In this episode, I interview Adam Lindsey, DPT. He’s the provider I refer clients to most because he’s thorough; assesses patients before, during, and after every session; uses highly effective manual therapy techniques that don’t hurt; and prescribes simple at-home exercises that work. In other words, he’s like me, but with a doctor’s level of knowledge and skill.
Dr. Lindsey has a unique personal history that’s taken him from Wisconsin, to India, and back again. Listen in as he tells us all about it, why he wanted to open a cash-pay practice, and why he (and I), think it provides superior care.
Adam Lindsey is the co-owner and director of Body Mechanics Physical Therapy – Madison. Body Mechanics specializes in hands on carehelping clients maximize the use and function of their most valuable asset – their body. Using a natural, highly personalized and cross-functional approach, Adam treats clients of all ages and activity levels and continually works to provide the best patient care possible.
Scott Robison: Welcome to episode two of the Integration Bodywork podcast. My name is Scott Robison. I’m a Licensed Massage Therapist in Madison, Wisconsin, and I’m really excited to introduce today’s guest, Dr. Adam Lindsey.
Scott Robison: Adam is the director of physical therapy for Body Mechanics Madison. He’s also the physical therapist I refer my client to most.
Scott Robison: Partly it’s because we’re like minded therapists. Partly it’s because he’s really driven to help his patients get better rather than funnel as many people through his practice as possible. But mostly it’s because when I refer clients back to him, like the triathlete that I referred to him recently who said, “Hey, Adam was able to see me the same day. Worked on my hip. Worked on my knee. He was awesome. Thank you.”
Scott Robison: Or I’ve sent a crossfit athlete to him who was having back pain and sciatic pain and he gave her some exercises. She did them four times, already later that afternoon she was feeling better.
Scott Robison: I sent an older lady to him who was having back pain. Leg pain. She called me a couple weeks later. Said, “I need to cancel my next appointment with you because I think Adam cured me.” Which is awesome. It’s a great outcome. It’s why I always love to refer to him and I’m really excited to have him on today’s podcast.
Scott Robison: We’re going to talk about his background. His interesting story and path to how he got where he is. We’re going to talk a little bit about why he opened a cash pay practice rather than operating inside the ins industry here in Madison. And more.
Scott Robison: So without further ado, I give you my interview with Dr. Adam Lindsey.
Scott Robison: Adam, welcome to the show.
Adam LIndsey: Great to be here, Scott.
Scott Robison: Adam, you’re a Wisconsin native but your personal and professional journey has taken you to places like Steamboat Springs in Colorado and India, but you’re back here in Madison. Give us your story.
Adam LIndsey: The trip to Steamboat Springs and India. These were things that my profession took me there. It was never like I thought, “Oh, I wan to go to these cool places.” Although they were cool. Going there was a means to have better skills as a physical therapist.
Adam LIndsey: So yes, we grew up here. Went to the UW here for education, but just kind of in that search for more skills and more education ended up going to these different places.
Scott Robison: Now when we’re talking about improved skills are we talking manual therapy skills or dry needling? What are we talking about?
Adam LIndsey: It’s manual therapy skills. There’s a group out in Colorado called the Institute of Physical Art and they do a certification for PT’s. So I went through their certification process and as part of that you can apply to do a fellowship program. So going out there I got to study for a year with the creators of Functional Manual Therapy, which is a style of physical therapy.
Scott Robison: As opposed to what? What are the other styles of physical therapy out there?
Adam LIndsey: There’s McKenzie physical therapy which everyone probably knows for the press up exercise.
Scott Robison: Of course. It’s a staple.
Adam LIndsey: Yes. And there there’s Maitland style therapy which is also a hands on therapy that looks at joint mobilization and soft tissue.
Adam LIndsey: So with the Functional Manual Therapy that’s my certification, we do a lot of hands on work with the soft tissues, with the joints. And then, of course, we do use exercise as well to … The exercise is always very specific to help maintain the changes that we make with our hands on treatment.
Scott Robison: Sure. And of course, the ability to do both those things is the reason I refer people to you all the time. I can do the soft tissue work, but if it really seems like an easy corrective exercise, Adam, you’re my guy.
Adam LIndsey: Which I very much appreciate.
Scott Robison: Of course. So the fellowship. Is that what took you out to Colorado?
Adam LIndsey: Yeah. I had met the creators of Functional Manual Therapy a few times in the certification process. And you’ve probably had this happen before, where you meet someone and you’re just like, “Oh my gosh, that person has it together.” They’re just so intuitive and the way they communicate and their skills.
Adam LIndsey: I had met Greg Johnson, and he’s the creator of Functional Manual Therapy. I’d met him a couple times and I just thought if there was any way that I could spend more time with him, I would. So that’s what took me out there for that year.
Scott Robison: Terrific. So what does a year-long fellowship in Functional Manual Therapy look like?
Adam LIndsey: It is intense. It was one of the most intense years of my life.
Adam LIndsey: You get a lot of mentorship time where you might be working with that mentor for a tough patient or you get one on one time where you’re working with them and they might help you with a particular technique to, you know … Oh, somebody’s vertebrae isn’t moving. Well how are we going to do that? Or I’ve got a problem I can’t figure out. So there’s a lot of mentorship time.
Adam LIndsey: There’s also a lot of testing. So you’re tested on every body region of your knowledge on it and how would you work with that body region. So it’s just a lot of intensity surrounding improving yourself, really.
Scott Robison: Got it. That sounds like a terrific experience. How did you get from Steamboat Springs to India? What’s in the middle there?
Adam LIndsey: The folks in Steamboat Springs, they co-owned a clinic in India called Vardan. They wanted someone who’d done the fellowship training with them to go to India and help train therapists there.
Adam LIndsey: Initially when they asked me to go, my son was about six months old and I thought, “You know, I just don’t know if that’s the right opportunity for us.” But we got to talking-
Scott Robison: Sorry. Didn’t mean to interrupt. I didn’t realize that your son was born while you were in India. I thought you were just still solo. That’s quite an adventure.
Adam LIndsey: It was a wild ride, but it was great and they took great care of us over there.
Adam LIndsey: So as we kept talking about it, it just became clear that hey, this is the next step in the journey. Let’s do it.
Scott Robison: What was the difference for you in terms of going from being the student in this therapeutic style to being a teacher?
Adam LIndsey: It’s a fantastic transition because, as you know, to teach something you have to know it that much better. So it was just another chance to re-go through all these skills and just solidify them and then teach them. And there’s a great joy in teaching. Having had that opportunity to have these great mentors to pass along that information and the teaching of it. There’s joy in that, so it was fantastic.
Scott Robison: My teaching experience has mostly been limited to eighth and ninth grade boys for the most part. That’s a whole different level of enjoyment and engagement. I’m sure that really seemed like it deepened your expertise in this material you just spent so much time studying.
Adam LIndsey: Absolutely. It was great.
Scott Robison: So what came next? You left India and came back here?
Adam LIndsey: Yeah. I came back here and I was looking around at various job opportunities and a gentleman by the name of Andy Kirk, who is the creator of Body Mechanics … He owns Body Mechanics in Milwaukee and Pewaukee. I got talking to him and basically said, “Hey, do you know of any jobs?”
Adam LIndsey: And he said, “No. Let’s make some.” That’s how-
Scott Robison: I like the spirit of that. That’s great.
Adam LIndsey: Yeah. Body Mechanics Madison came into existence. So he and I co-own Body Mechanics Madison.
Scott Robison: Got it. Awesome.
Scott Robison: You know, Adam, let’s take a short break and then when we come back we’ll talk more about your clinic and the business model and how you can help people here in Madison.
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Scott Robison: Alright. We’re back.
Scott Robison: Adam, tell me more about this clinic that you and Andy have partnered with.
Adam LIndsey: I think there’s a lot of things that kind of make us a little different than the typical model you might see. We’re a cash based clinic in that we’re 50 percent cash based. The other 50 percent is insurance based.
Adam LIndsey: I think we take a lot of pride in our hands on manual skills and just that that’s something maybe a little bit different than you get in other settings. That you are guaranteed to get that here.
Adam LIndsey: We’re I guess relatively small compared to a lot of the big outfits, but of course, looking to grow a bit.
Scott Robison: Is it just still you in the office now?
Adam LIndsey: It is still just me. Yes.
Scott Robison: Okay.
Adam LIndsey: Shouldn’t say just me.
Scott Robison: I understand. I’m in the same boat. Also looking to grow.
Scott Robison: What does it mean exactly to be a cash based practice?
Adam LIndsey: It means … As I said, yes, we do take some insurance, but a cash based practice is a practice that … Our clients are patients coming in. Most of them have insurance, but even some of those with insurance choose to go the cash route, meaning instead of going through their insurance they pay us cash.
Scott Robison: Why would somebody choose to do that?
Adam LIndsey: I think there’s lots of reasons, but kind of the economics of it in that insurance costs more and more for people every year. Deductibles and copays continue to rise, so even somebody with insurance, if they have a sizable deductible or copay, it may be smarter for them to just come here and pay cash because the cash price is lower.
Adam LIndsey: Everyone always says, “Well, how do you that?” Or, “Why is that?”
Adam LIndsey: And I think it’s pretty simple, and that is that we have less overhead. When you charge somebody a cash pay rate, you don’t have to figure in working through the insurance companies and the staff that it takes to do that.
Adam LIndsey: So there’s advantages to the client in that it costs them less, and there’s advantages to us in that it takes less to process that and do that.
Scott Robison: Sure. That makes a lot of sense. Has that changed how you’re able to practice? Like what your appointments look like versus what you might find at a UW clinic or something of that nature?
Adam LIndsey: I think it does in some ways. I think being a freestanding clinic, that’s what really changes things. I think we get into this discussion of value and what value do we provide people, and being able to take cash can be valuable for certain people. But I think having your own freestanding clinic where you’re making the rules also allows you to create value for people.
Adam LIndsey: So somebody’s experience when they come in our door is that they know who they’re going to see. They know that they’re going to see the same person every time. They know that we can adjust their appointment times. They know that we can see them as long or as short as need be. If we need to see somebody for just a quick 15 minute loosed up this or do that, we can do that. If we need an hour with them, we can do that.
Adam LIndsey: I also think just, again, being able to set our own rules. That access is so important for people. We can see them once a week. We can see them twice a week. It’s whatever they need.
Scott Robison: Got it. That sounds like a lot more flexibility and sort of adaptability than you typically would get in a bigger organization, which I guess is usually the benefit of being small.
Scott Robison: I guess you sort of answered this a little bit already. What do you say to people when they ask you about the cost of care?
Adam LIndsey: I always want to be clear with each of our clients that money is money, and it’s their time and it’s their treasure. We want to be kind of guardians of that and use it as effectively as possible. And I always say our care … obviously, it’s not free. But if you’re paying the cash price it’s significantly less than an insurance price.
Adam LIndsey: I had somebody who came in just the other day and they said, “Hey, can you write up a little proposal for me? Can you kind of write out what you think this is going to take, how many visits, what the cost will be?” Just kind of what their investment would be.
Adam LIndsey: And I said, “You know, I’d be happy to do that. I want you go in this with your eyes open and know exactly what I’m thinking and what this will cost. And so, yes, physical therapy is not free. However, we want to make it reasonable for people and we don’t want there to be anything hidden from them.
Scott Robison: Got it. I love it. It’s nice to be able to be transparent in that way. With you directly, right? Because when you’re having that conversation with an insurance company or a bigger clinic, it’s typically the front desk who’s not … they don’t know what your schedule of care is likely to be. They had to come back and ask you.
Adam LIndsey: Right. And I just feel very seriously about that accountability. That we want to … That yes, there is funds being exchanged and there is money involved, but at the same time, you’ve got a person. It’s not a nameless, faceless entity.
Scott Robison: Right. It’s a very personal. Right? Your field, my field is very personal services we offer people.
Scott Robison: So Adam, speaking of patient care, I know everyone is different, but in broad strokes how do you approach what you’re doing with people?
Adam LIndsey: I look at people in three different ways. I think the first way has got to be mechanical. And mechanical is do you have a joint or a muscle or something that isn’t functioning as it’s supposed to. So can we do something mechanical and change that likely restriction to move more efficiently?
Adam LIndsey: I think secondly we look at things in a neuromuscular fashion. So say you’ve got a problem with a joint in your back or your pelvis and we get it moving better. Then what we need to do is teach your muscles how to move that, how to control it, how to stabilize it.
Adam LIndsey: And I think the final piece of that is just function. So we’ve mechanically improved you. We’ve now improved your muscular function to support that change. But then how do we apply that to your function? So if you want to be in an office and you’re sitting all day, what does that look like? If you want to do a triathlon and be on your bike or run, well, what does that look like for the changes that we’ve made?
Adam LIndsey: So we need to do mechanical changes. We need to teach your muscles how to support those changes. And then we need to teach you how to function in whatever activity it is that you want to do.
Scott Robison: Got it. I know we’ve talked about the manual therapy piece. Are there any intervention types that you particularly favor?
Adam LIndsey: Hm. Well, I guess yes. So this certification, the Functional Manual Therapy. So Functional Manual Therapy often involves movement with the mobilization. So mobilization is where you’re taking a structure and you’re getting it to move. And that might be a muscle. It might be a joint. But oftentimes we’re positioning that joint up against its restriction, applying a very selective pressure, and then having the client move through just a gentle, easy range of motion against that restriction. So that would be called Functional Manual Therapy and that would be typically what we favor doing.
Scott Robison: Got it. Are there any interventions out there in the physical therapy realm or even in the self care realm that you think people should stay away from or you think aren’t particularly effective?
Adam LIndsey: I would say sometimes it’s hard to judge other profession’s interventions and what they might do. I guess people should just kind of listen to their gut a bit. If you’ve been doing something for months and months and you’re not getting change, well then don’t keep doing that. Look for something else.
Adam LIndsey: If you are receiving interventions that you find continually painful and again not pushing you in the right direction but you just feel discomfort with them, sometimes pain can be involved in some of these things. But at the same time, if you’re not getting any gain from that, that would be something that I wouldn’t be too keen to repeat.
Scott Robison: Sure. Yeah. That’s never a fun experience where you sort of have to grin and bear it. If you have to get out the leather strap, it’s probably a little too much. Right?
Adam LIndsey: Exactly.
Scott Robison: How do you know when you need to switch and do something different?
Adam LIndsey: I think it’s a continual process. We’re doing it not just every visit but throughout a visit. I like to say just the example of somebody comes in with back pain and we tested out the range of motion and we know that the right side bend or maybe even a backward bend is a bit painful for them. Well, we’re going to do some sort of intervention, meaning some work on a joint, muscle, perhaps an exercise, and then we’re going to retest that painful motion that they were showing. Oh, that backward bend. Oh, it’s better. Oh, great.
Adam LIndsey: So we want to be retesting all the time. We need to be adjusting our plan throughout a session every session. This idea of let’s do something for four to six weeks and see if there’s change, well that doesn’t work for me. We need to be assessing all the time to see if there’s change.
Scott Robison: Yeah. I love it. And Adam, you treated my knee last fall I think it was. When I did some heavy kettlebell swings. And that was exactly my experience. We tried an intervention. Stood up. Retest. Right? Do some more stuff. It was a really … It’s clear during the session what’s happening and whether or not we’re going in the right direction, so I really appreciate that.
Scott Robison: I was trying to set you up a little bit earlier, but maybe I’ll just ask this question more directly. Do you have an ultrasound machine in your office?
Adam LIndsey: Thank you for asking. No, we do not.
Scott Robison: Oh, really? Why not?
Adam LIndsey: It’s not that ultrasound is bad. I want to be clear about that. But I just feel we can make such better changes with our hands. I think we’ve got … Our hands are tools that make changes more quickly and it’s just a better use of time.
Scott Robison: Got it.
Adam LIndsey: It’s kind of that simple. And it also goes into this idea of I’m not sure exactly what an ultrasound costs, but I think it costs a lot.
Scott Robison: I think it does, too. I’m sure the diagnostic ultrasounds are more expensive than the therapeutic ones, but a friend of mine who’s an ultrasound tech said that the ultrasound machine is like buying a house and the probes are the cars you park in the garage. That seems like a bit much for a small shop.
Adam LIndsey: Well that, and if you’re going to have that type of equipment well, you’ve got to make that up somehow. So you’re going to make that up by your pricing. So you pass that along to your customers.
Scott Robison: You’re incentivized to use it even if it’s sort of a marginal case for it. Right?
Adam LIndsey: Yes.
Scott Robison: Couple last quick questions here. Adam, what would you say your therapy super power is? You’re not the only person that’s done this Functional Manual Therapy program. What do you feel that you do just about better than anybody else?
Adam LIndsey: I would say it’s my ability to watch somebody move and kind of derive what’s wrong with them from that, and then implement a strategy to change those structures and that movement pattern.
Scott Robison: Got it. That’s an awesome super power.
Scott Robison: Who is your ideal patient, Adam?
Adam LIndsey: My ideal patient … It’s actually kind of a simple answer. I like people who come into the clinic with a certain amount of intensity. Meaning they want to get better. They’re excited. They’re doing their homework. They’re analyzing themselves. They’re working hard to improve. I think it’s just fun to work with somebody with that. It’s engaging. I like that engagement.
Scott Robison: Got it.
Scott Robison: Is there anybody who’s a bad fit for you? The example I always give is if somebody calls me and says, “Man, I just had a terrible week at the office, or I’m getting married tomorrow and I just need to chill out.”
Scott Robison: I say, “Awesome. Let me give you five other names. Go somewhere else because other people do that better.”
Scott Robison: Is there anybody who’s not a great fit for you?
Adam LIndsey: I feel like with most individuals there’s something to be offered. If somebody comes in and I just don’t feel like … I’m struggling to think of an actual example. But if somebody else could do better for them.
Adam LIndsey: Actually, you might be a good example of this. Say that somebody has some soft tissues that they just really need some more continual work on this. They’re a weekend warrior. Maybe they’re closing in on retirement and they just need a little bit more help and more kind of continual care. That’s the kind of person that I’m going to say, “Hey, I know a guy named Scott who does a great job with his massage business. Go speak with him.” That type of person.
Adam LIndsey: I think also, though, as we get to know people we kind of figure out what we can help them with and what we can’t. So if there’s something I can help somebody with I’ll still keep working with them on that, but I’m going to always be upfront with them and say, “Hey, I’m not helping you with this. I think there’s somebody else who can.” And I’m more than happy to refer.
Scott Robison: Got it. Awesome. Where can people find out more about you and what you’re up to?
Adam LIndsey: Like everybody these days, we do have a facebook page. It’s Body Mechanics. And we have a website, and on our website we always have upcoming events and things like that.
Scott Robison: What’s the web address?
Adam LIndsey: Our website-
Scott Robison: Oh, sorry.
Adam LIndsey: It’s bmechanics.com.
Scott Robison: Got it. There’s a few folks around there who had that idea for a business name, so it’s good to have exactly the right web address.
Scott Robison: Any parting shots? Anything else you want to cover?
Adam LIndsey: No. Well. I always say no, and then I say something. I’m just happy to have the chance to talk with you and promote Body Mechanics and the profession of physical therapy a bit. So happy to be here.
Scott Robison: Awesome. Adam, it’s been great having you on the show. Thank you so much.
Adam LIndsey: Thank you.
Scott Robison: Well that’s it for this episode of the Integration Bodywork podcast. If you enjoyed it, please be sure to subscribe and leave us a five star review on iTunes. That’s how other people find the show.
Scott Robison: If you’d like to find out more about me and what I’m up to, you can go to the website www.integrationbodywork.net or you can see blog posts and subscribe to the famous weekly newsletter.
Scott Robison: Thanks for listening. I’ll talk to you next week.