Shifting Focus in Rehabilitation: A Conversation with Marcus Blumensaat RMT

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The status quo in the world of musculoskeletal healthcare needs to change. Bridging the gap between outdated norms, current practice standards and evidence-based care is what Marcus Blumensaat is working hard to do. In this episode we welcome Marcus, a registered massage therapist and continuing education provider, who shares his journey as a clinician, family man and a CE instructor. Also, Marcus shares his peculiar interest in watches!

Venturing beyond the traditional scope, we shed light on the overlooked significance of exercise and movement prescription and question the overemphasis on passive therapies. Marcus takes us through the insightful concept of 'movement optimism' and the need to shift perspective towards the abilities of patients rather than their disabilities. Together, we demystify common myths about posture and biomechanics and discuss the integral role of listening and ruling out red flags while empowering individuals to resume their beloved activities.

Finally, we steer towards the crucial transition from patho-anatomical, tissue-based models to evidence-based behavioral sciences in musculoskeletal healthcare. We explore the art of patient-centered care, therapeutic alliances, and effective communication strategies. Wrapping up, we navigate the intricate waters of healthcare regulation and the role of continuing education in crafting proficient healthcare professionals.

Marcus can be contacted through his website, www.marcusblumensaat.com
or via email, [e-mail]

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Episode Transcript

Eric (00:13):
Hello and welcome to another episode of the Purvis vs
Podcast.
My name is Eric Purvis and I'ma registered massage therapist,
course creator, ce instructorand curriculum advisor for
evidence-based massage therapyeducation.
This episode features anotherCE instructor, as I welcome
Marcus Blumensat.
We discuss the roles andresponsibilities of being an
evidence-based CE instructor aswe explore the difficulties in

(00:35):
challenging the status quo andcurrent practice standards for
massage therapy, despite awealth of contradictory evidence
.
If you enjoyed this episode,please share it on your social
media platforms.
Purvis vs can also be found onYouTube, so please check us out
there and be sure to like andsubscribe.
Hello everybody, thank you forbeing here for another episode
of Purvis vs.
Today I have Marcus Blumensat,a colleague, and another CE

(01:01):
provider, here in the wonderful,beautiful Victoria, british
Columbia.
So thanks for being here,marcus.
Now just tell us a little bitabout yourself.

Marcus (01:10):
Well, as you just said, I'm a registered massage
therapist with private practicein Victoria BC and also
continuing education educatorand then, I guess, personally
big family man.
I have a wonderful wife, twodaughters and my own time away

(01:32):
from work other than family.
I'm a mountain biker and myweird sort of personal hobby is
I'm also a watch enthusiast.
And yeah, that's about me.

Eric (01:45):
I love that you're the watch enthusiast, because when
we got together for coffee thattime we were commenting on each
other's watches.
You definitely know more aboutthem than I do.
I like.
I love watches, but those aresuch a cool things.
You don't really meet too manypeople that actually notice
watches or actually knowanything about them, whether
it's brands or types or what'syeah, and you have, like, how
many do you have?

(02:06):
You have a whole bunch ofdifferent watches, don't you?

Marcus (02:08):
Well, to clarify, they're all what I would call
entry-level, so they're notexpensive watches.
I'm on the very entry level.
Some of them I've had for yearsgifted to me by my dad or
whatever.
But yeah, I have like I think Ihave nine watches, but yeah,
they're all all entry-level,okay they'll do the job I always

(02:28):
make me think.

Eric (02:29):
every time I think of like people that like watches, I
always think of that scene withChristopher Walken in Pulp
Fiction.
Yeah yeah, yeah anyway, so yeah,that's great thanks, thanks for
being here.
Yeah, the reason I wanted tobring here was just kind of
we'll just chat about somethings.
I know we have a lot of stuffin common in terms of the way we

(02:51):
, the way we want the professionto go, the way we think
continuing education should be,but just, you're relatively
new-ish, I guess, into the theCE realm.
Just tell us a little bit aboutyour journey and kind of what
was your motivation behindwanting to be a CE provider?

Marcus (03:09):
Yeah, well, I guess it just started from my own journey
as a, you know, practitioner.
I was just always fairly keenon knowledge and information and
so I was always questioning youknow what I knew and if that
was maybe more right or lessright than anything else.

(03:30):
And so I just started takingcourses.
And you know, back earlier, youknow, say 15 years ago, there
wasn't much social media.
There was a little bit, butmainly it was courses and blogs,
and so I just started readingthose and my knowledge base
started growing.
And then social media came onthe scene really more strongly,

(03:51):
as well as podcasts, andbasically it just got easier to
access sort of all the worldleaders in musculoskeletal
healthcare.
And you know, they were writingblogs for free, they were on
podcasts, you could listen tothem talk for an hour for free.
And it was just like all of asudden it was like this endless
at-your-fingertips informationand and I was soaking it in and

(04:14):
and sort of changing the way Ithink and practice according to
this information, because it wasa lot of.
It was very different than whatI was taught, because, you know
, information evolves andscience evolves and we move
forward, and I just kept soakingit up and soaking it up and
changing the way I practice andeventually it got to the point

(04:38):
where there's all thisinformation.
It's so easy to access and itwas so different from people's
base education and verydifferent from how, I would say,
the majority of all healthcareprofessionals, musculoskeletal
healthcare professionals, werepracticing, so I not limiting it
to massage therapists, but allhealthcare practitioners and and

(05:00):
truthfully I felt like the gapwas so big I wanted to
contribute to bridging the gapfrom where people were to where
the latest research was, and soI just decided to start making a
course and start teaching andsort of try and, you know, join

(05:21):
the group of educators who aretrying to move musculoskeletal
healthcare in a more up-to-dateand evidence-based, you know,
place.
And so that was really my.
My motivation, I guess youcould say is is just wanting the
care that people receive whenthey go to someone in practice,

(05:41):
the care they receive, to be themost modern, up-to-date and
based on scientific evidencethat it could be.
Because I think that for themost part there is still quite a
gap out there between people'ssort of base educations they're
getting and then how they'repracticing on.
A lot of continuing educationthat's out there is is pretty

(06:05):
outdated as well, in my opinion.
So, yeah, that was themotivation is just basically to
move musculoskeletal healthcarein a more modern, up-to-date,
evidence-based way, and so, yeah, plug in away with it and
enjoying it.

Eric (06:20):
I love it.
Yeah, I think that's amotivation for a lot of us and
that was my motivation too iswhen you start to see what you
were taught and what you hadlearned in other courses, versus
then when you take a look atthe research and take a look
kind of best practice stuff, yourealize there's there's this
total incongruency between itand you think this doesn't make
any sense.
It's like this information,some of this information you

(06:42):
know that we're learning, hasbeen, has been out of date for
40 years, but it's still thecommon, the common narrative and
the common practice.
And it can be frustrating,right, because you want to.
You start to realize thatpeople are coming in to see you,
you know well-meaninghealthcare providers just don't
have that information andthey're basing treatments or

(07:03):
treatment plans or you knowself-management strategies on
information that isn't doesn'thave any evidential support yeah
, definitely exactly yeah, sothat's great.
So one thing I want to ask youto do, too, is is because we've
all kind of all of us that havegone through this kind of
evolution, this journey from ouryou know, our base level

(07:24):
education to dig in a deep diveinto the research and the
evidence and then trying to makesense of that and translate
that into our practice.
Then trying to translate thatinto something that's digestible
to learners, the people thatpay us and attend our courses or
listen to our podcast, whereverit might be.
What was, was there like aspecific course you took, or a

(07:45):
blog you you read, or a podcastyou heard, or something that
really inspired you and got youthinking oh, this is very
different from what I thoughtyeah, for sure I.

Marcus (07:58):
I mean, I started questioning my bias.
Which my bias?
Coming out of university andwith a degree in kinesiology, I
was very biomechanical, you knowthere was a proper way to have
by proper biomechanicseverything da, da, da.
So I was very symmetrybiomechanics and then I just

(08:19):
started questioning that bylooking at things out in the
real world and questioning it,questioning it, questioning it,
started reading some stuff.
I'm like, oh, there's someother people are saying
biomechanics aren't that big adeal and posture isn't that big
a deal, and so I was starting toget a little bit of affirmation
of of my doubts.
And then I took a Greg layman'scourse and for the first time

(08:43):
I've taken it three times.
At the first time I took it andit was like it was made for me.
It was the whole coursebasically confirmed all of my
questions and my doubts aboutwhat I had been taught, in the
way I'd been practicing and thewhole weekend I was just having
a aha moments after a aha momentafter a aha moment, and that

(09:05):
was the the true tipping pointwhere everything changed for me
and I just had such a fire litunderneath me and I was like aha
because, for those who don'tknow?
Greg is one of the mostknowledgeable MSK healthcare
professionals and educatorsaround the evidence, around
research, and so here he waspresenting these points backed

(09:32):
up by so many studies I mean,he's just an encyclopedia of
every study that's pretty muchever been done and here he was
backing up all these doubts Ihad and he was confirming them
with evidence and but he does aneffective job of, I think he's
a really good what I would callmaybe, fence sitter.
He's he's not saying certain oneway is right, one, or he's just

(09:52):
saying a lot of the time wejust don't know the evidence
doesn't know you know what'sbest, but it's certainly not
saying this, you know.
And so, yeah, that was thecourse, that was the moment.
And then, from then on, it wasa really, really quick, you know
good, slippery slope and intothe evidence and more so, and
changing my bias completely,changing the way I practice,

(10:15):
completely changing the way Ispeak with people, completely
changing the narratives.
I say, and yeah, that was thecourse nice.

Eric (10:23):
The Greg's course was great.
I I think I first met Greg in2016 because our clinic we used
to host him.
I think you probably attended acouple of times that we but we
brought him here and so I'vebeen I've probably seen it take
it been at his course probablyfour or five, maybe six times
all the time we brought him hereor to the west coast and seeing

(10:45):
him in other places too and,yeah, I really like.
I really like how he presentsthings and because he really
it's all about kind ofquestioning your what you think,
rather than just these hard andfast rules, which is great,
because humans aren't, don'tfollow rules, and so why should
our rehab follow, you know, formost part, follow these very

(11:05):
specific, you know protocols.
It doesn't matter as much andthat's why I like to.

Marcus (11:10):
I felt like learning his stuff provided more freedom, I
guess, more curiosity and intohow you practice versus then
things have to be this way yeah,yeah, I think the for me, one
of the biggest, biggest changesfrom him but also from my own
sort of investigation doubts,but he confirmed is his way, and

(11:34):
now I guess you could say myway of looking at people is a
lot more positive.
You know, I think the older wayto practice is looking at people
like they're broken and theyneed to be fixed.
And you know, I think Greg'swhat he uses, the term, you know
, movement optimist, and I likethat.
Basically, it's just a muchmore optimistic way of looking

(11:55):
at the human being.
You know, we are incrediblyadaptable and, for the most part
, once you learn about thescience, it shows that all
postures are basically normaland okay and most biomechanics
are fine, and you know it justis a lot more positive.
And so you end up empoweringpeople and enabling them versus

(12:17):
and you know, scaring them andtaking things away from them.
Ie, oh, you shouldn't do this,you shouldn't do that, you got
to be careful of doing this.

Eric (12:26):
So, and that's another big takeaway from you know that,
first course, and and now theway I look at the human as well-
so much of the way that we'reeducated and I'm gonna say, like
I would say across the board,it was the generalization, but I
would, based on my experiencesand based on people I talk to

(12:47):
and things that are still commonout there, you go on social
media and you see the thingsthat people are talking about
most of the way that we aretaught or educated, I think, is
more about disability care.
It's more what's wrong with theperson and how do we fix it,
rather than what's capable orwhat's possible with the person.
I really I always I like theidea of thinking more about the

(13:10):
ability rather than disability,because you know, more often
than not, right, people hurt butwe don't really know why.
But we can try and do somethings that make them feel
better and we don't have toblame them, and because
oftentimes it becomes blamingdoesn't it?

Marcus (13:22):
yeah, definitely, and I mean with almost all things.
It's you're picking outsomething that's wrong with
someone, but the thing is it'squote, unquote wrong, because
this is the whole point.
Is the evidence?
There is no evidence for a lotof these things we're telling
people are wrong, bad, poor,faulty.
We use these words and yetthere isn't a an actual

(13:44):
scientific evidence based to saythese things are bad, poor,
faulty, wrong.
You know?
So we're fixing these thingsthat we telling, that we're
telling people are wrong when inactual fact, they're not really
wrong.

Eric (13:57):
Where do you, where's that come from?
I've always wondered that, likedo you know?
Have you ever?
What are your thoughts on them?
Like where do these things comefrom?
Where we make stuff up?

Marcus (14:07):
well, I think I have a theory and it's, I think, in the
past.
I'm going to take, for instance, posture and symmetry and
biomechanics, those three things, because they're three of the
most common things that getblamed for people's pain or,

(14:28):
quote unquote, disability.
So the reason I think they cameto be in the position they are,
which is probably the mostfrequently blamed thing for
people's problems, is becauseit's really freaking easy to
look at someone and see they'reasymmetrical, like you can.
Just I could.
A hundred people could stand infront of me and I could pick

(14:50):
apart their posture.
I could find all sorts ofasymmetries, I could strength
test them from side to side andthey'd all be asymmetrical, you
know.
So it's dead easy, takes no timeto look at someone in TA
asymmetries.
It takes no time to look atsomeone and see quote unquote
poor posture or bad posture.

(15:11):
It takes no time to testsomeone's strength from side to
side and pick apart asymmetry.
Oh, you're weaker on this side.
That's the problem.
So it's really simple, you know.
I think that's why it probablytook hold.
That's my guess.

Eric (15:28):
I love it.
Simplicity is.
I mean, we want to have thesehard and fast rules, and there
is.
You know, the posture thing isa thing that it does drive me a
bit crazy, because people holdon to that as being the be all
and end all, and you know, thething I always want people to
understand is you know, postureis an option, it's not a rule.

Marcus (15:46):
Yeah.

Eric (15:47):
Right and I think you know I shared on my Facebook page.
I think you saw, I think youcommented on it.
It was like back in the fifties, like the chiropractors at the
time in the US were having likemisperfect posture competitions
or something as a way to kind ofsell their professionalism and
showing it, showing out howimportant they were as

(16:08):
healthcare providers.
I think it's just hilarious.

Marcus (16:10):
Like a beauty pageant.
Yeah, yeah, that was a goodlaugh.

Eric (16:14):
Yeah, I love that job.
It's like I can't even do.
It's a thing, it sounds likesomething that you couldn't even
make that up, yeah, so yeah,posture is a big one too, and
it's still common.
I mean some of the work I'vebeen able to do and people have
talked to in different collegesaround the country that's still
the main thing is all aboutcorrecting posture through,
whether it's through manualtechniques, stretching,

(16:36):
strengthening, you know, sitting, standing, all that stuff.
So, yeah, people listeningrealize that it's you know as
important, not as exciting, asit's been made out to believe,
but yes it is interesting though.
Hey, like these, these types ofthings I know we could, you
know we can focus on posture.
There's a million of them outthere, these types of things,
though it's amazing how those,those are still so commonly

(17:01):
perpetuated as a myth or as abelief in all the.
MSK professions, despite thefact that there is so much
evidence and so many otherpeople out there not just you
and I, but you know dozens orhundreds of other people out
there basically saying, no,that's not, that's not a big
deal, but it still seems like Idon't know how many people we
need to say don't worry all thetime about posture, it doesn't

(17:24):
matter all the time, as much asyou think it does.
Like when's it going to get tothat tipping point?
I don't know.
I always thought it was goingto be a lot sooner than it is,
because I've been at this for,you know, eight years or so now
and I thought there'd be bigchanges.
But I don't.
I don't see big changes,unfortunately.

Marcus (17:40):
Small changes.
Yeah, I mean it's alwaysestablished and ingrained around
the world and everymusculoskeletal healthcare
profession, though and not justin general medicine, in general
society, like it could be.
One of the simplest medicalbeliefs that's out there is that
posture is got.

(18:00):
There's good and bad posture.
That's one of it, got to be oneof the most ingrained beliefs.
So to change that belief, tochange that worldwide, you know,
is not going to be overnight,that's going to take time.

Eric (18:14):
Oh, yeah, because you're changing society, right, like
you said you're changing, you'rechanging culture.
It's just yeah.
At the very least though at thevery least, my hope would be
that, you know, new gradsentering the profession or even
existing people would start to,you know, not emphasize as much.
And you know, I think sometimesit's a fine line between not

(18:37):
just calling everything bullshitbecause you know then no one
listens because you're liketelling them that they're wrong,
and I just think it's a lesswrong option for people to not
reinforce those beliefs ratherthan just completely throw it
out the window and just don'treinforce them.

Marcus (18:56):
Yeah.

Eric (18:57):
Well and I think how harmful potentially they could
be.

Marcus (19:02):
And this kind of you can segue into another point about,
say, posture we can substitutea lot of different things in
here is in it.
I'm not saying that someonecouldn't feel better if they
changed their posture.
In fact I think it's great.
Sometimes changing your posturecan feel incredible.
I do it with people.
Sometimes I'll say, hey, trydoing this with your pelvis.

(19:23):
Oh yeah, the pain's gone, great.
Well, why don't you try andhold yourself like that for a
while until your pain calms downand then go back and try your
normal posture and see if it'sall right and tolerated, you
know.
So I think changing posture is agreat thing, but it's the
narrative that goes with it.
You know that's what it andthat's enter, put any other

(19:44):
thing in for posture, call itbiomechanics, whatever.
It's all the narrative thatgoes with it.
So I'm not saying any postureis bad, but it's.
It can be very helpful tochange postures and it can be
great, bring great effect aboutfor a person.
It's just the narrative you tagon with it.
You don't need to label theiroriginal posture bad.
It's just for the time being.

(20:05):
It's sensitive, so let's changeto this other one for a little
while and then we'll let thesensitive posture structures
involved in that.
Calm down and then we'll goback and try it.
So yeah, I think it's alsoimportant I always want to
clarify, whenever I say anythingabout, say, posture or passive
modalities, it's not often aproblem with the modality or or

(20:26):
changing someone's posture, it'sthe narrative that goes with it
.
That's really the main issuefor me.

Eric (20:32):
I would agree I'm the same way If it's more about whether
the beliefs that you have or thebeliefs that are being imparted
onto the person, and how isthat impacting their quality of
life?
Does it make them feel weak?
Does it make them feel broken?
You know?
Is it focusing more ondisability rather than ability?

Marcus (20:49):
Yeah, and I like what you said there too about.

Eric (20:50):
You know, yeah, sometimes you do want to change posture,
sometimes you want to, you wantto alter how people are standing
, sitting, moving, because, likeyou said, I think the area
might be sensitive.
Not doesn't mean it's broken,doesn't mean it's damaged
necessarily, and that is that isthe point of that I feel is
missed or is overlooked a lot oftimes.

(21:10):
When people have theseconversations, like if we have
these conversations, people hearlike, oh, you're telling me
that posture is garbage and it'suseless.
Well, that's not what we'resaying.
We're saying that an optimumposture for most people is not,
it doesn't, doesn't need to beachieved for them to feel better
.

Marcus (21:26):
Right.

Eric (21:27):
Yeah, but and the and see if it helps them.
If it helps them, then that's anew option for them.
It's an option, not a rule.

Marcus (21:35):
Yeah, and I think with, again, if we're just going to
stay on posture, again, thescience.
There's no evidence sayingthere is an optimum posture.
You know?
I mean, that's the point.
Yeah, exactly Right.

Eric (21:49):
Maybe if there was evidence that said so, then we
would be arguing for an optimumposture.
Yeah, yeah.
But I don't know what.
So?
So tell us a little bit whatkind of segue this into, into
telling us a little bit moreabout your course.
What's it called?
What are you teaching?

Marcus (22:06):
Yeah, it's called exercise and movement
prescription in modern clinicalpractice and I mean the name's a
little bit deceiving in thatyou know the majority of the
course is about sort of movementand getting people moving and
giving them exercise or movement.
But you know, half the coursemaybe is also about things like

(22:32):
the biopsychosocial model,health and centered care,
evidence-based practice.
You know these more globaltopics that are, you know, all
hot topics, discussion pointsaround the MSK healthcare world
around the globe by sort of theworld leaders.

(22:52):
So I go into those as well atquite some depth pain science
and communication.
You know all these things wecover in the course and I always
have a little slant towardsrelating them, I integrate them
by kind of relating them toexercise and movement.

(23:12):
Call it prescription, as that isthe title of the course.
So I really do work it back tothat.
But yeah, and then we of coursecover exercise and movement
prescription in depth because Ithink you know for most
educations the focused hour wiseand classroom hours is on more

(23:35):
passive therapies and you knowthere isn't as much time put to
communication, there isn't asmuch time put towards exercise
and movement prescription.
So you know that's what mycourse is trying to do is fill
that gap, because I for surethink there's enough time spent

(23:58):
in educational programs on thepassive modality side of things.

Eric (24:05):
Yeah, and that's.
There's not really much at allout there really given for for
the movement or the rehabscience aspect is.
It is usually, you know, verylinear, stretching and
strengthening type things, with,you know, following reps and
sets or along a specificprotocol.
At least that's why I rememberit and from what I've heard from

(24:26):
recent grads, that seems tostill be kind of the same case.

Marcus (24:30):
Yeah.

Eric (24:32):
I know in your course you have your, your, your gold
nuggets, your kind of yourlearning.

Marcus (24:37):
I love that idea.

Eric (24:39):
I think these are some of the things you need to get.
Do you want to share what someof those are like?
If someone was going to takeyour course and say they listen
to this podcast, I want to takeyour course.
What would be a couple of thekey things that they would bits
of information you like them toget from the course.

Marcus (24:54):
Yeah, that's well.
You know, the gold nuggets areoften like these little
practical things, like littlelike exercises.
I found to be like really goodfor certain things, so those are
sprinkled in.
You know, main takeaways fromthe course.
You know, listen to people.
I go on and on about that,listening to people validating

(25:16):
their experience.
I think major part I harp onthroughout the course repeatedly
is, I think, the number one jobof any health care
practitioners to rule out redflags.
So I find that vitally important.
That's what we should all allof us in medicine, medical field
, health care field be focusedon.
And if you're picking up onsomething you need to refer

(25:38):
people on.
And then, other than that, ifred flags been ruled out, it's
really about like the big takehomes, or reassure people that
they're not broken and thenempower them and help them get
moving or help them get back todoing the things they love.
Maybe they've given up thethings they love because they're

(25:59):
worried, because they've beentold they shouldn't do them,
because they think they're goingto make things worse, and so
they've stopped doing the thingthey love to do or the things
they love to do.
So I think the biggest takehome of my course is, once red
flags have been ruled out, youknow, try to empower people, try
and get them to feel morepositive about their situation

(26:24):
and try, and if it has to begradual, gradual, try and
gradually get them back doingthe things that they would like
to be doing.
And I guess that that would bethe quickest little summary of
the take home.

Eric (26:37):
Yep In two days if you get that.
That's that's.
I know it's hard to summarizeall the things because I know
your course is quitecomprehensive and many of you
covered in all thebiopsychosocial evidence base,
person's center care, painscience, communication
strategies, all those thingswhich is which is all really the
stuff that you know it seems tobe that's where the evidence is
going towards, more towardsthese kind of behavioral

(26:59):
sciences, kind of relationshipsciences, psychological science
type stuff, which is, I thinkthat's going to be, you know,
moving forward.
It's that's going to if, if, ifthe profession or MSK
professions want to follow theevidence like they should.
I mean it's even in ourcompetency documents that you

(27:20):
spoke.
You have to followevidence-based practice.
You know it really it moves youaway from the, the
patho-atomical, tissue-basedmodel and more towards these
kinds of behavioral sciencestuff.
So I think it's it's, it'sreally encouraging to know that
CE providers like yourself outthere are trying to do that and
hopefully, you know, along theway that'll get picked up by

(27:40):
more people and you know,hopefully the, the stakeholders
in our profession willeventually decide that they need
to do something.

Marcus (27:47):
Yeah, move us forward, yeah, and that that's ultimately
what it'll come down to, youknow, in the in the end.
But yeah, like I think that's aneat thing, the way you sort of
were introducing it and I thinkwhat's really was has been
fascinating for me andmind-blowing in my journey in
the last few years is learninghow the science is showing all
of the passive modalities thattherapists, clinicians, do to

(28:10):
people and they all work in theshort term.
They all help people in theshort term and they all help
each other generally about thesame in the short term.
And what's fascinating is isthey're not that specific.
So you know there's been reallyneat studies done comparing

(28:31):
clinicians who are doing tryingto do something very specific
they think they're fixingsomething specific versus a
group of therapists controlgroup that's just doing a
general something and it ends upthat both groups help people
about the same.
So you know it's showing thatall these passive things that
are being done to people or withpeople, they're all effective
in the short term, which isgreat, but they're not very

(28:54):
specific.
And you know where a lot of thebenefits coming from is just
having a therapeutic alliance,just someone being there,
someone listening, someonecaring, someone being with you
on your journey.
There's so much positiveclinical outcome that comes from
that.
So, you know, I think that's,like you say, where a lot of the

(29:15):
evidence is leading is, youknow, putting more time into
getting better at listening andcommunicating.
And coaching helping coachpeople through versus fixing
people, you know.

Eric (29:28):
So, yeah, I like to change the narrative from being like a
facilitator of wellness or fora facilitator of well-being,
rather than the fixer of yourproblem.
I think if we can just likeadopt that kind of mindset, it
changes everything about how weinteract and the way, the things
we say and the things we do andthe expectations that we have

(29:49):
of ourselves and theexpectations that the person in
front of us has changesdramatically.
And I'm sure you've noticed thatin your practice.
I noticed that in my practicetoo, and that's stuff I always
want to emphasize to people incourses is that you know they're
like what are you doing withyour hands and how do you do
this, how do you do that?
And I'm like don't ask me, askthe person on the table.

Marcus (30:09):
Yeah, because it doesn't matter what we do.

Eric (30:12):
It matters how the person experiences it.
Right, yeah, and then how theyexperience you.
Yeah, I was actually on anotherpodcast I reported, which
should be coming out probablyjust before this one or just
after this one.
We were talking I believe wewere talking about that about
the and other professions like,say, like in psychology and

(30:33):
psychotherapy.
How it's the same thing withthem is that they have different
interventions and differentideas that they grasp onto.
They've thrown differentacronyms of things they do, but
the neither one works betterthan the other.
It all comes down to therelationship between the
clinician and the therapist andthe person seeking your care.

Marcus (30:57):
Yeah, exactly, so why would it be different?

Eric (30:59):
for us?
Right, it wouldn't be.
I say the only difference withus is people come to see us
usually want to have their hand,want to be touched, they want
to have hands on, they want tohave feel us doing something to
them.

Marcus (31:10):
Yeah, yeah, I think I think there's the art, you know
the art of applying all this.
It's see, again, I'm notthrowing the baby out with the
bathwater.
I'm not saying passive thingsare bad.
I'm just saying if you had apie, and right now passive
modalities are 80% of your pieand you know, call it, education

(31:33):
is 10% and exercise andmovement prescriptions 10%.
I'm just saying we should maybethink about shrinking the size,
the slice of passive modality,increasing the size of, say,
call it, the education and thenthe exercise and movement
prescriptions.
There's so many different wayswe can help people and put
effort into helping people, andI I think you have to meet

(31:54):
expectations.
So part of it is doing whatsomeone expects.
And if someone expects to getsome passive treatment, you know
, meet them there.
But it doesn't mean you can'tdo all these other
evidence-based things that couldreally be the things that are
helping them more so in the longterm.
Right, the passive can help,you know, in the short term, but
you know, long term, I oftenthink it's more the information

(32:14):
we give people, just tellingthem we've, you know, ruled out
something.
Or telling them, yeah, you'retotally safe to get back to
playing badminton, you know, andit's those sorts of things that
could help more in the longterm.

Eric (32:26):
Yeah, I think that, too, the one thing that is important
to understand when we're talkingabout like the passive, like
the hands-on stuff is there'smany people and there's a large
percentage of the population outthere that is always going to
have pain.
Certain people, whether it'sfibromyalgia or, you know, myel

(32:50):
Emi or long COVID or some typeof systemic arthritis or
whatever name, a bunch ofdifferent things, some of them
neurological disorder, likethere's all kinds of different
things and systemic things thatpeople have where they're always
going to have pain and maybethem coming in just for a
passive treatment, as long asit's not under the guise of

(33:11):
you're fixing them or releasingsomething or blah, blah, blah,
as long as it's there as part oftheir management plan.
I see that's something that, asa profession, we have a lot of
value with.
That might not be the same asif, like you say, you go to
physio or a car or somebody else, where they're oftentimes
either very quick or they'retrying to make you do something
and maybe all you need to do isjust like chill out for a bit,

(33:32):
hang out with the therapist thatyou like in a safe, calm
environment, and then they dosomething to you just to help
kind of turn that volume down ontheir overall system.
And, like you said, it's veryshort term, but I think for some
people that can be verypowerful.
It's as long as it's not soldas like.
You need to do this or else youwill fall apart.

Marcus (33:51):
Yeah, amen, amen, like, and I mean that's you know the
biggest.
I have no beef with anymodality, any intervention,
nothing, depending on thenarrative that's attached to it.
You know, if someone said toanyone, hey, I'm going to do
this to you and I hope it makesyou feel better, I'd have no
problem with whatever it was,because that's about it, right

(34:13):
there.
You know, it's all about thenarrative that goes with it.

Eric (34:18):
Yeah, yeah, and that's something I always try and do in
my courses too, is I always?
I like we'll go through, like Iget them to do like the
skeptical bit, where I ask themyou know, what things are you
skeptical about, what things doyou want to know more about?
And I'll try and pull theresearch that I have on those
things and be like, yeah, thisdoesn't work this way, this
doesn't work this way, blah,blah, blah.
And then I always want, Ialways like to ask them, like,

(34:38):
well, how would you describethis in an evidence based way?
You know, it's not releasingthis, it's not, you know, doing
the things you've taught,rebalancing, whatever.
And it usually comes down intokind of this like, you know, is
this going to work for you?
Does this feel better?
You know it's, don't makeanything up, this is just all
symptomatic relief.
And I think if we just keep itas a simple narrative that it's

(34:59):
symptomatic relief, it might beshort term, but that can be
powerful on some people andsometimes it might not.
But rather than selling the fix, that's what I saw that all the
time in clinical practice waspeople would come in and they
were seeing, you know, dozens ofother people or had been to
seeing the same therapists foryears or months and they had
been, you know spent thousandsand thousands of dollars and

(35:21):
weren't actually given a properexplanation for it, and I just
felt like people can take anadvantage of it.

Marcus (35:29):
I just always drove me crazy.

Eric (35:31):
Yeah, well meaning healthcare providers.
They just are missing theinformation.
So that's why you and I are outhere, right?
That's why we're yakking aboutthis stuff Exactly A bit of an
echo chamber here, but that'sokay.
Yes, so here's the thing too.
Is I mean, you probably have aprobably a simple answer, but
courses like yours, right,you're not selling a modality,

(35:54):
you're not selling a specificlinear approach, you're selling
a knowledge, or your process orprinciples I guess you'd say
process, principles andknowledge.
Why do you think that courseslike yours are probably harder

(36:15):
to sell out than somebody that'sselling like a certification
program for a certain modality?

Marcus (36:24):
Yeah, that's a tough question.
I mean I think there could belots of reasons, though you know
, these ones say a passivetherapy or modality that's
tissue-based.
They're pretty exact anddefinitive, which I think people
like that.
I don't think people likeuncertainty.
So these passive therapies thatare being taught have a very

(36:49):
distinct narrative that goeswith them here's what's wrong,
here's what you're fixing.
It's simple and I think peoplelike that.
It's easier to understand.
I think both clients orpatients and practitioners love
answers and love definition andexactness, whereas what my

(37:11):
course is about there's a lot ofuncertainty, and that's if you
spend any time listening to theworld's best in the MSK
healthcare field, they allmention uncertainty.
Uncertainty is rife in theevidence-based world because we
just don't know why things arehappening.

(37:34):
That's why when someone goes toeight different MSK
practitioners about a problem,they usually get eight different
opinions of what's causing theproblem.
It's because no one reallyknows.
The research says 90 to 95% oflow back pain, which is the
number one disability in theworld, 90 to 95% of it is

(37:57):
non-specific, meaning you cannotfind out a true, singular cause
of a person's back pain.
In only 5 to 10% of cases isthere a definite, identifiable
cause of the back pain.
So right there, you know you'resaying, okay, the number one
disability in the world, 90 to95% of it.
We don't know why that personhas it.

(38:18):
That's what the science says.
It's uncertain.
So I think that's difficult,you know.
That's difficult as apractitioner, that's difficult
as the person with the back painto not know.
So I think that's a big thingthat's attractive about these
passive therapies that are beingtaught.
It's like there's a system anda name and you know rules and

(38:42):
it's like this will fix peopleand here's what you're looking
for.
And goodness knows it's veryeasy to find what you're looking
for and we all have it.
But it's not necessarily aproblem, you know, you know.
I think another thing might bethat a lot of people don't know
that we don't need to be fixingpeople.
A lot of people might just notknow that there's other ways of

(39:05):
helping people.
You know a lot of professionalsout there might think they do
need to fix people, they do needto fix asymmetries, etc.
So there might just be a lackof knowledge there.
That's one that I've came uponrecently.
When thinking about this, it'slike, well, people might just
not know and they might not knowthat, no matter the passive

(39:28):
modality, it's helping people inthe short term, but it's
helping them not in a specificway.
We think you know.
Once you understand that, wellthen what's the point of going
to learn a whole bunch ofdifferent passive modalities if
they're all working about thesame and it's not very specific?
I mean, I guess if you're boredin what you're doing and you
want something different to do,and that would be why you might

(39:49):
go.
But you know so I don't know.
Those are quick thoughts.

Eric (39:56):
No, that's great.
I appreciate you sharing thosethoughts, but we do.
We have clinically, we get, ourconfirmation bias.
We do something, people feelbetter, they report that we help
them and then therefore, welike, okay, this works and this
is why it works right.
So we often are like, well,we're taught, this is the
mechanism for this working.
And then I do it and people feelbetter and you get the oh, I

(40:18):
know it works because I've seenit work kind of argument, and
that I think that's somethingthat I really would love for our
profession or anyone in the MSKworld to just to stop and think
you know about why theirtreatments are working.
Are they working?
Because the reasons you thinkthey're working Doesn't matter.

(40:39):
Do you care?
So many people don't care?
Tell me, just like, whatever, Idon't care, this works for me.
People aren't complaining,they're getting better, and I
think that I think that's fine,and I don't.
I would never say that that'snecessarily a big problem.
I would say it's.
A problem, though, is if you'reseeing people coming in again
and again and again and they arenot getting better and they're

(41:01):
suffering and we keep on tryingto reinforcing that, oh, it's
because their back is out and,for example, I just was talking
to a colleague the other day whotold me a very sad story that
her mom was just diagnosed withbone cancer.

(41:22):
She has got a tumor in herspine, which is awful, and she's
had pain for over a year.
And her back and it started toprogress, getting kind of some
ridiculous pain down her leg,and she had been going to a
Cairo, and probably some otherpeople too.
But I remember, definitelyremember, her talking with a

(41:43):
Cairo and the Cairo is like oh,you're just out, you're out,
you're out here and you need toadjust.
And she was going in all thetime getting these adjustments
Right because this Cairo waslooking through things through a
very specific alignment youknow, spinal adjustment lens and
not you know this 95% of timeswhere it's not, where it's not

(42:06):
specific.
There's a 5% of time where itmight be something serious.
And they were looking at thisand they were.
They dismissed these ongoingsymptoms because they were
looking for, they had certaintywith this tissue based approach.
And now the woman's cancer isspread and you think, as a
healthcare provider, that's notokay to think in these, these

(42:29):
very linear, fixed ways.
And as I love your concept whencertainty and I agree because I
teach the same thing and allthe evidence says the same thing
is that you know we have thisconfirmation bias, we've seen
something before.
So I've had people blow backand dick their pain before I do
this thing and they get better.
So therefore I must bereleasing the tissue, I must be
doing this thing, and whensomeone doesn't get better, it's

(42:51):
because this area won't releaseor won't balance or whatever.
But what if it's not that?
What if it is cancer?
What if it is a fracture?
What if it is some, you knowsome type of arthritic condition
?

Marcus (43:06):
Yeah, I mean that's that's the ultimate worst case
is what you just described, andI'm sorry to hear that.
But I mean these are the thingswe need to think about in
practice, and what I saidearlier about one of the main
take homes is ruling out redflags, and part of that is a
continual process of clinicalreasoning, and if you're
noticing something not changingthe way you would expect it to

(43:29):
well, then maybe your, yourradar should be going off and
you should be consideringreferring on you know.

Eric (43:36):
So again, that goes back to that Oof that's bad, yeah,
and that's what happens, andthat's the thing.
That's one reason why I amreally adamant about this is the
stuff that I'm glad you're hereto talk about your experiences
and your knowledge and yourcourse.
And because that's something I'mreally passionate about too is
that there is this these timeswhere, if we have these blinders

(43:58):
on, we're only seeing thingsthrough one lens, we're seeing
things through a modality ortissue based rationale and we're
not looking at the biggerpicture.
We're not taking the zoom outapproach like you're talking
about with the nevron's baseversus ender biopsychosocial.
We're looking at the wholepicture Because people, like you
said, people are unaware.
I think that a lot of us are inour profession, are unaware of

(44:19):
the other evidence that's outthere.
And that's my experience I gettoo when I teach courses.
I mean, I was recently did acourse, or recently as a woman
recording this in in Manitoba,and the stuff I was talking
about was and most of thefeedback I got from the
participants was like they neverheard of this stuff.
Why did they never hear aboutthis stuff?

(44:42):
And I'm like I don't know.
I mean I don't know whereeveryone goes to get their
information, but I always putthat back on the stakeholders as
well, to be like we need to getmore of this information out
there.
Yeah, definitely, and it'sbecause if your only source of
information is taking a courseto achieve credits, then are you

(45:06):
really learning or are you justsatisfying a regulatory
requirement?

Marcus (45:11):
Well, it'd be nice if you could do both at the same
time.

Eric (45:15):
Yeah, exactly, Exactly yeah that would be ideal, right,
if your regulation requirementwas consistent with something
like an evidence-based practiceor something, but I guess that
kind of leads me to anotherthing I want to talk to you
about.
Which kind of leads onto.
This is that you know, asmassage therapists, at least in
Canada, we identify as healthcare providers, at least in the

(45:40):
regulated provinces.
We are considered that.
But what's your impression Like, do we want to be health care
providers as a professionnationally, or do we want to be
more service providers?
And maybe what's the difference?
Do you see the differencebetween a health care profession
and a service-based industry?

Marcus (45:59):
Yeah, to answer the first part of that question, I'm
not the person to answer.
I mean, I'm only oneprofessional in the profession,
right?
So I think you'd have to putsome kind of pull out to have
people answer that I can'tanswer what other people want to
be, I know personally.

Eric (46:20):
What do you want?
This is more about yeah.
Tell me your opinion.

Marcus (46:24):
I mean, I obviously would.
You know me and I would like tobe considered a health care
professional.
You know, and I think and thisis the thing, we're sort of out
of crossroads or we're on ajourney here where the evidence
shows that, regardless of yourprofession, some of the best

(46:47):
ways you can have a positiveoutcome, clinical outcome, ie
help people is by forming a goodtherapeutic alliance listening,
validating someone's experienceand, you know, ruling out red
flags and then just againreassuring them, they're okay,

(47:08):
and getting them back to doingwhat they love.
And like when the science baseI mean, I'm kind of, you know,
shrinking it, but that'sessentially what it says All
these things we think we'redoing to help people, yes, we're
helping them, but not in theway we think we are.
And so, you know, we're allpositioned, and registered
massage therapists in Canada arepositioned in a way to be

(47:30):
wonderful healthcarepractitioners who help people,
you know.
So I think it's more thansitting there.
It's there, it's to be done.
I think the tricky part is, youknow, when you get into the

(47:51):
whole regulation.
I mean, a healthcarepractitioner needs to be
regulated by a governing body,you know, and I think it's up to
that governing body to do agood job of governing whatever
the healthcare profession is,and I think a lot of
responsibility lies withgovernments and their regulatory
bodies that they create forhealthcare professions, you know

(48:15):
.
And so it's up to them to makesure the professionals are
continually educating and thento be continually educating with
evidence-based material, youknow.
So I think in Canada it couldgo a couple different ways.
I mean, if it isn't properlyregulated, whatever the

(48:37):
profession is, then I don'tthink it could be called the
healthcare profession and you gomore to a service thing,
service provider.
So I think a lot will come downto how it's regulated.
I don't know if that makessense, I kind of just.
I don't know if I got mythoughts out very well, but I'm
sure it's great.

Eric (48:56):
I know I got you.
I follow your discussion.
That, marcus, I appreciate it.
Yeah, the reason I brought thatup is because I've been in the
last year-ish.
I've been interacting with andteaching a lot more in some
unregulated provinces across thecountry, and it's I just, I

(49:18):
made an assumption.
So I made that, which you knowwe shouldn't assume, but I made
an assumption that, oh yeah,like, if you're an unregulated
province, you want to beregulated, you want to be
healthcare.
Yeah, but what I've actuallyheard from a lot of the people
I've interacted with withinthose other provinces is they
don't really want to be, they'rehappy to be the way they are,
where it's more of a service andthey do get reimbursement from
insurance and whatnot.

(49:39):
But and the reason being isthat because once you put you
want to put like a regulatorybody, it creates the perception
is it creates some barriers, Iguess, because there's like
there's licensing requirements,so there's more dues to pay,
there's, you know, your scope ofpractice changes right Like.
So for us in BC, we can't dolike in terms of all the

(50:01):
different things.
There's a lot of stuff we can'tdo which you can do in another
province, particularly inunregulated province, in terms
of, like going to needling orcupping or different things
which doesn't matter to me, andso that I think there's a worry
that people might want to havethat taken away.
But I agree with you, though,100%, that I really strongly

(50:23):
feel that our profession could,if it wanted to, could be like a
mainstream, like kind ofhealthcare profession, like we
could potentially work inhospitals or care homes or
outpatient facilities, you know,like where we have physios and
OTs, because I think there's areal, could be real benefit for
us.
But in order to do that wewould have to I would say we'd
have to be a healthcareprofession, and I would say we'd

(50:44):
also need to increase or changeour education, you know and
this is a contentious issuewhich some people listening
might be like shut up, eric.
But I think you know I'm biasedthat we need to have a degree
like we need to be in degreeuniversity based program based
on current best evidence, ratherthan a more technical kind of

(51:06):
private school which is, youknow, just basically teaching
you to pass an exam or, to youknow, entry level practice type
of stuff which is like what'sthe least we can give you to put
you in the public.
So hopefully you don't hurt toomany people.

Marcus (51:18):
Yeah, yeah, no, I mean, I think that'd be great.
It's difficult, you know.
I think that'd be great.
Yes, no doubt.
And the other side of it is, I'mkind of a fence that are myself
like Greg.
You know a person can getincredibly educated outside of
their formal education, and youknow.

(51:39):
So I don't think base educationis everything.
I think so much of a person istheir experience, but also what
they do for continuing educationon after their base education.
So, yes, I agree with you, itwould be, I think, a smart move
to make it a degree or amaster's degree and go from

(52:01):
there.
And then I still though eventhen you know, like I'll pick on
whatever physio, I mean I stillthink they have a lot of room
to grow in terms of betterregulating what continuing
education is out there, you know, and there's just so much
continue education out therethat's belief based and there's

(52:23):
not science behind it, and it'snot just in registered massage
therapy, it's in allmusculoskeletal health care
professions.
There's so much belief basedcontinuing education and I think
all governing bodies should bedoing a better job of regulating
it.
And I know it's costly, like somany things come down to

(52:46):
financials.
It's costly to regulate thecontinuing education, but I
think it ethically would be wiseand it's important and I just,
I think long term, like I'm 44,I'm going to be around for a
while longer.
I think long term change willhappen over time.
I just were too too intelligentof a species not to create

(53:07):
change and move in a morepositive direction.
I just don't know how quicklythat's going to happen.

Eric (53:13):
Yeah, yeah, it's definitely slow, it's glacial,
for sure.
I do like the point that yousaid that your base level
education doesn't necessarilymake you a better provider or
make you a better therapist, andyou can get a lot of education
without going through thatformal route for sure.
The thing I would, because again, you said physio is a master's

(53:34):
and in the States to be a physio, it's now a doctorate program,
which is crazy.
But so much money and so long,yet the information that they're
learning is still notnecessarily up to date.
It's still a lot of belief basedstuff which is crazy to me that
you could go, you could be in auniversity and learn a master's
or get a doctorate and it stillcannot be up to date, like I

(54:01):
just don't understand that.
And then so.
But I would say that in thenext evolution for our
profession would be, I think,would be to get us into, would
be better than it currently isright now.
It wouldn't be best, but itwould be better than it is right
now to get it out of theprivate colleges into a more of
a university setting so peoplecan learn that more.

(54:21):
You can still do all your handson stuff, you can still have
your clinical things, but itwould be really nice to just to
have future generations of RMTsbeing able at least being
introduced to some concepts ofuncertainty and being introduced
to like critical thinking andbeing introduced to like here's
some behavioral science andstuff, here's some psychology,
sociology, just think due toplant some of those seeds of

(54:44):
knowledge, I strongly feel wouldbuild even better therapists
than that are out there rightnow.
At least provide that platformfor them to grow.

Marcus (54:56):
Well, I mean, and then to take it further again.
I keep, I keep expanding outyour questions or comments to
all MSK health careprofessionals and in this case I
expand my next point out to allhealth care professionals,
period.
I think one of the very firstcourses that should be taught in
every health care profession ishere's what the biopsychosocial

(55:19):
model is, here's personcentered care, here's how to
apply person centered care.
You know here's basic, call itcommunication, human
communication.
So, like these basic things,you know that all health care
professionals should know atthis point that many don't

(55:41):
because they were educated inthe past when they weren't.
This stuff wasn't there.
And you know, I, in my course, Iasked people how many of you
have heard of thebiopsychosocial model and I'd
say I'll be generous, I'll saymaybe half people have heard of
it and then I'll say, ok, of youwho've heard of it, how many of
you know what it is?
And then of the 50% who'd evenheard of it, only 50% of those

(56:04):
know what it is.
So 25% of people know what thebiopsychosocial model is and
really, you know, every healthcare person in the world should
know what it is 100%.

Eric (56:17):
I use something similar in my course, you know, because my
main area of interest is inpain and particularly, you know,
learning and studying andchronic pain.
And I often ask people like youknow what's the one reason why
people go see a health careprogram?
And usually they'll say pain,because that's usually why
people come to see us.
Pain is impacting their abilityto do something.
That's important and I say, whohere know can give me a very

(56:40):
brief definition of pain?
And or I'm in.
I usually get like zero people.
Yeah maybe one person who'sfamiliar with the.
You know the ISP, you know thesensory emotional experience.
And then I'll say, okay, well,what is pain Like?
Describing your own words whatpain is, and I'll get any, any

(57:01):
number of different things aboutit being, you know, harm or
nervous system or inflammation,or whatever.
I'll get all kinds of differentthings.
And then it always makes me.
And then I would say I was likeso does it make sense that the
number of people come to see usis because they have pain or
they're experiencing pain?

(57:21):
It's the one thing that wedon't learn anything about in
school and it always is alwayslike that kind of like my gosh,
like I didn't, didn't realizethat, and you know.
So you said, yeah, peopleshould buy us, like social
person centered care.
And I would say I would add tothat I was like we got to
understand at least theuncertainty of pain which is

(57:42):
kind of consistent with thosethings you mentioned too,
because we know a definition andwe can talk all we want about
the nociceptive system and theneurophysiology and the cortical
changes.

Marcus (57:51):
And you know.

Eric (57:52):
But really what comes down to it is is you know how is
that impacting the person, whichis the person centered care?

Marcus (57:58):
Yeah, yeah, no, that's.
I think that would be a massiveanother again.
This is what I'm talking aboutthe classroom hours changing
from being so much about whatyou do to someone and then onto
these things like pain scienceAgain.
You know most programs coverpain science a little bit, but
not nearly what they could orshould you know, and so here we

(58:22):
are left to maybe learn about iton our own in our continued
education.

Eric (58:28):
Yeah, exactly, and you know the from some of the people
I've talked to that work atsome of the schools here in BC.
I think it's like their painand stress course is something
they maybe they get in the lastterm or two, depending on the
school, and it's like four orfive lectures like four or five
like like half days.
That's it at the end, whichmakes no sense.

(58:49):
Yeah, in my curriculum that Iwould give to a school, that
would be like the first thingthat they would do, one of the
first things they would learnabout, along with five sexual,
all the other stuff that wetalked about.
So, yeah, anyway, in theperfect world, yeah, yeah.
So the the I want to ask youabout to vote.

(59:13):
You know the we kind of touchedon briefly about you know
people taking courses.
You know because it's mandatoryor not In your courses that you
offer.
In your experience, do you everask people if?
Are they there just for credits?
Are they there because theyactually really want to learn
something?
I've never asked that, oh I askall the time is it's hilarious

(59:36):
answers you get.

Marcus (59:38):
Yeah, I would guess the majority would be just to.
They're doing it to get credits, I would imagine.
But they were intrigued by mycourse description and were like
, oh, I think this would be goodto learn about and so like, I
think there's probably a mixtureof like, curiosity and doing
them you know, their credits ina way that they're interested in

(01:00:01):
.
But yeah.
I would.
I would guess what are theanswers.

Eric (01:00:06):
Oh, sometimes people will be like I'm just here for
credits.
Some people will be like mostpeople are like saying those
answers where you just said ismost people are there because
they need credits and this issomething that interests them.
Yeah, but I'm always, I'malways curious that like if I
was offering course and therewas no credits, would you spend
that kind of money and two days,like on a weekend, to be here?

(01:00:26):
You probably wouldn't get nearthe same numbers you get some
people?
that probably not, and this goesto one of the things to yeah.
I know here in BC they'rechanging the quality insurance
program, but I just I feel thatwhen you make stuff mandatory,

(01:00:47):
people are forced to learn,which is great, but the what you
said before, which I thoughtwas so was really good, was the.
There's not much regulation interms of the continuing
education industry.
People can basically teachwhatever they want, and I know

(01:01:09):
that we will be moving towards anew system for con ed where
there won't be that approvalprocess.
But I'm just I'm curious whatthat's gonna look like, if
that's gonna, if that's justgonna be a free for all, what
people can just take nonsenseand because there's gonna be
less oversight, I imagine, overwhat is people learn, mm-hmm, I

(01:01:32):
don't know.
I'm skeptical.
I'm very skeptical about whatthat's going to look like.

Marcus (01:01:37):
Yeah, yeah, and I mean I would say I'm probably even
more pro accreditation, prooversight of continuing
education.
You know, personally I thinkall healthcare professionals
should have mandatory continuingeducation because the science

(01:01:59):
is changing all the time, so weneed to change with it.
Personally, I can't rationallyunderstand not having to go get
a course accredited by agoverning body.
I just can't understand thatfrom a logical, rational
perspective.

(01:02:19):
You have professionals taking acourse that is totally
unregulated or not accredited.
I mean that's just wild to me.
I just honestly don'tunderstand it and I can only
imagine it's because ofresources, because the amount of
financial and human resourcesnecessary to govern a healthcare

(01:02:43):
profession and overlook thecontinuing education of said
profession, I mean that's a lotof resources.
So, but at the same time, ifprotecting the public your
number one mandate, shouldn'tyou be having a say in what the
healthcare professionals arelearning and hence then doing
Insane to people?

Eric (01:03:05):
I agree with you 100% there, marcus, the.
I feel the same way too.
I don't see how a professioncan can actually provide it's
safe, effective, ethical care,which is, you know, usually
that's the college's mandates,right, that's what they're.
They're here for protect thepublic.
I don't see how they canprovide that when they're like
you can take whatever coursesyou want, and then you just have

(01:03:26):
to justify to us why you tookthat and why it's important.
And unless the, unless thecolleges themselves are going to
create courses and force us totake them, which I, you know,
we've had, we've experiencedthat before, and that's a little
bit ridiculous.
You know, like we had to take acourse on, like having proper
lighting in the room, rememberthat one.

Marcus (01:03:50):
I'm going to admit that I don't remember that.

Eric (01:03:54):
Oh, that was one of the ones I can take.
Anyway, there's been some weirdones right, and you know way to
take a whole one on likehygiene, which is okay, great, I
get it.
But I mean, do we need to takea course on learning how to wash
our hands and like do laundryand clean stuff?
I mean, it's we all do thatanyway, and if we didn't, then
that's a problem, right?
But yet they don't force us totake courses on like

(01:04:16):
evidence-based practice, or youknow, or you know current
evidence for low back pain orwhatever it might be right.
They don't force us to dothings that actually are
potentially more what we like,impactful to our clients or
patients every day.

Marcus (01:04:34):
Yeah, yeah, it's going to be fascinating to see moving
forward.
I mean, call me a you know anoptimist or like a silly
optimist I don't know the rightword, it's escaping me.
But I mean, I just hope in like75 years that everything's
moved into a more evidence-based, you know place, and it's not

(01:04:59):
going to happen overnight.
I'm just trying to do my bitand pitch in and I sincerely
hope that in 75 years we're in amuch more you know,
evidence-based, science-basedplace than we are today, which
is heavily belief-based and, youknow, I hope worldwide
governing bodies sorted out andhelp steer things in that

(01:05:21):
direction.

Eric (01:05:24):
I'm an optimist too.
I think it.
I mean, sometimes it may comeacross as a bit cynical, but I
think it's just after time.
You start to get a littlefrustrated when you see things
move so slowly.

Marcus (01:05:33):
There's a lot of good.

Eric (01:05:34):
you know education providers out there, like
yourself and others that are,that are really kind of
challenging the status quo andtrying to move that, that
evidence-based need a littlefurther forward.
So, you know, just as long aswe keep doing our best to try
and have these conversations andget this information out there,
and hopefully enough peoplewill listen and hope it's on,

(01:05:55):
the stakeholders will decidethat, oh, maybe we should, maybe
we should change things.
And then you know, I think thatwould be a sign of success, I
think for us anyway.
I don't know about you, but youknow I'm always excited when I
hear a school or an associationor a college, you know, changing
things and I'm like, yes,that's better than it was.

Marcus (01:06:18):
Yeah, yeah.

Eric (01:06:20):
And you always like to think he's like if it was.
There's never just a singleperson, there's a collective
right.
So there's a bunch of peopleout there right in the community
that are having theseconversations like we are right
now, and enough people listenand change will happen.
If we just sit back and acceptthe status quo, then I really do
feel that the people that arethat are going to be having the

(01:06:43):
most harm are those that come toseek our care.
Yeah, and we have an ethicalobligation to provide evidence
based advice and evidence basedcare and a higher value care is
really what the evidencesuggests, right, it tells you
kind of more about what's lesswrong and people need to.
People deserve that.
Yeah, specifically, spendinggood money.

Marcus (01:07:04):
Yeah, oh for sure.
You know, and I'm heartened,like, as technology advances and
you know, for instance,podcasts is they just become
more popular and more prevalent.
You know, I'm so heartenedbecause I'm listening to so many
podcasts from all of the worldof the most bright, intelligent
people who are full of passionand trying to move

(01:07:27):
musculoskeletal healthcare in amore evidence based manner and
it's just so uplifting andcharges my batteries, you know,
to keep doing my little bit andto contribute as well.
And as you say that that swelljust build.
I believe it will buildeventually and we will
eventually sort of weed out orflush out the belief that based

(01:07:51):
narratives will slowly disappearand I think it'll get to a
better place.
It is moving in that direction.
I love the optinism, marcus.

Eric (01:08:03):
So, yeah, let's keep, keep , keep doing the good work
you're doing, and I reallyappreciate you being here today
and sharing your time and yourthoughts.
It was fantastic conversation.
I really enjoyed that.
So thanks again.
And you want just, can you justgive everybody a just how they
can get ahold of you?

Marcus (01:08:21):
Oh yeah, I you know.
What's funny is, I'd say I'mnot incredibly amazing at social
media, but I'm on there.
I'm on Instagram it's justMarcus Blumensat, all lower case
.
At Twitter's, where I do a lotof getting research and
interacting with people there,I'm just at capital B it's

(01:08:45):
Blumensat with a capital B andyou can always email me.
Hello at Marcus Blumensatcomand my website's Marcus
Blumensatcom, and that's whereyou know you can find out about
my course, read my blogs, etc.

Eric (01:09:01):
And I'll make sure to put all that information in the show
notes.

Marcus (01:09:03):
I was going to say Blumensat's not an easy name to
spell, so I appreciate it if youcould put it in there.

Eric (01:09:09):
Yeah, yeah, check out the show notes and I'll have
Marcus's contact there so youcan get in touch with him if you
have any questions or comments.

Marcus (01:09:17):
And thank you for having me on.
It was a privilege.
Thank you Sorry.

Eric (01:09:24):
Thank you for listening.
Please subscribe so you can benotified of all future episodes.
If you'd like to connect withme, I can be reached through my
website, ericperviscom, or sendme a DM through either Facebook
or Instagram at EricPervisRMT.
If you'd like to get a hold ofMarcus, he can be contacted
through his website or socialmedia, and those contact
information can be found in theshow notes.