Exercise Prescriptions and Improved Patient Outcomes

Hi, everyone. welcome to this episode of Catch Up with ChiroTouch. Thank you for tuning in.

I'm your host, Camera Ferguson, and today my guest is Dr. David Cruz, founder of WebExercises. Dr. Cruz, welcome.

Thank you so much for inviting me. I'm really looking forward to the discussion.

The topic on today's podcast is exercise prescriptions and impact on improved patient outcomes. I'm very excited on the subject because I have some skin in the game, because at ChiroTouch, I work with the services team, including our SmartFit solution. SmartFit, it's an exercise prescription tool that integrates into the ChiroTouch software.

It's powered by none other than our WebExercises. I'm very familiar with the inner workings of the exercise prescription solution, but now I'm really eager to learn why doctors should consider incorporating this exercise into their care plans. I'll be learning just right along with our listeners, some of these interesting questions I actually want to ask.

Okay, so I've billed you as the founder of WebExercises, and I went into your background, and it's so much more. It's pretty interesting, I thought. Can you tell us about yourself?

What inspired you to become a chiropractor?

Yeah, so I went to chiropractic college at Life Chiropractic College West, graduated in 1996, and started my kind of career, probably a little green-eyed in the sense of wanting to change the world sort of thing. And just dove right in. Opened up my practice with a partner, with not one patient in the book.

So you got to learn to hustle. So there was a lot of hustling early on, just trying to get new patients when you start a practice from scratch. That I did for about five years, and then I kind of pivoted after that a little bit.

My undergraduate degree is in athletic training, which is essentially sports medicine. And so I've always really kind of been drawn to that rehab side. And so I really started focusing more on that.

And I think it was about 2004 or so. I just was really interested in how can I get people to participate more in doing some rehab. Exercise is, you know, really a foundation of I think wellness.

It's actually a foundation of chiropractic. And if you don't mind me sharing a story on that. Of course, chiropractic is probably founded with exercise and being healthy through exercise, going back to the beginning of the profession.

There was a gentleman in the 1800s named Bernard McFadden, and he really pioneered this in, he published a magazine, he had a sanitarium for health and wellness, and really professed that exercise is a key to wellness. Eat well, sleep, don't take the medication. Wellness can be done through exercise and really taking care of yourself.

The chiropractors of the early 1900s actually adopted that thinking, and they called it physical culture. And so even BJ. Palmer, if you look at some of the historical photos, at the Palmer Clinic, they literally have a gym.

BJ. Palmer adopted a lot of these early teachings of health and wellness. And so when I look back to how chiropractic and exercise fit together, it really goes back to our foundation.

It is really one, to me, one of the core principles that chiropractic is built upon through health and wellness. And so fast forward to early 2000 as I think that all of us clinicians, we do the best job we can, we help people, but there's also, I believe, a component which patients need to also participate. And how can we get patients to participate more often, more frequently, be more engaged, and that really was kind of the idea behind WebExercises.

So you're saying we are accountable to our own actions as well, right? Not only do you get the care from the chiropractors, but now it's time for you to take care of yourself.

Absolutely. And I think that's pretty much the model, the way I see it with regards to chiropractic care in the sense of we can provide the in-office treatment, the guidance, but we also need that patient to participate in their health as well. And we can do a variety of things.

I think every practicing clinician out there kind of determines what they want to do, whether they want to focus more on just getting people healthy and then getting maintenance, do they want to talk to them about nutrition or other parts of their health and so forth. And that's, I think, one of the advantages of the chiropractic profession is you have the latitude to really do what you would like as it relates to trying to help that patient improve in their health.

So how are you staying active and balancing your life then as a DC?

That's the hard part. Well, I got out of practice about five years ago. I started WebExercises in 2005 and really pretty much started it from the ground up.

The history of it real quickly is I had a patient as a programmer. We simply started putting some photos of exercise on my own office website and I'd print those out. And after I probably accumulated probably about 50 exercises, I asked them, could I potentially make this available to other chiropractors?

And that was really where the idea was seeded. And from there, we basically went into an agreement with a software company to build it. And it's really been a serendipitous path.

You know, it's one of those things where you have this idea, you have this vision, and sometimes we think success or what one would call success is this linear, but it's this squiggly line up and down sideways. And you just try and keep what that vision is that you want to see in focus and you kind of work through the different challenges. So I got out of practice in about 2015, partly because, honestly, it's become very challenging.

Clinicians, treating, utilization reviews and all sorts of things, because I did a considerable amount of med legal work even for the state of California. And I really like treating patients, and it became harder and harder with more red tape. And at that point, WebExercises was at the point where it needed full attention.

And I thought, well, I think I can help a lot more clinicians, providers, health care people through this kind of vision of WebExercises. And so I've been pretty much full time with WebExercises, 100% since 2015. And, yeah, we have a small team kind of all over the country since we're virtual.

So let's hear about the WebExercises and can you just elaborate how this will make the practice better and the patient outcomes?

Yeah. So, I mean, one thing I tried to keep in mind when this, when we started building WebExercises is I'm a clinician at Heller. And I know the pain points of running the clinic.

I know the challenges and what's important, what's not important. And so anything we do with WebExercises, I really try and keep the clinician in mind. I like to say it's, you know, by clinicians for clinicians, because I've been there.

I know what it is. The different challenges are. And so with that in mind, that's where WebExercises was built.

And that's kind of where we continue to try and strive. So we know that exercise is essential, whether it is for rehab, somebody's in a car accident. It's essential that they get some strengthening exercises.

Whatever that might be, a low back, neck, you treat sports injuries, a shoulder, knee, hip. Exercise is essential because pain changes the way we move. When you have an injury, what happens from a neurological standpoint is your body actually starts to rewire the way you move, which is kind of normal when you're in pain.

The problem is that when the pain resolves, so when we do a good job as a chiropractor and get people feeling better, what happens is that your neurology actually has been rewired and people still move differently. And so what exercise done or proper exercise prescription helps people strengthen, stabilize in the right way and get back to where they were before the injury. Otherwise, there's going to be a continual weak link.

And the number one cause of injury, literally from the literature perspective, is a previous injury. And that's a lot of times because it wasn't rehabbed properly. On the health and wellness side, I think if we look at from overall wellness, exercise is essential.

I mean, now in the days of COVID, if you look at one of the factors from a mortality standpoint is low cardiovascular health and fitness. So people that are, don't have a strong cardiovascular system were really affected more. And so whether you are working from a rehab perspective or trying to keep people healthy, there's unlimited number of reasons why people should move and learn to move better and more often.

And WebExercises and SmartFit allows that clinician to quickly create exercise programs and get those to the patients. With SmartFit, it takes the notes of the exercise program and automatically syncs them into the soap notes. So it's time-saving on the documentation side and it's time-saving just from the prescription side.

And we have thousands of exercises. There's protocols. So if a doctor isn't super familiar with exercise, well, they can just choose a protocol for low back pain or an ankle sprain.

If you're a season clinician, a sports chiro, well, you can choose anywhere from 2,000, 3,000 exercises and create your own program.

My fiance actually fell down the stairs one time, like three stairs, sprained an ankle. And guess what? I went to SmartFit.

I brought up the sprained ankle protocol and I had her do a couple of those workouts. So that's a great feature, even has a little bit of videos. So I actually want to ask you, what is your favorite feature of the WebExercises?

And what's your baby of that part?

Well, I think a couple of things. One is the content we create, we try and create it for specific reasons. It started with just a small library.

Now we try and recognize the different types of patients that come in the office. So we have, for instance, a geriatrics library that's available. We have a pregnancy library that's available.

We have, for instance, a yoga library that's available. So, we try and create some content which also represents different types of demographics that might come in the office. Of course, you can use any of the rehab exercises for anybody, but sometimes from a behavior standpoint in adoption, if a patient can relate a little bit more to that image, to that video, sometimes the adoption is going to be a little bit better.

Habits are hard to change and sometimes getting people to exercise that don't exercise regularly can be challenging. So, whatever we can do to help people overcome those challenges. Then I think the other real benefit is what I mentioned before, is that how do you save time?

Well, the protocols we talked about, but then documentation, documentation, documentation, right? It's not documented, it didn't happen. Well, it automatically pushes the exercises that were prescribed into CT, so you don't need it into the chiropractor, so you don't need to worry about going back, writing notes out and forward, it's automatically done for you.

When I show this to the practices that have been doing exercises, they love it, right? Because they're like, oh, it's already done for me. So, what's your suggestion for a practice that wants to kind of get started with the exercise planning?

Start simple. A lot of times, we think it needs to be complicated. Start simple in the sense of what is their main complaint and give two stretches or two, three exercises.

Let them gain confidence with that, and then you can always update add to that. The specificity of CT SmartFit and WebExercises is that it is designed to have the clinician in mind. There is millions of exercises a patient can go to online, whether it is YouTube or anywhere.

But the uniqueness of CT and WebExercises is that if you have the right exercise for the right condition, you are going to get the right results, and you need to be a clinician, DC, a CA, somebody in the office that needs to do the right assessment to then identify those right exercises, and that is where the real kind of success is going to come.

So if you are a ChiroTouch customer, you can check out CT SmartFit, and if you are not a customer yet, well, we'll be happy to welcome to our family. So Dr. Cruz, do you have any final thoughts, parting words?

CT SmartFit, we're working on an update. So sometime this year, everybody will be seeing an updated platform with more features and benefits. So with technology, you need to keep evolving, otherwise you're devolving.

So we want to make sure we're always evolving with ChiroTouch and port over the latest and greatest in the sense of what makes sense for practice, making it simple, making it effective for the clinic and the patient.

I cannot wait to see that. So I'm gonna start playing with all those little tools, see what happens, right? You'll hear from me again, I bet.

So thank you, Dr. Cruz, for sharing your knowledge on this topic. And thank you to our listeners for tuning in to Catch Up with ChiroTouch. Find more episodes of Catch Up with ChiroTouch on Spotify, iTunes and chirotouch.com/podcast.

Again, I'm your host, Cam Lo Ferguson, and I wish everyone listening a well adjusted day.

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