“There are a growing number of walking wounded out there…aches and pains that will almost certainly grow up to be injuries…..most of these folks just need an evaluation and some guidance; only a few would need actual treatment…We would call it ‘The Mini-Clinic’...We had no idea that it would become the spine of our MSK prevention model”
Giving a presentation in the assembly room in Irvington, New Jersey was always an adventure. The room was upstairs above one department’s garage bays and across the large parking lot from the other department. Not huge barriers in the grand scheme, but in those days, circa 1999, any reason to avoid “training” was good enough for a few and the two departments didn’t always see eye to eye, making the idea of an “all hands” an adventure unto itself.
Just getting to the facility, which was situated in the heart of one of the state’s more depressed (and at times dangerous) areas could be stressful. So it was no shock that by the time we’d get the 200 or so predominantly male and often overtired utility/construction workers into that dark and cavernous room, striking the right balance between information and entertainment required to keep most of them awake through 4 hours of training was not without its pitfalls. We learned a lot about what it really takes to help someone learn, change and grow toward better health those days and it challenged us. On the other hand, when the message clicked and someone “got it”, it was super rewarding.
Then one day something strange happened. The training was a wrap and I was packing up my slide carousel projector (a time when PowerPoint was “cutting edge tech” we didn’t have) when one of the guys walked up and said - “hey that was interesting, not really my specific issue though - how about my knee, can you help with that?”. We started to talk. It drew a crowd. Then, it was a shoulder question and more people hovered. I started to get the feeling from the local supervisor that it was time for me to leave and that this was now further delaying the start of the “actual work” so I wrapped up. I couldn’t shake the experience - there were so many questions that I could’ve answered. The preventative potential of helping these folks stay ahead of their aches and pains was obvious, the potential value of my knowledge in their environment was huge. There was only one hitch, an evolution that has long-since been made - my professional scope allowed me to evaluate but not treat without a physician’s referral. I was going to need support from someone at least 2 rungs higher in the organization, effectively my boss’ boss, the client company’s medical director.Dr. M was many years my senior but he was always very welcoming to me. He loved to hear my “war stories” of trying to help the folks in the trenches (literally) improve their health. He was skeptical but knew the health-risks were rampant so he provided cautious optimism and organizational cover when needed, albeit always with a chuckle and a sarcastic quip. Our quarterly meeting started like most do, a review of the stats, a few comments on roadblocks and a list of the items that were next on the project plan. Then, with a few minutes on the agenda, he asked, “is there anything else I should know about?” Ready and rehearsed I replied, keeping within the analogy, “there are a growing number of walking wounded out there…aches and pains that will almost certainly grow up to be injuries”. He was intrigued and asked me to elaborate. I explained that there were so many little things that could be done to guide folks, that I felt I could go a bit more custom with the resources provided and keep people on the right side of injury if given the time. He probed “so you want to provide physical therapy?”. Knowing that the referral requirement would sound like more work for him, I hedged, “well, not necessarily, most of these folks just need an evaluation and some guidance; only a few would need actual treatment”. My director Laurie interjected “the Street Department (Natural Gas Construction) has been asking about something similar, a possible next step after the training.”. The good doctor visibly wrestled with the idea and then looked up and said simply “give it a shot, but evaluation and guidance only - no treatment”.
In my enthusiasm I did what I would do countless times from that point - I said yes and excitedly got to work. We would call it “The Mini-Clinic” and it would start in Plainfield, NJ as a pilot program only a few months later. We had no idea that it would become the spine of our MSK prevention model, that it would be refined for nearly a decade, become the first-stop for thousands of people via dozens of future client-companies and in so doing be the moment that Pro-Activity’s Prevention wheels really started to turn.
-Mike E.
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