ONE-ON-ONE CARE: LISTENING TO CLIENTS’ NEEDS WITH MIKE PIZZI
If your goal is to help people, then you have to listen to their needs. Jordan Levin’s guest today is Mike Pizzi, an experienced physical therapist at Health Quest. In this episode, Mike shares his passion for having one-on-one care with his clients. It’s essential to know who your clients are, identify their goals, and personalize a program that helps bring them where they want to be. Join in the conversation and discover how Mike handles his clients, especially during the first meeting. How do you set expectations, so patients end up really happy? Tune in to find out!
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ONE-ON-ONE CARE: LISTENING TO CLIENTS’ NEEDS WITH MIKE PIZZI
I am here with a special guest, Mr. Michael Pizzimenti, who I have known for years now. He is a wonderful, awesome, honest guy. Thank you, Mike, for being here.
Thanks for having me. It’s been a pleasure knowing you and the relationship we’ve established over the last few years.
Both of you and I would go back and forth. When we met, we pretty much hit off right away. A lot of it has to do with our personalities, but we also had a very common bond between athletics and sports, physical therapy and CrossFit. I remember when I first met you, I was in Colorado at the time and Henry teaching intro sessions. I remember him telling me, “We got this young guy, a physical therapist coming in. I think you would like him.” I remember you when I and are talking, we hit it off. What do you remember about that?
Physical Therapist: If you don’t have a solid team that knows what they need to do, enjoys what they do, and has the same amount of passion that you do, there’s only so much that you can accomplish.
The first thing I wanted to do when I came to the area was a CrossFit gym closest to me and meet the owners. I worked a lot with the CrossFit Athletes in Macomb where I came from. After meeting you and seeing the community that you had built, it was one of the things that my goal was after some time is to develop and be integrated into the community like you have been. The thing that I like about CrossFit is the family and the community. That’s what keeps CrossFit relevant too is people know each other. We became good friends very quickly. You were at my wedding. We had a whole table dedicated to CrossFit in our wedding. It shows the closeness, passion and love that you have, not only for what you do but for the people that are in your gym, much like in my clinic.
What was it about West Bloomfield that made you decide to open up?
I have some family members on this side of town. I’ve been with HealthQuest for many years and it was a location that we wanted to branch into Birmingham, Bloomfield, West Bloomfield area. They had been talking about it for a while. We hadn’t had any clinics within twenty minutes of the area that I’m in. Everything aligned right and then I made a move in 2016. It has been great. I have a whole family that I’ve found out here. I met my wife through your gym. Everything has worked out wonderfully. The company is happy. I am happy I’m out here.
It makes me thinking of I was probably one of your first clients back in the day. I was in there when you opened up and I remember spending a lot of time with you, learning more about physical therapy and how much work I needed to get my body moving well. What do you remember about that?
I had a lot of time back then when I first opened up. The schedule wasn’t full. We both had the opportunity to work with each other for an extended amount of time, 1 to 1.5-hour at a time. That was awesome for both of us. You had a lot of things and mobility issues going on. I knew about your passion for what you do. I knew that you loved doing CrossFit and it’s something that I wanted you to stay doing with it. I never want to tell anybody, “You can’t do something.” It was, “How can we get you to do this pain-free, where you can age well and it doesn’t wear you down?”
Those sessions were awesome too because I loved the one-on-one interaction and I still do. Unfortunately, things prevent us from spending as much one-on-one time as we want with everyone. We have a business to run but one-on-one care is what I’m very passionate about. We try to maximize our one-on-one time with everyone. Those 1 to 1.5-hour sessions and to see the results after years of working with you and what was even more impressive was you bought into it. You understood the importance of what we were trying to do. You’ve made it a lifestyle of yours too. The gains that you’ve made. You’re moving. You know this and anybody that knows you knows. You made tremendous improvements with how you move and it has saved your body.
That’s the important thing that I want people to understand. I’ve done this through the years. I tried to teach my clients and other people as well. Physical therapy is a way and a preventative basis. Anytime anybody has some specific issue going on, we say, “Go to a physical therapist. Go see Mike because the older you get, it’s going to get worse. In order to catch, these things are on a preventative basis. You’re going to get better results over time.”
Nothing gets people to buy in more than results.
Most people’s issues are caused by some postural discrepancy. They’re sitting all day at work or some movement-based fault, whether you’re squatting wrong, overhead lifting wrong, doing yard work wrong or cutting vegetables. There seems to be an overuse type of injury, A lot of times, it has to do with poor movement patterns. This is aside from any car accident or acute injury where somebody runs into you. Those are a whole separate thing but most of the things we see are chronic low back pain, knee arthritis, tendonitis, overuse stuff. Our goal is to get you back on the horse as fast as possible but then teach you things in the future to help you move better, so it doesn’t become a recurrent thing where things were down over time.
What I like to tell people about is that people think that whenever there’s a specific pain area, it’s not always that specific area. It is other things going on and people focus so much on that. How did you educate clients when they come in and let them know that this what stuff is going on?
I show them. Nothing gets people to buy in more than when you can either show them a video, in person or an ankle-foot model for ankle mobility and how it relates to the low back or even shoulder. An ankle problem can cause shoulder issues with bigger movement patterns. Being able to get somebody to appreciate the fact that everything’s connected through education, video, showing them specifically or having them try something out in the gym like, “Try putting your feet or knees in this position,” and then they can feel an immediate effect, people tend to buy into that. Nothing gets people to buy in more than results. You try to lose weight, you lose some weight and you stick with the program.
When you can teach somebody how to move better and they see immediate results like that felt better or, “I was able to do more reps or weight now because I’m moving more efficiently. I’m not sore like I was after a workout,” they buy in and at that point then you can open up the book as far as, “What else do you want to do to me?” At that point. They have a certain level of trust with you then, and that’s something I try to establish as fast as possible. It’s the trust factor.
That’s one of the things that drew me to you when we first met, then watching you grow the practice and working with these people individually, not only the clients but your employees and staff is phenomenal. I walk in that door. Everybody’s got a smile on their face. In 2020, you can’t see people’s smiles but you can see it in their eyes.
You have to look at eyes.
I applaud you for developing them. Who or what led you to developing such an amazing team?
It all comes down to how I was raised coming from a tight family. My foundation has always been a strong family, large family gatherings, showing our love, affection and respect for each other. I always had that as a good foundation and the older I get, the more I realize that’s not always the case for everybody. I realized the better we got along, the more we could accomplish even as a family. I came from a great team in Macomb at HealthQuest.
Physical Therapist: It’s super important to know who the person is, personalize your program to them, and know their wants and needs.
When I moved out to West Bloomfield, something that I wanted to emulate is to build a strong team because that’s our foundation. If I don’t have a solid team that knows what they need to do, enjoys what they do and has the same amount of passion that I do, there’s only so much that I can accomplish. Our main goal is to help people. The better our team is, the better we can accomplish the end goal which is having a healthier community that lives life better.
There are so many different physical therapy places and they all different specialties. For me, with CrossFit, we try to cater all ages and abilities, why I believe you can with that, how would you define your clientele? I know you do a lot of stuff with athletes as well, so I’m guessing if you have a little a bit of a mix of everything in terms of clientele?
The mix is something that I like. Working with West Bloomfield High School, Bloomfield Hills and St. Mary’s close to CrossFit community with you and me. I’ve developed a lot of the younger athletic crowd into the clinic. I’ve integrated them into the clinic. It’s fun to take care of somebody that’s on a division one scholarship, semi-professional and professional athlete, to the weekend warrior that’s trying to stay in shape into their 30s, 40s and 50. All the way to somebody that’s in their 80s and want to be able to pick up their great-grandkids, get on and off the toilet, or go up and down the stairs.
It’s nice to be able to treat somebody, and then you turn, and the next patient is somebody completely different. Our approach is to know who that person is, personalize the program to them and know what their wants and needs are. That’s super important. We don’t do any cookie-cutter stuff in our place. I want to know what you care about, want to get back to, and then we develop a program that fits those needs to get you back to where you want to be. Not everybody has the same goals.
Everybody’s different. That’s part of when you do during the initial assessment. That’s how you define what that is. I’ve heard you talk about it and setting the expectation in the beginning, saying, “This is what’s going on. This is the problem. Here’s your solution and how we’re going to get there.” When I said in the intro, consultations with patients so you can get the problem, what’s going on and what’s the solution?
The first visit is the most important visit. It ends up you set your expectations because what you want to do and this is for relationship in life, it’s expectations and then being able to fulfill them. Having somebody, “This is what you should expect and this is what we’re going to be able to do. What are your goals? There are the steps we’re going to take to get to those goals.” Also, to have them understand that we need realistic expectations too.
If you blow smoke up there and you have unrealistic expectations, what that does is it lowers your quality and the satisfaction too with what you’re trying to do with that patient when the patient doesn’t have necessarily a great outcome. If you could set expectations right off the bat, understand their goals and then formulate a plan to achieve those goals, patients end up being happy. Not everybody’s going to get back to 100%. If you can get them to understand that but also empower them to maximize and optimize what they have, people end up having great responses and they’re very happy with the end result.
Sometimes, no matter what you say, patients need to hear from somebody else.
That’s very important because you’re solving their problem. People are coming to you and you do a wonderful job with that. It made me think about it. You’re working with such a wide range of individuals. I imagine you work with young kids like 3 or 4 years old, an athlete, somebody who wants to be healthy, to somebody who’s 80 to 90 years old.
I’m going to plug you in quickly.
Let’s take someone for example. As a young kid, somebody who’s in the 20s, 30s, 40s, 80s and 90s, my question is I’m curious to know what have you learned from them?
You can learn a lot from everybody and with the older population, you start to understand what matters to them is a lot different than what matters to a younger kid. They’ve lived more their life. The things that are important to them might not necessarily be the same things that are important to somebody who’s 18, 19, 20 years old. You formulate programs where you’re looking at an older individual and it won’t be as aggressive as an approach unless they want it. They have a different appreciation for limitations after PT. A lot of them are degenerative issues. The older you get, the more we have to do to get them to a point where they want to be.
The younger person ends up healing fast. A lot of times, you don’t necessarily need to worry about long-term deficits as you’re younger. As an older person, your cap is a little lower as far as where we end up. That’s an expectation talk that we have at the start. With an athlete, it’s a lot more maintenance as far as they get disinterested very quickly. You have to keep them very active in their program, progress quickly and move through the program a lot faster. When an athlete hits 50% to 60%, they can get back to the court, field or gym. That’s where we see a lot of athletes say like, “Thanks a lot. See you later.” The older person wants a longer-term program to get them to where they need to be, to whatever it is not just simple ADLs of life.
There are different challenges. We’re treating somebody that’s 80 years old with chronic low back pain. That person may be there a lot longer because we need to do more work with that person versus an athlete that has some tendonitis. They’re going to be in and out of PT fast. It’s all about programming and you have to learn how to program for each one individually so you don’t flare up the older person and then you don’t have the younger person get disinterested because the program is boring, monotonous and it’s the same thing over again.
You have the same challenges with your population too, having a class full of fifteen people. You get a lot of people maybe that have a lot of limitations and you have other people that are ready to go all out. You have to be able to see and this is what challenges you too is the older you get, the better you have to move. The more of a tactician you have to be. Somebody can get away with crappy form in their twenties. They can get away with a lot of things in their twenties and be okay with it.
As you age, you have to become smarter at volume control, load control and core. Poor movement patterns will end up costing you as you get older, too. Understanding that through the course of life, understanding the spectrum of life and then being able to put somebody on a spectrum and like, “This is where you are and this is what we can do with you.” You keep people happy and you have them end up achieving more goals than that.
Physical Therapist: The reason why people are in the gym and the reason why people come to physical therapy is to be healthier.
The older we get, the more we start to realize these things. For me, to achieve 100% at the beginning of my workout days that I’ll do to feel crazy or go nuts but as I’m getting older, I started to realize that I can’t move as well, so you and I go back and forth and make some corrections and work on the mobility. I’ve taken that mindset and I’ve tried to teach my clients that, “We’re getting older, not younger, start paying attention more to what you’re doing.” For me, having you as a resource, not just physically working on me but from the education aspect, I’ve learned a lot from you. I can take that information when I’m coaching clients. I start to see these different bits and pieces here and there, shoulders hurts, maybe it’s not the shoulder, maybe it’s lats that are connected to the chest that’s tight.
It might be a thoracic spine or a bunch of things going on. My goal is not to tell somebody that they can’t do something, but as you age, the educational piece becomes important. What modifications can we do to have you still achieve what’s your end goal is. Do you want to stay in shape, get in better shape, lose weight or put some more muscle on? You want to be an elite athlete at 55 years old and haven’t done too many athletic things since your twenties? It’s the realistic expectations.
The reason why people are in the gym and why people come to PT is to be healthier without injury. If you’re injured and you’re hurting, you can’t work out or you can’t do the things you want to do. Not only from our perspective, we want to get people to a point where they’re pain-free and moving better, but we do want to play that preventative thing where, “These are the modifications now you have to make for later in life to enjoy a high quality of life and be a better mover where you’re not going to be aching for years, and you’re going to be in and out of PT.”
That’s more difficult when I do my initial consultations, which is, for example, sitting in a chair. When you get 70 to 80 years old, you need to be able to sit in that chair without using our hands, bars around the corner or the street, flexibility and you need to be more mindful of that. When I do that assessment, if there’s anything questionable that’s causing you some pain, go see Mike, get a few consultations over there, see what he says. What I love about the relationship is you can say this, “You’re good. Go ahead and work out, just don’t do X, Y, Z.”
Be constantly hungry to learn more stuff and do more.
For a lot of people, a couple of quick pointers can solve the issue. After the fact is, “Try these modifications out. If they don’t work, then we’ll initiate something a little bit more formal. We’ll fix you up.” I’d try to do this with everybody, all coaches and athletic trainers from the schools too, “Is it okay if I talk to your coach or athletic trainer about your case?” They say, “Yes,” then now we have good, tight communication. Nothing’s fallen in between the cracks.
Whenever that athlete does return to the field or your gym, you understand what you have to focus on or maybe keep your eyes on. There needs to be some accountability part on the client themselves or the athlete and having a coach or an athletic trainer understand the dos and the don’ts too, they can also help to enforce some of those things too. It’s for the person to keep them healthy and moving the way they want.
I can’t tell you how many times I will send someone to you and before that, I’ll say, “This is what you need to do.” It doesn’t make sense but then they go to you. You talk about proper deadlift mechanics, core stability or shoulder stuff. They come back. All of a sudden, it makes sense. Having that network of people is very effective.
Sometimes no matter what you say, they need to hear it from somebody else. That’s like my parents. Whenever something’s aching in them, I tell them to do a couple of things. I’m still their son. I’ll have my old boss from Macomb HealthQuest say the same thing and then they start to do it. Sometimes you need to hear it from a different voice or perspective. Eventually, poor movement leads to pain and nothing makes people change more than, “I need to get out of pain mentality.”
Let’s talk about your staff. Now you have two locations, West Bloomfield in 2016 and you put up Beverly Hills. You partnered up with Aaron Suttles. I’ve had the pleasure of working with Aaron and all the PTs at your facility. It has been phenomenal. Aaron is a great resource because he was a personal trainer and still is, and done PT stuff too. Between the two of you and all the other guys, it’s just a great warm resource. What is it about Aaron that made you say, “Let’s go and set up a second location?”
Something near and dear to my heart is my team. I put them as one of my top priorities. I love the mentorship role and educating. Everybody’s got different needs and wants at the clinic, from the front office to the techs who are looking to get into PT school and then to my PTs. Every PT has got a different goal. Aaron, in particular, his goal was, “I want to be an owner like you. I want to do what you do.” Very quickly, I realized he is very like-minded like I was. He had the yes man attitude, “Whatever you need, I can do.” He had critical thinking ability, so if there was an issue, he could solve it very quickly in an efficient manner. He is a very fast learner. Every time I tried to mentor him and teach him up, there are very few times where I had to go over the same thing twice. He’s very quick and efficient like that. You could tell he shared the same passion that I did. That was the biggest thing, too.
If you truly care about the community that you’re in, people under you and you want to take care of everybody, your team included, as well as the community, good things will end up happening no matter what. When we started to look for clinic number two, it was a no-brainer that Aaron was going to be the guy to do it. I can’t be happier for him. He’s having some nice success already in Beverly Hills. Because he’s so good and the time that I dedicate to mentoring, it allows me to be a little bit more outward-facing where I don’t have to deal with so much detail in the clinic on everyday affairs.
Guys like Aaron are able to run Beverly Hills efficiently. My therapists are able to do all the things they need to do at the clinic. My office staff and clinical support staff are phenomenal. I’m very passionate about my team. It allows me to be a little bit more stress-free. I am a little bit less stressed out during the day because then I can focus on things that I need to do on the outside, whether it’s marketing, holding meetings or finding issues that I need to address very quickly and then mentoring staff to improve.
That’s a very powerful thing because that’s how to grow a business. You start out with one location, you hit these milestones. You’re like, “I’m going there.” I remember talking about this. “I’m going to hit that milestone.” You hit it. You are very good. You were so excited about it. It was like, “I’m going to cheer with you.” The exciting part is you’ve set those goals and accomplished that.
Goal-oriented, I need something to shoot for, so when I achieve one, there’s got to be another one right after it. It’s kept me hungry. I’m young and I have enough energy to go after more. I try to instill that in my staff too. I want them to be goal-oriented as well. You don’t get stagnant. Things don’t get stale. You’re always constantly hungry to learn more stuff and do more stuff. I try to instill that hunger and that appetite for more through my staff members too.
The last thing I want to do is have them start to show up to work and say like, “This is the same old stuff and monotonous.” That’s when life can get boring and disappointing. Hopefully, they can see my passion and my energy. My team is phenomenal and patients that come on in say the same thing, “The energy here is different. It’s positive, upbeat and fun.” That’s exactly the clinic that I wanted years ago when I opened.
The main thing with this is your passion, what started many years ago when you were a young kid that you took that passion and come riding with it. It’s a similar aspect to me. You and I grew up in sports and that took a while to figure out where I’m going with this then I got invited to CrossFit and watching an opportunity between the two of us being what I call solo entrepreneurs. There are plenty of opportunities for growth, and that’s where we’re at. Do you have any other further plans for other locations or are you going to stick with the two?
I got more plans. I only did number two because I had a phenomenal team and a lot of success in West Bloomfield. If I didn’t have a solid team like that and I had to still focus on what’s going on in my clinic in my four walls, I wouldn’t be able to do what I did. Because Aaron is so good at what he does, I believe that I can do another one and keep it going too. I want to be able to spread this positive energy and we hired a therapist at Beverly Hills. He shares the same energy and the same positivity too. Until I feel like we’re not accomplishing that goal, why not keep going? Right now, yes. There is another one insight and what the future should hold great things.
What brings you joy?
Helping people and seeing the fruits of my labor. I spent a lot of time mentoring and educating. I love to see technicians get into school and see my staff members hit milestones in their life. One of my therapists got married and to see the team become a family is important to me. My personal family, my wife, we got a kid coming on the way. That’s super important to me. At the end of the day, I want a close group of family and friends.
When life is done, I want to be able to say, “I made a stamp. Life was good.” Whoever came in contact with me, I have had positive things. Hopefully, they took 1 or 5 things from me. Hopefully, the good stuff, to be able to plant seeds for themselves and spread out too. My company in West Bloomfield and Beverly Hills, the more seeds we can plant and spread this around too. It brings me nice joy to see everybody succeed, patients with their outcomes and my employees with their lives.
I loved everything that we talked about, putting it all together and I hope we can do this again. We’ll see where we’re at.
This is the first time we’ve gotten done this. We’ve had some great conversations over the years and this was another one of them. Anytime you want just ask me and I’ll come right back on here.
Sounds great.
Thanks a lot, Jordan.
Enjoy the rest of your day.
You too, buddy. Take care.
That’s cool.
Bye-bye.
IMPORTANT LINKS:
athletesCrossfitHealth questpersonalized programphysical therapypreventionPablo GonzalezNancy R. Kaufman, MA, CCC-SLP: Owner & Director, Kaufman Children’s Center for Speech, Language, Sensory-Motor and Autism Treatment
