I spent the first decade of my career in a busy outpatient sports ortho practice. Five-year-olds to ninety-five-year-olds. Turf toe, TMJ, vertigo, post-surgical knees, you name it, I probably saw it. I was good at it. People got better and they kept coming back, which in that world means you're doing something right.
But there was a wall I kept running into, and it showed up most clearly with one client, a young athlete, complex knee surgery, doing everything right in her recovery. Every extra visit had to get approved one at a time. Four visits. Five. Six. Eventually a rep told me, "She can walk and she can bend her knee without pain. That's good enough." I argued. I got genuinely mad. Because for a young athlete with a whole athletic life still in front of her, walking and bending the knee were nowhere near good enough. But to that insurance company, that was the finish line.
That call sat with me. Because it wasn't just her, it was the pattern underneath almost every client I had. We'd get people out of pain, get them moving again, and then hit the edge of what the room and the visit count would allow. Sleep, stress, nutrition, the bigger goals people almost didn't want to say out loud. I'd send an email. Print a sheet. It never bridged anyone forward. It just marked the end.
The real question came later, sitting with a different client near the end of their plan of care, better, but not all the way there. I asked myself something I hadn't let myself ask straight on before: does she actually need to be in this room with me for this to keep working? And the honest answer was no. What she needed was someone who could keep guiding her past the room, her independence, her confidence, the lifestyle stuff that actually drives whether someone stays well. None of that required four walls and a timer. The gap was never about caring enough or being skilled enough. It was the model, not the people in it. The room was the constraint.
What came after wasn't one clean decision. It was a stretch of genuinely not knowing what came next, knowing something had to change and not having a map for it. What moved things forward was finding other people already building past the same wall, questioning it, trying things, failing, trying again. I built alongside them. Fewer people, more depth. Systems that let the coaching keep going outside the room. Enough of my own capacity protected that I actually had something left to give, to clients and to my own family.
I do this now because people deserve to keep going past "good enough." Past whatever an insurance rep or a visit count decides is the finish line. Toward the goals they were afraid to say out loud. That takes a model built to go the distance with someone, not just get them out of pain and send them on their way.
Book a call and we'll figure out where you're stuck and what getting you back actually looks like.
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