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Kevin Burciaga: A Physical Therapist’s Perspective on Healthcare

Today’s episode features Kevin Burciaga who shares a physical therapist’s perspective on healthcare. Based in California, he is also passionate about rational eating. A millennial and a YouTuber, he joins Rob Oliver on the Perspectives on Healthcare Podcast.

Here are 3 things that stood out from Kevin Burciaga presenting a physical therapist’s perspective on healthcare:

· Quality healthcare is connecting the patient with the best solution
· You need to look at each person: what medications are they on, what is their history, what is their mental state, what kind of help do they have at home, what is the onset of the problem, what else is going on in their life
· Showing the patient that they can do more than they think they can is also quality care

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Here is the transcript of

Rob Oliver: Thank you. And welcome. My guest today is Kevin Burciaga. He is a physical therapist. He is a YouTuber. He is all about the concept of rational eating. He is a millennial member of Generation Y. He is from Modesto, California, and he joins us today. Hey, Kevin, welcome to the show, man.

Kevin Burciaga: Thanks for having me.

Rob Oliver: You bet. So let’s jump right into it. Can you tell me about yourself and your role in health care?

Kevin Burciaga: I’ve been a physical therapist for six years. I just passed my six year anniversary here hard to believe. And I’ve been doing primarily home health, geriatrics, post surgical rehab. And then my own business is the National Eater. So it’s a YouTube channel. But it’s also a program to help people overcome eating disorders. I kind of have a split career at this point.

Rob Oliver: Okay, so the concept of physical therapy, I think we have a general understanding of can you tell me a little bit more about the rational eater and what that’s all about?

Kevin Burciaga: I have my own history of eating disorders, and so I turned my problem. I turned my mess into a message and then into a solution. And it’s a methodology that I developed over many years through a lot of trial and error school of hard knocks. And now I’m helping people with the same problem, mainly my generation and then Generation Z, the 2000 and beyond. Right. I would say between 20 and 40 helping those people overcome similar problems using my methodology.

Rob Oliver: Okay. How do you see the intersection between your two? Are they separate rails? That, like physical therapy is one thing and eating disorders are another thing? Or do you see some intersectionality between them?

Kevin Burciaga: It’s both health in physical therapy. We’re promoting optimal movement and then rationally. I’m promoting optimal nutrition. Although I don’t tell people exactly what to eat. I can’t a dietitian, but I’m trying to help. I’m helping people get from where they are now to where they want to be. So it’s a similar process, right? Like here’s your patient or here’s your client. Here’s your goal. Can you help them achieve that goal?

Rob Oliver: Got it. In both instances. What I’m hearing you say is it’s getting you from where you are to where you want to be.

Kevin Burciaga: Yeah, exactly. It’s just setting goals, which you do in physical therapy. And then I do in my business. And one of the things that I learned as a clinician, I’m applying in my own business. Okay. Let’s establish goals. Let’s measure progress. Let’s have milestones. Let’s figure out what’s working. Let’s modify the plan of care. So when I started six years ago, I wasn’t planning to do this. I wasn’t planning to help people with Eds. I just wanted to recover on my own and then move on with my life. And then I realized that I had my own solution. Why not promote this, right. But I learned a lot of things while I was doing PT that applied in my business.

Rob Oliver: Okay. Thank you for sharing that. What does quality health care mean to you?

Kevin Burciaga: It’s connecting the patient with the best possible solution to their problem, which in many cases could be doing nothing. Sometimes there’s no one intervention that’s going to solve this problem. Sometimes you just have to let it run its course, which is a hard proposition to sell sometimes. Well, your back pain, it’s probably going to go away in the next few months. There is this inclination to do something. If there’s a problem, then you got to do something but quality health care, if the answer is to do nothing. Well, that doesn’t cost anything. Right. Right. So that is the optimal solution. So it’s like it’s finding that bridge from the patient to that theft solution.

Rob Oliver: It’s so interesting that you say that because what you’re talking about is looking at all of the possibilities. And among the possibilities is the possibility that there’s no necessity for intervention. How do you make that determination?

Kevin Burciaga: And like you said, that’s a hard sell. How do you share that with people in a way that they’re not just like, what do you mean? I just have to wait for this to work its way through.

Kevin Burciaga: It’s a hard call. And that’s where skill and critical thinking comes in, because let’s say 70% of the people don’t need. Well, let’s say half the people don’t need any intervention. Well, then half do, and you have to figure out which people really need it, which don’t. And it’s a combination of things it’s hard to list, but what medications are now, what’s their history, what’s their mental state, what kind of helps that they have at home? What’s the onset of the problem? Was there a fall? Was there something traumatic, like what else is going on in their life and then to convince them that nothing is needed, some people are more receptive that than others because it’s actually good news that this thing will resolve on its own. Oh, wow. Really? I’m not broken. Like, I don’t need surgery. That’s a huge relief for a lot of people. Sure, doing nothing versus going through the medical system and never really getting better. Are you saying all I need to do is do some simple exercises and change some things in my home. Great. Let’s do that. Although you get some people who think that surgery is a quick fix or doing something, they have to do something, and doing nothing is not an option. But I say doing nothing is often doing something right. And it’s the best solution in some cases. So it’s a balance because you’ve got to consider their goals. But you also have to consider money, right? Resources. And then what you don’t want to do is deny somebody services or not intervene when you should intervene.

Rob Oliver: Okay. I’m thinking in there you would have to do some work to address symptoms. So I’m assuming someone’s having back pain and you’re like this particular issue is likely to resolve itself in a couple of months. Let’s help you to be more comfortable with what’s going on until it gets to that point. Is that part of what you’re talking about?

Kevin Burciaga: Sure. Yeah. I mean, let’s look at different positions you can sleep in. What kind of shoes are you wearing? Seriously, what kind of mattress are you sleeping on? What kind of help do you have at home? Do we need to order equipment? Are you using a heat pad or something? Just for simple, basic relief. Can you get up and walk around every 2 hours? Can you avoid these positions? There’s always something simple, and that’s my methodology. It’s like, let’s start with the simple things. Let’s start with the obvious and then we’ll progress from there.

Rob Oliver: Okay. I think you’ve kind of covered this a little bit. Can you talk to me about a specific example of quality health care?

Kevin Burciaga: In my life?

Rob Oliver: It can either be in your own life or it can be with someone that you have worked with, a client or somewhere that you have seen quality health care at work.

Kevin Burciaga: I’ll give something in my life. If I see something really routine, like knee pain, I’ll show them a few exercises that are very basic, very easy to do. They are low costs that are probably going to help the problem. And sometimes. And here’s an uncomfortable truth about physical therapy. Sometimes you just need to get them to do something and you’ll get some result. It might not be a specific result, but it is something I think showing the patients that they can do more than what they think they’re capable of is quality care, because then they start to get stronger, they feel a little more resilient. They start feeling better. And then patients symptoms start to reduce.

Rob Oliver: Okay. What I’m hearing you say just to synthesize what I’ve heard you say so far. Sometimes doing nothing is the right thing to do, and sometimes it’s just doing something is enough to get things headed in the right direction. Is that properly understanding what you’ve said so far?

Kevin Burciaga: Correct. And when I say nothing, maybe I should be one more clear. We don’t need to do anything fancy. We don’t need some complicated maneuver. I don’t need to manipulate them or something, but they don’t need to take a medication. They don’t need a surgical intervention like we can do something that’s very simple, very low cost. It’s going to start producing results now.

Rob Oliver: Okay. So then let me just make sure you’re saying when you say do nothing, you’re talking like radical intervention. Where by nothing means you’re not going in to do surgery. You’re not doing it, but you’re giving them some maybe simple exercises to do some lifestyle adjustments that may help to reduce the issue and help to alleviate it over the course of time. But it’s not that they’re not doing anything where they’re just sitting around, waiting for it to get better. It’s that they’re doing incrementally small steps or simple procedures to move forward with that. Is that correct?

Kevin Burciaga: I’m giving them simple things they can do right now to start producing that change. I’ve never seen a patient say, well, we don’t need to do anything, have a nice day, and then give them a Pat on the back. I’ve never done that. Okay. There’s always something that we can do, but very low cost and something they can do on their own.

Rob Oliver: Got it. Okay.

Kevin Burciaga: That’s what’s important.

Rob Oliver: Sure. So you’re kind of empowering them with some things that they can do on their own to move forward.

Kevin Burciaga: Yeah. Showing them what they can do, putting them in charge.

Rob Oliver: Got it. What do you wish people understood about your role in health care? And you can take that either direction as a physical therapist or working with folks with the eating disorders.

Kevin Burciaga: I’ll focus on the physical therapy. You need to see a physical therapist as a consultant. Unless it’s a mechanic, you know, you’re not a car. The body is not a car. Oh, here’s what’s broken. Let’s get our toolbox and let’s fix it. Cars are not people. And the reason why is because we have mines. So when you combine bones and joints with psychology, it’s a lot more complicated. Whereas if you have a flat tire, you fix the tire and you start driving again. It’s not so easy for humans. This is why you can do surgery after surgery, after surgery and never seen improvement, because now you’re dealing with a person who has certain emotions and certain beliefs, and that makes it that much more complicated. So if you’re going to see a physical therapist, seek one that acts more like a consultant and doesn’t see you as something that needs to be fixed. We are tour guides here. Like here’s some things you need to do. Here’s the prognosis here’s what I think is wrong here’s what not to do. Let’s keep things simple. Come back. Let’s reassess.

Rob Oliver: Okay. Very interesting concept. Thank you for sharing. That what excites you about the future of health care?

Kevin Burciaga: I would say the role technology, specifically, AI will play. Ai is an artificial intelligence, right. Right. I guess augmented intelligence, too. So it can be either one. Sure. Especially when it comes to differential diagnosis. I think that would be a tremendous aid, I. Equate. It to instant replay and baseball. The Institute of Instant Replay and Baseball about ten years ago. And then you look back at the era before instant replay, and you look at all the blown calls that they made these were supposed to be like professional umpires and making these horrible calls. But now that doesn’t happen because we have technology to make sure that that doesn’t happen. I think differential diagnosis will be. I mean, I think AI, when it comes to diagnosis will be the same thing. We won’t have to rely on physicians and physical therapists to come up with the best diagnosis because there are so many variables involved. It’s really hard to pin down a good diagnosis. And I think AI will be a tremendous tool.

Rob Oliver: Okay. Just really quickly. Can you tell me what is the difference between artificial intelligence and augmented intelligence?

Kevin Burciaga: I think augmented intelligence is when you have either a phone or you have something in your eye that gives you additional data about your surroundings.

Rob Oliver: Okay. Got it. Thank you. What is one thing medical professionals can start doing today to improve the quality of health care?

Kevin Burciaga: Stop focusing on what you’re going to do to the patients or focusing on what the patient can do for themselves, prefer more simple solutions, more low cost solutions, and then progress from there. Quick thinking in terms of okay, we need to do medication. We need to do surgery. We need to do this. Even in my profession, we don’t do surgery, but it’s really something to say. You need to come here twice a week for six weeks. What would a home exercise program get the same effect? And I think a lot of times the answer is yes.

Rob Oliver: Right. It’s so interesting that you say that my mom talks about when she was young, she grew up in the Richmond, Virginia, area, didn’t have a whole lot of money. And so when they needed dental care, they went to the school of dentistry. And she feels like whatever technique they were learning that week is, somehow they found in the patient’s mouths. And they were performing that technique. And it was something that they were so focused on their own skill set and the things that they were learning, that they were kind of pigeonholing people into it that didn’t necessarily need it. And I think that in a little bit that’s kind of what you’re talking about. Instead of being excited about new treatments and all of those novel approaches, let’s see if we can start with a simplistic approach and use that first before we go beyond that. Is that a fair understanding of what you’re saying?

Kevin Burciaga: Yeah, I see Pts doing laser therapy. I’m thinking before we start doing laser therapy, why don’t we focus on what we do? Well, like exercise, education, behavior modification. Let’s master that before we start shooting lasers on the people.

Rob Oliver: Okay. It’s one of those things where shooting laser sounds advanced, and I don’t want to overstate it, but it sounds fun and cool, and it’s the cutting edge. And maybe it’s not where we need to start. Hey, listen, Kevin, thank you for being with me today. I really appreciate your willingness to share your perspective on healthcare.

Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.

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