[Podcast] Dr. Carrie Pagliano, PT, DPT: Work-Life Integration

Healthy, Wealthy, & Smart Episode 340: Work-Life Integration, Can it be Done? w/Dr. Carrie Pagliano, PT, DPT, OCS, WCS.

Karen Litzy guest stars Dr. Carrie Pagliano to discuss women as leaders and entrepreneurs in physical therapy, elicit the support from your team, a framework for creating value, and embracing vulnerabilities and practicing gratitude. Dr. Pagliano is the president of the Section on Women’s health of the American Physical Therapy Association.

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Welcome to the Healthy, Wealthy, and Smart podcast. Each week we interview the best and brightest in physical therapy, wellness, and entrepreneurship. We give you cutting-edge information you need to live your best life healthy, wealthy, and smart. The information in this physical therapy podcast is for entertainment purposes only and should not be used as personalized medical advice. Now, here’s your host, Dr. Karen Litzy.

Hey, everybody. Welcome back to the podcast. Today’s episode is brought to you by the fine people over at Net Health. So what do they do? They have ReDoc, powered by Xfit, which is a cloud-based, fully integrated EMR billing solution. You can expand your visit capacity, get paid for your services leaving no money left on the table, ramp up patient engagement so you keep them coming back, and finally, eliminate worries about documentation and compliance. To learn more about ReDoc and complete revenue cycle management services, check them out at nethealth.com/healthy.

All right, on to today’s episode. So this was an episode that was a Facebook Live a couple of weeks ago, and my guest is Dr. Carrie Pagliano. She is the newly-minted president of the Section on Women’s Health, which is part of the American Physical Therapy Association. She received her Masters in physical therapy from the University of the Sciences in Philadelphia, and then a Doctor of Physical Therapy from the University of Saint Augustine for Health Sciences. She is double board-certified in orthopedic and women’s health, and holds manual therapy certifications from USAHS. She founded the Medstar Georgetown University Hospital PM&R Pelvic Floor program, and in 2014, founded the MGUH Women’s Health PT Residency. She is co-instructor for women’s health focused real time ultrasound education, teaching assistant for pelvic floor education, and clinical instructor for student education. It’s a lot of education. She lectures nationally in the areas of chronic pelvic pain, integrative practice models, and pelvic floor dysfunction, and she is a newly minted entrepreneur. Yay, Carrie! So in this episode, we talk about all of that. We talk about how she manages being a mom, leader, and entrepreneur in physical therapy.

How to elicit the needed support from your tribe to catapult you to success, a framework for creating value, and solving people’s pain points when building your own practice and embracing your vulnerabilities, practicing gratitude over even the smallest of successes. So a huge thank you to Carrie for coming on to the podcast and for doing it live on Facebook. So I’m not really going to edit this because we want to keep it with that live feel. So everybody enjoy and thanks again Carrie for coming on the podcast.

Okay. So we are live. Hi everyone. Welcome to Healthy, Wealthy, and Smart live. If you happen to be watching live, I would live for you to write down where you’re watching from and who you are so that we can see it in the chat and if you have any questions as we lead up towards the end, we’ll be happy to take some questions as well. So welcome to Healthy, Wealthy, and Smart live and I am here with Dr. Carrie Pagliano. So welcome and can you tell us a little bit more about yourself?

Sure. So I’ve been a PT since 1999 and I primarily practice in the area of women’s and pelvic and pediatric health. I recently opened, as recently as last week, I opened a practice in Arlington, Virginia. Then I’m also the new president for Section of Women’s Health for the APTA. So that’s the work side and then I also have two kids, seven and four, and an amazing husband who I can’t do any of this stuff without. That’s a little bit about me.

So huge obviously changes and shifts in your career in the past month I would say.

Yes.

As everyone knows, yesterday was International Women’s Day. So in honor of that, I’d like to talk a little bit about what it’s like being a woman, being a mom in the workplace, owning your own business, being in a leadership position within the APTA and just so people know. When you’re in these leadership positions, it takes up time. We’ll talk a little bit about that. It’s not like it’s a volunteer position.

Yeah.

You are volunteering.

The labor of love.

Yes, to be part of this position. I think that’s another thing people need to remember when they look at the American Physical Therapy Association and all the people in it. The majority of them are volunteers that are just there to make everyone’s experience as a physical therapist in the United States better. So let’s talk about what it’s like being a mom, being a very new business owner, and being part of the leadership within the Section on Women’s Health. So how do you do it? I’ll just throw it over to you now.

I’m tired now that you said all that. It’s funny I was thinking about this a little bit this morning and I think when you actually start to write it down, it does get a little bit scary. This is just what normal life has become. You don’t wake up one morning in PT school and say, “Hey, I want to be president. I want to own my own business. I want to have kids. I want to do all this stuff.” For me, it’s just been a natural progression and thinking about International Women’s Day yesterday, I was talking to a friend of mine who’s a PT. She does PRN work and I said, “Well, are you a member?” She’s like, “Well, I’m just PRN and I made a decision to do the mom thing.” I’m like, that’s still kind of amazing. So we have so many ways in our profession in which women and specifically moms can choose to be a part depending on where they are in their family development and whatnot, but there’s still so much that just the PRN mom PT has to offer to those newer physical therapists.

So one of the things I was really thinking about yesterday was regardless of where we are in our career and family life cycle, we have a lot to offer and thinking I’m just this or I’m just that, we need to own up to the fact that we still run the home. We get the kids off to school, although this morning was not pretty. We get our patients taken care of. We do all these things and it’s just kind of what normal is. So taking a second yesterday and just celebrating that a little bit and how amazing women are, especially in our field that’s I think predominantly female, that was actually kind of special yesterday to stop and think for a second, “Hey, we do a lot of stuff here.”

Yeah and I think the word just is like a nasty four letter word. The J word.

Yes.

So many women say that. Well, you know I’m just PRN. Or I just do this.

Right.

Or I remember when people used to ask about this podcast lik, “Oh, I just do it on the side.” So it minimizes what you do. So is that something that you used to do?

Exactly.

Do you still do it? Do you have any advice on how to overcome that feeling of well I’m just?

Sure. I mean my background, I just, here’s the just again. I left working in a large hospital system and I worked there for 10 years. I started working there prior to my kids. Actually started building a residency program while I was pregnant with my oldest. Eventually filtered into PRN and had a really strong run as PRN and got to the point where both my kids were in school full time and this is me literally in August. I wrote this down. I said, something has to change. I knew I was going to go into president. I knew we had closed our residency and I’m sitting there thinking, something’s got to change. It’s not I’m just doing this, I’m just doing that. It’s now where can I make an impact, where am I happy? Where do things match up? If I want to be around for my kids, how do I make that happen? If I want to be there for my patients, how do I make that happen?

Where I was sitting over the summer was a place that if I had to call out sick or the kids were sick and I had to stay home, I had no way to reschedule my patients. Whereas finding some flexibility now with my own practice, if my kids are sick, I can reschedule to another day. I have that control. So that just piece of it is, yeah it was just PRN, but I was really handling a lot of things within that. A residency and building a pelvic program. I think minimizing it we do it a lot and I think we just do it offhand and don’t realize it. I have been trying to be more conscientious now to acknowledge what we do. When I was talking with my friend yesterday I said, “This isn’t just. You do all these things.” We don’t give ourselves credit at all. Like oh, well this is just what we do. No, you’re baller. You’re doing some amazing things.

Yeah.

So pausing and taking a second.

Just congratulating yourself for all that you do. I remember at the Women in PT Summit last year, I think you stood up and you were like, “Well, I’m announcing that I’m starting my own practice.” It was amazing. It was a little emotional, along with I mean there was a lot of emotion that day, but it was a little emotional.

Yes, there was.

You had all that support there and everybody was obviously really excited and now here you are in your office doing this interview.

Yeah, I’m in my office. That’s the thing too that I think we don’t give ourselves credit for either. I mean I had started to think about doing something over the summer. The Women in PT Summit was September and when you get to the point where articulate it to people, then it starts to become more real and at that point, I had no idea. This space is three blocks from my house. I have walked past it. We have lived in our home for five and a half years. It wasn’t even for rent. I wasn’t even looking for a space. I did some home visits initially, a side hustle. You find things when you start looking and you find things when you’re open and it’s an uncanny ability that I think women have is making things happen. My first couple weeks doing the home care side hustle, like okay this is great. I’m seeing patients in my neighborhood. Just dropped my kids off at school. I can see somebody on the street.

Then I realized being on my knees in somebody’s living room floor and I’m almost 42, I’m in decent shape, but I was like I’m not doing that. So you start to think, okay something’s got to be different. So having the flexibility to say okay, it doesn’t have to be one way and I don’t know exactly how this is going to go, but the openness to be able to see opportunities that may not have been obvious before.

Yeah, so once you open up your mind to those possibilities, it sounds the space found you. The universe spoke back and the space found you.

Yeah.

It was always there, but you weren’t ready to receive it yet.

Yes.

Now that you were, it was perfect.

Well, and that’s the thing I was thinking about as well. There’s so many women leaders that have come before us that I mean you’re a fantastic example too, that saw that entrepreneurial spirit when the risk level was much higher. I mean I’ve been out of school almost 20 years now and the idea of going out on your own, it was to become a NovaCare, become like a Health South and I had no appetite for that kind of risk. I knew I really wanted to be good at what I did. You find out very quickly that in corporate and hospital practice, you hit the ceiling pretty quickly, but those women that were out there I mean locally, I’m going to name drop.

Jen Chu in my area in the DC metro area, Stephanie Coleman, they had businesses before they had kids and they had the kahunas to do it when the risk was high. Jenny Gablesberg out in California, I’m like I don’t know how they do multi location clinics.

Yeah. Or Michelle Collie.

Michelle Collie. She’s another one in New England.

And kids I mean. What?

Exactly. Exactly. Now I mean I feel like there’s such an insurgence of women and especially moms in the entrepreneurial space because my local entrepreneurial group AWE, it’s Awesome Women Entrepreneurs in Arlington. Most of the women here decided to become an entrepreneur because their kids were in school and they tried basically you sit down, you’re like okay well what do I want to be when I grow up? So in our space because we have the flexibility in what we do, it can be consulting, it can be the side hustle, it can be doing PRN. It’s not just PRN. It’s like you’re part of the team too. That’s what I want to encourage also and to understand is we’re an asset. We’re going to be loyal. We’re going to stay and we want to contribute. So you really want to make us part of your team.

I mean I was at Georgetown for 10 years and if they were interested in building that program further, I still would’ve been there. So there’s a lot that we can contribute, but there’s a huge entrepreneurial spirit right now and I think technology is also facilitating that. Online scheduling and I can’t wait for this whole telehealth thing. That I think is going to make it easier for moms to see a couple patients while their kids are at preschool. I just feel like now’s a really good time and women are owning that space to say, “Hey, there’s other women out there who need this from the patient side. I’m happy to be there as an advocate for them on the professional side.”

One thing I want to circle back on that you had said during that talk there is that you have an entrepreneurial group that you’re a part of.

Yep.

Can you talk a little bit more about that because I doubt it’s just all PTs.

No, it’s not. I’m actually one of two. This is the thing too. When you’re scared about going into this, listen to every podcast that you can and of course all the side hustles you did. Okay, find these other people. I literally googled I don’t know women entrepreneurs and I’m super lucky in Arlington. So AWE originally was Arlington Women Entrepreneurs and it’s not branched out in the DC metro area, so they just made it Awesome Women Entrepreneurs. We get together and what’s really nice about is we all have similar pain points. Everybody knows what it’s like to have that first. So the first meeting I went to was even before I’d started my home business and I said I’m just trying to figure out what to do and to do it right.

So they would have a speaker come in and then at the end everybody goes around and does their one minute elevator pitch. I’m like, I don’t have one. Hi, I’m Carrie. I’m a physical therapist. I am going to start a practice and I have no idea what I’m doing. That’s my elevator pitch.

That’s not a bad elevator pitch when you’re in a group of entrepreneurs because then guess what? Everybody has a hand raised to tell you how they can help you.

Yes. That’s the thing is you start to realize that everybody’s gone through it and then you start to meet. So I have a brunch scheduled with someone who’s a reporter for some major media outlet and I found an integrated medicine position for another referrals and I mean we have things that are shared and I think women, we do a really good job about finding our tribe and stepping out of our own profession and finding people that have similarities. That’s what I do with my patients as well. I mean doing pelvic health in the first two minutes, you’ve got to get trust pretty quickly. So if they’ve come in post partum and they’ve got diastasis, I’m going to share with them I’ve gone through this too. I’ve got two kids. I had diastasis. I know exactly what you’re talking about. Don’t be scared about telling me to do crossfit because guess what? I go to the crossfit box next door. It’s establishing that trust and that rapport and that tribe mentality.

There’s so many different ways to do it. So look at making a local women PT one because there’s so many of us around here that are building that, but the attitude is not of we’re competitors. The attitude is hey, there’s a lot to go around. We have a lot of similar things that we’re going through. Let’s try and all work through this together and that’s actually really fun.

Yeah. Now you had mentioned about you all had similar pain points. Can you just tell the listeners maybe give two pain points, and what they were and how you worked together to solve them?

Okay. So one pain point is very recent. It’s going through setting things up with local municipalities. So how do you get a certificate of occupancy. If you need a sign, did you know that you also need a commercial builder permit to hang said sign?

Even if it’s just a little tiny sign?

Oh, even if it’s just a little tiny sign. That takes time. It takes at least a day and I mean no one in Des Moines, Iowa is going to be able to tell me how that works in Arlington, Virginia. So having local entrepreneurs that can tell you exactly hey, this is something that you need to do. This is how you work it. That was invaluable. I think another thing too is the pain points of how do you figure out the balance piece and I think balance is such a funny word too. There’s a lot of mom run businesses in Arlington and moms that have kids that are older that are in high school and my kids are younger. They’re pre-k and first grade. Just I think having that touch point of, I was talking to a friend of mine that her kids had my son’s kindergarten teacher. I think her kids are 16 now. They knew exactly what I was going through with my kids locally and they were running a business and so you can’t really get much closer than that.

So understanding okay, well how do you balance the demands of a local education and making sure the kids get to the activities and do what they need, but then also balancing what you need to do to keep your company afloat and get your name out there and get the word out to moms groups and those sorts of things? So I think locally that’s what they did the most was really bring it down to ground level because these are my neighbors. That part’s really cool. That these are my neighbors and they’re kind of doing the same thing. That’s really fun.

Very cool. Yeah, I think those are some great pain points that a lot of people can relate to. Hi, everyone joining us. Alex, Jennifer. Earlier Jennifer said, “So true. I learned so much from the ‘PRN moms’.”

Yeah. They’re a treasure trove of information let me tell you.

Exactly. So now you alluded a little bit to work life, we’ll say balance, I think there’s no such thing. I think it was Michelle Collie, is she the one who said work life integration or work life, I can’t remember what she said?

It was something around those terms, yeah.

At the Women in PT Summit. It was something like that.

Yeah.

So you’ve got your own business. You’ve got two young children and you’re the president of the Section on Women’s Health for the APTA. Now I mean I’m on the nominating committee for the private practice section which is nowhere even near the amount of work that I see the Private Practice Board doing. So how do you feel like because this is all new, so do you have a game plan to be able to integrate this into your life and into your lifestyle?

Yeah. I think even when I considered running for president. I mean I was in VP position before that. It’s still different. The gravity of the situation is still quite different. I mean for me and it’s funny, I was just thinking I’m just working this many hours. I really work all the time.

Don’t say the J word. I’m calling you out every time.

I know. I know. No, but I knew patient care wise and this is the thing too. You just wake up one morning you realize these things. It’s been kind of practice in coming along. When I started back to PRN practice, I would work Tuesday, Thursday and initially tried to maybe work two times and work a part time status. That just wasn’t working. It was too much and I like teaching a little bit. I like working with students. I like working with mentees. I think the first part I guess was just figuring out where my buckets are filled and working with patients filled some of the buckets, but also working with my profession fills a lot of buckets. Working with students and mentees fills buckets. Being with my family fills buckets. So I knew that about myself and that wasn’t something that came up all of a sudden. That was something that I kind of realized over time. Then I think structuring my schedule based on that.

So I’m still kind of figuring that piece out now with flexibility also comes the problems of becoming too flexible. You’re like, oh I can just squeeze this person in. I can do that. So I really have to stick to my guns of I don’t want to see a new patient right before lunch because I know it’s going to spill into my lunch and I need to get stuff done because when I leave the office, I can’t be thinking about what sin the office. I need to be fully present for my kids. Same thing with the president stuff. I mean we’re super fortunate we have an amazing board right now. We have an amazing new executive director that really just lets us work our strengths. I think if it weren’t for that, I would be much more tentative about incorporating that piece. Where we’ve come with the Section on Women’s Health is really allowing the board to govern instead of trying to figure out how to run a million dollar non-profit which I don’t know how to do by the way.

Allowing me to use my skillset and the rest of the board to use their skillset to move our membership forward. So I guess the summary piece is really being honest with what I wanted and then making sure that this stuff fit in. I do teaching too by the way. I’m adjunct at Marymount University, but it’s a mile down the road. My chair lives a couple blocks. A lot of the students end up becoming our babysitters. It’s one stop shopping for a lot of different things. So it’s making sure that it serves you and serves your family and whatnot.

Do you recommend people to get a piece of paper out or their computer out or iPad, whatever you’re using to write on these days and actually making a list of things that are most important or most meaningful and then seeing how? It seems like a big, broad esoteric thing, but once you put it down on paper, do you then look at that and say well this is how much energy and time I can put into this bucket or this bucket or this bucket and then schedule appropriately or how do you work it?

Yeah. I mean earlier in my career and again, I guess that set me up. I would love to say that I’ve calculated this. I’m just unfortunately not that bright. It’s been kind of a slow progression and understanding of myself, but I used to say yes to just about everything because everything sounded cool. Then in the last couple of years I’ve had the year of the educated no, the year of the educated yes. Then really this summer I’m that person I need to write stuff down and of course there’s all these planners and stuff now. The five year planners of what’s your purpose? I have no idea. That’s kind of a big question and I’m that person I need to set myself up to succeed and find something that I can do and that’ll help fill in the gaps till I get to the bigger question of what’s my purpose. Maybe on my death bed I’ll figure that one out.

I think you can figure it out. I think if you worked through it. I mean you know what your purpose is as the president of the Section on Women’s Health, you just said it.

Yeah. No that part I get.

Yeah. I mean I think your purpose and overall being on the planet, that’s a big one.

I think that’s how I was interpreting that. Yeah, that one I don’t know.

Yeah. I mean I think you’re looking at what is your purpose opening your business? That’s part of your brand. So what is the purpose?

Right.

What is your promise to your customers and then what makes you different? How do you stand out?

I think that’s the part that I started to figure out and when you start to write down, okay what are the things that I really enjoy doing, then you prioritize those and figure out okay, does this fit in and if it’s one of those things where I can’t live without it, I figure out how to make it fit in. So for example, self care. Being really cognizant that I am my better self with my family if I have self care. Usually that’s the first thing to fall by the wayside.

Always.

So I block out two hours a week for crossfit. I have an hour for yoga. I’ve got to figure out when the weather gets a little warmer, but those are non negotiables for me. So I kind of started with that and then it’s funny how those non negotiables start to turn into things that fill up the rest of your life. So my crossfit box happens to be on the other side of the fence from my office. So that serves me in a couple different ways. I think looking at what you really enjoy and what makes you have those warm fuzzies and good feelings at the end of that day, that’s the part where you want to put your time and your energy in. Really kind of being on my own, I really tried to reflect at the end of the day like is this all worth it because it’s obviously a really steep climb in the first part. I’m leaving smiling everyday. Okay, that’s the right thing. That’s the right thing to do.

When I leave my students, it feels me invigorated to go do other stuff. Yep, that’s the right thing to do. That working with our board on the Section on Women’s Health, I feel like I’m able to be there for up and coming therapists and show people that we can be involved even if we’re just working that part time job. There’s a place for us. There’s stuff for us to give. As long as I keep it in those simple categories, it makes it doable.

That’s great. I think that’s great advice for anyone listening if they’re feeling a little overwhelmed or they’re feeling like they’re just. It’s a great way to look at things. What am I good at? What do I love to do? On the business side of it, what’s someone going to pay you for?

Right.

Let’s be honest. I mean you got to get paid too. You have a business.

Yeah.

So what do you love, what are you good at, what will someone be willing to pay you for? If you really love something and you’re really good at something, it’s awesome and it can be that self care.

Right, right.

No one’s going to pay you for it, then it’s a hobby. So you can’t expect everything you do for you to get paid for number one, but number two, you can expect everything that you love to do and you’re good at to get you excited and to add to your life.

Yeah. I mean anybody that’s interested in getting more involved in their profession, I’m not going to lie, that was probably the one time it was a calculated decision where as you start to become more of a volunteer, you’re not going to get paid, but that’s gets me to CSM. That gets me around other people that do fill my bucket up. So I think getting paid it’s got to be able to obviously put food in your kids’ mouths, but it can look like a lot of different things. Getting yourself in those situations can also pay off later on too.

Absolutely.

You can end up meeting people that open up opportunities for other things. So I hate just looking at did I get a check for this? It’s a little short sided. I think if you start to be open about what that payoff looks like, then all of a sudden you’ve got I think a lot more options of things to do.

For sure. Because like scaling a business and scaling your involvement in let’s say for example APTA in some way, the return on investment may not be immediate and scaling doesn’t mean bringing in more money. Scaling can be opening up your network. Scaling can be traveling to speak somewhere. Having like you said, other opportunities open up down the road because you never know.

Exactly.

So I think oftentimes when people think oh, scaling your business it means raising your rates, hire more people, do this, do that when in fact a scale of a business can be it’s still just you, but now your world is open to so many other opportunities and that’s scalable.

Exactly, exactly. I think unique to where we are here. I mean I’m probably 15 minutes form APTA headquarters and I mean I’ve lived in the DC area since ’01 and probably the first time I went down there and went in the building wasn’t until the last four five years or so and what I’ve come to realize too that’s actually really amazing is of course the people that are on staff at APTA live here. These are my neighbors that work for this organization that’s working to help my profession and they’re happy to be your support system too. You can find those support systems wherever and my neighbors are happy to advocate for me as individuals for what I’m doing individually so that part’s actually super cool too.

Yeah, I mean I think you’re able to cultivate win-win relationships and that’s always what we’re looking to do. You never want to enter in a relationship and say well, what can this get for me? You’re entering in, saying how can I help number one. This is what I need help with and this is how I can help you. Right? So if you’re talking about the APTA and the people that work at the APTA, you’re going and saying well, how can I help? What can I do to be of service to the organization? They’re saying, maybe XYZ and if you need something, we’re there to give you support. We’re there to give you a referral of a patient for God’s sake. So I think if you can, especially as a new business owner, cultivate a win-win with every single person you meet basically because you’ll see when you have your own business, every person you talk to it can be a win-win relationship.

Yeah, yeah.

I mean you’re setting yourself up for success. On that note, we’re going to take quick 30 second break to hear from our sponsor, Net Health. PTs what do you hope to accomplish in 2018? I bet providing even better patient care and increasing revenue are top on the list. First, expand your visit capacity. Then get paid for your services, ramp up patient engagement, and eliminate worries about documentation and compliance. The good news is, there’s one solution that brings it all to the table. Redoc powered by Xfit is a cloud based, fully integrated EMR billing solution. Imagine PT billing, coding, compliance experts taking the back office work off your hands and reporting to you. Learn more about ReDoc and complete revenue cycle management services at nethealth.com/healthy.

I think so much of that, you hit the nail on the head I think with not going in with what can this person do for me. It’s going in and being your authentic self and then also getting that in exchange and whatever comes out of that is going to have so much more value because it’s inherently who you are and what you want and inherently who they are and what they want. So that part I think you really formed those lovely authentic relationships, but that can be really something much bigger.

Yeah. Very special as well. Hi Howie, Howie Barrett says hi.

Hi Howie.

Carrie, hello. Yeah. There are so many different ways to run a business, to raise a family, to work, to teach, to do all of those things as a woman, as a mom, and as a business owner. I think that you are setting yourself up in a really, really good position. So what advice would you have for let’s say a student who may be coming out of school? I mean you teach students. You have to give them advice, right? So what advice would you give to a student coming out of school if they wanted to have the family, have the business, be a volunteer, be more than they thought they might or could be?

Right. We actually get that question a lot. There were a couple of us that did a presentation at CSM last year. It was Karen Brandon, Jenny Gablesberg, Cecily de Stefano, and myself. We did a hashtag Mama Kate mafia.

Sold out.

It did. It literally started as a joke where we’re super moms, sometimes we have our cape flying high. Sometimes it’s trapped in the car door and sometimes we left it at the cleaners. I think that’s reality. I think the misconception that we have this all figured out and we’re on Pinterest all the time and everything is perfect. I think the sooner you drop and I think, I tell my patients I was like, the second you conceive, anything you plan is kind of over because the kid didn’t read the directions. I think when you choose to be a mom, that’s the case. You have to be flexible and run with it. If you choose that that’s the path you want to go down, I think the thing to remember is that you’re a mom. You’re not dead. Things don’t have to end.

You mean life doesn’t stop?

No, sadly not. No, it’s going to change. It’s going to look different and we see that about kids too. When babies are little and they’re not sleeping, in my reality my son didn’t sleep the first five years of his life and then you extrapolate four and you’re like oh my God, they’re never going to sleep. It doesn’t get better, it just gets different. You get maybe better at handling right now, but there’s always going to be something different that you have to work through. I think being open to change because what you resist persists. If you keep fighting it, it persists. That was a struggle I had when I first had my oldest seven years ago is you’ve got this demanding child in the middle of the night that wants to wake up and wants to eat. It really doesn’t matter what you want. So I think the sooner you can just roll with it.

There was a student Megan Mitchell, she was the University of Maryland. She had something on Twitter the other day and she’s like I realized that I’m trying to be perfection coming out of PT school and on my exams and I don’t know if that’s the best idea.

No.

My days sometimes are a hot mess. This morning, hot mess. I don’t have time. It is what it is. Try and be as present with what you’re doing at the time and you keep going. I think the sooner you can figure that piece out, probably the better.

Yeah and I was on a call with one of my mentors the other night, Chris Winfield and someone asked him, he’s like super connector or media personality. Someone had asked him a question about their message and it’s not perfect and it’s not this. You said you were a hot mess this morning which I highly doubt, but I’ll take your word for it. What he said that was very memorable to me is that your mess becomes your message. I think that’s exactly what that Mama Kate Mafia. Your mess of how do I handle the kids and the this and the that. So that mess then became your message. I think it’s really important for people to remember that and it’s really important for people to remember that. I mean they’re seeing us on social media and we’re celebrating our wins which is awesome and you should always do that and always celebrate your wins and let people celebrate them with you, which reminds me I have to do that in a women in PT group actually.

This group that Chris Winfield runs every Friday, he’s like what were your wins? Give me your wins. Then when you write them out, you’re like well, I did more than I thought I was going to do this week. So these are your wins this week, what are your plans for next week? So it keeps you accountable, but also allows you to look back and say oh my God, look at all I did this week. Some of the wins could be I don’t know I cleaned my apartment. It doesn’t have to be grand wins. It’s not like you won the Nobel Prize or anything. If you did, awesome. I think it’s important to look back at those wins in the week and where you’re going to go and also looking back on if my life was a hot mess, how can I take that, whatever your morning was this morning and educate others on how I got through this hot mess or how I just dealt with it or how I was present in it? So I think it’s important.

I think you’re totally on point there and wins, again it’s really tough in this day and age. I sound like an old mom now, but trying to keep up with social media because everybody’s got their gorgeous amazing kids and their amazing posed photos.

Everybody’s perfect.

Oh, everybody’s perfect. My dinner was off of Pinterest. So I mean that’s one of the beauties though I think of Mama Kate Mafia is just acknowledging we’re on a text group and that morning where you realize five minutes before you walk out the door that your kid has lice and every single mom cringes and has a silent scream when you hear that word. You realize five minutes before and you’re like, all right well what are we going to do here? The fact that we get through it and somebody else has been there and understands. That goes back to ultimately that tribe mentality. Your win may not look like Pinterest. Your win may be I got to my podcast interview on time and dry shampoo is the best thing ever and that’s my win for today. The fact that you’re not alone in this and I think having some vulnerability to say yes, I do all these things, but it’s far from perfect, but I’m kind of okay with that because I know you guys are my go to. So that vulnerability to be human I think.

Absolutely. Yes Howie. He said, “Easy to think you are losing if you don’t reflect on your winning.”

That’s a great point.

So true.

We were talking through and she’s got an older kid and really kind of concerned about next year the kid going off to college and what’s she going to do and we talked about that morning gratitude and that evening gratitude and I know I am better when I write it down. It may be as simple as I got a shower today. It may be as simple as the kids didn’t die today and I didn’t have to wrap my daughter in bubble tape. It could be as simple as that.

Yeah.

Yeah, acknowledging those wins that’s a really great point and writing it because it makes it real.

Yes, if you write it down it makes it real. I just write three things at the end of the day and sometimes it’s like I am thankful for snow boots. Simple. It doesn’t have to be huge. For the past two days, I was really thankful that I had snow boots because then I don’t show up at my patient’s apartment like a hot mess with wet feet and being gross and going into their beautiful apartments looking like I just walked out of a river or something. It doesn’t have to be this big, huge, grand things.

No, no.

I’m thankful for my partner. It could just be like thank God I have snow boots.

Exactly.

Then you realize all these little things that you have and how fortunate you are.

Yeah. I think when you’re going back and to talk about how I got to this point, it’s not these big magnificent steps to get here. It’s little ones that when you look back added up to something big. It’s the little gratitudes that if you don’t acknowledge them, they tend to go unnoticed. The things that I think for me that I’ve had to do a much better job on too is so for example my husband has been an amazing support system and it’s little things. It’s not grandiose stuff. It’s like he hangs my sign. He hangs stuff on my wall. He took the kids to school so I could run down to the county offices yesterday morning before my patient. Remembering that it’s not about me. It’s everybody around me that makes this happen. I didn’t get to CSM by myself. It was my neighbors and my students and our nanny and my mother in law and my husband. It’s surrounding yourself with people and remembering it’s those people that get you where you are.

Absolutely.

Gratitude point.

On that, what I’d like to end with are maybe two or three things that you want the listeners to take away from the conversation today.

Sure. I think you don’t have to know exactly what the ending looks like, but you need to know it’s time to change and start to explore it. Be open to exploring it. You may not know what the ending’s going to be like or what it’s going to look like eventually, but be open to starting to explore it. The other is not to put limits on yourself. That whole just thing. I’m just a mom and I just work part time. That doesn’t cut it anymore I don’t think. You have so much to offer and so much to give and be aware of all the skillsets that you have to multitask and organize and those are things that people want. To make sure that you give yourself credit and probably with that last piece is what we just touched on is take those moments to heart and be present and really just walk around and say gosh, this is all right. This is pretty good. I did a good job. I’ve got some amazing support around me.

Acknowledge it because if you don’t, before you know it gosh it’s going to be gone. It’s the same thing with your kids. Before you know it, they’re going to be grown up. So those are probably the three biggest things.

Well I think they are a perfect way to end and if anyone wants to get in touch with you, how can they do it?

So my website is just my name CarriePagliano.com. So that’s the easiest way to get to me. Twitter I’m CJ_PaglianoPT. I’m also on Instagram @CarriePagliano.

Perfect. Very easy for everyone to remember.

Trying to be.

Yes. So thank you Carrie for taking the time out in the middle of your day and coming out. Thanks to everyone for being on with us. Jennifer, Alex Howie, Neal, couple other people. Thank you so much. Maureen. Thank you so much for tuning in. Have a great week everyone and stay healthy, wealth, and smart.

Hey everyone, so how much did you love that Facebook live episode? I loved it. A big thank you to Carrie Pagliano for sharing all of her ups and downs of starting her business and having a family and being a leader in physical therapy. Of course a big thank you to our sponsor for today’s episode, Net Health. So if you want to provide even better patient care and increase your revenue for your business, check our Redoc powered by Xfit. Again it’s a cloud based, fully integrated, EMR and billing solution plus you can opt in to completely outsource billing services. That’s the best way to optimize revenue. Imagine your physical therapy billing, coding, and compliance experts taking the back office work off your hands and reporting to you. Let’s you do what you do best and that’s treating your patients. To learn more abour Redoc and complete revenue cycle management services, check them out at Nethealth.com/healthy.

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