The Hidden Power of Pattern Recognition - Annie O'Connor, PT, OCS, MDT
Most clinicians overlook the simple truth: effective patient care isn’t about flashy techniques, but about understanding patterns, trust, and humility. Annie O'Connor, a phenomenal pioneer in pain classification and holistic health, shares the groundbreaking frameworks that can transform your practice — and your patients’ lives. If you’re tired of overcomplicated models that don’t stick, and ready to become a more intuitive, empathetic, and effective healer, this episode is your game-changer.Annie takes us on a journey from her early days of deep clinical study to her innovative Pain Mechanism Classification System, highlighting how binary, straightforward models can streamline complex pain and health issues. You'll discover how to recognize and interpret patient patterns within seconds, building trust through honest communication, and shifting from treatment to ongoing assessment—an approach that’s more effective and sustainable. We break down the importance of the therapeutic alliance, the power of humility, and how seeing the human in front of you can dramatically improve outcomes.
Key Takeaways
The evolution of pain science and why many models have overcomplicated treatment
How to use simple binary classification systems to organize complex data
Practical tools for observational skills, patient engagement, and re-measuring to track progress
The role of humility, trust, and the power of words in relationship building
Strategies for integrating frameworks like pain mechanisms and psychosocial factors seamlessly into everyday practice
Why clinicians must adapt continually in a rapidly changing healthcare environment driven by AI, self-guided care, and digital health platforms
Full Transcript
Annie O'Connor (00:00.462)
change and I'm kind of I'm loving it. You know I just actually officially left Anthem and Elevance Health and which is good it was a very cool five years you know getting to see the potential of you know I don't know where we're going today well I do know where we're going a little bit I mean I did kind of put some thought into it so
Beau Beard (00:09.749)
Okay.
Beau Beard (00:14.755)
Yeah.
Annie O'Connor (00:24.338)
But it was great. It was a validating experience to say, it's time to take things to the consumer and let's just do this. So yeah, well, I never left. when you have a company and a practice and then all of a sudden you decide to take a full-time job, what a nutcase that was. But I will tell you that
Beau Beard (00:33.048)
Yeah.
Too bad.
Beau Beard (00:39.744)
fifth
Annie O'Connor (00:53.23)
That lens is a really important lens and you know I feel I'm a little more rejuvenated to talk to, to be advocates for people definitely, but to more so really kind of rally providers you know so I mean just because I think we are truly the glue and you know these are my thoughts I don't you know without having you know the farm cast doing whatever farm cast is going to do but just you know there's
We're doing neat, you know, I got a cash based practice too, both. don't, you know, and I'm working out and I work on whoever wants to submit and doing the best we can there. But it's not the resolution to the problem, right? It's just, it's a knee jerk reaction and it's a good one because, you know, I think they're, they're understanding, but the abrasiveness always falls on the person that's hurting, right? And, and so that, that's always hard, but in any event,
I do see, wow, there is a simple side to a solution to change this pale. But we have to rally, we have to rally unitedly as providers. They did this to us, right? They don't call us Kairos, PTs, MDs anymore. They've demoralized us all to just be called a provider. So to me, it's like, okay, fine, if you wanna play that game, then let's rally all the providers and come back at you because you're
Beau Beard (02:05.845)
Yeah.
Annie O'Connor (02:21.457)
clearly not understanding what it takes to get people better and to walk from intervention to prevention and to be involved in these pain, you know, to be involved in things that are important to people, pain, functional and health optimization, right? Like they've become better at the pathoanatomical game than we are. And so that, so therefore they regulate you to the point where you're, you know, you've, you're insane.
You know, or you compromise your moral ethics and running practices. And, and that's, you know, that's a game, right? That's what I call corporate. We shouldn't be, or we should be changing that game drastically. Cause you want to force that, and especially AI technology. This is the time. Cause I really actually saw, and maybe we'll just stop here because I could go on forever with this. geez.
Beau Beard (02:50.541)
on.
Beau Beard (02:57.838)
And I was gonna say, maybe we shouldn't be playing that game. Yeah, we're playing a different game.
Beau Beard (03:15.928)
But we're already recording. is why, because it all starts out and no, this is great. This is why we do this. So yeah, welcome to the party.
Annie O'Connor (03:22.735)
Yeah, well, you know, I trust whatever you, you know, first off, I miss you. Good job doing everything you're doing. You know, and all this stuff. Ethan tells me about Farmcast and you know, I just love Ethan. So yeah, I'm sure he did him and me and Gramps and, know, hopefully he's slowly getting better. But in any event.
Beau Beard (03:30.04)
you as well.
Beau Beard (03:35.406)
and said hello.
Annie O'Connor (03:44.914)
I don't even know where the heck I left off on, because I probably was going to say something important. See, this is what happens when you have a menopausal brain, like you leave, you know? I mean... Yeah! I'm all over the place.
Beau Beard (03:54.476)
Well, we got to see where you're at right now, know, kind of leaving Anthem. But the question that I've never heard answered, or maybe it's ever been posed on something I've listened to is how did you get sucked into kind of you know, being the guru now of paying categorization and how did you get there in the first place? Like what was the impetus or the push to get you in this world?
Annie O'Connor (04:14.171)
Thank you.
Annie O'Connor (04:21.713)
Yeah, that's well, you know, first off, it's all God, though. OK, I don't know where every, you know, I, you know, I don't want to offend anybody in there. when God's got a calling on your life, OK, you know, there are all of a sudden things just kind of happen. Right now, you know, my prideful young self would have said, it's me until I realized.
through deep study that I am truly scripturally the fool that God is using to shame the wise. Okay, so, you know, when you start to realize like, you really aren't that smart and these things that have happened to you have nothing to do with you. That you're, you know, you got a calling on your life, right? And anybody who has a calling on their life, you have a calling on yours. You realize that you don't make a lot of money because you get about a buck 20 an hour.
with all the amount of time and effort you put into things, but that quickly passes. But look, I'm 40 years in practice, okay? Just rest there for a second. I don't even know if you're 40. So I don't wanna, 42. So when you were two, I decided to jump into the world of serving the public. And here's real, the skinny on the story is I came out of
Beau Beard (05:29.07)
too, apparently.
Annie O'Connor (05:43.089)
know, physical therapy practice in 1986. And I, hey, I was a four sport athlete in college. So God even knows how I got through all that. I, you know, so I really was kind of really, really wanted to be a river raft rider down the Colorado river. mean, like my hopes and dreams were not physical therapy, but in any event, when you're the oldest of five and you got parents and you're the first one that's going to college and it's that kind of story.
you know, you all of a sudden have to have a job in this profession and blah, blah. So I get a job at RIC back then where you didn't have a resume, it was a cattle call, you had 15 minutes and you you got chosen. And I really quickly learned, and I'm gonna say, hopefully this is not offending people, this is all bullshit. This stuff really doesn't work.
You know, what is this? Hypox, ultrasound, massage, manual medicine, exercise, repeat. You know, it's like what? I'm not looking for relationships, you know, like three times a week I have to seize people. like, what's your problem? You know, it just was really frustrating to me that whatever was getting sold. So then I was on a mantra of, okay, you know what? I'm not going to be a PT. I actually studied with the chiropractors. That's where I hooked up with Craig Levinson. And I just started to say, hey, this
with PT stuff. We're going to Cairo. I'm in osteopathic school. meet Michael Geraci, the DO. You know, I'm all over the place. I'm moving cranial bones with John Barnes and Sedona. don't know how many times it showed up there. It was that 20 Gary Gray course until he told me to stop coming. You know, I was just on this like, somebody's got to get this right. Like, I'm in, and now I want to be an ATC. I'm all over the place. And I spent, and I went back to...
know, get my master's in orthopedics, two musculoskeletal manual medicine residencies, because one wasn't enough. So I'm on this five-year kick, like somebody's got to have the answer. Because what we're doing, yeah.
Beau Beard (07:49.966)
Can I ask you something real quick? Did you have your own ideas, theories or suppositions at that point or were you just kind of like, I don't have any answers and I'm searching?
Annie O'Connor (07:56.749)
No. No, I'm searching. And I'm searching, though, in a profession.
Beau Beard (08:04.405)
Mm-hmm. Yeah.
Annie O'Connor (08:06.074)
to only realize everyone's selling the same old shit, they just call it something different. And there's a lot of cults out there and there's a lot of silos and you know, you know, I had a good, you know, I was really good at sports so I got my foot in the door in a lot of things. But in any event, I started to say, this is all baloney, I'm going into management. And so I kind of jumped into.
Beau Beard (08:08.652)
Yeah. Yeah. Concentric purple.
Annie O'Connor (08:34.52)
running the clinics and doing that stuff. And joint commissions came to our hospital in 1994 and gave us a slap on the hand that we were not doing well with pain.
And so because I was the leader, know, like Joel Press and myself got pulled in as the medical doctor and lead therapist, like get your act right in two weeks, you got to solve our Jayco problem for pain. So I had to literally combine sections because David Butler is speaking on pain mechanisms. Don't know how that got in there, but anyway, I show up there.
And I sat for the first time listening to why we hurt, not where we hurt. And I was like, this is it. This is it. This is why this works there and this works there. was finally a framework. And so I came back and told Joel, look, doctors, you do pathoanatomical, therapist, chiros, OTPT, whatever we are.
you are doing pain mechanisms. And we are going to serve these people not from only where they hurt, but why they hurt. And we are going to groove this framework into practice, study it, make it better, teach it. And that began a 35 year career with them. And we applied it to anyone who hurt, neurological to musculoskeletal to pediatric to old, to high performing athletes to.
a traumatic brain injury patient that has back pain who couldn't roll in bed and just saw such patterns and consistency. at the same time, you got Keith Smart in the rehabilitation of Institute of Ireland and here O'Connor or Kolsky or in press or the Rehabilitation Institute of Chicago. And we're all like working this framework into practice that Louie Gifford and David Butler gave to the world. And you know, the history behind biopsychosocial is so...
Annie O'Connor (10:37.484)
But that really was the story that then I was back in the clinic. You know, I was running the clinic, but I realized like if you want to do something in the clinic, you got to be an administrator. So I allowed myself to stay in the operational side to things, which was a gift because I learned efficiency and partnerships and how to draft a lot of business and how to keep a lot of volumes.
Beau Beard (10:40.216)
Mm-hmm.
Annie O'Connor (11:04.996)
but I also was in a position to make real true clinical change, right? And...
Beau Beard (11:09.408)
Mm-hmm and give yourself permission. I would assume in some realms that you didn't have permission before
Annie O'Connor (11:14.86)
well or learned how to say forgive me I didn't realize I needed to ask permission before I embark on whatever you thought we did wrong or I didn't realize we had a policy that we can't do these things. You know those were the days as I say you know but that was truly the story that got me involved with the pain mechanism classification framework and to this day you know the world of hurt approach book
It's a collaboration of classification systems. It's really using the pain mechanism as the overarching framework. But come on, MDT, DNS, FMS, know, MSI, all these, M-E-A-R-T, you know, literally so many different frameworks can be used within that framework. And we should, we should, right? And that's, you know, in pain science too, like,
The paint science generation all of a sudden came out and I still was like, no, man, we have a beautiful framework to say why would I spend time teaching this person about the nervous system and safety versus this person about stress and coping and lifestyle change versus this person about true sensory motor retraining.
You know, the sub-grouping of the central nervous system to this day has not been replicated in any other classification model other than pain mechanisms and the world to hurt approach. And I still believe it's about 15 years ahead of a carer right now, especially in persistent recurring central nervous system dominated pain problems. you know, that's my story. and you know, five years ago, Anthem,
Beau Beard (12:52.035)
Mm-hmm.
Beau Beard (12:58.638)
So I'm assuming...
Annie O'Connor (13:02.062)
recruited me to run their digital MSK program. And all I saw was, wow, you can pretty much bypass the provider and the payer, bring this directly to the consumer and through self-assessment and digital platforms, they literally can change their lives. And that was really something that was really profound because it was organized to the top five to 15 % of people who were pretty suffering, pretty bad and had
high utilization patterns. So, you know, I really kind of got humbled that people do want to get better. And when they are continuing to seek, it's because we're not meeting their needs. And we should maybe consider more self-guided prevention models rather than intervention models, because we've over-medicalized. We've over-medicalized pain. And so it was a very humbling experience. And so now it's like, OK, close that shop up and
Get back out to the world and start focusing on self-guided because we've got to help people, Bo. We've got to help people, you know?
Beau Beard (14:09.728)
Something I've seen, you I met you for the first time at the RTP symposium in Dallas that you taught at and being involved with RTP from its inception is when I was a student and bringing it to Logan and then joining the board and, know, then working with all the students and teaching. Yeah. I kind of got to see the polarizing swings like in politics, right? If you got a really, you know, right wing and then you come in the next time and it's left wing. What I started to see was when I was in school, it was very, you know,
mechanistic ART adjust, you know, that's what we do. And all the stuff with Butler and Mosley and all, was just kind of permeating at that point. And then as I started working with students, I was like, well, the pain science realm categorization, and it's almost like we shelf things, like we can't adapt and evolve and like capture it all, or at least most people have a hard time doing it all. So for those people that just listened to your, you know, framework that's existed, you know, for, like you said,
you know, a better part of three decades, almost four decades now. What, how do people reconcile? Like you said, there's an overarching category or framework of pain classification that all of these can work within. But for those people that aren't paying classifying or the other side are maybe a little too dismissive of all of the, I don't know how to best put it mechanistic techniquey part. Where's the marriage between like, how do we make, how do we dance between the two to be a practitioner that
Annie O'Connor (15:05.101)
Yeah.
Annie O'Connor (15:24.879)
Yeah.
Beau Beard (15:33.14)
understands as best as we can. Nobody's going to be an expert like you in one domain per se or any of the subtype domains. But how do we do the stance of integrating all these techniques and understanding pain and applying appropriately in a time efficient and effective manner? seems like a, it seems crazily daunting to most practitioners nowadays. That would be my take.
Annie O'Connor (15:54.16)
Well, my first advice is I say to myself every day, allow yourself to be a beginner. No one starts off being excellent. And, you know, and that's, you know, that's hard to do in this day and age of too much information. It's just too much information, right? So, you know, so you got to like take a step back and you have to realize to, I think personally, what is really truly your skilled service?
Beau Beard (16:23.746)
Mm-hmm.
Annie O'Connor (16:24.237)
because your skilled service is ongoing assessment. It's not treatment. And so if you are in your mind saying your skilled service is active release therapy, MDT, FMS, whatever it is, dry needling, you know, you're the pelvic person, you you've really whittled yourself down. Really, our skilled service is ongoing reassessment.
Beau Beard (16:53.581)
Amen.
Annie O'Connor (16:54.453)
Amen. so now this is why I really actually have completely invested in R2P over the last two years plus now. you guys are, I mean, amazing things are happening and attending grand rounds every month with Kyle and Corey is just, I mean, they are really doing good things, right? And I can't believe, you know, well, I do believe because I love being with clinicians, whatever we are, we're sharpening.
Right? And so you have to get yourself into an environment that clinically sharpens you on these patterns. Because you have to set up your mind that every time you see this person that you are going to tap into these patterns and ask yourself what's dominating right now. Now you also have to be geared towards serving as Craig Liebenson always has said, a patient centric.
Beau Beard (17:44.302)
Mm-hmm.
Annie O'Connor (17:52.656)
approach and what does that really mean? That means you recognize they only come for three problems, Bo. They hurt, they have persisting pain, reoccurring pain, or they really are truly searching functional optimization, whether that's high performing or, you know, just being a regular or Joe out in the garden, you know, or they really truly are searching for health optimization. And your ability to understand that
Pain is a nervous system problem, therefore you better think about it like a nervous system, not a pathology anatomy problem. Now I'm not saying there isn't no suception in there, okay? But if you are getting yourself wrapped up with no suception and you're denying every other part of the nervous system, those are gonna be long hard days and you won't be efficient.
Beau Beard (18:26.946)
Mm-hmm.
Annie O'Connor (18:43.811)
You know, now let's talk about function because function isn't extremely important. And, function doesn't beget pain and pain doesn't beget function. And so you can't sit here and sell yourself some story about the kinetic chain or developmental sequencing or, you know, the greatest of all times athletes go to performance moves and, know, and think you're going to change somebody's pain. You know, and so you, but you
Beau Beard (18:49.091)
Hmm.
Annie O'Connor (19:09.561)
But let's agree when we're actually making that transition through skilled ongoing assessment that this person's got this pain under control. This is working. They are healing. They are recovering, whatever your words are. And you are not focusing on performance. You better shift gears here.
Beau Beard (19:26.664)
Mm hmm. So what
Annie O'Connor (19:28.151)
Okay, because you know, so that those are all important, right? And then let me take it one step further because the chiropractors really are owning the space here. I can't think of any other discipline that does, you know, to the point I'm jealous and I keep stalking Bill Morgan to give me some kind of like grandfather clause degree, but he's never going to do it, but that's okay. He still smiles like the best smile ever. But you know, the reality is how about and now a special
have we got immune system issues going on, stressed out immune system? And when do we really step back and say, this isn't about function, this isn't even about the nervous system, this person needs something, whether it's detoxing, glucose monitoring, fasting and healing. I mean, we have got to take a look at what we're talking about here. So, you our ability to make those assessments quickly every time someone's coming in, because, you know, that's patient-centric.
Beau Beard (20:18.306)
Mm-hmm.
Annie O'Connor (20:27.564)
That's peace-centric, you know, and if you're a provider that can organize your mind in that fashion, you won't burn out.
You won't burn out and you won't keep seeking, you know?
Beau Beard (20:38.616)
or not.
And I keep telling, you know, students and interns that come through and they're always asking the question, which it's no, it's not a bad question. It's just where they're out of like, what, courses should I be taking? What should I be doing next? And, you know, I'm always telling them, Hey, all the alphabetized techniques and methods that we have are going to become and keep becoming less effective as we deal with more and more unhealthy organisms. So realize just like you said, those, you need those for a lot of reasons to understand how things work and palpation skills.
Annie O'Connor (20:51.31)
Thank
Beau Beard (21:10.722)
But also something I want to hear from you is two part question. What can students or docs or, you know, providers be looking to or doing to equip themselves better for that? Like we could say, study functional medicine, do X, Y, Z, but that kind of, that's very general, right? That's like walking out of another earth. Right. So what do you, again, because we, second ago, you said,
Annie O'Connor (21:30.508)
Hello. To general.
Beau Beard (21:38.83)
overarching framework. Well, then we still need to subdivide and determine, you know, was this a nervous system problem? Can we move on to performance and function? Do we have an immune system problem? Again, now I'm imagining I'm in a student's mind right now. And they're like, Oh, my God, like, I'm never gonna get this down. Like, where could we start? Or how maybe, could we start to say, Hey, yeah, we all get kind of the same education, ATC, PT, Cairo. After that,
What do we start doing? How do we start creating a framework for ourselves and start thinking about this differently? Any tips on that?
Annie O'Connor (22:12.3)
got a lot of tips on that. First let's honor and validate what we go through as providers through our education, whatever we are. We are going to learn, we are serving the human system. So what does that mean? We have to learn anatomy, we have to learn pathology, we have to learn physiology, and in some of our respective fields we learn biomechanics and things of that nature, right? So you have to understand that that has to be served.
by the discipline of which we're choosing to come out and be licensed. Okay? And you cannot expect, even though, again, chiropractic, you're the group that's applying far more of this alternative subgrouping methodology in your curriculums than any other discipline. So kujo's to you. But you cannot expect that you're coming out of school with that knowledge.
Okay, now could you again, could you be involved in a group like R2P, which is really closing the gap between gang, this is what we got to learn because we got to be licensed characters. But this is what you're going to do when these people show up day one, right? And so we've got some foundational sub grouping methods that you've got to have in your toolkit so that you can use these techniques more efficiently. Okay, now, you know, hey, I'm
Beau Beard (23:36.878)
Mm-hmm.
Annie O'Connor (23:41.773)
Six courses of the world hurt because of this. Right? Got an overview where we cover the entire nervous system. I got a two-day nociception, two-day is it tight, is it trapped, is it sensitive, and two-day on the brain. Two-day applying this to neurological dystonia, taxia, spasticity, and the toughest things we see. And a one-day foods and fasting course so that you can really make the leap to immune system classification. I haven't seen a system of
Beau Beard (24:02.946)
Mm-hmm.
Annie O'Connor (24:11.47)
post-graduate continuing ed personally, and I've been to all of them, that actually covers the gamut on all of these classification models.
Beau Beard (24:16.27)
Mm-hmm.
Beau Beard (24:20.77)
You got to come to art of assessment. We got one here in the farm. Come on. I am not saying it is. We'll bow down to Annie any day.
Annie O'Connor (24:24.43)
Well, I... When am I gonna...
Annie O'Connor (24:31.81)
there. am like a lifelong learner. I've been told not to come anymore. Lorimer, every time I show up on the class, he's like, do not bring up the pain mechanism classification system. I'm like, why? You guys created it. Why have you gone to a non-specific IASP recommendation of nociception neuropathic nosoplastic? Seriously, because we've left this pain clinician
to pain researcher and until something has an RCT validated study, la la la la la, we can't tell clinicians about, know, look, this is gonna help you. And that's hard, that's hard. So I'm all on the farm cast. Tell me when I can come. I want to hear what you're doing because it's things like this, that we need. It's really.
Beau Beard (25:18.39)
or send you an invite.
Beau Beard (25:24.43)
Well, and that's in the impetus impetus for my course, not that this is like, you know, I want to hear from you was that we don't, we get a lot of tools, both in school and outside of school. have our own ideas. Nobody gives us a framework to work within. We'll get basically conceptual frameworks. You know, I look at DNS as a good movement conceptual framework of how we learn.
Annie O'Connor (25:44.778)
Exactly.
Beau Beard (25:46.304)
I look at what you've done as a great, like you said, there's a great overarching and then you're, know, multiple classes where you're kind of niching in on all of the things that are kind of, we're trying to nail down on what happens with a organism called a human. but I, I kind of saw like the stop gap was like, where do we start? How do I just start the path of learning this with each patient and with each rep where I have tight feedback loops and I'm making sure that I'm
paying homage to pain, but then also realizing when I can kind of divert, you know, not necessarily away from it, but not have to sit there and focus on it with a microscope. So in your eyes, if we're talking about, you know, yeah, it's a daunting task, but it's also kind of what we signed up for, right? This is a lifelong process. We learn, treat every person. We hope we get better because dear God, I should send, you know, condolence letters to my patients I treated 10 years ago.
Annie O'Connor (26:30.542)
It is.
Beau Beard (26:41.41)
But what, when we're talking about the clinician, cause we could talk about the frameworks. mean, me and you could sit down and talk for probably 24 hours on frameworks. When we see traits of clinicians who tend to do better with this, right? Yeah. We're people have different intellect levels and things like that of grass. But when we see traits of a clinician, is there anything that stands out that have a student or a new doc is listening? They could be like, I'm going to try to work on that trait or I know that's not my sweet spot. So I'm going to divert.
Annie O'Connor (26:46.753)
Yep.
Beau Beard (27:10.348)
Is there anything you're like, hey, you need to kind of hone these things outside of the clinical frameworks to build yourself as a clinician? Anything come to mind?
Annie O'Connor (27:19.873)
therapeutic alliance.
Beau Beard (27:23.062)
And he will give us detail because we talk about that a lot. what what people.
Annie O'Connor (27:23.297)
Yeah, mean, yeah, trusted, trusted. You have got to be a trusted healthcare partner. Which means you're in it for the long haul. Or like this, I'm in this till death do us part. Okay, like if you can't say that to that person, you're never gonna make it happen. So.
You know, it's really about that. I mean, if you look at outcome research, come on, outcome research is clear. You can form trusted healthcare partnerships very quickly. You're in it to win it, okay? You are going to have the best outcomes. The second group that gets the best outcomes is therapeutic alliance plus the fact that you use alternative subgrouping methods. The worst group is the people who got certifications and advanced degrees. So this is not like,
Beau Beard (28:13.666)
Mm-hmm.
Annie O'Connor (28:20.369)
New news. Now it doesn't get pumped out there because what professional organization is going to pump out stuff like this? Right. And, you know, every clinician I've met that's been in the trenches for a long time, they tell the same story. They love their patients. They're there for their patients. They're accessible. Okay. And they show that they're advocates and will walk with them. So to me, this is the number one skill of a
out of a doctor, a therapist, anybody coming out is that. you know, community-based care is so much more powerful than health organization care. I feel again, you know, I don't know how many times I'm gonna like just my, if any physical therapists are listening, they're probably like, what the hell's your problem? You don't give us any credit. You give the chiropractors all the credit.
And I don't do that, but I watch, know, and chiropractors are very community based. They're in it for a long time. There's a lot of father, daughter, father, son, mother, daughter, handoffs of practices that have been in the community for decades. And these, this is it. This is it. You know, and so if you have that, that about yourself, right? You know, and you know,
You're willing to go like this. Because I have to do this every week. Well, geez, you were on my mind all weekend because I was giving up my personal time to become a better clinician again. And I have so much smarter than the last time you met me. And I might have said some things that probably didn't align with exactly what could be.
considered targeted precision medicine for you. So I want to review some things and I want to humble myself saying I was wrong and we need to possibly consider trying this. And if you can't pull that off.
Annie O'Connor (30:29.485)
It's going to be a hard career for you to really do ongoing skilled reassessment and advocate and work with your team, patients, whoever, community as a partner. Because you've got to be able to be humble. These are the most important experiments we will ever run the N of 1. Yeah.
Beau Beard (30:47.906)
Yeah. I think outside of the humility, think something you're bringing up that is a, we all know it, nobody talks about it, is how abstract of a world we live in as clinicians and providers that everything's gray. And that's, think what stalls a lot of people's progress is they need, create, they try to create a framework with absolutes, right?
Annie O'Connor (31:11.233)
Well, don't use clinical reasoning.
Beau Beard (31:14.38)
Yeah.
Annie O'Connor (31:15.829)
It's not clinical reasoning, it's patterns. that'll be the first, I will say that over and over again. I'm so tired of hearing about clinical reasoning. You'll reason yourself right into the wrong answer or whatever is the thing that you just did or read or whatever, you know? And that's the way the human brain works anyway. It's a little bit of what we call mirror neurons. So, you you have to be on guard, you know?
Beau Beard (31:30.99)
Hmm.
Annie O'Connor (31:40.427)
You have to be like, you know, I've always said a criminal investigator. You do not want to put the wrong guy in prison because it takes, you know, a non-for-profit agency and a life to get them out. You know, so, you know, you really have to be into pattern assessment and, you know, and you have to be open to say that there is more than one grouping method that can meet that need. Now, I'm not saying pathoanatomical is not important.
Beau Beard (31:44.142)
Mm-hmm.
Beau Beard (32:03.596)
Mm-hmm.
Annie O'Connor (32:06.957)
If you've got progressive red flags, there's no other system that we should be using than that. Okay, but let's agree, in a musculoskeletal practice, especially in a community-based situation, that's probably less than 3 % of the time. You know, so it's hard when you come out of school and you may only use what you've been trained less than 3 % of the time. And that's an acceptance that has to happen, an acknowledgement and acceptance and a commitment to ongoing education.
Beau Beard (32:19.98)
Mm-hmm.
Beau Beard (32:27.662)
Mm-hmm.
Annie O'Connor (32:36.476)
And you need to line yourself up in that ongoing education to be more holistic. Like, do I have a grouping model for pain? Do I have a grouping model for function? And do I have a grouping way of thinking about chronic illness, comorbidity, and things of that nature? And, you know, come on, Bo, we live between, somewhere between big pharma and big wellness.
Beau Beard (33:05.742)
Mm-hmm.
Annie O'Connor (33:05.772)
trillion dollar industries, right? And that's why I've always said, hey, words, moves, foods and fasts are free. Okay. Like, you know, if you can be the dealer of words, moves and foods, you're going to have a lot of wonderful years as a practitioner and many people will migrate to you because they're sick and tired of big pharma, big wellness.
Beau Beard (33:12.141)
Yeah.
Beau Beard (33:28.782)
Yeah, there's I've always said the free market is our best advocate is chiropractors. And it doesn't seem like it right now. But we're heading the further you go, the better it gets for us if you've positioned yourself correctly, you know, which is taking care of people in a community based, you know, manner. Let's back up. You said words was the first one and you're a wordsmith the way that you delivered basically I was wrong to the patient was way more eloquent than just saying, Hey, I'll call myself on that one. How, you know, I know you talked about
Annie O'Connor (33:55.776)
That's an MI tactic.
Beau Beard (33:57.612)
And that's what I was going to say. What are your tips for those young docs, students, people that are maybe realizing even later in practice, the way I interface with my patients is the biggest deterrent to their outcomes and my progression as a clinician. What should they be doing or what should they be looking at?
Annie O'Connor (34:11.789)
When I sell this t-shirt, will everyone please buy this one? You don't own their outcome, but you own the measurement of their outcome. And, you know, so I can tell you right now why you're not confident in what you're doing or not positioning yourself to have good communicative skill, because you're owning their outcome. Yeah.
Beau Beard (34:23.19)
Yeah.
Annie O'Connor (34:39.53)
And you don't own it. You own the measurement of it. And you have to be thorough in your measurement of it. You cannot be willy-nilly and just throw an ODI out there. Or you cannot be willy-nilly and just think you're going to measure the COOS, or a lower extremity functional scale. You you need to be holistic, which means, and again, Craig Liebenson and Steve Yeoman, when they created the yellow flag wrist form over 35 years ago, because we were sick and tired of forms, and we needed to get to evidence-based
evidence influence medicine and cover the domains that dominate the yellow flags, which are sleep, fear avoidance, pain avoidance, self-efficacy, and only four questions in self-efficacy, and emotions. And we're all over the place with forms, and we're still so abrasive, you know, that we don't keep tapping into, hey, has the locations changed? Has the intensity changed?
Do we still have the presence of widespread pain? What is the self-efficacy? How has it changed? How has pain avoidance changed? How has sleep changed? Knowing now, we know so much more now than we did 30 years ago, that when you are actually getting someone better, the first thing that gets better is the psychosocial. And once the psychosocial starts to improve, the function improves. And the last thing that improves is the pain.
Beau Beard (35:55.502)
Mm.
Annie O'Connor (36:04.831)
And so equip yourself with good ability to communicate expectations that are realistic. And that's, yeah.
Beau Beard (36:13.998)
So I was gonna say, how soon in a patient interaction are you explaining the realistic scenario? And I think that gets missed.
Annie O'Connor (36:18.39)
Day one. Day one. Well, you have to have a framework that allows you to say what that means, right? Okay? And it doesn't take much. mean, let's like be a little honest. If I'm literally talking about healing, I don't care if it's your brain, your nerve, your cartilage, your muscle, your tendon, glop, glop, glop. Statistical changes if you're doing good dose.
priming movements within six weeks.
Beau Beard (36:50.136)
Mm-hmm.
Annie O'Connor (36:51.724)
You can't do anything to make that better, but they can. Now you may be a nice adjunct. have a little dry meal, a little whatever, sprinkle this, sprinkle that, but sell it right. Don't sell it on you. Sell it on, I just helped you with the confidence. Now by taking that segment to end range, babe, you can now stretch your heart desire because you know it can do it.
Beau Beard (37:02.382)
Mm.
Beau Beard (37:18.03)
you
Annie O'Connor (37:19.062)
You know, so we lack that ability to transfer what we're doing into the confidence of that person, especially if I got a yellow flag measure that says this person doesn't have confidence.
Beau Beard (37:33.036)
And if I was selling a t-shirt, it would say competence falls confidence, a shadow. confidence, Confidence falls confidence, like a shadow. And that's what, so you have to, like you said, whether it's communication legitimately, you know, we have, called it dumb down. called a triage checklist because it blows my mind because we got beat into our head in Cairo school, you know, you your global exam, regional exam, neurologic exam. And then basically you're treating somebody. I mean, you know, that's all you were doing. And now it's like,
and no knock on anybody's students are coming out. They don't know how to determine is this actually pathway anatomical or like they kind of get trapped in a model. And then that's what everything is rather than a assessment hierarchy where they're like, Hey, yeah, this isn't an injury. There's no path. Okay, we can, we can kind of move on, right? We've, we've ruled it out. We don't need to protect them. We can kind of move on. There's not a healing cascade. We got to kind of worry about too much. So when we, when we need reps in that realm and we're not competent,
Which means we're not confident. And we also maybe on the same note, aren't competent and confident even what we're looking at. Like I became interested in ART, but now I'm not even confident that was leading me the right direction. What's the home base? Like, how do we have it? So we have a, you have an audit system for a patient, right? Determinations of my changing pain, am I changing function? Where, you know, where am I working? Yeah. What are our feedback loops for our education? How do we know we're heading the right way?
Annie O'Connor (38:52.854)
Motion, yeah. Whatever's relevant to you, yeah.
Annie O'Connor (38:59.756)
Four questions have to be answered and they have to be held accountable. What's wrong with me? Why do I hurt? Or what's wrong with me? Why can't I perform? Or what's wrong with me? Why is my A1C out of control? Okay, like we need to be able to answer that question and you have to, you know, this isn't about showing him a hinge joint and giving him an anatomy about the ligaments. Okay, this is bigger than that, you know, so unless
Beau Beard (39:15.725)
Mm-hmm.
Annie O'Connor (39:30.256)
Truly, oh my god, two weeks ago a linebacker took you down on a twist move and okay, well then let's be competent there. Okay, but you know the reality is you have to be able to answer what's wrong with me in a tangible way. Is it a stressed out immune system? Is it a sensitive nervous system? Is it a stalled healing tendon because we've just allowed it to get deconditioned? You have to be able to pull it out into some nomenclature that makes sense.
non-medical because we're over-medicalizing. The second question that I really, I don't leave a session without is what they can do for them. And it speaks to self-efficacy, the two primary things that are most important, confidence in the condition that they're managing and confidence in their pain control, especially if we're dosing directions, if it's a directional preference or remodeling.
if it's stress-orientated tissue programs, right? Or it's just literally, you know, hey, we gotta try to have one less Diet Coke a day, okay? Like, you know, what can they do? Like, sell that so hard, okay? And then question number three, how long, Annie, is this gonna take?
You know, and I'm realistic. Like, let's agree, you're realistic, but you're not gonna break their hope. Okay, so if I'm working with someone who's had a 10 year history here, I'm gonna be like, yeah, babe, time in time out, you know, like, I'm gonna take it in chunks of statistical change. And I'm gonna show you based on these measures through progress monitoring, because we are in it together. And it's based on your data.
that this is going to be statistically better in this domain in this many weeks by you staying on that path. And then the fourth question, what am I going to do for
Annie O'Connor (41:34.951)
Am I really truly just accountability partner and we're scheduling by need and I'm giving you access or no wow you have to get in here twice a week for the next two weeks because we've got to push this segment to end range for you to get to end range. You know like what is truly my role.
Okay, in defining that. I never leave a session without regrouping on those four questions based on the reassessment. And if I provide after summary consultations, which I usually do for all of my patients, okay, boy, I answer them in there. You know, and then follow up and follow up. got to follow up, you know, and whether you're doing follow up texts, follow up emails, whatever that is.
Beau Beard (42:00.675)
Mm-hmm.
Beau Beard (42:12.727)
Mm-hmm.
Annie O'Connor (42:22.699)
You know, those are the things that really anchor this down, right? They really anchor this down. So answering those four questions to me are huge, huge.
Beau Beard (42:24.941)
you
Beau Beard (42:34.516)
One thing that I know I struggled with is I kind of realized I needed a bigger lens to look at the organisms through that I was looking at it through the lens of what I was taught was that people's expectations of what was being provided. So they come in and again, this goes back to your statement of what you're, better watch out what you're selling. Cause that's what they're going to come in for. You sell yourselves as Cairo PT, you know, Mr. Mrs. That does X.
Annie O'Connor (42:53.643)
Thanks.
Beau Beard (43:03.626)
And then we have a conversation about not having a diet coke. Sometimes that's not so easy. So again, any words of wisdom on how to make those moves in particular for docs, you know, a student coming out, they can kind of reinvent themselves on the fly and be like, okay, I've I'm approaching it. But what if you're in this, you know, very, you know, adjust soft tissue, you know, maybe pass a modality practice and somebody's listen, it's like, dude, I'm I'm realizing I need to switch stuff up. You can't pull the rug out from underneath people. How do they
Annie O'Connor (43:17.585)
yeah.
Beau Beard (43:32.49)
How did the conversations need to applied where is it just what you said earlier? Like, Hey, I was wrong. I've kind of evolved. We're going to change things up. Cause I know I've had patients give me pushback like, so what you're not, you're not going to adjust my back. And I'm like, you know, and I mean, I can handle it now 10 times better than I could year one.
Annie O'Connor (43:45.563)
yeah.
Everything is going to be better. like that's the best thing about practice. It just keeps getting better. Okay, and probably why I'll never get out of it because I just love it, you know. But let's take that question two ways. Let's take it, yeah, when you get out, how you start your cell is really important. Okay, and that doesn't mean we can't change what we're talking about in
the second part of that scenario. you know, to me, people are like, you're physical therapist. I said, no, I'm not. And they're like, well, you're licensed. I said, yeah, whatever. That had to occur in order for me to be able to do all this whatever in Illinois. But here's who really, truly I am. I am a person dedicated to the problems of pain, functional decline, and health optimization. OK, so if you're hurting, if you're not moving like you want to move.
If you're not performing to the capacity you want to perform, or you're struggling in your health and you want a non-pharmacy, non-procedural, non-surgical answer, I am your gal. Like this has been my life's work. And then I follow that up with, I also will be the last physical therapist you will ever see because I'm in it for, till death do us part. I want to be your partner. You know, I really want it to be, I want to be the family therapist. Okay.
So I might be a little dramatic in it. I am very dramatic. Okay. But you got to make sure you sell yourself whole. When you limit that, it is very difficult to do the backpedal on visit four or five going, holy crying out loud. I've been all over the pelvis and now I got to talk about psychosocial, you know, or shoot, I thought this person could remodel this tendon, but they're so unhealthy.
Beau Beard (45:25.902)
you
Beau Beard (45:37.708)
Yeah.
Annie O'Connor (45:45.001)
you know, and I've got to like shift gears here, you know, cause I got to, I got to deal with the health immune system of the healing because it's not even going to get cut with dry needling, you know, so you got to be careful in that. Now, humility wins the game. It will always win the game. It always overtakes pride. When you overtake pride, you win. Okay. And so
Beau Beard (45:53.102)
Mm.
Annie O'Connor (46:13.297)
If you have been working in a certain path and you aren't getting the expectations, okay, do yourself a favor and remeasure. Cause when you remeasure, you can have the conversation and then you can humble yourself saying, I really thought this was your most dominating issue, but on reassessment, it looks like we may have to move here. You know, we knocked over
Beau Beard (46:23.607)
Mm-hmm.
Annie O'Connor (46:41.438)
that dominoes and we got two or three to dock down but bam look who's standing right there and we've got a segue. Okay so you can do that when you remeasure. It's very difficult to do it when you don't have data.
Beau Beard (46:46.647)
Mm-hmm.
Beau Beard (46:58.122)
It can only change what you measure, right? And that's...
Annie O'Connor (47:00.04)
You can only change what you measure. And I think that's really important. So if you're traveling down and you haven't retaked a measurement, do it. Then have the conversation, you know, and humble yourself of this is what you thought. But through ongoing reassessment, we're realizing something else is dominating.
Beau Beard (47:20.598)
And something that I realized, like I'm picturing a conversation out of the patient yesterday that I started on her foot, you know, just kind of working on some function stuff. And I was like, I do your hip, you know, stability pattern on your hip, you know, because she's coming in kind of just because she wants to move better. And I was like, I, yeah, that's a thing, but I should have started up here and it's, you know, visit four and she, know, but that conversation to me is just a normal one. Now I don't feel bad that I messed up. If you want to call it that it's just literally
Annie O'Connor (47:45.961)
Yeah
Beau Beard (47:49.652)
I'm running experiment and I'm always checking myself. So as long as the data is clean, I'm just explaining what I'm seeing. Now, like you said, hopefully I've got a really good partnership and they're like, yeah, okay. Yeah. I'm you're making a left turn, not right. Yeah. We're just going left. Okay. and again, that just takes reps. But what I realized was I wasn't bought into my own system. early on of like, I'm not, you know,
I'm not just treating the body and the parts and the movement I'm treating. Now I'm like, I'm treating the whole thing. So I got it. It's going to take time. I'm going to mess up. I'm need the, the reps. And once you realize that it just, it kind of is this, you know, as Brett, you know, friend of ours, Brett Winchester would say, just kind of frees you up when you buy into this functional model. You're like, you're like, my God, yeah, I've got a job. My job is tough, but also I've got a good system to work in and I'm just doing my job. I'm not tethering myself to some outcome. That's probably.
never going to happen in my mind, but I've got to realize what can actually happen to that patient.
Annie O'Connor (48:50.858)
And tapping into them, you are bringing up good things. I'm always asking, hey, what do you think is going on? What do you believe? What have you been reading? What did G.P.T. say? Because I know you already did it. Really drafting from them, they are the expert of them. And the analytical side to their own. They're analyzing all the time what's happening.
Beau Beard (48:59.107)
Mm-hmm.
Annie O'Connor (49:19.762)
Tap into that and appreciate that. And then I've been so humbled that they're actually more right than I was, you know, when that happens to you time and time again. You know, then, you know, but you got to tap in. You got to understand what they're thinking, what they're believing, what they're, you know, and you got to really, what they're reading, what they've been told, what what experiments have you run? You know, what have they yielded? What are the meds doing? You need to really be
Beau Beard (49:42.967)
Mm-hmm.
Annie O'Connor (49:48.606)
getting information from them.
Beau Beard (49:51.49)
Yeah. I mean, how many times have you seen a patient that needed, you know, you to push on a joint a lot of times they move it and they were already doing that, just not enough or not. Like they're already like, it feels really good when I do this. And you're like, I think we might do more of that with some more.
Annie O'Connor (50:07.367)
Exactly.
Or they've actually, because I've reorientated how I train them, like I often will use the, especially in any directional preference of tissue modeling, you know, framework is, I need you to find that pain. Find that pain, because if you find that pain, that's your way out. That's your key out. And, you know, once they are now moving to find that pain, my God, they've come back with better remodeling and...
Beau Beard (50:22.894)
Mm.
Beau Beard (50:28.162)
Yeah.
Annie O'Connor (50:40.094)
directional preference than I've ever even thought of. I mean, I can give you stories. Even in the people who've got a spinal cord injury with severe spasticity, and I tell them, you've got to push further. They've got people sitting on their backs. They text me a picture, and I'm like, what does the baseline say? Best day I had with my legs in the chair. It sounds good. Looking forward to talking to you.
Beau Beard (50:42.957)
Yeah.
Beau Beard (51:08.45)
You
Annie O'Connor (51:09.03)
And I thought to myself, I don't know if I'd put that on my Instagram reel yet. But yeah, I think it's all in how we get them into the partnership of their own treatment. So it's a word game. It's words, right? It's words. And corrective exercise, we have to be really good at, is it truly something that just needs a direction? Is it really something that needs?
capacity, stress capacity training, whether we think it's tissue based or function based or, know, even, gosh, come on, I came up in the motor control days of early Sarman and Pavel and Gary and all these incredible quality people. You know, is it really a quality problem? You know, or is it a quantity problem? Because, you know, we can't make people feel bad about how they move, right? And that's really, it's a delicate.
Beau Beard (51:49.688)
Mm-hmm.
Annie O'Connor (52:09.13)
conversation, you know, as providers as well as, you know, people. And sometimes they don't even need to do exercises. Guys, they got to get back to their life, you know, whether they need the graded exposure to fear, the graded exposure to dopamine rewards or the graded exposure to, you know, recognition and the brain down training. You got to, you know, you got to be able to call it when it really is for corrective exercise or like, no, you don't need any exercise. Do whatever you want. You know, like
We have to be able to humble ourselves in that area, even though we've spent our life studying exercise, right? I mean...
Beau Beard (52:46.21)
when you talk about quality and quantity, a very like a burning question that I'm always asking people when I get, you know, in conversations with people like you that have been in the trenches for a long time is when we're dealing again, I know the framework will work for athletes. It works. It has to, right? It's still a human, but when we get up to people that are literally pushing into boundaries that are, you know, they're always going to be run up against capacity and they're always going to be dealing with some little, you know, ache or pain.
how much does that framework fall apart? Because that's kind of one of the combos of like, well, when we're dealing with athletes, it changes versus this, know, stay at home mom that's had pain for 10 years, just come and go, and she has three, four cycles of it. Right, so how do we reconcile that?
Annie O'Connor (53:25.361)
think it does but I mean personally I don't think it does. What do mean how do we reconcile it?
Beau Beard (53:31.608)
So if we say, so if we say an athlete, you're like, you know, if somebody's like, Hey, it's still could be, you know, the, how they're framing their pain. It's, know, the central sensitivity of the, sensitization of this kind of scenario. But then we're talking about like how they throw a baseball and then somebody else comes in like, well, it's how they're throwing the baseball is why their elbow hurts. How, how far apart are those two really? Or they actually speak in the same language that they don't look like, or they don't
know that they're looking through the same pane of glass. Are you with me on that?
Annie O'Connor (54:02.922)
Kind of, let me make sure I've heard you. So you got one really defending the quality biomechanics of the baseball throw. And then you got the other one over here saying, you know, we really truly got a yellow light, green light on the traffic light. know, and...
Beau Beard (54:18.542)
Yeah, and both may understand both worlds, but they still approach they're starting at two different intervention points
Annie O'Connor (54:25.625)
They are, you know, to me the overarching framework is the traffic light guy. Okay, so, you know, if you've got a yellow light, which is still safe pain, which just means you need adaptation time. That's all it is. Hey, you need time to get to green. That's all. Okay, so to me that question now goes back to the person. If you can't tolerate having post exercise or performance pain, even though it's safe,
Beau Beard (54:30.093)
Yeah.
Beau Beard (54:34.51)
Mm-hmm.
Annie O'Connor (54:55.517)
then we have to adjust your capacity to green. Not because of the condition, because of your tolerance. Okay, so I've had enough talks with the athletes about that. And I mean, get the traffic light right here. I'm like, come on guys, seriously, what does it say? And they're like, so you're telling me that if I can tolerate this pain that I'm having, right? I'm like, yeah, keep going.
Beau Beard (55:12.942)
Mm-hmm.
Annie O'Connor (55:24.583)
that I could throw. Yes.
And then I'm also taking it a step further because I also said something that was even more important that you didn't pick up because you never do. You need time to adapt. And most adaptation, if you're doing the level that you're doing, it's going to be 14 days. Now, are you willing to wait to 14 days to have that show you that you actually met that capacity and you're ready for more? Because if you're not, then yeah.
Beau Beard (55:41.39)
Mm-hmm.
Beau Beard (55:47.47)
Mm-hmm.
Annie O'Connor (55:59.645)
Let's call the cattle black right here. No big deal. Let's adjust the training program to get to green and move on.
Beau Beard (56:05.836)
Mm-hmm.
Annie O'Connor (56:07.178)
Because this is not that hard. You know? Now you going, oh, Annie, it hurts when I come through here to let it go. That really isn't the mechanics per se. It's your brain thinking something bad's going on at that moment. And it makes that adjustment.
Beau Beard (56:26.126)
Mm-hmm.
Annie O'Connor (56:28.123)
Okay, because of the pain, especially if the adjustment is happening with the pain.
Beau Beard (56:36.566)
Okay, can I, let me.
Annie O'Connor (56:37.193)
So that's a clear question that everyone should be asked if they're dealing with somebody who's having pain. Are you really having pain at the time you're making that bozo mood you're making right there? Because if you are, then it's about the pain. It's not about the biomechanics.
Beau Beard (56:52.942)
how do we reconcile the, whether it's a coach at this point, and if we took a picture just because we're using that example for some reason, somebody's not having pain and they try to intervene. And we then we kind of come to the determination, like maybe post-hoc of like, they had the elbow surgery because they didn't correct that where somebody else like, well, I would have corrected that before it started hurting. How do we reconcile that in the framework?
Annie O'Connor (56:58.263)
Cheers.
Annie O'Connor (57:11.281)
it.
Annie O'Connor (57:18.757)
with martinis.
Beau Beard (57:20.398)
Hahaha!
Annie O'Connor (57:22.197)
You got to take them off with martinis. Everyone's got to get laid and drunk so they get like they really just feel good about themselves. And because there is no reconciliation of that to the right. That's just an underlying belief. And so we might as well have fun because we're on a panel discussion. So bring on the martinis and let's talk about it. You know, it's just I don't have an answer. It's purely to me and I don't know. OK.
Beau Beard (57:33.484)
Yeah.
Annie O'Connor (57:48.967)
What I do know from clinical experience, especially working with some of the greatest athletes of all time, I can tell you some great stories there, all right, is when pain is literally the issue, then get in the traffic light guide and don't make it an issue. Because what you're seeing, if pain is happening to, if they're making that move differently because of pain, you're seeing the manifestation of what they think or what they've been told.
Beau Beard (58:02.07)
Mm-hmm.
Beau Beard (58:06.167)
Yeah.
Beau Beard (58:16.334)
Mm-hmm.
Annie O'Connor (58:18.345)
Now, whether I give it a central sensitivity or whatever, it doesn't matter. It really is that apprehensive change of movement pattern was relative to that really quick processing that went on. So a little noceoceptor went in and the brain's like, oh my God, you know, you got a rotator cuff problem. You know, they told you about the scapula, blah, blah, blah, blah, blah. And bam, that noceoceptor now has, you know, a little sensitivity to it. Oh, so let me just wing out this elbow a little bit and get that ball over there.
Beau Beard (58:47.288)
and
Annie O'Connor (58:48.774)
Right? And so you have to really, if pain is the issue, get over in the traffic light guide and end the issue. Okay? And really get into their hearts about what their tolerances are.
Sell it like it is adaptation doesn't matter 14 days if you are doing it Okay, now if we are trying to be preventive Because we believe that this way they throw could yield something down the path First off don't prophesize that for anybody. That's terrible Don't ever do that You wouldn't want that done to you. Do not do it to other people
Beau Beard (59:27.672)
Right.
Annie O'Connor (59:35.002)
Okay. And don't, don't be the surgeons that, know, come on, be, be better than them. Like they love to look at an extra, replace every joint in your body. You know, like even though there are countless of evidence that says we wouldn't, you know, so don't prophesize relative to someone's movement pattern that they'll have a problem. I would tell you that is your first catching correct in your own practice. Now being preventive,
is important. Performance training is important and we all want to be in that world. We want to be the dentists where we want to prevent MSK pain. Okay, so you don't prophesize. You have good ways at looking at prevention of functional movement program and you design functional strength training relative to that issue you're seeing biomechanically and that function you're dealing with. You close that gap and you train in contact.
Beau Beard (01:00:14.734)
Mm-hmm.
Beau Beard (01:00:32.75)
Mm-hmm.
Annie O'Connor (01:00:34.696)
because if you train in context the neuromuscular system will figure it out okay but yeah don't prophesize don't ever say that
Beau Beard (01:00:44.15)
Yeah. So it comes, mean, in that, and since it's back to words, mean, I'm going to try it. Well, it's going to be very non-secular because I'm just going to start lightening up with questions because I got too many and I wish I could make it a nice flowy conversation, but I just, yeah, I'm just going to get messy with it. if you, just cause I've had questions for you forever since the first time I heard you talk, what if
Somebody's listening and they're like, I just want the hit list. Like I want Andy to make me better at my job in the next like 10 minutes, not, you know, hopefully they've learned so much already. If we're just looking at like a non-responder, what are, if somebody walks in, we know that within the first, what 12 to 15 seconds we've developed, you know, rapport and an idealized image of what that person is. How's a clinician start to pick up some of the things that's going to give them a better, if we're going to say categorization, you know, of that.
Annie O'Connor (01:01:14.865)
Nuts.
Beau Beard (01:01:35.438)
person is, you know, obviously we can't necessarily cope or until we apply an intervention, but like a responder or somebody that's, know, whatever's going on, are there any like little tips, tricks, things that you've kind of realized like over the years of like, man, I really pay attention to, you know, how people say things, how they present them. know all of these are important, obviously, but anything you lean more towards, or you've even kind of found on your own that's not, you know, in a book someplace or taught.
Annie O'Connor (01:02:00.14)
Well, so let me make sure I understand responder is that movement will change their symptoms. Is that how we're?
Beau Beard (01:02:07.884)
Yeah, so if somebody comes in and you know, a new student, they've read your book, they went to one of your courses, and they're like, I'm trying to be real, I'm trying to be a very observational, I'm trying to be Sherlock Holmes, trying to know how many stairs lead up to my house, you know, without having to go out and count them, I just know what types of things are you paying attention to with the patient interaction, rather than just what they're literally saying to you and what you find on your exam, anything out
like in the organism, the way people say things, like you said, that emerge with patients are like, hey, when they say this type of thing or they present in this type of way or anything that stands out, you're like, hey, really pay attention to this that is not talked about a lot. Anything that's like an underlying.
Annie O'Connor (01:02:49.96)
Yeah, thank you. That's much more helpful.
The thing that for me that drives me a lot in the interaction is that I within eight seconds know they have nothing of any red flag nature.
It's bit me in the ass too many times. I've got some terrible stories to tell. Okay. so I will tell you that you have a duty. I don't care how many times you've seen that person that you still make sure they have no progressive neurological, right? They haven't switched on you in some way. They haven't had some trauma like from the last time they saw you. I could give you countless stories. So I,
I tell myself in eight seconds, need to make sure nothing has changed or even on a first line, you don't hear about trauma and stuff like that. Okay. My second thing is very much wrapped around what they want to get done because what they want to get done is a key thing. It's so key. Like, Hey, what is the goal of our session today?
You know, what do you want to have happen today? What are you expecting today? Because when you're operating within what they want, you get so much more done. And you can pick questions that are more meaningful relative to that. And I can give you a ton of examples. So, but that to me is really like the essence of setting that up, right? What do they want to get done? They got nothing red flags. And then I work into language.
Beau Beard (01:04:39.66)
Mm-hmm.
Annie O'Connor (01:04:40.155)
Because if I'm hearing, let's say I'm on a follow-up and I've got the, you know, we all have these people. Annie, know you told me I needed to try this and that. And I totally understand why. And I just didn't get a chance. I can't, the kids, well, you know, I got this really contemplative, okay, shoot.
This person needs accountability and you know, I need to make sure I'm operating in an acceptance commitment therapy type of approach with this person. Okay, so my behavior is going to change to change their behavior. Okay, because right now it's not about me trying to resell anything I've already sold. They already know. In fact, they probably teach it better than me. You know, it's just I didn't pick up that the behavioral need was accountability.
Beau Beard (01:05:36.59)
Mm-hmm.
Annie O'Connor (01:05:37.413)
Alright, now you got the other person that, you know, their language is different in the sense of, you know, they're giving you a lot of excuses, they give you blame, they say yes but, they, I saw so and so and she said, boy, you should never do this, you know. So when they are really the, boy, I got the resistance coming out, then I know I've got to switch my entire approach to MI strategies.
Otherwise I'm never going to get anything done because I am not treating now at this point, anything relative to any of the things that they're coming in. I'm treating the behavioral problem and acceptance commitment therapy. The basic principles are so easy. Am I the basic principles are so easy, but if you can pick that up, my God, you're going to save yourself just amounts of things. Right? So to me, those are like, okay, don't get that. All right.
Beau Beard (01:06:17.389)
Yeah.
Annie O'Connor (01:06:33.561)
Here's the goal. whoa, wait. Okay, shoot. I got, I got to make a behavior change on myself here because this one's not in a place to receive. And so it doesn't matter what I'm trying to sell and respects to education or doing things, right? This is a behavior problem, you know, and
Beau Beard (01:06:56.408)
point. All the things that you just listed, which are all I mean, hopefully people are I'm I would be filling a notebook up with notes if I was listening to this. They're all based on your observational skills. And one thing we talked about in the art of assessment courses, like observational skills as a skill set, the A is never taught in our schooling. Overall from like kindergarten through grad school, we're going to interact with somebody besides like do your ABCs and die imaging and
look at their skin. Do you think you're naturally just gifted in observation? Because like Amy Herman, book called Visual Intelligence, where she works on the skill by going through art appreciation classes for CIA operatives, military and police officers. Or do have any hobbies that put you in a category where like, I'm just like, more aware of myself, my environment, or do you just think it's dumb luck? This is just how I'm built. And that's, you I'm in a good
Annie O'Connor (01:07:33.381)
No.
Annie O'Connor (01:07:52.999)
Well, I am a Sunday kid. Sunday kids are just kind of, want to have fun. All right? And I have a real love for people. I really do. love people. I love, I use the Ackerman often, like, listen, observe, value everything and everybody they bring and everything they say. And so I have just an uncanny way of really loving on people that way. And so...
Beau Beard (01:08:08.632)
Mm-hmm.
Annie O'Connor (01:08:22.504)
It's not something that I've trained, you know, but it's something that, you know, I feel like every 45 minute session of the day, I'm training, right? I mean, here's the, you have all kinds of, just by the way people walk in with you, right? And how, mean, if you can't observe and don't observe,
Beau Beard (01:08:25.262)
Mm.
Annie O'Connor (01:08:47.377)
Are they getting dorsiflexion eversion at the ankle? Is knee extension happening at terminal stance? I didn't even see that arm swing. Just, just observe the naturalness of how they present to you when they're not being asked to move. This is so critical. Cause as soon as you get into the room and or wherever you're headed and you're in now, okay, they know they're going to be watched.
Beau Beard (01:09:06.583)
Mm-hmm.
Annie O'Connor (01:09:16.647)
you're going to see the complete disconnect. And as soon as you see the disconnect with respects to what you observed as they're walking in, picking up things, helping people, and now I want them to bend over and it looks like, you know, I got some like crazy thing coming on. That disconnect right away tells me I'm in the central nervous system. And, you know, I'm freeing myself of all this.
Beau Beard (01:09:38.83)
Mm-hmm.
Annie O'Connor (01:09:43.835)
biomechanical knowledge I have right now and I'm honing in on how I help reduce the threat value of what's going on and really truly understand how I'm going to help them because it's going to be a lot easier, right? So that observation alone to me is probably the most valuable, you know.
Beau Beard (01:10:02.062)
Yeah, I love that. mean, I couldn't agree more of, yeah, seeing that seeing the human. And then I kind of tell patients all I mean, I'll tell them straight up, I go, I'm gonna watch you move. And I'm going to do all this stuff. But you're going to put on a mask, like everybody wants to either be better or be worse, or just not tell what's going on. And I don't mean with your words, but like, how you move or the disconnect between what you're doing, when you tell me something. And we had a fun conversation with a patient just two weeks ago about this. And she goes, what do
you think I'm lying to you? was like, no, I didn't say that. But it's just fun when you again, you're playing this game, right? It's a game within you. But the game is like you said, maybe the most valuable game that all of us are playing on both sides, right from the provider to the patient of like, if this is for your health, this is for the way you feel every day that you know, and how you interact with other people. yeah, I mean, obviously, I put it on a pedestal, because it's what I do for a profession, but
Annie O'Connor (01:10:34.491)
Thank
Beau Beard (01:10:59.269)
we're also seeing that it's becoming maybe the major plight of society overall of just, you know, people aren't healthy, they can't move. And now we're just kind of seeing the ramifications. So if we.
Annie O'Connor (01:11:09.287)
This is the hardest time in 40 years of practice from my perspective to be a provider. number one, the health of people. I feel, you know, I've got a lot, I don't want to go into conspiracy theories here, but I really, no, we're not ready. You know, it's not what you want out of this. You know, but I just,
Beau Beard (01:11:20.194)
because of the health of people or other variables.
Beau Beard (01:11:31.374)
Come on, Annie.
Annie O'Connor (01:11:39.289)
I've witnessed such suffering and sickness and it's happening younger and younger and younger. And so it's a very difficult time to be a provider when you're dealing with that. Okay. And you know, when in the eighties, I mean, we quoted, you know, readiness to change if that's what we're going to use or contemplated pre-contemplated blah, blah, blah, all these words, right? You know, it was literally, you may encounter that about
20 % of the time, right? It's 80 % of the time, if not growing. You know, people are there sometimes not because they even want to be there. Now that may be more, they may be more there for the chiropractic community chiropractor because you guys are sometimes the last hope, okay? But in the health organization, hospital-based standard PT practice,
Half the time they don't want to be there. Right? And so that is a really difficult thing. And we don't have enough behavioral training to really put stakes in the ground and get people accountable and less resistant to doing their part. you know, so that, think it's just a harder time. It really is a harder time. the demands.
You know, like I told you, the payer's gotten very sophisticated in regulating these, you know, surgery, everything. They've got very sophisticated in regulating everything. And they have grand operational structures, you know, within, you know, who they own and how we access and what we do. And so efficiency in my mind is like, you have to be
incredibly efficient. know, and efficiency means you really understand your business. And you cut a lot of fat. And you schedule by need and you, you know, put a lot of ownership on the person that you're sitting there with and the partnership. You know, everyone's effective. Not many people are efficient. And, you know, so that's why I think it's a harder time than ever.
Beau Beard (01:13:59.842)
Yeah.
Annie O'Connor (01:14:03.489)
is efficiency is a demand and it's an art and you've got people that have far more resistance to change behaviors and accountability and you know upregulated nervous systems, whatever you want to call it. I'm tired of all these words right? You know it's and you got really sick people that are suffering you know so like it's difficult.
Beau Beard (01:14:27.086)
Yeah.
Annie O'Connor (01:14:29.303)
And I would tell you, like, you're coming out of PT school, you're coming out of OT, chiropractic, medical doctor, whatever you're coming out to, even personal trainers. mean, personal trainers now have been given chronic pain.
Which is probably good to be honest with. You know, I see that sometimes it's a good thing and I love when they come to the courses so they've got some armor, you know, armor against them. But it's really a difficult time. So you gotta, you know, even though you listen to all these people that are great experts or whatever, we practiced in times that were easier, you know.
Beau Beard (01:14:47.298)
Yeah.
Beau Beard (01:15:06.53)
Yeah. Yeah. Like, like I said, the tools are getting less effective, even though everybody and I agree that the efficiency we talk about that all the time in here as well as, know, whether it's where I start with somebody, what tools I use or how my business runs, like we may all get to the same end road, but it's probably going to come down to how fast I get there, how long that lasts, the partnership I built along the way. And that's kind of the name of the game. And, yeah, I agree wholeheartedly and.
okay. I'm gonna hit you. go ahead.
Annie O'Connor (01:15:37.648)
You know, I learned so much of this when I was running the Musculoskeletal Partnerships for RIC, when we were doing self-employed cash-based care. And I felt like we were like, we can cure that case in six visits, in five visits, in nine visits, you know? And it was fun times, but, you know.
I mean, when senior leadership comes down and says, visit six, we're at zero. We are losing money after that, you know, but then you have ethical moral values, you know, but then they were saying whatever it takes, get it done. Okay. You know, we learned a lot about schedule by need. We learned a lot about accountability. We learned a lot about communicating, partnering, when people should be telehealth and not in person. And it was, it was incredible.
you know, because we put the gauntlet down on the case rates. And, you know, so I think if I was running my own clinic, you know, after having run all their clinics, I don't have to, now I'm in my own little private world. I would definitely be nurturing my team in a case rate model. Because...
Beau Beard (01:16:52.616)
Mm-hmm. Yeah.
Annie O'Connor (01:16:55.236)
That ultimately is what's going to differentiate you in the community. Because everyone's doing the same stuff. Yeah.
Beau Beard (01:17:00.182)
Agreed. Yeah. Yeah. We might, sell it different, but yeah, it's, it's, it's the same soup. okay. Last two questions I give everybody here. we were talking about, know, you've been in the game for a while and what is something that you thought was true or you held true for, you know, long time or use or whatever. They were just like, that's not true. Or I don't do that anymore. You know, it's just, it was false to begin with. Anything come to mind?
Annie O'Connor (01:17:27.142)
Thanks.
Annie O'Connor (01:17:31.04)
gosh, say it one more time. But what was true?
Beau Beard (01:17:33.58)
Yeah. So something that you held to be true or that you used in practice that you're just like, that's, that is not valuable. It never was valuable or it never was true, or you've just completely changed your mind on.
Annie O'Connor (01:17:43.619)
I hope I'm answering it correctly, but I want to do due diligence to a couple things. know, and again, this is, know, when I really early on in my career thought the whole McKenzie thing was baloney. And boy, I was humbled by 20,000 million times and I've got incredible relationships with them in the sense I just could not believe
that someone could easily get better with just going to the end range of a direction. Well, that could be more true. They actually are the most missed mechanism of all time because they are non-traumatic. And I had a big belief trauma and pain were connected. And now I kind of realize how the humility on, I have more people that have had no trauma and pain than trauma and pain. So that was a very humbling
Beau Beard (01:18:41.492)
Mm-hmm. Yeah.
Annie O'Connor (01:18:45.977)
you know, experience even on the other side of that.
Annie O'Connor (01:18:53.665)
Even though I was out with John Barnes moving bones all over Sedona, and boy, those were some good times, okay? I never really truly appreciated the somatization, mind-body connection, I don't care, emotional, social, psychological trauma, and how personal that is, right? Being raised kind of a Southwest side Irish Catholic, Sox fan, know, trauma's trauma. You got beat up by the nuns.
Beau Beard (01:19:15.5)
Mm-hmm.
Annie O'Connor (01:19:23.213)
Okay, may be, But you know, like, so it's really personal, it's really real, and the amazing physiological processes of someone having that going on in their head or in their brain or in their heart and how it manifests within the body is an amazing phenomenon. And you know, now I'm so much more in tune.
Beau Beard (01:19:23.778)
Come on, get over it. Yeah.
Annie O'Connor (01:19:49.551)
with picking that up so much sooner and validating it and helping people really get to that stress talk a little earlier, right? And using the millions of treatments that are out there for people to really go through some of that healing, right? And collaborating and connecting. So those were two areas where I don't know if I answered it correctly, but I've gotten a lot of humility around.
Beau Beard (01:19:57.762)
Mm-hmm.
Beau Beard (01:20:12.354)
Yeah, absolutely.
Beau Beard (01:20:21.281)
Well, let's flip that question on its head. What's something you think to be true or you're like, got a really strong theory, but maybe there's no empirical evidence for it or, you no RCT doesn't even have to be necessarily something you could study, but is there something you're like, I just, think this is the way it is. And, know, there's not.
Annie O'Connor (01:20:21.967)
We'll see.
Annie O'Connor (01:20:44.321)
Well, I think we've made pain science too complicated.
And I don't have enough evidence on it yet, but one of the things that I've done, I think within the world of hurt, and I know those that have gone to some of the courses if they are listening. And if we have to say dumb it down, which I can't stand when we say that, because it's really not about that. It's a simplification to get change is, you know, we're making it too complicated. You know, like people don't need all this, you know, knowledge. They just need.
to it's safe to move. They need to know how to regulate stress and they need to know when their brain's forgotten their body. And like we've made this just too complicated. And you know, it's serving, it's again, serving an academic model where I feel like I need a brain reprocessing theory certification course now. And you know, I'm not, can't be this provider and you know, I'm not saying that that stuff isn't good for you, but it really isn't good for the people.
Beau Beard (01:21:32.291)
Yeah.
Beau Beard (01:21:48.045)
Yeah.
Annie O'Connor (01:21:50.149)
I've seen even more things come from this word no so plastic. I can't tell you I've too many You know, I'm but again the pool that I'm I'm Fishing in unfortunately, I'm like the seventh eighth therapist that people have seen or they've seen for Kyra, you know so, you know, they've been mauled by people's words, you know, and So I you know can't say I'm having too many firsts
impressions. So I do. I think we've made it too complicated and I don't, you know, I don't think we have to train pain science. can't even stand the damn word, you know. Like these are just like, hey, they have an MCL sprain, show them where the freaking MCL is and get over with it. Hey, they have some pain avoidance and you're catching it up on yellow flag wrist form or you know, TSK four, 17, 11, whatever you want to use.
Beau Beard (01:22:37.902)
Mm-hmm.
Annie O'Connor (01:22:46.607)
then teach them to traffic light guide and be done with it and share the secret sauce and stop this baloney or whatever you're doing. You know, don't get into the depth of the DRG. know, now I'm not saying like sometimes people don't need that. Like intellectual people may need you to go intellectual for them, but I'm going to tell you, general public, after what I've been through for the last five years, you know, when they learn, I didn't, you're right. I, I am not confident if I should push this pain.
Beau Beard (01:22:57.934)
Mm-hmm.
Annie O'Connor (01:23:16.285)
here, read this and tell me what you've learned. well then I'm a green light. Okay, what's that mean we're gonna do? I guess I'll just go back to doing this. I haven't been doing it, so it makes sense I'll do it. You know, I have had way too many of these conversations through every mode possible to say we're making it too complicated. So that's my thought process on that. Can't wait to run an RCT where we just...
Beau Beard (01:23:38.99)
Mm-hmm.
Annie O'Connor (01:23:45.561)
do a simple this and versus this versus that and say who prevails, right? I don't know if that'll ever happen, but.
Beau Beard (01:23:51.992)
Yeah. Well, yeah. that's, I computer program. I'm blanking on his name, but he always kind of said complexity, we got simplicity. Like you can't, it's not dumbing down. Like if something's complex, you have to make it simple to create frameworks and create heuristics to work with them because it's too hard to bring all the complexity to every case. Like it exists, but you got to create a framework and you work within it. And as I always tell people,
Annie O'Connor (01:24:17.177)
Well, hey, that's why the pain mechanism classification system is a really, it's a binary classification system. It's, you know, if you think about the peripheral nervous system and direction tissue function, okay, if you think about neuropathic and tight, trapped, if you think about central and sensitivity versus effective versus motorotic, you're using three binary classification systems to organize data to do comparison to funnel it in. And, you know, and that's why to me it's...
You know, it is the future. It is the future, especially with persistent recurring pain. So yeah, binary classification systems win. Pathoanatomical is not a binary classification system. It's got over 11,000 different code choices now.
Beau Beard (01:24:57.507)
Do you?
Beau Beard (01:25:06.254)
Yeah. Do you think, or I'm sure you get this question a lot coming from where you just left your post for the past five years, but also the book that you wrote and then the tsunami of AI with that being the future and by, you know, classifying and then using, you know, basically, like you said, a simplistic model to apply to what should I do in the scenario? Do you think that we run more of a risk as clinicians of being pushed out of our jobs or do you feel like we still have a pretty
pretty solid place to serve.
Annie O'Connor (01:25:38.538)
I partly got out of it because I want to wake up the clinicians like we better be on our guard. Let's talk about people seeking healthcare knowledge right now. There's a lot of data about that right now. You got 30 % of the people educated, all right, using health influencers, podcasts, books, they're self-guided. I mean, they are crazy and you and I are probably in that group to be honest with you, but okay.
Beau Beard (01:26:06.487)
Yeah.
Annie O'Connor (01:26:08.325)
but they're not using medical community doctors or their insurance companies. You got 25 and those are those mostly are women and, and you know, they're college educated. Okay. You've got 25 % not even using health influencers. They're, they're using all chat, GBT, they're using, they're going to urgent care and ER when they got catastrophic events, they're college educated, mostly young males.
Beau Beard (01:26:19.918)
Mm-hmm.
Annie O'Connor (01:26:38.212)
You know, they're not even going to the healthcare. They're not going to a CHIRO, a PT, an OT, like PCP, right? So right there, you've got 55 % of the people going out on their own. All right, now 30 % of them are still seeking knowledge from the PCP. Now, they're all over 70, so they're a dying breed, right? And actually, several of them are jumping out because they're becoming tech savvy.
Beau Beard (01:26:42.638)
you
Annie O'Connor (01:27:06.788)
And then you got a good 11 % that are in answering surveys. So here's where we are. We're right now, right here at about a 55 % of them. If we are smart, Bo, we got our own self-guided apps teaching people really good stuff, generating a beautiful platform.
Beau Beard (01:27:19.245)
Mm-hmm.
Annie O'Connor (01:27:27.822)
keeping people for the long haul, keep them out of the healthcare system. Right? We're banding together, PTOT, Cairo, personal trainer.
in a platform pumping out publications on this stuff, taking it to the next level. Yeah, because if we don't, yeah, the insurance companies are already doing this with these digital MSK care access care triage programs.
Beau Beard (01:27:58.284)
Yeah. And from what we've seen, a lot of people are forced to do that before they. Yeah.
Annie O'Connor (01:27:59.065)
Yeah.
They are. They are. So, you know, stay tuned because the world of her digital is coming. You know, I mean, like, you know, it's and I'm really here to kind of bind us together because it really truly I do believe the provider is going to be the glue that's solving this problem. But we have to be like self guiding people. Hand selecting ones that need to be coach guided.
And we have to be able to navigate to payers and deal with payers through EMR and proper classification models and make them change. Because if you pump out your assessment, hey, this pathogenatomical diagnosis that you're requiring me to use because I got a bill is irrelevant. And I'm going to use an alternative subgrouping method because this is more relevant. And these are the psychosocial factors that are impeding recovery.
Beau Beard (01:28:37.315)
Mm-hmm.
Annie O'Connor (01:28:54.22)
and this is what my treatment's gonna look like and I'm scheduling by need so I'm stretching this one out. As soon as that gets thrown through the EMR and comes up into and they don't have an AI pathway for that, it gets dumped to a human, thank God, and that human's gotta go like this, wow, we're getting a lot of this. We don't know anything about this. We force them to learn. We force them to learn. But if we just kinda say,
Slap that code on there because I know I can get this and build this way. You're playing their game and they're better at it than you.
Beau Beard (01:29:32.544)
Anthropology, if you change the language, you change the culture and that's, I, I, I agree with you. I think that is, it seems I'm sure to a lot of us myself, even hearing you say it, like, you know, Sisyphus pushing the rock up the hill. It's like, really? You want us to change it from the inside out? But I mean, that's, I agree. I mean, who else is going to do it? Yeah.
Annie O'Connor (01:29:51.748)
We can do it though. We can do it. mean, kind of Jane's software, I'm putting a plug for them. I have not met a better software company right now doing EMR that is more willing to think out of the box and make some changes. it doesn't take, yeah, it doesn't take much to get things like this going. It really doesn't, right? But we got to take care of the whole person. Pain, function, health optimization. You can't just drop.
Beau Beard (01:30:07.488)
Antic user advice. Yeah.
Annie O'Connor (01:30:22.442)
one app that's just gonna do FMS and call it, it's just not gonna work. You'll subserve a group of people. So it's my thought, yeah. Wow, you got like crazy all over the place, Bo, you and I. I like it. I got a little.
Beau Beard (01:30:33.282)
Yeah, large swath. Any...
Welcome, welcome to the farm cast. mean, this is how it goes. that's why we're recording. well, before we wrap up, mean, first of all, I want to say thank you so much, not only for being on the podcast, but I mean, everything you have done and continue to do for a, your patients and then our profession overall. I know I've learned, I mean, I'm, I've had this book, you know, since its inception. mean, it sits on the shelf and gets pulled out quite often. but yeah, I just want to thank you overall. Just, you know, you're kind of a beacon in the profession for many reasons. And I hope that.
you know, for God's sake, if somebody hasn't heard of Annie O'Connor, and it's your first time listening to her, go look up the world of hurt and everything she's offering in terms of book and the courses and you know, the forthcoming app. But before we jump off any just last, you know, piece of advice, words of wisdom, anything like that.
Annie O'Connor (01:31:27.191)
Well, Bo, just thank you. These things to me are like hallmarks of my career. To kind of collaborate with you and get sharpened like this, I mean, it's it's very meaningful to me. you're welcome. It's my pleasure. It's been one heck of a ride. I don't see myself in retirement. I would probably hurt people. I don't know. So just thank you. You're doing some great things.
And you know, my one thing, don't quit. Never, never, never, never quit. You It does to its part because you guys, you're doing good things. And you know, like I told you in the beginning, allow yourself to be a beginner. No one starts off to be an expert. work on that relationship because it goes a long way. Yeah. Yeah,
Beau Beard (01:32:02.36)
till death do us part, right?
Beau Beard (01:32:17.41)
Yeah. Well, thank you again, Annie. Appreciate it.
