Shifting Focus in Rehabilitation: A Conversation with Marcus Blumensaat RMT

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 Bridging the gap between outdated norms, current practice standards and evidence-based care is what Marcus Blumensaat is working hard to do.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

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

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

Marcus can be contacted through his website, www.marcusblumensaat.com
or via email, hello@marcusblumensaat.com

Transcript

Eric: 0:13

Hello and welcome to another episode of the Purvis vs Podcast. My name is Eric Purvis and I'm a registered massage therapist, course creator, ce instructor and curriculum advisor for evidence-based massage therapy education. This episode features another CE instructor, as I welcome Marcus Blumensat. We discuss the roles and responsibilities of being an evidence-based CE instructor as we explore the difficulties in challenging the status quo and current practice standards for massage therapy, despite a wealth of contradictory evidence. If you enjoyed this episode, please share it on your social media platforms. Purvis vs can also be found on YouTube, so please check us out there and be sure to like and subscribe. Hello everybody, thank you for being here for another episode of Purvis vs. Today I have Marcus Blumensat, a colleague, and another CE provider, here in the wonderful, beautiful Victoria, british Columbia. So thanks for being here, marcus. Now just tell us a little bit about yourself.

Marcus: 1:10

Well, as you just said, I'm a registered massage therapist with private practice in Victoria BC and also continuing education educator and then, I guess, personally big family man. I have a wonderful wife, two daughters and my own time away from work other than family. I'm a mountain biker and my weird sort of personal hobby is I'm also a watch enthusiast. And yeah, that's about me.

Eric: 1:45

I love that you're the watch enthusiast, because when we got together for coffee that time we were commenting on each other's watches. You definitely know more about them than I do. I like. I love watches, but those are such a cool things. You don't really meet too many people that actually notice watches or actually know anything about them, whether it's brands or types or what's yeah, and you have, like, how many do you have? You have a whole bunch of different watches, don't you?

Marcus: 2:08

Well, to clarify, they're all what I would call entry-level, so they're not expensive watches. I'm on the very entry level. Some of them I've had for years gifted to me by my dad or whatever. But yeah, I have like I think I have nine watches, but yeah, they're all all entry-level, okay they'll do the job I always make me think.

Eric: 2:29

every time I think of like people that like watches, I always think of that scene with Christopher Walken in Pulp Fiction.

Eric: 2:36

Yeah yeah, yeah anyway, so yeah, that's great thanks, thanks for being here. Yeah, the reason I wanted to bring here was just kind of we'll just chat about some things. I know we have a lot of stuff in common in terms of the way we, the way we want the profession to go, the way we think continuing education should be, but just, you're relatively new-ish, I guess, into the the CE realm. Just tell us a little bit about your journey and kind of what was your motivation behind wanting to be a CE provider?

Marcus: 3:09

Yeah, well, I guess it just started from my own journey as a, you know, practitioner. I was just always fairly keen on knowledge and information and so I was always questioning you know what I knew and if that was maybe more right or less right than anything else. And so I just started taking courses. And you know, back earlier, you know, say 15 years ago, there wasn't much social media. There was a little bit, but mainly it was courses and blogs, and so I just started reading those and my knowledge base started growing. And then social media came on the scene really more strongly, as well as podcasts, and basically it just got easier to access sort of all the world leaders in musculoskeletal healthcare. And you know, they were writing blogs for free, they were on podcasts, you could listen to them talk for an hour for free. And it was just like all of a sudden it was like this endless at-your-fingertips information and and I was soaking it in and and sort of changing the way I think and practice according to this information, because it was a lot of. It was very different than what I was taught, because, you know, information evolves and science evolves and we move forward, and I just kept soaking it up and soaking it up and changing the way I practice and eventually it got to the point where there's all this information.

Marcus: 4:41

It's so easy to access and it was so different from people's base education and very different from how, I would say, the majority of all healthcare professionals, musculoskeletal healthcare professionals, were practicing, so I not limiting it to massage therapists, but all healthcare practitioners and and truthfully I felt like the gap was so big I wanted to contribute to bridging the gap from where people were to where the latest research was, and so I just decided to start making a course and start teaching and sort of try and, you know, join the group of educators who are trying to move musculoskeletal healthcare in a more up-to-date and evidence-based, you know, place.

Marcus: 5:31

And so that was really my. My motivation, I guess you could say is is just wanting the care that people receive when they go to someone in practice, the care they receive, to be the most modern, up-to-date and based on scientific evidence that it could be. Because I think that for the most part there is still quite a gap out there between people's sort of base educations they're getting and then how they're practicing on. A lot of continuing education that's out there is is pretty outdated as well, in my opinion. So, yeah, that was the motivation is just basically to move musculoskeletal healthcare in a more modern, up-to-date, evidence-based way, and so, yeah, plug in away with it and enjoying it.

Eric: 6:20

I love it. Yeah, I think that's a motivation for a lot of us and that was my motivation too is when you start to see what you were taught and what you had learned in other courses, versus then when you take a look at the research and take a look kind of best practice stuff, you realize there's there's this total incongruency between it and you think this doesn't make any sense. It's like this information, some of this information you know that we're learning, has been, has been out of date for 40 years, but it's still the common, the common narrative and the common practice. And it can be frustrating, right, because you want to. You start to realize that people are coming in to see you, you know well-meaning healthcare providers just don't have that information and they're basing treatments or treatment plans or you know self-management strategies on information that isn't doesn't have any evidential support yeah, definitely exactly yeah, so that's great.

Eric: 7:14

So one thing I want to ask you to do, too, is is because we've all kind of all of us that have gone through this kind of evolution, this journey from our you know, our base level education to dig in a deep dive into the research and the evidence and then trying to make sense of that and translate that into our practice. Then trying to translate that into something that's digestible to learners, the people that pay us and attend our courses or listen to our podcast, wherever it might be. What was, was there like a specific course you took, or a blog you you read, or a podcast you heard, or something that really inspired you and got you thinking oh, this is very different from what I thought yeah, for sure I.

Marcus: 7:58

I mean, I started questioning my bias. Which my bias? Coming out of university and with a degree in kinesiology, I was very biomechanical, you know there was a proper way to have by proper biomechanics everything da, da, da. So I was very symmetry biomechanics and then I just started questioning that by looking at things out in the real world and questioning it, questioning it, questioning it, started reading some stuff. I'm like, oh, there's some other people are saying biomechanics aren't that big a deal and posture isn't that big a deal, and so I was starting to get a little bit of affirmation of of my doubts.

Marcus: 8:37

And then I took a Greg layman's course and for the first time I've taken it three times. At the first time I took it and it was like it was made for me. It was the whole course basically confirmed all of my questions and my doubts about what I had been taught, in the way I'd been practicing and the whole weekend I was just having a aha moments after a aha moment after a aha moment, and that was the the true tipping point where everything changed for me and I just had such a fire lit underneath me and I was like aha because, for those who don't know? Greg is one of the most knowledgeable MSK healthcare professionals and educators around the evidence, around research, and so here he was presenting these points backed up by so many studies I mean, he's just an encyclopedia of every study that's pretty much ever been done and here he was backing up all these doubts I had and he was confirming them with evidence and but he does an effective job of, I think he's a really good what I would call maybe, fence sitter.

Marcus: 9:49

He's he's not saying certain one way is right, one, or he's just saying a lot of the time we just don't know the evidence doesn't know you know what's best, but it's certainly not saying this, you know. And so, yeah, that was the course, that was the moment. And then, from then on, it was a really, really quick, you know good, slippery slope and into the evidence and more so, and changing my bias completely, changing the way I practice, completely changing the way I speak with people, completely changing the narratives. I say, and yeah, that was the course nice.

Eric: 10:23

The Greg's course was great. I I think I first met Greg in 2016 because our clinic we used to host him. I think you probably attended a couple of times that we but we brought him here and so I've been I've probably seen it take it been at his course probably four or five, maybe six times all the time we brought him here or to the west coast and seeing him in other places too and, yeah, I really like. I really like how he presents things and because he really it's all about kind of questioning your what you think, rather than just these hard and fast rules, which is great, because humans aren't, don't follow rules, and so why should our rehab follow, you know, for most part, follow these very specific, you know protocols. It doesn't matter as much and that's why I like to.

Marcus: 11:10

I felt like learning his stuff provided more freedom, I guess, more curiosity and into how you practice versus then things have to be this way yeah, yeah, I think the for me, one of the biggest, biggest changes from him but also from my own sort of investigation doubts, but he confirmed is his way, and now I guess you could say my way of looking at people is a lot more positive.

Marcus: 11:39

You know, I think the older way to practice is looking at people like they're broken and they need to be fixed. And you know, I think Greg's what he uses, the term, you know, movement optimist, and I like that. Basically, it's just a much more optimistic way of looking at the human being. You know, we are incredibly adaptable and, for the most part, once you learn about the science, it shows that all postures are basically normal and okay and most biomechanics are fine, and you know it just is a lot more positive. And so you end up empowering people and enabling them versus and you know, scaring them and taking things away from them. Ie, oh, you shouldn't do this, you shouldn't do that, you got to be careful of doing this.

Eric: 12:26

So, and that's another big takeaway from you know that, first course, and and now the way I look at the human as well- so much of the way that we're educated and I'm gonna say, like I would say across the board, it was the generalization, but I would, based on my experiences and based on people I talk to and things that are still common out there, you go on social media and you see the things that people are talking about most of the way that we are taught or educated, I think, is more about disability care. It's more what's wrong with the person and how do we fix it, rather than what's capable or what's possible with the person. I really I always I like the idea of thinking more about the ability rather than disability, because you know, more often than not, right, people hurt but we don't really know why. But we can try and do some things that make them feel better and we don't have to blame them, and because oftentimes it becomes blaming doesn't it?

Marcus: 13:22

yeah, definitely, and I mean with almost all things. It's you're picking out something that's wrong with someone, but the thing is it's quote, unquote wrong, because this is the whole point. Is the evidence? There is no evidence for a lot of these things we're telling people are wrong, bad, poor, faulty. We use these words and yet there isn't a an actual scientific evidence based to say these things are bad, poor, faulty, wrong. You know? So we're fixing these things that we telling, that we're telling people are wrong when in actual fact, they're not really wrong.

Eric: 13:57

Where do you, where's that come from? I've always wondered that, like do you know? Have you ever? What are your thoughts on them? Like where do these things come from? Where we make stuff up?

Marcus: 14:07

well, I think I have a theory and it's, I think, in the past. I'm going to take, for instance, posture and symmetry and biomechanics, those three things, because they're three of the most common things that get blamed for people's pain or, quote unquote, disability. So the reason I think they came to be in the position they are, which is probably the most frequently blamed thing for people's problems, is because it's really freaking easy to look at someone and see they're asymmetrical, like you can. Just I could. A hundred people could stand in front of me and I could pick apart their posture. I could find all sorts of asymmetries, I could strength test them from side to side and they'd all be asymmetrical, you know.

Marcus: 15:01

So it's dead easy, takes no time to look at someone in TA asymmetries. It takes no time to look at someone and see quote unquote poor posture or bad posture. It takes no time to test someone's strength from side to side and pick apart asymmetry. Oh, you're weaker on this side. That's the problem. So it's really simple, you know. I think that's why it probably took hold. That's my guess.

Eric: 15:28

I love it. Simplicity is. I mean, we want to have these hard and fast rules, and there is. You know, the posture thing is a thing that it does drive me a bit crazy, because people hold on to that as being the be all and end all, and you know, the thing I always want people to understand is you know, posture is an option, it's not a rule.

Marcus: 15:46

Yeah.

Eric: 15:47

Right and I think you know I shared on my Facebook page. I think you saw, I think you commented on it. It was like back in the fifties, like the chiropractors at the time in the US were having like misperfect posture competitions or something as a way to kind of sell their professionalism and showing it, showing out how important they were as healthcare providers. I think it's just hilarious.

Marcus: 16:10

Like a beauty pageant. Yeah, yeah, that was a good laugh.

Eric: 16:14

Yeah, I love that job. It's like I can't even do. It's a thing, it sounds like something that you couldn't even make that up, yeah, so yeah, posture is a big one too, and it's still common. I mean some of the work I've been able to do and people have talked to in different colleges around the country that's still the main thing is all about correcting posture through, whether it's through manual techniques, stretching, strengthening, you know, sitting, standing, all that stuff.

Eric: 16:39

So, yeah, people listening realize that it's you know as important, not as exciting, as it's been made out to believe, but yes it is interesting though. Hey, like these, these types of things I know we could, you know we can focus on posture. There's a million of them out there, these types of things, though it's amazing how those, those are still so commonly perpetuated as a myth or as a belief in all the.

Eric: 17:05

MSK professions, despite the fact that there is so much evidence and so many other people out there not just you and I, but you know dozens or hundreds of other people out there basically saying, no, that's not, that's not a big deal, but it still seems like I don't know how many people we need to say don't worry all the time about posture, it doesn't matter all the time, as much as you think it does. Like when's it going to get to that tipping point? I don't know. I always thought it was going to be a lot sooner than it is, because I've been at this for, you know, eight years or so now and I thought there'd be big changes. But I don't.

Eric: 17:38

I don't see big changes, unfortunately.

Marcus: 17:40

Small changes. Yeah, I mean it's always established and ingrained around the world and every musculoskeletal healthcare profession, though and not just in general medicine, in general society, like it could be. One of the simplest medical beliefs that's out there is that posture is got. There's good and bad posture. That's one of it, got to be one of the most ingrained beliefs. So to change that belief, to change that worldwide, you know, is not going to be overnight, that's going to take time.

Eric: 18:14

Oh, yeah, because you're changing society, right, like you said you're changing, you're changing culture. It's just yeah. At the very least though at the very least, my hope would be that, you know, new grads entering the profession or even existing people would start to, you know, not emphasize as much. And you know, I think sometimes it's a fine line between not just calling everything bullshit because you know then no one listens because you're like telling them that they're wrong, and I just think it's a less wrong option for people to not reinforce those beliefs rather than just completely throw it out the window and just don't reinforce them.

Marcus: 18:56

Yeah.

Eric: 18:57

Well and I think how harmful potentially they could be.

Marcus: 19:02

And this kind of you can segue into another point about, say, posture we can substitute a lot of different things in here is in it. I'm not saying that someone couldn't feel better if they changed their posture. In fact I think it's great. Sometimes changing your posture can feel incredible. I do it with people. Sometimes I'll say, hey, try doing this with your pelvis. Oh yeah, the pain's gone, great. Well, why don't you try and hold yourself like that for a while until your pain calms down and then go back and try your normal posture and see if it's all right and tolerated, you know.

Marcus: 19:36

So I think changing posture is a great thing, but it's the narrative that goes with it. You know that's what it and that's enter, put any other thing in for posture, call it biomechanics, whatever. It's all the narrative that goes with it. So I'm not saying any posture is bad, but it's. It can be very helpful to change postures and it can be great, bring great effect about for a person. It's just the narrative you tag on with it. You don't need to label their original posture bad. It's just for the time being. It's sensitive, so let's change to this other one for a little while and then we'll let the sensitive posture structures involved in that. Calm down and then we'll go back and try it. So yeah, I think it's also important I always want to clarify, whenever I say anything about, say, posture or passive modalities, it's not often a problem with the modality or or changing someone's posture, it's the narrative that goes with it. That's really the main issue for me.

Eric: 20:32

I would agree I'm the same way If it's more about whether the beliefs that you have or the beliefs that are being imparted onto the person, and how is that impacting their quality of life? Does it make them feel weak? Does it make them feel broken? You know? Is it focusing more on disability rather than ability?

Marcus: 20:49

Yeah, and I like what you said there too about.

Eric: 20:50

You know, yeah, sometimes you do want to change posture, sometimes you want to, you want to alter how people are standing, sitting, moving, because, like you said, I think the area might be sensitive. Not doesn't mean it's broken, doesn't mean it's damaged necessarily, and that is that is the point of that I feel is missed or is overlooked a lot of times. When people have these conversations, like if we have these conversations, people hear like, oh, you're telling me that posture is garbage and it's useless. Well, that's not what we're saying. We're saying that an optimum posture for most people is not, it doesn't, doesn't need to be achieved for them to feel better.

Marcus: 21:26

Right.

Eric: 21:27

Yeah, but and the and see if it helps them. If it helps them, then that's a new option for them. It's an option, not a rule.

Marcus: 21:35

Yeah, and I think with, again, if we're just going to stay on posture, again, the science. There's no evidence saying there is an optimum posture. You know? I mean, that's the point. Yeah, exactly Right.

Eric: 21:49

Maybe if there was evidence that said so, then we would be arguing for an optimum posture. Yeah, yeah. But I don't know what. So? So tell us a little bit what kind of segue this into, into telling us a little bit more about your course. What's it called? What are you teaching?

Marcus: 22:06

Yeah, it's called exercise and movement prescription in modern clinical practice and I mean the name's a little bit deceiving in that you know the majority of the course is about sort of movement and getting people moving and giving them exercise or movement. But you know, half the course maybe is also about things like the biopsychosocial model, health and centered care, evidence-based practice. You know these more global topics that are, you know, all hot topics, discussion points around the MSK healthcare world around the globe by sort of the world leaders. So I go into those as well at quite some depth pain science and communication. You know all these things we cover in the course and I always have a little slant towards relating them, I integrate them by kind of relating them to exercise and movement.

Marcus: 23:12

Call it prescription, as that is the title of the course. So I really do work it back to that. But yeah, and then we of course cover exercise and movement prescription in depth because I think you know for most educations the focused hour wise and classroom hours is on more passive therapies and you know there isn't as much time put to communication, there isn't as much time put towards exercise and movement prescription. So you know that's what my course is trying to do is fill that gap, because I for sure think there's enough time spent in educational programs on the passive modality side of things.

Eric: 24:05

Yeah, and that's. There's not really much at all out there really given for for the movement or the rehab science aspect is. It is usually, you know, very linear, stretching and strengthening type things, with, you know, following reps and sets or along a specific protocol. At least that's why I remember it and from what I've heard from recent grads, that seems to still be kind of the same case.

Marcus: 24:30

Yeah.

Eric: 24:32

I know in your course you have your, your, your gold nuggets, your kind of your learning.

Marcus: 24:37

I love that idea.

Eric: 24:39

I think these are some of the things you need to get. Do you want to share what some of those are like? If someone was going to take your course and say they listen to this podcast, I want to take your course. What would be a couple of the key things that they would bits of information you like them to get from the course.

Marcus: 24:54

Yeah, that's well. You know, the gold nuggets are often like these little practical things, like little like exercises. I found to be like really good for certain things, so those are sprinkled in. You know, main takeaways from the course. You know, listen to people. I go on and on about that, listening to people validating their experience.

Marcus: 25:19

I think major part I harp on throughout the course repeatedly is, I think, the number one job of any health care practitioners to rule out red flags.

Marcus: 25:28

So I find that vitally important. That's what we should all all of us in medicine, medical field, health care field be focused on. And if you're picking up on something you need to refer people on. And then, other than that, if red flags been ruled out, it's really about like the big take homes, or reassure people that they're not broken and then empower them and help them get moving or help them get back to doing the things they love.

Marcus: 25:56

Maybe they've given up the things they love because they're worried, because they've been told they shouldn't do them, because they think they're going to make things worse, and so they've stopped doing the thing they love to do or the things they love to do. So I think the biggest take home of my course is, once red flags have been ruled out, you know, try to empower people, try and get them to feel more positive about their situation and try, and if it has to be gradual, gradual, try and gradually get them back doing the things that they would like to be doing. And I guess that that would be the quickest little summary of the take home.

Eric: 26:37

Yep In two days if you get that.

Eric: 26:39

That's that's.

Eric: 26:40

I know it's hard to summarize all the things because I know your course is quite comprehensive and many of you covered in all the biopsychosocial evidence base, person's center care, pain science, communication strategies, all those things which is which is all really the stuff that you know it seems to be that's where the evidence is going towards, more towards these kind of behavioral sciences, kind of relationship sciences, psychological science type stuff, which is, I think that's going to be, you know, moving forward.

Eric: 27:09

It's that's going to if, if, if the profession or MSK professions want to follow the evidence like they should. I mean it's even in our competency documents that you spoke. You have to follow evidence-based practice. You know it really it moves you away from the, the patho-atomical, tissue-based model and more towards these kinds of behavioral science stuff. So I think it's it's, it's really encouraging to know that CE providers like yourself out there are trying to do that and hopefully, you know, along the way that'll get picked up by more people and you know, hopefully the, the stakeholders in our profession will eventually decide that they need to do something.

Marcus: 27:47

Yeah, move us forward, yeah, and that that's ultimately what it'll come down to, you know, in the in the end.

Marcus: 27:54

But yeah, like I think that's a neat thing, the way you sort of were introducing it and I think what's really was has been fascinating for me and mind-blowing in my journey in the last few years is learning how the science is showing all of the passive modalities that therapists, clinicians, do to people and they all work in the short term.

Marcus: 28:15

They all help people in the short term and they all help each other generally about the same in the short term. And what's fascinating is is they're not that specific. So you know there's been really neat studies done comparing clinicians who are doing trying to do something very specific they think they're fixing something specific versus a group of therapists control group that's just doing a general something and it ends up that both groups help people about the same. So you know it's showing that all these passive things that are being done to people or with people, they're all effective in the short term, which is great, but they're not very specific. And you know where a lot of the benefits coming from is just having a therapeutic alliance, just someone being there, someone listening, someone caring, someone being with you on your journey. There's so much positive clinical outcome that comes from that. So, you know, I think that's, like you say, where a lot of the evidence is leading is, you know, putting more time into getting better at listening and communicating. And coaching helping coach people through versus fixing people, you know.

Eric: 29:28

So, yeah, I like to change the narrative from being like a facilitator of wellness or for a facilitator of well-being, rather than the fixer of your problem. I think if we can just like adopt that kind of mindset, it changes everything about how we interact and the way, the things we say and the things we do and the expectations that we have of ourselves and the expectations that the person in front of us has changes dramatically.

Eric: 29:54

And I'm sure you've noticed that in your practice. I noticed that in my practice too, and that's stuff I always want to emphasize to people in courses is that you know they're like what are you doing with your hands and how do you do this, how do you do that? And I'm like don't ask me, ask the person on the table.

Marcus: 30:09

Yeah, because it doesn't matter what we do.

Eric: 30:12

It matters how the person experiences it. Right, yeah, and then how they experience you. Yeah, I was actually on another podcast I reported, which should be coming out probably just before this one or just after this one. We were talking I believe we were talking about that about the and other professions like, say, like in psychology and psychotherapy. How it's the same thing with them is that they have different interventions and different ideas that they grasp onto. They've thrown different acronyms of things they do, but the neither one works better than the other. It all comes down to the relationship between the clinician and the therapist and the person seeking your care.

Marcus: 30:57

Yeah, exactly, so why would it be different?

Eric: 30:59

for us? Right, it wouldn't be. I say the only difference with us is people come to see us usually want to have their hand, want to be touched, they want to have hands on, they want to have feel us doing something to them.

Marcus: 31:10

Yeah, yeah, I think I think there's the art, you know the art of applying all this. It's see, again, I'm not throwing the baby out with the bathwater. I'm not saying passive things are bad. I'm just saying if you had a pie, and right now passive modalities are 80% of your pie and you know, call it, education is 10% and exercise and movement prescriptions 10%. I'm just saying we should maybe think about shrinking the size, the slice of passive modality, increasing the size of, say, call it, the education and then the exercise and movement prescriptions.

Marcus: 31:48

There's so many different ways we can help people and put effort into helping people, and I I think you have to meet expectations. So part of it is doing what someone expects. And if someone expects to get some passive treatment, you know, meet them there. But it doesn't mean you can't do all these other evidence-based things that could really be the things that are helping them more so in the long term. Right, the passive can help, you know, in the short term, but you know, long term, I often think it's more the information we give people, just telling them we've, you know, ruled out something. Or telling them, yeah, you're totally safe to get back to playing badminton, you know, and it's those sorts of things that could help more in the long term.

Eric: 32:26

Yeah, I think that, too, the one thing that is important to understand when we're talking about like the passive, like the hands-on stuff is there's many people and there's a large percentage of the population out there that is always going to have pain.

Eric: 32:45

Certain people, whether it's fibromyalgia or, you know, myel Emi or long COVID or some type of systemic arthritis or whatever name, a bunch of different things, some of them neurological disorder, like there's all kinds of different things and systemic things that people have where they're always going to have pain and maybe them coming in just for a passive treatment, as long as it's not under the guise of you're fixing them or releasing something or blah, blah, blah, as long as it's there as part of their management plan. I see that's something that, as a profession, we have a lot of value with. That might not be the same as if, like you say, you go to physio or a car or somebody else, where they're oftentimes either very quick or they're trying to make you do something and maybe all you need to do is just like chill out for a bit, hang out with the therapist that you like in a safe, calm environment, and then they do something to you just to help kind of turn that volume down on their overall system.

Eric: 33:41

And, like you said, it's very short term, but I think for some people that can be very powerful. It's as long as it's not sold as like. You need to do this or else you will fall apart.

Marcus: 33:51

Yeah, amen, amen, like, and I mean that's you know the biggest. I have no beef with any modality, any intervention, nothing, depending on the narrative that's attached to it. You know, if someone said to anyone, hey, I'm going to do this to you and I hope it makes you feel better, I'd have no problem with whatever it was, because that's about it, right there. You know, it's all about the narrative that goes with it.

Eric: 34:18

Yeah, yeah, and that's something I always try and do in my courses too, is I always? I like we'll go through, like I get them to do like the skeptical bit, where I ask them you know, what things are you skeptical about, what things do you want to know more about? And I'll try and pull the research that I have on those things and be like, yeah, this doesn't work this way, this doesn't work this way, blah, blah, blah. And then I always want, I always like to ask them, like, well, how would you describe this in an evidence based way? You know, it's not releasing this, it's not, you know, doing the things you've taught, rebalancing, whatever.

Eric: 34:47

And it usually comes down into kind of this like, you know, is this going to work for you? Does this feel better? You know it's, don't make anything up, this is just all symptomatic relief. And I think if we just keep it as a simple narrative that it's symptomatic relief, it might be short term, but that can be powerful on some people and sometimes it might not. But rather than selling the fix, that's what I saw that all the time in clinical practice was people would come in and they were seeing, you know, dozens of other people or had been to seeing the same therapists for years or months and they had been, you know spent thousands and thousands of dollars and weren't actually given a proper explanation for it, and I just felt like people can take an advantage of it.

Marcus: 35:29

I just always drove me crazy.

Eric: 35:31

Yeah, well meaning healthcare providers. They just are missing the information. So that's why you and I are out here, right? That's why we're yakking about this stuff Exactly A bit of an echo chamber here, but that's okay. Yes, so here's the thing too. Is I mean, you probably have a probably a simple answer, but courses like yours, right, you're not selling a modality, you're not selling a specific linear approach, you're selling a knowledge, or your process or principles I guess you'd say process, principles and knowledge. Why do you think that courses like yours are probably harder to sell out than somebody that's selling like a certification program for a certain modality?

Marcus: 36:24

Yeah, that's a tough question. I mean I think there could be lots of reasons, though you know, these ones say a passive therapy or modality that's tissue-based. They're pretty exact and definitive, which I think people like that. I don't think people like uncertainty. So these passive therapies that are being taught have a very distinct narrative that goes with them here's what's wrong, here's what you're fixing. It's simple and I think people like that. It's easier to understand. I think both clients or patients and practitioners love answers and love definition and exactness, whereas what my course is about there's a lot of uncertainty, and that's if you spend any time listening to the world's best in the MSK healthcare field, they all mention uncertainty.

Marcus: 37:24

Uncertainty is rife in the evidence-based world because we just don't know why things are happening. That's why when someone goes to eight different MSK practitioners about a problem, they usually get eight different opinions of what's causing the problem. It's because no one really knows. The research says 90 to 95% of low back pain, which is the number one disability in the world, 90 to 95% of it is non-specific, meaning you cannot find out a true, singular cause of a person's back pain. In only 5 to 10% of cases is there a definite, identifiable cause of the back pain. So right there, you know you're saying, okay, the number one disability in the world, 90 to 95% of it. We don't know why that person has it. That's what the science says. It's uncertain. So I think that's difficult, you know. That's difficult as a practitioner, that's difficult as the person with the back pain to not know. So I think that's a big thing that's attractive about these passive therapies that are being taught. It's like there's a system and a name and you know rules and it's like this will fix people and here's what you're looking for. And goodness knows it's very easy to find what you're looking for and we all have it. But it's not necessarily a problem, you know, you know.

Marcus: 38:54

I think another thing might be that a lot of people don't know that we don't need to be fixing people. A lot of people might just not know that there's other ways of helping people. You know a lot of professionals out there might think they do need to fix people, they do need to fix asymmetries, etc. So there might just be a lack of knowledge there. That's one that I've came upon recently. When thinking about this, it's like, well, people might just not know and they might not know that, no matter the passive modality, it's helping people in the short term, but it's helping them not in a specific way. We think you know. Once you understand that, well then what's the point of going to learn a whole bunch of different passive modalities if they're all working about the same and it's not very specific? I mean, I guess if you're bored in what you're doing and you want something different to do, and that would be why you might go. But you know so I don't know. Those are quick thoughts.

Eric: 39:56

No, that's great. I appreciate you sharing those thoughts, but we do. We have clinically, we get, our confirmation bias. We do something, people feel better, they report that we help them and then therefore, we like, okay, this works and this is why it works right. So we often are like, well, we're taught, this is the mechanism for this working.

Eric: 40:15

And then I do it and people feel better and you get the oh, I know it works because I've seen it work kind of argument, and that I think that's something that I really would love for our profession or anyone in the MSK world to just to stop and think you know about why their treatments are working. Are they working? Because the reasons you think they're working Doesn't matter. Do you care? So many people don't care? Tell me, just like, whatever, I don't care, this works for me.

Eric: 40:44

People aren't complaining, they're getting better, and I think that I think that's fine, and I don't. I would never say that that's necessarily a big problem. I would say it's. A problem, though, is if you're seeing people coming in again and again and again and they are not getting better and they're suffering and we keep on trying to reinforcing that, oh, it's because their back is out and, for example, I just was talking to a colleague the other day who told me a very sad story that her mom was just diagnosed with bone cancer. She has got a tumor in her spine, which is awful, and she's had pain for over a year.

Eric: 41:32

And her back and it started to progress, getting kind of some ridiculous pain down her leg, and she had been going to a Cairo, and probably some other people too. But I remember, definitely remember, her talking with a Cairo and the Cairo is like oh, you're just out, you're out, you're out here and you need to adjust. And she was going in all the time getting these adjustments Right because this Cairo was looking through things through a very specific alignment you know, spinal adjustment lens and not you know this 95% of times where it's not, where it's not specific. There's a 5% of time where it might be something serious. And they were looking at this and they were. They dismissed these ongoing symptoms because they were looking for, they had certainty with this tissue based approach.

Eric: 42:19

And now the woman's cancer is spread and you think, as a healthcare provider, that's not okay to think in these, these very linear, fixed ways. And as I love your concept when certainty and I agree because I teach the same thing and all the evidence says the same thing is that you know we have this confirmation bias, we've seen something before. So I've had people blow back and dick their pain before I do this thing and they get better. So therefore I must be releasing the tissue, I must be doing this thing, and when someone doesn't get better, it's because this area won't release or won't balance or whatever. But what if it's not that? What if it is cancer? What if it is a fracture? What if it is some, you know some type of arthritic condition?

Marcus: 43:06

Yeah, I mean that's that's the ultimate worst case is what you just described, and I'm sorry to hear that. But I mean these are the things we need to think about in practice, and what I said earlier about one of the main take homes is ruling out red flags, and part of that is a continual process of clinical reasoning, and if you're noticing something not changing the way you would expect it to well, then maybe your, your radar should be going off and you should be considering referring on you know.

Eric: 43:36

So again, that goes back to that Oof that's bad, yeah, and that's what happens, and that's the thing. That's one reason why I am really adamant about this is the stuff that I'm glad you're here to talk about your experiences and your knowledge and your course.

Eric: 43:52

And because that's something I'm really passionate about too is that there is this these times where, if we have these blinders on, we're only seeing things through one lens, we're seeing things through a modality or tissue based rationale and we're not looking at the bigger picture. We're not taking the zoom out approach like you're talking about with the nevron's base versus ender biopsychosocial. We're looking at the whole picture Because people, like you said, people are unaware. I think that a lot of us are in our profession, are unaware of the other evidence that's out there. And that's my experience I get too when I teach courses.

Eric: 44:24

I mean, I was recently did a course, or recently as a woman recording this in in Manitoba, and the stuff I was talking about was and most of the feedback I got from the participants was like they never heard of this stuff. Why did they never hear about this stuff? And I'm like I don't know. I mean I don't know where everyone goes to get their information, but I always put that back on the stakeholders as well, to be like we need to get more of this information out there. Yeah, definitely, and it's because if your only source of information is taking a course to achieve credits, then are you really learning or are you just satisfying a regulatory requirement?

Marcus: 45:11

Well, it'd be nice if you could do both at the same time.

Eric: 45:15

Yeah, exactly, Exactly yeah that would be ideal, right, if your regulation requirement was consistent with something like an evidence-based practice or something, but I guess that kind of leads me to another thing I want to talk to you about.

Eric: 45:30

Which kind of leads onto. This is that you know, as massage therapists, at least in Canada, we identify as health care providers, at least in the regulated provinces. We are considered that. But what's your impression Like, do we want to be health care providers as a profession nationally, or do we want to be more service providers? And maybe what's the difference? Do you see the difference between a health care profession and a service-based industry?

Marcus: 45:59

Yeah, to answer the first part of that question, I'm not the person to answer. I mean, I'm only one professional in the profession, right? So I think you'd have to put some kind of pull out to have people answer that I can't answer what other people want to be, I know personally.

Eric: 46:20

What do you want? This is more about yeah. Tell me your opinion.

Marcus: 46:24

I mean, I obviously would. You know me and I would like to be considered a health care professional. You know, and I think and this is the thing, we're sort of out of crossroads or we're on a journey here where the evidence shows that, regardless of your profession, some of the best ways you can have a positive outcome, clinical outcome, ie help people is by forming a good therapeutic alliance listening, validating someone's experience and, you know, ruling out red flags and then just again reassuring them, they're okay, and getting them back to doing what they love. And like when the science base I mean, I'm kind of, you know, shrinking it, but that's essentially what it says All these things we think we're doing to help people, yes, we're helping them, but not in the way we think we are. And so, you know, we're all positioned, and registered massage therapists in Canada are positioned in a way to be wonderful healthcare practitioners who help people, you know. So I think it's more than sitting there. It's there, it's to be done.

Marcus: 47:44

I think the tricky part is, you know, when you get into the whole regulation. I mean, a healthcare practitioner needs to be regulated by a governing body, you know, and I think it's up to that governing body to do a good job of governing whatever the healthcare profession is, and I think a lot of responsibility lies with governments and their regulatory bodies that they create for healthcare professions, you know. And so it's up to them to make sure the professionals are continually educating and then to be continually educating with evidence-based material, you know. So I think in Canada it could go a couple different ways. I mean, if it isn't properly regulated, whatever the profession is, then I don't think it could be called the healthcare profession and you go more to a service thing, service provider. So I think a lot will come down to how it's regulated. I don't know if that makes sense, I kind of just. I don't know if I got my thoughts out very well, but I'm sure it's great.

Eric: 48:56

I know I got you. I follow your discussion. That, marcus, I appreciate it. Yeah, the reason I brought that up is because I've been in the last year-ish. I've been interacting with and teaching a lot more in some unregulated provinces across the country, and it's I just, I made an assumption. So I made that, which you know we shouldn't assume, but I made an assumption that, oh yeah, like, if you're an unregulated province, you want to be regulated, you want to be healthcare.

Eric: 49:27

Yeah, but what I've actually heard from a lot of the people I've interacted with within those other provinces is they don't really want to be, they're happy to be the way they are, where it's more of a service and they do get reimbursement from insurance and whatnot. But and the reason being is that because once you put you want to put like a regulatory body, it creates the perception is it creates some barriers, I guess, because there's like there's licensing requirements, so there's more dues to pay, there's, you know, your scope of practice changes right Like. So for us in BC, we can't do like in terms of all the different things. There's a lot of stuff we can't do which you can do in another province, particularly in unregulated province, in terms of, like going to needling or cupping or different things which doesn't matter to me, and so that I think there's a worry that people might want to have that taken away.

Eric: 50:19

But I agree with you, though, 100%, that I really strongly feel that our profession could, if it wanted to, could be like a mainstream, like kind of healthcare profession, like we could potentially work in hospitals or care homes or outpatient facilities, you know, like where we have physios and OTs, because I think there's a real, could be real benefit for us. But in order to do that we would have to I would say we'd have to be a healthcare profession, and I would say we'd also need to increase or change our education, you know and this is a contentious issue which some people listening might be like shut up, eric.

Eric: 50:54

But I think you know I'm biased that we need to have a degree like we need to be in degree university based program based on current best evidence, rather than a more technical kind of private school which is, you know, just basically teaching you to pass an exam or, to you know, entry level practice type of stuff which is like what's the least we can give you to put you in the public. So hopefully you don't hurt too many people.

Marcus: 51:18

Yeah, yeah, no, I mean, I think that'd be great. It's difficult, you know. I think that'd be great. Yes, no doubt.

Marcus: 51:27

And the other side of it is, I'm kind of a fence that are myself like Greg. You know a person can get incredibly educated outside of their formal education, and you know. So I don't think base education is everything. I think so much of a person is their experience, but also what they do for continuing education on after their base education. So, yes, I agree with you, it would be, I think, a smart move to make it a degree or a master's degree and go from there.

Marcus: 52:01

And then I still though even then you know, like I'll pick on whatever physio, I mean I still think they have a lot of room to grow in terms of better regulating what continuing education is out there, you know, and there's just so much continue education out there that's belief based and there's not science behind it, and it's not just in registered massage therapy, it's in all musculoskeletal health care professions. There's so much belief based continuing education and I think all governing bodies should be doing a better job of regulating it. And I know it's costly, like so many things come down to financials. It's costly to regulate the continuing education, but I think it ethically would be wise and it's important and I just, I think long term, like I'm 44, I'm going to be around for a while longer. I think long term change will happen over time. I just were too too intelligent of a species not to create change and move in a more positive direction. I just don't know how quickly that's going to happen.

Eric: 53:13

Yeah, yeah, it's definitely slow, it's glacial, for sure. I do like the point that you said that your base level education doesn't necessarily make you a better provider or make you a better therapist, and you can get a lot of education without going through that formal route for sure.

Eric: 53:30

The thing I would, because again, you said physio is a master's and in the States to be a physio, it's now a doctorate program, which is crazy.

Eric: 53:39

But so much money and so long, yet the information that they're learning is still not necessarily up to date.

Eric: 53:46

It's still a lot of belief based stuff which is crazy to me that you could go, you could be in a university and learn a master's or get a doctorate and it still cannot be up to date, like I just don't understand that.

Eric: 54:02

And then so. But I would say that in the next evolution for our profession would be, I think, would be to get us into, would be better than it currently is right now. It wouldn't be best, but it would be better than it is right now to get it out of the private colleges into a more of a university setting so people can learn that more. You can still do all your hands on stuff, you can still have your clinical things, but it would be really nice to just to have future generations of RMTs being able at least being introduced to some concepts of uncertainty and being introduced to like critical thinking and being introduced to like here's some behavioral science and stuff, here's some psychology, sociology, just think due to plant some of those seeds of knowledge, I strongly feel would build even better therapists than that are out there right now. At least provide that platform for them to grow.

Marcus: 54:56

Well, I mean, and then to take it further again. I keep, I keep expanding out your questions or comments to all MSK health care professionals and in this case I expand my next point out to all health care professionals, period. I think one of the very first courses that should be taught in every health care profession is here's what the biopsychosocial model is, here's person centered care, here's how to apply person centered care. You know here's basic, call it communication, human communication. So, like these basic things, you know that all health care professionals should know at this point that many don't because they were educated in the past when they weren't. This stuff wasn't there.

Marcus: 55:45

And you know, I, in my course, I asked people how many of you have heard of the biopsychosocial model and I'd say I'll be generous, I'll say maybe half people have heard of it and then I'll say, ok, of you who've heard of it, how many of you know what it is? And then of the 50% who'd even heard of it, only 50% of those know what it is. So 25% of people know what the biopsychosocial model is and really, you know, every health care person in the world should know what it is 100%.

Eric: 56:17

I use something similar in my course, you know, because my main area of interest is in pain and particularly, you know, learning and studying and chronic pain. And I often ask people like you know what's the one reason why people go see a health care program? And usually they'll say pain, because that's usually why people come to see us. Pain is impacting their ability to do something. That's important and I say, who here know can give me a very brief definition of pain? And or I'm in. I usually get like zero people.

Eric: 56:48

Yeah maybe one person who's familiar with the. You know the ISP, you know the sensory emotional experience.

Eric: 56:55

And then I'll say, okay, well, what is pain Like? Describing your own words what pain is, and I'll get any, any number of different things about it being, you know, harm or nervous system or inflammation, or whatever. I'll get all kinds of different things. And then it always makes me. And then I would say I was like so does it make sense that the number of people come to see us is because they have pain or they're experiencing pain? It's the one thing that we don't learn anything about in school and it always is always like that kind of like my gosh, like I didn't, didn't realize that, and you know. So you said, yeah, people should buy us, like social person centered care.

Eric: 57:36

And I would say I would add to that I was like we got to understand at least the uncertainty of pain which is kind of consistent with those things you mentioned too, because we know a definition and we can talk all we want about the nociceptive system and the neurophysiology and the cortical changes.

Marcus: 57:51

And you know.

Eric: 57:52

But really what comes down to it is is you know how is that impacting the person, which is the person centered care?

Marcus: 57:58

Yeah, yeah, no, that's. I think that would be a massive another again. This is what I'm talking about the classroom hours changing from being so much about what you do to someone and then onto these things like pain science Again. You know most programs cover pain science a little bit, but not nearly what they could or should you know, and so here we are left to maybe learn about it on our own in our continued education.

Eric: 58:28

Yeah, exactly, and you know the from some of the people I've talked to that work at some of the schools here in BC. I think it's like their pain and stress course is something they maybe they get in the last term or two, depending on the school, and it's like four or five lectures like four or five like like half days. That's it at the end, which makes no sense. Yeah, in my curriculum that I would give to a school, that would be like the first thing that they would do, one of the first things they would learn about, along with five sexual, all the other stuff that we talked about. So, yeah, anyway, in the perfect world, yeah, yeah.

Eric: 59:09

So the the I want to ask you about to vote. You know the we kind of touched on briefly about you know people taking courses. You know because it's mandatory or not In your courses that you offer. In your experience, do you ever ask people if? Are they there just for credits? Are they there because they actually really want to learn something? I've never asked that, oh I ask all the time is it's hilarious answers you get.

Marcus: 59:38

Yeah, I would guess the majority would be just to. They're doing it to get credits, I would imagine. But they were intrigued by my course description and were like, oh, I think this would be good to learn about and so like, I think there's probably a mixture of like, curiosity and doing them you know, their credits in a way that they're interested in. But yeah. I would. I would guess what are the answers.

Eric: 1:00:06

Oh, sometimes people will be like I'm just here for credits. Some people will be like most people are like saying those answers where you just said is most people are there because they need credits and this is something that interests them. Yeah, but I'm always, I'm always curious that like if I was offering course and there was no credits, would you spend that kind of money and two days, like on a weekend, to be here? You probably wouldn't get near the same numbers you get some people?

Eric: 1:00:30

that probably not, and this goes to one of the things to yeah.

Eric: 1:00:36

I know here in BC they're changing the quality insurance program, but I just I feel that when you make stuff mandatory, people are forced to learn, which is great, but the what you said before, which I thought was so was really good, was the. There's not much regulation in terms of the continuing education industry. People can basically teach whatever they want, and I know that we will be moving towards a new system for con ed where there won't be that approval process. But I'm just I'm curious what that's gonna look like, if that's gonna, if that's just gonna be a free for all, what people can just take nonsense and because there's gonna be less oversight, I imagine, over what is people learn, mm-hmm, I don't know. I'm skeptical. I'm very skeptical about what that's going to look like.

Marcus: 1:01:37

Yeah, yeah, and I mean I would say I'm probably even more pro accreditation, pro oversight of continuing education. You know, personally I think all healthcare professionals should have mandatory continuing education because the science is changing all the time, so we need to change with it. Personally, I can't rationally understand not having to go get a course accredited by a governing body. I just can't understand that from a logical, rational perspective. You have professionals taking a course that is totally unregulated or not accredited. I mean that's just wild to me. I just honestly don't understand it and I can only imagine it's because of resources, because the amount of financial and human resources necessary to govern a healthcare profession and overlook the continuing education of said profession, I mean that's a lot of resources. So, but at the same time, if protecting the public your number one mandate, shouldn't you be having a say in what the healthcare professionals are learning and hence then doing Insane to people?

Eric: 1:03:05

I agree with you 100% there, marcus, the. I feel the same way too. I don't see how a profession can can actually provide it's safe, effective, ethical care, which is, you know, usually that's the college's mandates, right, that's what they're. They're here for protect the public. I don't see how they can provide that when they're like you can take whatever courses you want, and then you just have to justify to us why you took that and why it's important. And unless the, unless the colleges themselves are going to create courses and force us to take them, which I, you know, we've had, we've experienced that before, and that's a little bit ridiculous. You know, like we had to take a course on, like having proper lighting in the room, remember that one.

Marcus: 1:03:50

I'm going to admit that I don't remember that.

Eric: 1:03:54

Oh, that was one of the ones I can take. Anyway, there's been some weird ones right, and you know way to take a whole one on like hygiene, which is okay, great, I get it. But I mean, do we need to take a course on learning how to wash our hands and like do laundry and clean stuff? I mean, it's we all do that anyway, and if we didn't, then that's a problem, right? But yet they don't force us to take courses on like evidence-based practice, or you know, or you know current evidence for low back pain or whatever it might be right. They don't force us to do things that actually are potentially more what we like, impactful to our clients or patients every day.

Marcus: 1:04:34

Yeah, yeah, it's going to be fascinating to see moving forward. I mean, call me a you know an optimist or like a silly optimist I don't know the right word, it's escaping me. But I mean, I just hope in like 75 years that everything's moved into a more evidence-based, you know place, and it's not going to happen overnight. I'm just trying to do my bit and pitch in and I sincerely hope that in 75 years we're in a much more you know, evidence-based, science-based place than we are today, which is heavily belief-based and, you know, I hope worldwide governing bodies sorted out and help steer things in that direction.

Eric: 1:05:24

I'm an optimist too. I think it. I mean, sometimes it may come across as a bit cynical, but I think it's just after time. You start to get a little frustrated when you see things move so slowly.

Marcus: 1:05:33

There's a lot of good.

Eric: 1:05:34

you know education providers out there, like yourself and others that are, that are really kind of challenging the status quo and trying to move that, that evidence-based need a little further forward. So, you know, just as long as we keep doing our best to try and have these conversations and get this information out there, and hopefully enough people will listen and hope it's on, the stakeholders will decide that, oh, maybe we should, maybe we should change things. And then you know, I think that would be a sign of success, I think for us anyway. I don't know about you, but you know I'm always excited when I hear a school or an association or a college, you know, changing things and I'm like, yes, that's better than it was.

Marcus: 1:06:18

Yeah, yeah.

Eric: 1:06:20

And you always like to think he's like if it was. There's never just a single person, there's a collective right. So there's a bunch of people out there right in the community that are having these conversations like we are right now, and enough people listen and change will happen. If we just sit back and accept the status quo, then I really do feel that the people that are that are going to be having the most harm are those that come to seek our care. Yeah, and we have an ethical obligation to provide evidence based advice and evidence based care and a higher value care is really what the evidence suggests, right, it tells you kind of more about what's less wrong and people need to. People deserve that. Yeah, specifically, spending good money.

Marcus: 1:07:04

Yeah, oh for sure. You know, and I'm heartened, like, as technology advances and you know, for instance, podcasts is they just become more popular and more prevalent. You know, I'm so heartened because I'm listening to so many podcasts from all of the world of the most bright, intelligent people who are full of passion and trying to move musculoskeletal healthcare in a more evidence based manner and it's just so uplifting and charges my batteries, you know, to keep doing my little bit and to contribute as well. And as you say that that swell just build. I believe it will build eventually and we will eventually sort of weed out or flush out the belief that based narratives will slowly disappear and I think it'll get to a better place. It is moving in that direction. I love the optinism, marcus.

Eric: 1:08:03

So, yeah, let's keep, keep, keep doing the good work you're doing, and I really appreciate you being here today and sharing your time and your thoughts. It was fantastic conversation. I really enjoyed that. So thanks again. And you want just, can you just give everybody a just how they can get ahold of you?

Marcus: 1:08:21

Oh yeah, I you know. What's funny is, I'd say I'm not incredibly amazing at social media, but I'm on there. I'm on Instagram it's just Marcus Blumensat, all lower case. At Twitter's, where I do a lot of getting research and interacting with people there, I'm just at capital B it's Blumensat with a capital B and you can always email me. Hello at Marcus Blumensatcom and my website's Marcus Blumensatcom, and that's where you know you can find out about my course, read my blogs, etc.

Eric: 1:09:01

And I'll make sure to put all that information in the show notes.

Marcus: 1:09:03

I was going to say Blumensat's not an easy name to spell, so I appreciate it if you could put it in there.

Eric: 1:09:09

Yeah, yeah, check out the show notes and I'll have Marcus's contact there so you can get in touch with him if you have any questions or comments.

Marcus: 1:09:17

And thank you for having me on. It was a privilege. Thank you Sorry.

Eric: 1:09:24

Thank you for listening. Please subscribe so you can be notified of all future episodes. If you'd like to connect with me, I can be reached through my website, ericperviscom, or send me a DM through either Facebook or Instagram at EricPervisRMT. If you'd like to get a hold of Marcus, he can be contacted through his website or social media, and those contact information can be found in the show notes.