Interview with Jessica McKinney, PT, MS - August 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.

This interview’s guest is none other than Jessica McKinney, PT, MS – proud member of #PelvicMafia and Co-Founder of Marathon Physical Therapy and Spine Medicine located in the suburbs of Boston, MA. As you’ll soon read, Jessica has been a very busy lady lately. She even published an article titled “Pelvic Floor Muscle Evaluation Findings in Patients with Urinary Incontinence” in the Journal of Women’s Health Physical Therapy.

Jessica founded Women’s ACTION Initiative – a non-profit that empowers women to prioritize Pelvic & Pre-natal Health in the US & abroad. Her practice, Marathon, also supports Share Mayflowers (Twitter) launched by Women’s ACTION Initiative (Twitter) as a public awareness campaign focused primarily on the topics of female pelvic and perinatal health.

Jessica’s passionate involvement in her field is a huge source of inspiration for me. I encourage you to contribute to and/or participate with the above-mentioned charities.

In this interview, we get into the backstory of her current practice and lessons reaped from the experience so far. We’ve just scratched the surface; I hope to dig a bit further in a future follow-up interview. Enjoy!

What sparked your initial interest in Physical Therapy?

Truth – mom and dad are in healthcare and church ministry, respectively. Add to it that I’m a first child and I think I had no alternative but to follow their example and go into some ‘helping’ profession!!! I seriously started considering healthcare as a profession around 9th did a science project with my mom on the body’s inflammatory process (by scraping my arm, taping glass slides to it for a few days, then looking at the slides under a microscope)…a project that helped me conclude that working at a microscope wasn’t a great fit for me! Meanwhile, my mom hurt her knee skiing and went to physical therapy. After this personal experience, it was her suggestion that I explore PT as a career. I was 15, then, and have been on this career path ever since.

How has your practice of Physical Therapy changed over the years?

I jumped into orthopedic manual therapy training immediately out of school, while simultaneously beginning to study and cultivate a practice in women’s health (pelvic and obstetrics). It is hardly the case now, but at that time those two worlds didn’t really mingle. As such, I took longer than I would’ve liked to connect the two worlds in my own practice. As the years have passed, I certainly find my own practice of the two “specialties” indistinguishable.

Virtually all of my clinical care is with obstetric and pelvic health populations, but I am just as likely to address persistent postural issues or gait abnormalities stemming from lower quadrant dysfunction, as I am to address the pelvic floor directly. I also am incredibly excited about how contemporary neuroscience and the empowerment of education are influencing my current practice. It is a very exciting time!

What lead you into pelvic health?

Pelvic health is the absolute last place I thought I would be. Honestly, in our very modest exposure during PT school, I thought it was quite possibly the grossest direction my career could take. Thankfully, I don’t always know what is best for me! My last clinical affiliation serendipitously afforded me steady exposure to both obstetrics and pelvic health, and I was hooked. Through my clinical instructor, Genne MacDonald, and our patient interactions, I saw such a human side to women’s health and the effects of treating – or not treating – pelvic floor dysfunction. I was someone drawn to PT so much by the desire to have a career that helped people, and I was hooked. The field of pelvic health requires a brilliant combination of service, emotional intelligence, and clinical problem-solving, plus a dash of social justice…its been such a nice fit for me and I am forever grateful for my unexpected exposure at the beginning of my career!

Congrats on 10 years of Marathon Physical Therapy! What drove you to start your own practice?

This may be the easiest answer of all the ones in this interview, and to which I must acknowledge that it was completely a joint effort with my husband, J. Alex McKinney (physical therapist, massage therapist, and strength and conditioning specialist)! We both began our professional life in Chicago, Alex with AthletiCo and I was with SRI Physical Therapy and we loved our jobs. No kidding…if we still lived in Chicago, I can’t imagine we ever would’ve left those companies! We moved to Boston to be closer to Alex’s family as we were planning starting a family of our own, and neither of us could find a position or company that filled us with the same excitement for innovation and professional growth as the ones we had left behind. So within a year of moving to Boston we decided we were willing to take a run at creating the type of workspace where we could both flourish – and the type of place where others would want to do so, too. It has grown steadily since since inception.

What were the major hurdles you’ve had to overcome over the years (early & recent)? And how did you meet these challenges?

In many ways, the hurdles remain the hurdles.

1. There is a huge challenge in being in the business of PT when your first love – and the only reason you started the business to begin with – is being a clinician. I love being a PT; downright love it. And with Marathon, I wanted to create a place where PTs who love being PTs can flourish, and do it in a collaborative way with other team-members who love what they’re doing just the same (athletic trainers, massage therapists, strength and conditioning specialists, & more). Learning to operate as a business owner in order to make this dream a reality is a hurdle I face continually.

2. Massachusetts is a tough market. High cost of living, lower-than-national-average reimbursement, and closed insurance networks. Hurdle, hurdle, hurdle. It has forced us to adopt a nimble and dynamic approach to programs and personnel and to highly value relationships with the people and communities we serve. Makes me feel its kinda like Broadway….if you can make it here, you can make it anywhere!

3. Family. My husband and I founded and run Marathon together, we had our 1st [baby] 3 months to the day after opening the doors of our 1st first 5 years averaged a new baby for our family for every new clinic (babies stopped at 3…clinics going to 6+!). I’ve tripped over that hurdle and landed face down a number of times! We have a tremendous support system – family and loving childcare providers to help with the children and motivated and passionate staff who encourage us to actually take a vacation!

Rumor is that Marathon has some exciting stuff lined up for 2014. What’s up your sleeve?!

2014 has been and continues to be great! There are three main areas where the rumors are true:

1. Student Athletes: Our summer performance enhancement camps and additional programming had hundreds of participants at the middle and high school levels! The program has been building for years and we are thrilled for it to have such a huge year. Very proud of the Marathon Sports Med Team!

2. Women’s and Pelvic Health Education: Throughout 2014 we have been implementing the new School of Pelvic Health curriculum; a series of topical pelvic and obstetric health educational seminars, as well as targeted group and individual exercise, including a yoga component in partnership with Dustienne Miller of Your Pace Yoga. This added program is proving such a valuable piece of comprehensive care in our pelvic and women’s health practice!

3. New Clinics: We have 3 new clinics on track to open before the end of 2014! We are incredibly excited – both for what it means to members of the Marathon team who are a part of this growth, as well as the opportunity for us to become a part of three new communities here in Massachusetts.

Could you share some of the valuable lessons over the years of owning your own practice?

Man, this sounds so corny, but trust your gut – about people, locations, whether owning your own practice is right for you – all of it. Maybe that isn’t a ‘lesson’ for everyone, but it sure has been one for me.

Don’t hire to fill a slot; don’t try a new program because the next guy is doing the same thing…find authenticity in who you are as a practice and what you stand for. Hire, start programs, etc., accordingly. Finding the right fit is crucial in all aspects of the business. Relationships are imperative. Again, this is with staff….does Sally at the front desk have a true passion for country line dancing…and if she does, maybe this opens up a whole new market. Or maybe that just helps to understand why she wants to leave early on Thursdays. Same goes for patients, clients, and referral sources. A course of care is just that, something with a finite limit. But a relationship is something different and allows for a provider, a practice, or a colleague to be a go-to resource, indefinitely.

I’d like your take on Residencies: Would you recommend it? AND how could it affect your hiring process?

In short, I like them. I’m sure I would really love the experience of being a resident, actually (in my pre-kids days! Would be a little too much to juggle right now!). I think that they afford valuable supervised and directed didactic and clinical education in focused practice areas, which is hugely advantageous to any provider looking to ‘go deeper’ than an entry-level skill and knowledge set. That said, I think that we face a few distinct barriers to having more mainstream residency participation – availability of residency slots and reimbursement – the latter of which gets to the hiring process question. As an employer, I would absolutely be interested in the candidate who completed residency, however I operate – as do many others – in a reimbursement landscape that doesn’t account for this type of added professional training. A PT visit is a PT visit and is reimbursed the same, whether performed by a PTA, a new grad PT, a residency-trained and board-certified PT, or a PT with 20 years of experience and advanced degrees. I suspect that as (if…) reimbursement stratification and/or practice patterns allow for higher revenue per visit this will be a boost to the demand for residency-trained PTs. It is a very dynamic landscape now, and will likely remain for quite some time, as we see PTs specializing and contributing to the field through a variety of paths – residencies, fellowships, independent study, hands-on clinical exposure, and the like. We’re an evolving profession, which makes the proliferation of residencies an exciting development, but means I wouldn’t for a second think less of the candidate who has a resume solid with clinical experiences and professional development courses. “It takes all kinds of kinds” – a song by country singer, Miranda Lambert – would seem to sum it up! 

Running a business can get taxing. What measures have you taken to balance work & family life?

Oy!! See above!! Our children are surrounded by people who love them and are invested in their development consistent with how we are. I talk to my kids a lot about why I work – not, “Mommy has to work to buy groceries, school supplies, and pay for our home”, but “Mommy helps take care of other people, especially other mommies, so that they can be healthy and do what they want in life”. When they complain about homework, I talk to them about homework in the context of preparing you for meaningful work later in life.

More linearly, we also keep a few calendars going, including one that shows the kids where mommy and daddy are out late for meetings or traveling for work. Furthermore, we accept that any semblance of balance requires constant communication and readjustment. We’re readjusting all. the. time.

Most impactful books and/or authors?

I particularly enjoy the writings of L. Lewis Wall, MD, PhD, MA, a urogynecologist at Washington University (St Louis, MO) and founder of the Worldwide Fistula Fund. I appreciate his case for obstetric fistula as an international public health problem, and that it could arguably be recognized as a neglected tropical disease. Half the Sky, by Nicholas Kristoff and Sheryl Wu Dunn, was published in 2009 and stands as a manifesto about the plight of women in low resource countries through the lens of human trafficking, gender-based violence, and maternal mortality and morbidity. It can be a hard read, sometimes, but worth it, completely.

I love returning to read previous course manuals (NAIOMT and Herman and Wallace manuals, in particular), as well as the books, articles and/or blogs and musings of several other great thinkers: Diane LeeLorimer Moseley, Mary Massery, David ButlerPaul HodgesGray Cook, Lee Burton, Erl Pettman, and James Collins (and so many, many more I don’t have time to name!).

If you could travel back in time and face yourself soon after graduating from PT school, then what advice would you give yourself?

Study, travel, and read more before you start your family and trust your gut in bridging pelvic health and your orthopedic manual therapy training. You’ll know enough to do it way earlier than you think.

There’s more to life than work. Tell us about one of your more memorable life adventures.

Hmmmm, do I work too much/find too much “adventure and fun” in work if I’m finding this the hardest response….???? J One thing that consistently comes to mind is the evolving adventure of learning to surf! I’m from southern WV, and didn’t get any natural opportunity for surfing growing up, but somehow have always wanted to know how to ride. My first exposure was on a quick trip to Costa Rica ~5 years ago, and I’ve spent time on beaches in MA, RI, VA, and SC ever since, trying to learn the art and sport of riding a wave. Most of the time, its pretty sloppy and nothing graceful to watch, but never have I been so bad at an activity and loved it so much! I improve every season, I have fun every time I’m out, and geek out about how great it is for my posture and motor control (trunk extension, unstable surface, reaction time, perturbations – great stuff!!)! And last year my 9 year old son and I rode the same (tiny little) wave side by side…memorable life adventure!

Jessica, thanks for the fantastic interview. Looks like 2014 is a fantastic (and very busy!) year for you and everyone at Marathon! I wish you the best of luck, and look forward to doing this again.

Connect with Jessica via Twitter, and find Marathon Physical Therapy and Spine Medicine on Twitter & Facebook.

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