted to pay the money for the courses and the tools. So I just made my own! EDGE/EDGEility Tools are now used in every professional sport in the US (that I can tell from my sales by who the tools are going to, or by ATCs contacting me personally), and I have distributors in Asia, Europe, South America, and Canada. I am blessed that all this crazy blogging I do pays off with social media sharing and exposure!

Tell us about The Eclectic Approach – what differentiates it from other approaches?

Well, in my courses, I spend anywhere from 15-30 minutes – you can tell by this interview I can ramble, on giving credit where it’s due to my influences. I am just teaching what many of us do in the clinic, take what works for us, from what we have learned from other clinicians and “gurus” and combining it. I always say in my courses, that I invented nothing, someone was nice enough to say, “But you packaged it together so well!”

The Eclectic Approach is systematic and based on MDT/SFMA plus patterns I have come to recognize over the years. Taking traditional OMPT courses, you’re left with hundreds of ways to assess and treat, and come back on Monday often more confused. It also has touches of modern Pain Science and really emphasizes that patients MUST be independent, because it’s the HEP that really makes them better, along with your positive interaction, not our magic hands. It’s also based on concepts and treatments that are easy, which we tend to take for granted after going to school for years.

You mentioned that teaching The Eclectic Approach has taken you to a number of places (including Chile). What have you learned from your teaching experiences so far? Biggest takeaways?

I learned that it’s not a great time to teach a course right before CEUs are due, I taught one course where literally all the clinicians were done practicing 1-2 minutes after I taught them, just like PT students! Most of the time, I have to tell people we have to move on, but this group I could’ve finished 3 hours early!

One of my favorite things I learned was that you can present pain science, and modern manual therapy in a way and not come across like a smug know it all. “sorry if this offends you but that’s the way it is” is a problem in our current social media.

I also really enjoyed teaching in South America because not only were my hosts amazing, literally great tour guides, but I learned that it’s very different with the chiro vs PT thing there. I also learned that PT when performed poorly, is performed poorly there as well, with an emphasis on physical agents, no hands on techniques, and generic exercises, the same ol’ shake and bake, just different country. I’m looking forward to teaching in Vancouver, the Philippines, and Italy later this year to see how they compare!

I’m curious, tell me more about the difference between Chiropractors and PTs in South America?

The difference is that there are none! Chiropractic is not a licensed profession in South America according to the Physios I teach with. All of the chiropractors are Physios with an additional certification or continuing education. They tried to block my spinal manipulation course – just like some of the DCs try to here!

Give us your overview of the variety of themes (and fads) that weaved through the world of Physical Therapy since your graduation.

Around the time of my graduation, in the ripe old year of 98, everyone was hopping on the TA bandwagon. I never really got into it, but dabbled here and there. In Buffalo, everyone also started doing “functional exercise” a la Gary Gray, which ended up being an excuse to see more patients and spend less time with them. One idiot POPTs doctor even told a little old lady patient of mine that walking was not triplanar, thus it was not a good exercise. HUH? I can then say we moved onto CPRs, still hotly debated. Spinal manipulation ended up being well researched as well as MDT. IASTM taking off with no excellent research behind it, and now modern manual therapy combined with pain science. This was as I experienced it and YMMV.

There is also the ever rising costs of healthcare with our reimbursement rates dropping, getting less visits, and caps abound. I plan on being cash based sooner or later, but my situation is unique, but I can empathize for the private practice owners who this really effects.

Physio Answers – What is it? How did it start? And what makes this a unique online resource?

Physio Answers is my blog for the public. I saw that there was (and still is) a lot of poor information out there on stretching, fitness, health, and pain. I wanted to make it kind of like a WebMD but written by real physical therapists, only in blog format. I have a lot of great contributors and any physical therapist can apply to write for it! Most of them have their own blogs and allow me to take their posts and include them on my site, giving them credit and linking back to their site! It’s win/win! I started having regular posts on it this earlier last year and it’s really taken off with over 10,000 facebook followers and has double the hits of The Manual Therapist – naturally there are a lot more of regular Joes out there than clinicians, as it’s a blog for the public.

What simple ideas/basic concepts do you believe will help all Physical Therapists become better/smarter/wiser?

Less is more – you’d be surprised how little force you can use one someone to improve their motion

If MDT is not working for you, you either chose the wrong direction, or the patient does not understand end range (or you did not educate them properly)

Find what motivates your patient and realize that patients have different learning styles, visual, tactile, auditory, and try and adapt so they get your message.

Remember the basics, rest, walking, eating, sleeping, hydration, how often do you ask your patients about simple concepts like this?

You’ve just traveled back in time and are sitting face-to-face with your 20 years old self. What advice would you give to him?

Clinically: You don’t know it all, and for God’s sake, stop beating on people to make them move better!

Personally: Start working on your symmetry and stop with the huge pounding overstrides so you don’t have to quit running due to knee pain. Also, invest in something called google.

Now let’s time-travel forward 20 years. Describe the world of Physical Therapy you would like to see in the 2030’s.

Hopefully we’ll have a universal practice act, not state by state, and primary care direct access covered by all insurers. Does that sound ridiculous? We should be able to order radiology and prescribe basic pain meds or anti-inflammatories like the PTs in the military or the Physio’s in the UK (meds).

I hope your vision becomes reality! What hurdles does the profession need to overcome in order to achieving your vision? And what can be done to make this dream a reality?

1) MDs

2) ourselves – many PTs feel like the MSPT wasn’t needed, forget the DPT, and other PTs not in private practice could give a hoot about direct access, they still defer to MDs and often tell patients they need surgery

3) HMOs

You’ve mentioned HMOs twice! Give us your take on HMOs.

Well, like I mentioned earlier, I have a unique perspective from working in HMO Peer Review for 6 years part time. I can say, at least for the company I worked for, we’re not the enemy and many of us were clinicians with our own private practices. From the sample of PTs I could see, there was rampant abuse of PT benefits with patients going for 100s of visits prior to management with no change in subjective or objective measures. I can see why HMOs popped up because without management, it was a free for all in the 80s.

I still hate all the things about HMOs that most of us in private practice do, low reimbursement especially in WNY! Some of the lowest in the country. Really, we often get paid less than $40 a visit depending on the HMO, many of our patient’s copays are higher than our reimbursement.

Life is an adventure. Describe one of your most memorable adventures so far.

Pre-family – Climbing my first multi pitch climb in the Gunks. Climbing 500 feet or so, you often forget to stop and smell the roses, but when you get to the top, what a view! The sense of accomplishment was amazing! When I climbed regularly, digital cameras and cameras on phones were nascent, we only had ass shots from the ground back then.

Post-family – Catching 2 of my 4 daughters, the 3rd in the hospital – instant Niagara Falls coming out of my eyes, seriously the most emotional I have ever been. From dry to huge tears of joy stat! My fourth and most recent daughter, was a home birth. Watching my amazing wife going through labor, coaching her when needed, reassuring her doubts, was really breath taking. It was all her, with very little coaching needed this time. Our midwives suggested she labor in the tub for a bit, then she got the urge to push, and in two pushes, out comes Leila into my hands in the water! Life is an adventure, and I can say I am a baby catcher! That won’t be part of The Eclectic Approach though!

This was an amazing interview. Thank you for sharing your story!

Find Dr. Erson Religioso III on twitter @The_OMPT & @PhysAnswers

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