[00:00:06] Speaker A: Welcome to the game changer Unlocked. I'm your host, Brian Fetzer. Today's episode centers around one powerful theme. Rethinking health.
Not just treating symptoms, not just managing pain, but asking whether we are approaching health in the right way, personally and systematically.
We're going to be talking with Jillian in the first episode and then we're going to transition into talking to some nurse practitioners about how the healthcare system works and how value based care across the country needs to be reshaped to start. Joining me first is Jolyn Keillor who is of Rome Fitness and Wellness, R O A M. And I'm going to get Jillian to tell me a little bit more about that. A movement and rehabilitation specialist, she is helping women, men of all situations, you know, reduce pain, rebuild confidence and stop normalizing discomfort. Jillian, I'm excited to have you on the show. How are you doing today?
[00:01:14] Speaker B: I'm good, how are you?
[00:01:15] Speaker A: Awesome.
[00:01:16] Speaker C: Awesome.
[00:01:17] Speaker A: Hey, so I gotta ask you this. When women, men come to you, what are the three complaints that you're having the most?
Back, hips, knees, what might that be?
[00:01:29] Speaker B: I think a lot of what I end up seeing is low back pain.
The people that come to me kind of have been failed by the traditional medical system, the routine kind of PT, chiropractic care. So by the time I see people, it's low back pain. But that doesn't necessarily mean that their issue stems from their low back. So sometimes that comes from hip issues, sometimes that comes from ankle issues, sometimes that can come from any sort of history of upper extremity things, injuries, trauma.
[00:02:03] Speaker A: In your experience, you know what usually drives these issues? Is it like weakness, poor mechanics, stress load, lack of recovery?
Is there something that kind of hits it?
[00:02:16] Speaker B: Yeah, I think it can be a little bit of all of the above.
If I look at kind of the kid population that I work with. I spent kind of the last 12 years of my career in a high school setting. So I've worked a lot with adolescent athletes.
A lot of the stuff that they have, especially if they end up presenting with low back pain, ends up being kind of a muscle imbalance or a load based issue.
A lot of those kids in that high school age are growing and developing still.
There's a lot of changes that are happening through the body and sometimes not managing that load can predispose them to some stress related injuries. Some of that can also be driven or exacerbated by some muscle imbalances.
If I look at the adult athletes that I work with are the adult people that I work with that end up presenting with low back pain or some of those issues. Sometimes that's driven from a biomechanical issue or a strength imbalance as well, just depending on what they're coming to. Me having been a part of in the past, whether it's like golf athletes and that's a heavy unilateral rotational sport, or it's former football or current football, where it's a lot of impact.
So it just kind of depends.
[00:03:39] Speaker A: So. Okay, I, I want to go back a little bit because Rome is a unique way and everybody, when they have a company, they, they, they've certain reasons why their company's called what it's called.
What is Rome and what does it stand for?
[00:03:56] Speaker B: Rome is an acronym. It stands for resilience optimization and alignment through Movement. So when I started looking at what I wanted to name my company a couple years ago, I had a guy that I was working with who was very military based. And I was trying to help him or have him help me get a name for my company. And when I told him all the components of what was important to me and how I kind of approached my client care, he helped me come up with that name. But we want to build resilience and optimize the body.
Stress alignment. Right. And postural changes. And then of course, emphasize movement.
[00:04:37] Speaker A: Absolutely. And when you just mentioned postural changes, you know, do you see a lot of individuals that struggle with posture?
[00:04:45] Speaker B: Oh, yeah. I mean, if you take into consideration how we all live our life, especially now that everybody's on a cell phone all the time, you know, text neck has become a term. But I think because so many people spend most of their life sitting, then we've got some postural changes through the low back too.
[00:05:03] Speaker A: So yes, I used to refer to it as the T. Rex syndrome.
You're, you know, real close, you know, close mind with your hands.
[00:05:14] Speaker B: Yeah.
[00:05:15] Speaker A: If you had a, if you had to pick a pattern, you know, why do you, why do people feel tight? I mean, the tightness that somebody might feel, you know, why, why is that? Why does that happen in the body?
[00:05:30] Speaker B: I think for some people, that tightness comes from an inhibition in those muscles. I think those muscles kind of shut off to try and stabilize a, stabilize a body segment.
So stretching, while it feels like it may be what happened, it may be that that muscle is kind of weak and inhibited. Right. So really then the, the correction for that would be building strength in there too. But you know, stretching feels good. I think temporarily it helps people feel a little bit Better right. Until all of a sudden it doesn't.
[00:06:06] Speaker A: But you just mentioned the movement part. So when you're talking about stretching, there's dynamic and static stretching.
And in the name of your company, you talk about movement.
Is it more doing mobility exercises to kind of get that relief from the tightness?
[00:06:24] Speaker B: There's a couple of different ways that I approach that. A lot of it comes from Dr. Boyer's paradigm, who is a French osteopath that developed the technique Eldoa.
But in all of that, he's got some osteoarticular warmups to target the joint specifically and making sure that all of that normalizes and moves well. And then we've got myofascial stretching and Aldoa that use the body's tensegrity system to kind of hold the contraction at enraged motion and help decompress or open up those joint spaces.
That neurological facilitation that happens through that, too, also helps improve the sliding of the fascial tissue, which is ultimately going to help increase mobility.
[00:07:07] Speaker A: Aldo is a technique that's not super common, I would say, in the United States, is that correct?
[00:07:14] Speaker B: No, I don't think there's a ton of us out there that do it.
You know, as far as I know, I'm one of like four in Nashville, in middle Tennessee area that.
That offer it at some level for the people that we work with.
But hopefully, hopefully it's something that can gain a little traction and popularity, because for me, it's the only thing that really got me out of my chronic low back pain.
[00:07:41] Speaker A: When you think about chronic back pain, I want to throw out a subject that really hits a lot of people is desk life.
If somebody's sitting at their desk, they're sitting so much, and then they go right in from that into, hey, I'm going to go work out. So they go right in there and they try to do this intense workout.
What's an issue that can kind of evolve from that?
[00:08:09] Speaker B: Well, I think when people sit at their desk all day at work, they sit in the. They sit in the car to drive to and from work, they sit to eat, they sit to watch tv. So you can generalize some of that, too, as to being in that shortened hip flexor position.
Right. If we're getting a little technical in some of the anatomy, you've got some of those hip flexor muscles that insert on the front portion of your spine, but then there's a big connection of that musculature then to through your diaphragm. But if all of that stuff becomes shortened, right. And then a little bit weaker, then that's going to affect, right, the tension through those muscles and therefore possibly the way that this, the spine moves.
[00:08:52] Speaker A: Is there something that somebody could do kind of in a transition from hey, I'm getting done with work, I'm getting ready to go to the gym because I get my workout in, Is there something that somebody could do kind of to alleviate that so it's not so stressful in the body.
[00:09:07] Speaker B: I mean, I think people need to take a good opportunity to work out.
It's hard to give recommendations because some of that depends on exactly how people kind of present or walk in. But in general, making sure that they have a good strong core. And that core doesn't really just mean like your six pack abs that you have that people can see that's kind of some of those muscles talking about that stabilize the spine. I think there's a lot of dysfunctional breathing patterns too, but the diaphragms kind of manage, right. That abdominal cavity area and can influence the spine. So people need to make sure that they can breathe, people need to make sure that they can move.
And we do a lot of segmental movement too in Dr. Gui's paradigm, a lot of segmental strengthening where we target specific muscle fibers. So there's a lot of specificity in those exercises. But a lot of the thing that I see with people across the board is that they can't separate moving their shoulder blades from their spine, for example, or they can't isolate movement through their pelvis without rounding their entire back. Or they can't move a hip without also moving a low back. So like teaching people to move in a segmental and intentional way can be helpful too.
[00:10:32] Speaker A: So if somebody wants to get a hold of you, somebody wants to find out more to work with you or find out a little bit more about some of these subject matters. How can they do that? Where can they go?
[00:10:45] Speaker B: Well, my website is roamfitandwell.com so can send me a message through there or I'm on Instagram at jpkeeler. My last name K E E L
[00:10:56] Speaker A: E R.
That's pretty simple, pretty easy to do. Do you do some remote work working with people outside the area or is it all hands on?
[00:11:07] Speaker B: A lot of it is hands on and I think that there's a lot of benefit to being in person and hands on because there's a manual therapy component that we can put in there too. And then you've got the very specific tactile cues that you can do in exercises to help really make those efficient.
But there's a lot of benefit to virtual stuff too. And I do do some virtual work. I work with a lot of equestrian clients with Tony Sandoval and all of our work is virtual.
[00:11:33] Speaker A: That's awesome. That's phenomenal. Hey, we're going to come back after this segment. We're going to kind of dive a little bit more into what kind of actually works when it comes to rehab and getting your body back in line.
So we'll be coming right back after this commercial break with more on the Game Changer Unlocked.
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I'm back here with Jillian Killer Keeler. Excuse me. And now we're going to shift to, you know, from problems to kind of solutions and kind of want to dive into some of the actual work that you do even more so when somebody comes in with pain, what's the first step before you ever treat that you'd be looking for in an assessment maybe that most people miss?
[00:13:14] Speaker B: I don't know that it's necessarily that I'm looking for things that people miss, but I'm looking for things outside of the area of complaint.
So it's really taking kind of a global view of the patient or the client and zooming out a little bit to seeing what could have contributed to that.
A lot of people, like I said, end up coming to me with low back pain.
And a lot of times low back pain isn't because there was a direct injury to the low back. It's usually that there was a deficit or there's an issue somewhere else that is affecting the low back that ends up being the weakest link that gives up.
It's zooming out, looking at the client as a whole. And then what makes my assessment approach different is a really in depth assessment of the way that the SI joints move and that the pelvis moves.
[00:14:09] Speaker A: You know, use tools beyond like basic physical therapy and plain English. What's, what's your approach to creating kind of a plan that sticks more like a hands on mobility, strength movement like Repatterning.
[00:14:25] Speaker B: Yeah. So I use a little bit of all of it. I think manual therapy can be really beneficial in helping to provide acute pain relief and then help facilitate a little bit of a change so that the person can focus on the mobility or the strength exercises that have been prescribed.
I use a lot of stuff, like I've mentioned before, that come from Dr. Voyer in his exercise paradigm. So the Aldo and the segmental strengthening stuff, but really helping people to feel better and creating them a plan, is creating them a plan that they're going to stick to. You know, consistency is really kind of key when you look at trying to help people feel better. And I know that some people, after talking to them about lifestyle and the time that they have to commit and where they're at, maybe only have a handful of minutes or can only handle four exercises. And some people, you know, decide that they can manage 45 minutes of training a day. So it's really taking into consideration, yes, what I assess and what we observe and what we plan to treat to address their area of complaint. But a big part of that is taking into consideration their lifestyle and what they're willing to commit to the process.
[00:15:44] Speaker A: Do you find a lot of people struggle with making that commitment?
[00:15:49] Speaker B: Yes, I think it's tough one, if you've been in a chronic pain cycle for a long time, to want to get back into movement when a lot of the movement is what has caused you the pain is something that we've got to work through.
I think the ALDO exercises are very challenging because you're basically at an end range contraction and you're sustaining that for an entire minute. So those aren't like bend over, touch your toes, passive stretches to make changes through that hamstring or whatever segment it is that you are trying to target.
Something that I had a mentor say to me too is sometimes people just aren't in enough pain to make that commitment.
[00:16:37] Speaker A: That makes a lot of sense.
One of the things I struggle with, and I think it's probably pretty common with most, is neck and shoulder tightness, you know, from stress. The screens, we talked about screens earlier, you know, what, what do you, you know, do to help get relief from that? And, you know, why does it keep coming back? Because I know me personally comes back all the time.
[00:17:03] Speaker B: Well, you know, some of that is going to depend on, on the person specifically. But I think being in a desk posture or being on a cell phone or being in a place where you're rounded forward right. Chronically kind of changes the length, tension, relationships in some of those muscles there too. I think there's a big connection between scapular movement, so the shoulder blades, the way that those move, and the strength that those have.
And then posturally, we have an aldo we call the desk worker Aldo, which would be at the level T6, T7 for people who don't have all of their spinal vertebrae memorized. Right. The T6, T7 segment is kind of right at the bottom of your shoulder blades. But that one is a good one that anybody who's got kind of that rounded posture, even like heavy rotational athletes, get a T6, T7 Eldo, because that's in kind of that block part of the spine. So making the postural changes, making sure that the shoulder blades move well, are all helpful. And then, of course, you can't just look at the backside of the body where there's an issue. You've got to look at the front side, too, and take all of that n consideration as well.
[00:18:17] Speaker A: You mentioned fascia work a little while ago.
Can you explain that a little bit more?
Because I think most people, when they hear fascial work or joint space, and they kind of tune out because they're like, I don't even know what this is talking about.
[00:18:33] Speaker B: Yeah, Fascia has become a buzzword, which is kind of exciting because for a while, I think it was just this sort of like, esoteric tissue that existed, but people didn't really understand.
But the fascia is. Is in your whole body. It runs through a lot of stuff, and there's different layers to that.
But the fascia is kind of what makes up that tensegrity system through the body. So by using the way that all that tissue connects is how the Aldoa exercise can target specific segments in the spine or the hips or the SI joint.
Not only that, the fascia tissue is really important in the communication through the body. So almost that like a.
A neurological level. So if you've got unhydrated or dehydrated fascial tissue, tissue that doesn't slide and glide and move well, then that's going to impact that communication to the. To the brain.
[00:19:28] Speaker A: It's fascinating. I mean, it's. It's a great subject. I. I'm actually fascinated by it.
So let me. Let's ask another question a little specifically. When you talk about what people can do to kind of make a minimum effective routine, you know, for. For somebody that's busy, you know, if somebody only has, you know, less than 30 minutes in a day, what could they do to feel better?
[00:20:00] Speaker B: Move, get. You know, don't go home and just do some more sitting. So move, but move in a productive way.
Every single one of my clients is going to get the Aldoa for L5s. 1. We talk about that being that baseline Aldoa, because it's at the very bottom of the spine where the lumbar and the sacrum meet.
There's a lot of compression that happens there through gravity and standing. And if you're a rotational athlete, then there's a lot of shearing forces that happen at that part of the body, too.
So everybody gets that. That Aldoa. The other thing that's really neat about Aldoa, that gets at kind of a deeper level is the way that the exercise allows the inhibition or the water uptake, so the disc to rehydrate, which is important. You know, people. I think people talk about how you. You're taller at the beginning of the day and you're short at the end of the day, and that's because of gravity. And then the disc dehydrates from all of that compression. And so by allowing all of that to refill, you know, helps with some of that kind of stuff, too. So everybody's going to get that kind of exercise. I think there's a lot of people who probably need to work on, you know, stretching or improving movement through the front of their body, but it's hard. It's hard to say because the reason that I have back pain and the reason that you have back pain are probably very different reasons.
[00:21:39] Speaker A: Interesting. So let me ask you this, then, is something that somebody can do. Do you have a difference between walking versus running? For somebody to be active, or does it really matter?
[00:21:52] Speaker B: I think it depends on what your goals are. But if somebody has a lot of pain, I don't know that running is the most productive use of time just because of the impact that happens through. Through the joints through that. I think a lower impact, if you're looking for a higher intensity cardio, would be more beneficial.
I think walking is great. I think at the end of the day, the exercise that you can commit to do is going to be the best exercise to do, because that consistency and that commitment to movement are hard for people sometimes.
[00:22:23] Speaker A: That makes a lot of sense. I mean, it's practical sense, I think, the way we look at it. So, again, you know, where can viewers learn more about your work and take some next steps towards, you know.
[00:22:37] Speaker B: Yeah, so they can look me up on Instagram @jpkeeler k e e L E R send a message or Visit my website, roamfitandwell.com that's awesome.
[00:22:49] Speaker A: Jillian. We appreciate so much you being on the show and I think, you know, a lot of, lot of, a lot of good advice you're able to give. And I think, you know, talking about some of the new forms and new ways to help somebody is so beneficial, which is absolutely amazing.
[00:23:08] Speaker B: Well, I'm honored to be asked and excited to share what I have that's helped me so much. So hopefully it can help some of your viewers as well.
[00:23:16] Speaker A: Absolutely. And we talked about reclaiming your health at an individual level.
Next, we're going to zoom out to the system that supports that or in a lot of cases, fails to support health.
We'll be back right after this commercial break with my next set of guests and excited to talk to both of them.
Up next on the Game Changer Unlocked, we're talking about a powerful force reshaping healthcare by empowering clinician entrepreneurs. I'm honored to welcome Lorraine Bock and Lynne Rapselber, co founders of the National Nurse Practitioner Entrepreneur Network, or the nnpen, the national voice and an accelerator for nurse practitioners and entrepreneurship.
Lorraine is a board certified family and emergency nurse practitioner with a rich background in clinical care and practice leadership, built and operated her own primary practice care for over 15 years, continues to be a mentor and educate future NP leaders.
Lynn, a doctor of nursing practice and a national recognized expert on reimbursement, coding and health policy, leads the NNPN as a CEO and spent decades guiding the nurse practitioners to sustainable business success. And together what they're doing is pretty amazing.
Lynn, Lorraine, I am so excited to jump in and ask you a couple questions. I my sister, my stepmother, both nurse practitioners. So I know a little bit about it, but I don't think a lot of viewers really know what actually is a nurse practitioner.
I'll let either one of you answer.
[00:25:23] Speaker C: Sure, I'll take that one. A nurse practitioner is an RN who goes back to school for advanced graduate training to become an advanced practice nurse nurse practitioner. And we can assess, diagnose, treat, prescribe, medications and we do that independently through licensure, certification exams.
And we're providing care across the patient populations. So we're in pediatrics, neonatal, women's health, adult geriatrics, family nurse practitioner and psych, mental health and acute care.
[00:26:01] Speaker A: That's a lot for sure.
Definitely a lot for sure.
Both of you talk about sick care versus healthcare, so give me in plain English the difference and where do people feel that there's a gap for in Real life.
[00:26:18] Speaker D: So right now, the way that the healthcare system is designed in the United States, people primarily access the healthcare system when they're sick. You know, we're all supposed to go get our one year physical. But when you talk to people, if they're healthy and they're well, they don't often go. And when we do go, we don't spend a lot of time talking about the things that keep us healthy, like optimum weight management, nutrition, exercise, preventative health care, like getting a mammogram or a colonoscopy. You know, many times you'll find that people are behind on that in the system today, you know, and, and, and it's designed this way.
People are rewarded for staying healthy by not having to pay their co pays or not having to pay their deductibles or what have you, because we make it so that they have to pay up until a certain point. Whereas, you know, in many other countries, healthcare is not charged to the, to the person, to the patient. And they're encouraged to go, they're encouraged to get their checkups, they're encouraged to get their lab work. They don't have to pay extra for that. And so in the United States, providers get paid when people show up in the office. It's really a sick system. And we treat people after they've got the diseases. We don't invest a lot of money in keeping people well. And as nurse practitioners, our whole background is begun as a nurse in preventative care, keeping people well, making sure that they're doing the things they need to do to stay healthy.
[00:27:46] Speaker A: It's sad in a lot of ways.
You know, when you, when you start hearing, hearing about that and kind of the system is a little skewed.
Let's, let's talk about labs. You know, when someone's told your labs are normal but they still don't feel okay, what does the NP approach do that's a little differently than maybe a normal one?
[00:28:11] Speaker D: Well, I think one of the things we do is we don't just look at what's on the paper.
You know, it's nice to say your labs are normal, but if you're still feeling lousy, something is askew.
And is that something that's going on in your life emotionally? Are you having a lot of stress from something else? And we really sit down and we talk about all of the things. Are they eating poorly? Their labs might be fine, but they're eating poorly and they're not, Their body's not being properly developed with nutrition and Things like that.
So I think one of the ways that nurse practitioners really differ from our colleagues in medicine is we are trained from day one as nurses to look at the person as a whole person. It's really whole person care, and that is so important.
[00:28:58] Speaker A: I like how you said you might see one thing, but there's something that's causing it, and you got to kind of figure it out a little bit. It's a not, not the easiest approach, but if you're taking the whole body approach, it makes a world of difference.
[00:29:15] Speaker C: And when people experience care by a nurse practitioner, they realize the first thing they say is, wow, you listen to me, and the patient will tell you what's wrong if you just listen to them.
[00:29:26] Speaker A: Listening is an acquired skill. I would say definitely an acquired skill.
You built the NNPN around nurse practitioner entrepreneurs.
You know, what was, what problem and were you seeing that said, hey, we need a network for this?
[00:29:47] Speaker C: The biggest problem is Nurse Practitioners. PAs and physicians are not trained in business. We get zero business education as we're growing through our nursing career. And that is a problem when we're expected to go out and start businesses and help the communities that we serve. If we don't have that foundational support, it's very difficult. And many of our previous colleagues, including Lorraine, who we often say is our proof of concept, she's been through every iteration of issues, and she's still standing. She's that phoenix.
But a lot of NPs want to start businesses, but they just don't know where to go. So we decided to create a network with thoroughbreds in our stable of people who understand that the nursing model is different and really want to support those nurse practitioners to develop these great businesses in the communities that they serve.
[00:30:38] Speaker A: Yvette, what's one myth that you want to clear up about nurse practitioners? Is there about the scope, the expertise, the quality of care? Is there something that you want to know?
[00:30:50] Speaker D: I think the biggest myth for me is that we became nurse practitioners because we couldn't become doctors. Were physicians like, I. I'm a nurse because I wanted to be a nurse, and I'm a nurse practitioner because I wanted to be a nurse practitioner. I didn't want to deliver care the same way that my medical colleagues do.
So for me, that's the biggest myth. Lynn, I don't know what your biggest myth is, but for me, that's the one people always say. Oh, well, you just. You couldn't become a doctor. Yeah, no, I could have. I. I really could have, but I didn't want to.
[00:31:19] Speaker C: And I think it's the whole concept of taking care of that whole person person that is so different. And I think again, once people experience care by an np, they understand that the model is different, we do things differently and our investment in the patient engagement is really, I think, one thing that makes us stand out.
[00:31:37] Speaker A: And I want both of you to answer this question too, if you zoom out.
Why do you believe a nurse practitioner led practices are a key part of kind of fixing access and outcomes in healthcare? When you said the sick care versus
[00:31:55] Speaker C: healthcare, the biggest reason our numbers are growing, we're 461,000 of us. And I think that as we see needs in our communities and we're developing these practices around that, it just makes a lot of sense that we need to start fixing healthcare from the ground up in the communities that we serve. And many of the nurse practitioners are small business owners. So they're not only helping the patients, they're creating small businesses employing people within their community, contributing to the economic value and sustainability of that community as well.
[00:32:30] Speaker D: I think for me it's, it's the whole care. You know, we are, we are changing the way people look at health care. Right now health care is in silos. You know, you've got cardiology, radiology, urology, whatever specialty you want to do. And the difficulty is that those specialties, particularly with the emr, the electronic medical record being the way it is, it's, it's difficult to communicate. And for nurse practitioners, we're trained from the beginning to look at the holistic part of health care, the whole person care. And that, that changes health care. When you start looking at someone, something other than a gallbladder or a bad heart or kidney disease, it really makes a difference in the way that people are treated and the way that their care is managed.
[00:33:13] Speaker A: That's awesome. That's awesome. So if somebody wants to find out more about the nnpen, where do they go?
How can they find out more?
If I'm a nurse practitioner and I want to find out more about the network, how do I find that?
[00:33:31] Speaker C: Just go to www.nnpen.org.
that'll take you to our website and there's a wealth of great information in there. How to join, what services we offer, the community that we're creating and opportunities for engagement and education.
And there's one in particular. And I'll let Lorraine talk about office hours.
[00:33:52] Speaker D: So we have on the third Tuesday of every month at 8:30pm Eastern Time, we have what we call our office Hours, little play on words there. And we bring experts from all over the spectrum in healthcare business in to talk to people about running their business, opening their business, selling their business, hiring people, firing people, and anyone can come to that. You don't have to be a member of the National Nurse Practitioner Entrepreneur Network to join Office Hours. If you are a member. There are some benefits that you get for being a member, for attending Office Hours, but that really is a way to learn about what we do, what, what we offer because we bring in people that are partners with us, people that have interesting things to talk about. We've talked about, you know, how do you, what do you do if you get caught in, in an investigation? How do you deal with that? How do you avoid getting caught up with insurance fraud? All of those topics that are critical and sometimes people are afraid to ask those questions. So I think Office Hours is our biggest outreach.
[00:34:53] Speaker A: And just to make sure people understand this is a national organization. It's not just located in one state or one segment of the country.
[00:35:02] Speaker C: Absolutely, yeah. We're across the nation.
And the nice thing about our network is if we don't have an answer, we have resources and know where to find those answers for our members.
There's different pathways from each state to become an NP and to create a business.
And it's not one size fits all in every state. So those are some key things that I think people really need to understand the value that we're bringing to help them.
[00:35:30] Speaker A: That's awesome.
Hey, the next segment we are going to talk, we're going to dive a little bit into the directory and what has been built and kind of the vision that supports it. We'll be right back after this with the Game Changer Unlocked.
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As we wrap up today's episode, we're focusing on the NP directly the directory that they've put together. It's a value based care and how kind of pieces are starting to shape the future.
So Lynn, Lorraine, you know, let's talk about what you've built. You know, what is the nurse practitioner, the NP directory and who is it for?
[00:37:03] Speaker D: So last year, we launched what we call Destination np, which is directory and a few other services for nurse practitioners. And it's built to create something that has never been created before, which is a collection that is curated and monitored of NP entrepreneurs and business owners across the United States. One of the things that we found that has been so difficult is connecting NP owners to one another. For some reason, it seems like when you're practicing alone, and I know this from personal experience, you're in a vacuum and you can't find anyone else who's doing what you're doing. And one of the things that we know from creating the community of NNPEN is that being in a vacuum is very lonely, and you really need to have the support of others who are in the same situation that you are. So we started building the directory.
[00:37:56] Speaker C: Lynn it also gives visibility to NP practice owners. A lot of them are doing great work, but they're flying under the radar. And it's really time that we start to come out of the woodwork and really be collaborating together and creating leverage so that we can affect healthcare policy especially and give opportunities for NP practice owners to get adequate reimbursement, good contracts, things like that. That as an n of one practice owner and 250 to 1,000 patients, you. You're not going to have that leverage. But if we have 1,000 NP practices with 500,000 patient lives, boy, does that have impact.
[00:38:34] Speaker A: Just to check in. I mean, the directory can help a patient who's thinking, hey, I want to find a provider who will actually listen and kind of help me long term.
[00:38:44] Speaker D: Yes. The directory is designed for three specific areas. One is to connect patients to NPs. So patients can. Can search the directory for an NP and they can sort out location, they can sort out specialty, they can even sort out, if they prefer, the gender of the provider, all of those kinds of things. It's also designed for students. One of the problems that NP students have today is finding preceptors. So our directory allows its members to designate whether or not they would consider being a preceptor in their bio. So students can search it and find NPs in their area or their specialty. And then the final thing is to connect NPS to NPS so that if you want to refer to another NP in your community in another specialty, or you have a patient who's moving, this happens all the time. We get inquiries. My patient's moving to, you know, wherever. Dallas or Los Angeles or, you know, Podunk, Idaho, or whatever. Does anybody know a nurse practitioner in that area that they can go to. And so the directory will provide that type of connection for all of those three areas, all those three patients, people.
[00:39:51] Speaker C: And the other area I think it does support MPs as well is if you're a psych NP and you want to find a primary care MP in your area to collaborate for rental space, for example, or shared services, you can find each other through this directory to do that.
[00:40:08] Speaker A: So I want to go back and you said support preceptors. If a new student doesn't know what that means, what is that specifically mean?
[00:40:19] Speaker D: Go ahead, Lynn.
[00:40:21] Speaker C: So students in particular often go into nurse practitioner school to come out to open a business. However, the rigors of going through the training kind of deflate that experience for a little bit. But I think if we can get them engaged with an NP practice owner from the get go and they really want to be part of that NP led care, finding a nurse practitioner practice owner to do their precepting is really going to be very helpful because you'll be learning right from a business owner. And oftentimes these can lead to employment opportunities within that practice which sustains that NP practice viability for the long term.
[00:41:01] Speaker A: Well, we definitely know that quality matters in whatever it is. When people look at choosing a nurse practitioner practice, what should they be looking for?
[00:41:16] Speaker D: I think they want to look for someone who's compatible with them. You know, a lot of times our insurance will dictate where we can go for care or who we can see. And just because your insurance says, oh, you've got to see X or Y doesn't necessarily mean you're compatible. And when I say compatible, you know, of course you want them to be smart, you want them to be well experienced, you want them to be good clinicians. But if you can't talk to them, they don't listen to you, or you don't feel that you have a connection with the person who's taking care of you. It's extremely difficult to build a trusting relationship. So I think, you know, most NP practices will allow you to have what they call a 15 minute get to know you appointment where you can go in and you don't actually become a patient yet. But you talk to the np, you can ask them about their philosophy, you can ask them about, you know, where do you admit to. I mean, these are things that you don't think about when you go to a practice until after it's over, you know, when you need the service, when you need to be admitted, or when you need to go to the emergency room. Those are things that, you know, if you take that 15 minute, get to know you appointment and you ask some questions about what your philosophy is, you know, if you don't like medicine, talk to the np. If it's someone who relies on medication for their treatment, they're not going to be compatible with you. You know, if you want to do some sort of biometric testing, make sure
[00:42:36] Speaker A: they understand that that's, that's true.
Lynn, what were you going to say on that one?
[00:42:43] Speaker C: I was just going to say I definitely agree with that and I think that with value and the value based care, it's really a longitudinal process because it deals with how well we get patients, good outcomes and whatever that outcome outcome is whether it's optimum level of wellness or. Well, it's whether it's a pathway to, you know, a peaceful passing. That's what nurse practitioners do when they start developing these relationships. And I've heard too many times that care is so fragmented right now and that you can't even be guaranteed that that primary care provider that you have today is going to be there tomorrow. And when you develop relationships with an MP LED practice, the chances are we're not going anywhere. Because we're embedded in the communities which we serve and because we have our own business, we develop the kind of practice that we want to deliver that kind of care because we're not encumbered by an organizational structure.
[00:43:36] Speaker A: Well, you just mentioned the word value based care and I wanted to kind of come back on that because I think it's important.
What is that? Simply when you say value based care,
[00:43:50] Speaker C: it's providing the type of care that the patient needs, meeting them where they are, getting them to provide the preventative care they need to stay healthy and well, if they have a chronic illness, can we keep them to their optimum level of wellness? And to Lorraine's point, it's not just looking at medication, it's really looking at your diet, are you sleeping, what's your home situation like?
Do you have a social circle? There's so many things that go into assessing whether a patient's to going, going to be having a good outcome or not. And it's not simply just assessing these things, it's actually doing something about it. So if somebody does have food insecurity, we hook them up with a homeless or a food bank. If they don't have a home, we can get them hooked up with a homeless shelter. We are connecting with the community resources to provide that optimum level of wellness and help them to stay as healthy as they can.
[00:44:44] Speaker A: That's awesome. That's definitely awesome.
[00:44:46] Speaker D: So many people deal with providers who are transactional.
You come in, you've got something going on. We fix that and don't come and see me until the next time you have something that you need from me. Whereas I think nurse practitioners, we are born and bred to be relational. You know, we want to build a relationship with you. We want to understand that, you know, you have six kids and you have to work full time and you broke your arm and, oh my gosh, how are we going to help you get the resources you need to take care of your six children? And how are we going to get you the finances that you need to manage while you're off work for, you know, four to six weeks, while you have the broken arm or whatever that, whatever that might be? You know, it's much more relational.
And when you see a provider, you know, if you're a transactional person, then you need to deal with the transactional provider. If you're a relational person, like most people are for healthcare, most people want relationships in healthcare, not transactions, then you need to be able to ask those questions up front and find out what kind of a provider you're going to end up with.
[00:45:45] Speaker A: You mentioned cost and, you know, every, you know, that's a big statement across the board for everybody nowadays is the cost.
You know, when employers payers, you know, communities talk about lowering costs and kind of the improve plus improving outcomes. So you want something a little cheaper, but you want a better outcome.
You know, what, you know, what do you want the directory and the practice of nurse practitioners to play in that solution?
[00:46:17] Speaker D: Go ahead, Lorraine, Go ahead, Lynn.
[00:46:22] Speaker C: Well, I think overall, when an NP sees a patient, because we're trying to keep them to their optimum level of wellness, they're going to actually phone. Plus employer standpoint, they're not going to be out of work as much. They're going to be able to be employed. Nurse practitioners go where the needs are. So we may go to the employer and see patients on site and keep them at work.
We also lower costs because we go to where the patients are. We might go to their homes. We might actually prevent that elderly person from going to the ER or the urgent care when they can be seen in their home and be evaluated for the conditions that they might have. If they go to the er, the urgent care, they might get a medication that is going to contradict with all the other things that might be going on with them and it will add to the cost of care and not really solve the problem.
[00:47:11] Speaker A: That's awesome.
To kind of close up. Where can somebody find out more about the directory and about what you're doing with the NNPEN?
[00:47:24] Speaker D: The directory can be
[email protected] online. If you go on there, you'll get right into the directory. And if you're a patient, you can look at it. If you're a nurse practitioner, you can look at it. If you are a student, you can look at it. And if you're an NP business owner and you own your own practice, please join the directory. The only way that this thing becomes a valuable resource is if it's populated as accurately and as fully as possible.
The other thing is just to come to our website at www.nnpen.org.
all of our resources are on there. Our Business Basics accelerator course, which provides training for nurse practitioners who want to become entrepreneurs. The directories on there, our office hours are advertised on there. We have webinars. We have the office hours recordings. We have resources of other businesses that we vetted that you might need as a nurse practitioner, business owner, like billing or coding. I mean, the amount of
[email protected] is just remarkable. And I think that's probably our most unsung hero in all of NN Penn is the fact that our website has so much on it.
[00:48:30] Speaker A: That's so awesome. Thank you both so much for joining the show today and kind of getting some light on nurse practitioners, but then on the incredible directory and all that you guys are doing for community for us. And that's so thankful. We appreciate it so much.
[00:48:50] Speaker D: Thanks for having us.
[00:48:52] Speaker C: Thank you.
[00:48:53] Speaker A: Today we looked at health from two different angles, the body and the system.
Jillian Keiller, she talked about rebuilding strength, restoring movement, and helping people stop normalizing pain. Then Lorraine and Lynn, we zoomed out, you know, challenging how care is delivered and how nurse practitioners are expanding access, value and trust across healthcare. You know, through the Nurse Practitioner Entrepreneur Network, the NN Penn. This episode is about more than symptoms. It's about solutions, both personal and systematic.
You know, to our guests, thank you for leading a real change and not just lip service.
And to the viewers, stay proactive, stay informed, and keep unlocking your potential. And even more so, keep changing the game. I'm Brian Fetzer. This has been the game changer unlocked. We'll see you next time.
