Evidence-based Medical Practitioners. A Client-centered Approach. Chris Hovorka
Chris Hovorka, Midwestern University, transforms clinical practice for people with orthoses, prosthesis to a client-centric approach improving quality of life. Chris’s goal is to graduate evidence-based practitioners (clinician scholars) by transforming university school curricula worldwide and moving towards client-centered approaches. It’s about valuing the client’s lifestyle, medical conditions, needs, as part of a personalized plan of care.
Transcript
skeletal muscles are the most prevalent in our bodies and what we rely on every day to move.
Chris Hovorka:Essentially an orthotist prosthetist is mitigating forces to enable a person to move.
Chris Hovorka:. Catherine: Hello, I'm Catherine, your host of this variety show podcast.
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Chris Hovorka:C H R I S N O L E Thank you again for listening and for your support of this podcast, your positive imprint.
Chris Hovorka:What's your PI?
Chris Hovorka:there is an estimated 30 million people worldwide who need prosthetic or orthotic devices.
Chris Hovorka:Of the 30 million, it is estimated that about 75% of developing countries do not have a prosthetics, orthotics training program, which means patients are left without a means to better their quality of life.
Chris Hovorka:The percentages change as more people worldwide become amputees due to traumatic occurrences.
Chris Hovorka:These numbers that I just mentioned are estimates from the World Health Organization.
Chris Hovorka:Well, my guest today, Dr.
Chris Hovorka:Christopher Havorka, is advancing research on treatments using prosthesis to enhance the quality of life through better mobility.
Chris Hovorka:Chris is also training rehabilitation medical professionals to enhance the lives of people with mobility challenges.
Chris Hovorka:Chris is now working at Midwestern University in Arizona and is changing the statistics of the World Health Organization by developing a program, which he will talk more about.
Chris Hovorka:And I'm excited to hear more about this program and to hear about all of his positive imprints.
Chris Hovorka:Chris, welcome to the show.
Chris Hovorka:It is so good to have you.
Chris Hovorka:Well, thank you, Catherine.
Chris Hovorka:It's a pleasure to be here today..
Catherine:Oh, thank you.
Catherine:And, and you have so much that you've given to our community worldwide.
Catherine:You've worked in the United States, but everything you do is global and right now you're over in Arizona.
Catherine:You really have given yourself to these programs and to, to the community.
Catherine:And thank you for that.
Chris Hovorka:Well, you're welcome.
Chris Hovorka:It's a pleasure to be here today and I'm happy to share with your audience this area that we call orthotics and prosthetics.
Chris Hovorka:It seems that it's becoming more understood today than ever before.
Catherine:In part one episode 195, Dr.
Catherine:Hovorka shared his incredible journey from athlete to athletic trainer to how he is transforming lives worldwide with his research and as a healthcare provider in orthotics and prosthetics.
Chris Hovorka:I wanna make a greater difference than what I'm doing now in training people to exercise.
Chris Hovorka:I think I could do that and make a greater impact in a person's life.
Chris Hovorka:So I said, I think I wanna be an orthotist, prosthetist, , . So then I went to the local Veterans Administration Center where they had an orthotics and prosthetics facility, and I saw these practitioners that
Chris Hovorka:And these people were walking outta there with smiles on their faces and , there was a lot of gratitude and happiness in the room.
Chris Hovorka:And I thought, I'm hooked.
Chris Hovorka:This is what I wanna do.
Chris Hovorka:I re pivoted my career towards orthotics and prosthetics.
Chris Hovorka:I essentially had to start over again with a lot of training, but I was, I was hooked.
Chris Hovorka:And that was the start.
Catherine:In part two, Chris shares how he is transforming and influencing change in healthcare by guiding the transition of university healthcare programs to a client centric approach through training.
Chris Hovorka:Yes.
Chris Hovorka:It's a topic that's very close to my heart and, uh, hopefully can make some positive changes and imprints in the area of orthotics and prosthetics and healthcare for people that require those technologies.
Chris Hovorka:So there's this kind of historical continuance.
Chris Hovorka:Of, uh, device centrism that still pervades the accreditation standards to inform the school's curricula.
Chris Hovorka:So my proposal and what I'm intending to do at, uh, where I'm currently at, at Midwestern University in Arizona is to get ahead of that.
Chris Hovorka:and by looking at , the trends in technology and healthcare, they strongly suggest that , the use of of technologies can improve
Chris Hovorka:clinical efficiencies and replace, in many cases, replace the fabrication component for prosthesis and orthosis.
Chris Hovorka:Many of the 3D printing technologies have already shown that the quality of the product that's printed is as good, or sometimes better than a handcrafted product.
Chris Hovorka:So why not, get ahead of this trend?
Chris Hovorka:Develop a curriculum that trains students to do the traditional handcrafting, which is required for accreditation standards, but really spend more time training students
Chris Hovorka:I'm essentially aiming to do so.
Chris Hovorka:It's kind of just a balance by spending more time training the students, , on client-centered approaches to diagnostics,
Chris Hovorka:problem solving treatment, decision making, and utilizing digital technologies to replace some of these really labor intensive handcrafting approaches.
Chris Hovorka:I believe that we can get there with our curriculum.
Chris Hovorka:I've already developed the curriculum and I'm beginning to make the case to our accrediting body that we can do so..
Chris Hovorka:This client-centered training approach that we're creating for the next generation of Orthotists and Prosthetists, I believe is necessary because it gets at some of the problems that we discussed earlier.
Chris Hovorka:One of the problems is if we remain on our current course, , of device centrism, and don't change that, we're gonna continue to produce graduates that are going to
Chris Hovorka:carry over errors in the care delivery because they're not spending an adequate amount of time with the patient, nor do they have appropriate amount of training to know what to
Chris Hovorka:The other is that it's gonna take the next generation of care providers , to develop the body of knowledge, to show that spending more time with the patient, And less
Chris Hovorka:And the only way to do that is to engage in scientific studies.
Chris Hovorka:And , we are still lagging as a profession to engage in evidence-based practice that creates substantive change.
Chris Hovorka:So I'm proposing that we have a pretty good idea of what the problems are, but we haven't in the past generated solutions to train our next generation, and that's what I'm proposing to do now.
Catherine:And so moving forward, do you see 2023, the curricula will be changed or 2024 or 10 years?
Catherine:20 years.
Catherine:What do you see as actually being the transition?
Chris Hovorka:The best we can do as a profession and as individuals is to pay very close attention to current past and current trends.
Chris Hovorka:And then based on that, knowledge, we can prognosticate and estimate how to position ourselves for the future.
Chris Hovorka:In my prior experiences looking at the future of the profession of orthotics and prosthetics, I happened to guess correctly about 20 years ago, , where I thought
Chris Hovorka:next Generation of providers to engage in science.
Chris Hovorka:So I had had this notion of starting a program at a school where I was at Georgia Tech at the time, and we capitalized on the scientific, , resources that are available at
Chris Hovorka:At that time it was, , somewhat of a new concept known as evidence-based practice.
Chris Hovorka:Mm-hmm.
Chris Hovorka:. and the graduate side of that program ended up, several of them ended up becoming leaders in the profession, , where they were the heads of research agencies and the heads of clinics and other medical
Chris Hovorka:So we had a little bit of insights, , looking at the prior trends.
Chris Hovorka:Before we started that program and they suggested a need to create evidence-based practitioners, which we today call clinician scholars.
Chris Hovorka:, the profession, however, was fairly slow to respond to that, and it took writing a couple of papers and advocating at a national level to encourage, , a national change
Chris Hovorka:by upgrading all of the degree programs in orthotics and prosthetics from what they called a baccalaureate or post-baccalaureate certificate to one, , clear degree, which was the master's degree.
Chris Hovorka:That was eventually decided upon and agreed upon, , at a national level after we graduated our first class.
Chris Hovorka:But it took about five or six years to create a national standard requirement for all future graduates , to come into the profession with a minimum of a master's degree.
Chris Hovorka:So the point I'm trying to share with you is we had some insights based on, past and current trends that informed this, , evidence-based practitioner of the future and a curriculum that we created.
Chris Hovorka:And then as we produced graduates, and they began to show their skills and capabilities the profession gradually came around and said, yeah, I think we need to do this.
Chris Hovorka:We need to upgrade to the master's level.
Chris Hovorka:And that took about five or seven years to do so.
Chris Hovorka:The patients of today more than ever, have more complicated conditions and disease processes than ever before in the history of.
Chris Hovorka:If you look at the, if you look at , the number of people that have more than three, , clinical conditions, comorbidities 20 years ago, they call
Chris Hovorka:If you look at patients that were treated in US healthcare 20, 30 years ago, the number of those individuals that had multi morbid was way less than 50%.
Chris Hovorka:If you now fast forward to today the number of people that are undergoing care and specifically care and orthotics and prosthetics by far, the majority
Chris Hovorka:So in other words, if I was a practitioner treating a patient 20, 30 years ago, they may have only one or two medical conditions that are not, that weren't that complex.
Chris Hovorka:They were still very profound, but they weren't that complex and they could be treated by a person with maybe a little less knowledge and medicine and physiology.
Chris Hovorka:Well, that's no longer the case today.
Chris Hovorka:Fast forward to today, people have multiple medical conditions.
Chris Hovorka:They're receiving multiple medications or other types of overlapping treatments, some of which are counterproductive, and so the clinician today has to unravel that complexity to understand.
Chris Hovorka:How to, what are the most important problems and how to mitigate all those other problems that the individual has.
Chris Hovorka:So it's no longer a luxury to have additional knowledge in medicine and physiology.
Chris Hovorka:It's a necessity in order to appropriately deliver informed care.
Chris Hovorka:So we need, as a profession, to replace some of these manufacturing inefficiencies with digital.
Chris Hovorka:3D manufacturing efficiencies so that we can use that same time that saved time and efficiencies in manufacturer to spend more of it with the patient and really
Chris Hovorka:In some cases that might require some additional research.
Chris Hovorka:And so this trade off between, utilizing , and, uh, capitalizing on these digital technologies and AI informed manufacturing processes that will enable us to, as a profession, to deliver more
Catherine:Wow.
Catherine:And that all makes sense.
Catherine:Words put everything you said into a really awesome perspective, and that is appropriate care.
Chris Hovorka:When you look at healthcare, healthcare and changes in healthcare are largely influenced by technology.
Chris Hovorka:There's an interplay between technology and healthcare.
Chris Hovorka:The onset of the computer changed clinical practice and how, how decisions are made and how paperwork and documentation is done.
Chris Hovorka:If you look at the technology of devices that people use, like prosthesis and orthosis, particularly with the area back again in computers like machine learning and artificial
Chris Hovorka:There are ways now where we can produce and manufacture a device like an orthosis or prosthesis virtually.
Chris Hovorka:Through scanning, surface scanning equipment to render a shape of a body part, we can alter that shape and then we can manufacture it through 3D printing.
Chris Hovorka:We can print it through using metals through 3D printing metal structures.
Chris Hovorka:We have plastic structures, we have carbon composite structures.
Chris Hovorka:We can print.
Chris Hovorka:I'm not saying just because we can, that we should, not always, but we have technologies when used appropriately to create devices in a more efficient and effective manner.
Chris Hovorka:When a provider like myself can utilize technologies to produce devices with greater efficiencies, we have time savings.
Chris Hovorka:I don't have to make some of these devices by hand, which are rather time consuming.
Chris Hovorka:And I can't create something by hand exactly the same every time.
Chris Hovorka:I'm not reliable.
Chris Hovorka:Whereas certain technologies, you can create the same device or same piece of equipment, same every time.
Chris Hovorka:There's some value to that.
Chris Hovorka:But where I, where I'm going with this, Catherine, is with the existing and likely future technologies that are coming on the market for device design and production, I can create those
Chris Hovorka:That time savings can be then used with more face time with the person.
Chris Hovorka:I can get a better understanding of the client that I'm working with, get a better understanding of their goals, their needs, and spend more time fitting and ensuring that the device is appropriate and safe.
Chris Hovorka:That, to me, is a game changer because it broadcasts to me that we can now become technology managers and client-centered practitioners where we can work with the client or the patient.
Chris Hovorka:Let's use an example here.
Chris Hovorka:A person comes to me because they have a, acquired a lower limb amputation because of a car crash.
Chris Hovorka:They lost their limb due to a traumatic injury, and now they're seeing me because they are in need of a replacement artificial limb, I can now spend more time with
Chris Hovorka:They may have other conditions like diabetes, heart disease, on top of that limb loss that need very specific attention and a specific designed device to enable them to move safely and effectively and not hurt themself.
Chris Hovorka:I can spend more time to not miss those critical details in a person's medical history that will further inform the plan of care so that I make less errors.
Chris Hovorka:And because of that, I can only do that now because the technologies available are more efficient and effective for device design and production.
Chris Hovorka:Now let's take that to not just a local level let's now take that to a global level, again, with digital technologies such as the, the mode that we're using through a, a digital platform.
Chris Hovorka:I can see you, you can see me, I can communicate and work with a team of other care providers on the other side of the world.
Chris Hovorka:I can see the patient using a handheld camera, even a phone or I could do it with a whole team of care providers and we can consult together and we can do education and training.
Chris Hovorka:So we can not only take our training program that we're putting together here in Arizona, but we can also create care and educator extenders to people on, in, in other countries, other parts of the world.
Chris Hovorka:So that's one of our goals is to not only do local training for students in the United States that come to our program, but that we also give back to other communities in less
Chris Hovorka:And I think that model tends to be more effective rather than me coming with my own team.
Chris Hovorka:We parachute into the community, we deliver our own set of care, and then we leave.
Chris Hovorka:That obviously that model of coming in which is very well intentioned, but if we don't train the local providers, it's not sustainable.
Chris Hovorka:It's actually does more of a disservice than an appropriate service if you don't train the local providers.
Catherine:And so today we're looking at that future of , , the transition . And proposing strategies for academia to prepare this generation of professionals to evolve and value the care.
Chris Hovorka:Yeah.
Chris Hovorka:It's important to provide a little bit of background on, uh, the profession itself and the need for change.
Chris Hovorka:If you look at the orthotics and prosthetics profession, it's one of the few healthcare professions that a medical device is provided and utilized by a person in some cases for the rest of their life.
Chris Hovorka:It's very visual.
Chris Hovorka:In many cases.
Chris Hovorka:It's, it's really hard to obscure the device.
Chris Hovorka:It's out there.
Chris Hovorka:, So I'm just bringing up our first point of the discussion is that this profession, orthotics and prosthetics is unique in that it's providing a device that's very, , visual and that brings up a lot
Chris Hovorka:The other part that's even more relevant to our discussion in the background is , the, the roots of the profession.
Chris Hovorka:And that is that the profession started as a crafts, an artisan trade.
Chris Hovorka:The profession was rooted where persons designed, , devices by hand.
Chris Hovorka:Almost every part was customized and to that particular individual, whether it was a brace, whether it was a prosthesis.
Chris Hovorka:Most of the early practitioners, we called them technicians back then, they were very skilled artisans.
Chris Hovorka:, but not necessarily, , clinical care providers.
Chris Hovorka:That context is important because in professions that are very skill-based, there is a stereotype of not wanting to share.
Chris Hovorka:When I started in the profession 30 years ago, which was still very handcraft oriented and there were very little commercially available parts, I had to make a lot of things myself, and
Chris Hovorka:It was this notion of let's just keep the information to ourselves and not share.
Chris Hovorka:It was a barrier to advancement in methods and techniques of how we provide care.
Chris Hovorka:The other part, , that's important to the discussion about it, why a change is that with the onset of digital technologies, computer technologies, , that really advanced the technology creation.
Chris Hovorka:So, in other words, 30 years ago as a practitioner, I would design and create a lot of the parts for a device myself for the patient.
Chris Hovorka:And about maybe 15, 20 years ago, we could now create commercially available orthotic and prosthetic products that we could never do before.
Chris Hovorka:Another part is that the reimbursement for orthotic and prosthetic care is going down.
Chris Hovorka:It's not going up, , for various reasons.
Chris Hovorka:One of which is the medical and healthcare system is very expensive in the United States.
Chris Hovorka:And, , national decision makers at the national level are trying to find ways to reduce costs.
Chris Hovorka:So orthotics and prosthetics is, , is affected through cost cutting measures by reducing reimbursement.
Chris Hovorka:Okay, so what does this mean?
Chris Hovorka:We have a profession that has a tradition of handcrafting.
Chris Hovorka:We have this, , reduction in reimbursement, and we have new technologies that are replacing handcrafting.
Chris Hovorka:Well, this now offers a lot more opportunity for change and, and to perhaps improve care through change.
Chris Hovorka:And let me give you an example.
Chris Hovorka:. , there are some prosthetic orthotic devices that are too complex to 3D print, and in those cases they still need to be handcrafted.
Chris Hovorka:But the majority of devices, I believe the technology is now shown, , can be 3D printed.
Chris Hovorka:So that's the strategy.
Chris Hovorka:Capitalize on digital technologies to improve efficiencies in the manufacturing of prosthetic orthotic devices.
Chris Hovorka:And the time savings can then be spent by the practitioner, , with the patient.
Catherine:Why is it that these financial efficiencies have to come on the responsibility of the practitioners?
Catherine:When costs start to be cut at the practitioner's level, what are we losing as a medical client?
Chris Hovorka:Yes.
Chris Hovorka:Great question.
Chris Hovorka:Uh, so, so to answer that question kind of relates to the history of the profession based as a technical trade.
Chris Hovorka:, as the profession advanced towards a clinical practice and less of a technical trade, one of the things that didn't evolve with it was the reimbursement system.
Chris Hovorka:So the current reimbursement system in orthotics and prosthetics has not changed, , since it was formulated decades ago, and that is that the, the care provision is solely anchored to the device.
Chris Hovorka:In other words, as a clinical practitioner, if I was to see you as a patient all the time that I spend with you to get to know you, to understand your needs
Chris Hovorka:and I can't bill for it.
Chris Hovorka:I can only bill for the product that I provide to you.
Chris Hovorka:, it's called , durable medical equipment, uh, reimbursement plan through the federal government.
Chris Hovorka:And until our profession can, can show an appropriate amount of evidence to overturn that and show that there's an improvement in care that can be provided through spending more
Chris Hovorka:So it's a conundrum.
Chris Hovorka:Chris explains the client centric training approach.
Chris Hovorka:This client-centered care approach, which is part of our model.
Chris Hovorka:We're adopting some principles that were very successful with that approach in Europe and Canada.
Chris Hovorka:, I've formulated the curriculum.
Chris Hovorka:I've written some position papers to help my colleagues in academia and in clinical care in the United States understand
Chris Hovorka:our approach.
Chris Hovorka:And that's strategic because I, I need to help engage in some open discussion of this approach so that I can begin to identify and recruit supporters.
Chris Hovorka:When you're proposing something new, there are people that are nervous or not comfortable and sometimes that discomfort can come out as anger or frustration.
Chris Hovorka:It takes many different behavioral forms.
Chris Hovorka:And my approach is to be patient, to be open, to have some discussion and not discount other individuals views.
Chris Hovorka:And so there's gonna be a period, I guess what I'm saying is , I'm preparing for resistance as I begin to unfold and unveil our model.
Chris Hovorka:The client or the person , in some cases, they're the expert.
Chris Hovorka:They're the expert of themselves.
Chris Hovorka:. They're the ones in most cases that know themselves better than anybody else.
Chris Hovorka:So, , it's taken me a while to figure that out.
Chris Hovorka:, it's kind of intuitive and obvious, but sometimes we get caught in the weeds.
Chris Hovorka:I'm a victim of that too.
Chris Hovorka:But I've learned now that by engaging in open discussion and establishing rapport with a person so that they feel comfortable to have honest and truthful conversation with another, like myself
Chris Hovorka:And also on the other hand, to get to the truth of what's not appropriate, what's overreaching.
Chris Hovorka:In many cases that's, that's a problem where there's not this honest discussion about, okay, we can do this for you, but you know, this other thing that you want, we probably
Chris Hovorka:If you don't drill into that honest discussion with a person, the goal may not be achievable, and then the treatment plan is overreaching
Chris Hovorka:and it can be a big error.
Chris Hovorka:So this client centered approach and the practitioner understanding the value of the person just reoriented, you know, that the person is part of the plan of care, they participate.
Chris Hovorka:That's a critical element to this new, this new approach of client-centered practice...
Catherine:I applaud you for that.
Catherine:And Dr.
Catherine:Michael Gerhardt, from Germany, whom I had on the show, he said, and I love this quote, and I use it often.
Catherine:Let's try to get it right instead of trying to be right.
Catherine:And I think that's exactly what you're doing.
Catherine:You're trying to get it right.
Chris Hovorka:I've seen persons who may or may perhaps not be as physically capable as I am and seeing the challenges that they have to face in their
Chris Hovorka:and the attitudes that they have.
Chris Hovorka:It's inspiring for me.
Chris Hovorka:It's hard to not be positive and grateful for what I have.
Chris Hovorka:So I'm inspired and that's what makes it relatively easy for me to, to take the positive approach.
Catherine:So, Chris, with all of the work that you've done and all of the patients you've worked with can you tell us about one of the most inspiring times that you had with the person that you fitted with the device
Chris Hovorka:yes.
Chris Hovorka:The handful of people, but one person that really stood out to me is I was practicing many years ago on the East Coast up in the, up in New England, and I was referred
Chris Hovorka:She was very outdoors oriented.
Chris Hovorka:And she was hiking in the woods up in Massachusetts, I believe, and
Chris Hovorka:, she fell and cut her leg on a fallen tree.
Chris Hovorka:While the fallen tree had been undergoing decay, and when she cut her leg, unbeknownst to her after she cleaned the wound out in the field it became infected.
Chris Hovorka:And she acquired a, a condition called Meningococcemia, which is just a fancy word, that she had a, she had a an infection
Chris Hovorka:that went systemic.
Chris Hovorka:It went not only localized in her leg, but it went throughout other parts of her body.
Chris Hovorka:And this particular infection is vicious because one of its effects is it kills certain types of tissues.
Chris Hovorka:And so essentially her body's immune system was causing decay of what used to be viable tissues in her extremities, her hands and her feet, and as part of a life-saving maneuver
Chris Hovorka:The, the surgical team had to amputate all four of her limbs at different levels in one, one limb she was amputated above the knee, another limb.
Chris Hovorka:She was amputated below the knee on both upper extremities she lost her hands, so all four extremities she had varying levels of limb loss and this woman, by the way, was in her early twenties.
Chris Hovorka:She had her whole life ahead of her.
Chris Hovorka:Bright very, very ambitious.
Chris Hovorka:Happened to be physically very attractive.
Chris Hovorka:She was a former model, so imagine a former model youngish 20 something, life ahead of her is now disfigured.
Chris Hovorka:And I should add that this particular condition also causes extensive scarring.
Chris Hovorka:So she had scars on her neck and part of her face, so, This was obviously life altering medical event.
Chris Hovorka:And I think any, any typical person that would likely encounter that would be devastated.
Chris Hovorka:I mean, that could be it would be so easy to fall into a, a deep depression and it would be difficult to, to become motivated.
Chris Hovorka:Like how do you recalibrate your life after all that.
Chris Hovorka:You don't, anyway, so I'm kind of getting to the point that it was difficult.
Chris Hovorka:Well, when I saw her for for the very first time, she was so grateful to be alive.
Chris Hovorka:She had a lot of life in her and she was only looking to the future.
Chris Hovorka:So, I was impressed and kind of taken aback by how positive and hopeful she was despite these potential limitations, and she motivated me to become a more I wanted to be the best I could be.
Chris Hovorka:I mean, my, I felt a, a profound responsibility to not let her down, so she motivated me and helped me up my game just with her own attitude and behavior.
Chris Hovorka:It was so inspiring.
Chris Hovorka:And I ended up working with a team of, of other Orthotists and Prosthetists and physicians.
Chris Hovorka:It wasn't me alone, I was part of a team to provide these devices to her.
Chris Hovorka:And then we also worked with another group of therapists to help her train and adapt and learn to cope with her new lifestyle with these technologies.
Chris Hovorka:And I would see her occasionally for adjustments and follow-ups.
Chris Hovorka:And every time I saw her, she was just engaged in more and more activities.
Chris Hovorka:She ended up , going on to get a master's degree in social work.
Chris Hovorka:Her goal was to help people and and to help utilize resources to enable people to get through their challenges of their life.
Chris Hovorka:. And she ended up also becoming an advocate for people with limb loss, a spokesperson.
Chris Hovorka:And today, she's now a national figure.
Chris Hovorka:So she was one of my most inspiring stories based on the, the number of challenges she had ahead of her.
Chris Hovorka:And she overcame and excelled.
Chris Hovorka:She found her own, her own positive imprint and, and excelled at it.
Chris Hovorka:It was really, really cool.
Catherine:That is such a great story, and I'm so happy for, for you that you were inspired to become the better Chris, and, and to go beyond what you thought you ever could, and of course for her, so, so inspiring.
Catherine:Thank you so much for sharing that.
Catherine:Wow.
Catherine:Wow.
Catherine:So, Well, with that, your work is again, the extensiveness because it, it doesn't end with just a model of a program.
Catherine:It's not going to end because it's a continuing process of researching these treatments and researching how to provide a better quality of life for people who have movement
Catherine:Chris, this has been extremely inspirational and , I am truly inspired by your work and the fact that you started your work at such a young age by being inspired by others who had some sort of movement limitation.
Catherine:And I truly applaud you sticking to your journey and really realizing that there was not just a future for you as far as work goes, but a future for you
Catherine:implementing the needs, implementing for the needs of people around the world to better their lives and to bring them a better quality of life through your research on prosthetic treatments
Catherine:So to end today, Chris, and you have been inspiring, what are your last inspiring words you would like to share
Catherine:?
Catherine:. Well, I, I guess a couple, uh, that I've learned along the way, which have really helped to inform me and my attitude, and that is , I found that when I stay curious , and I have
Catherine:And I found that being curious and wondering has just opened up so many doors , and new thoughts and frontiers for me that has just been really remarkable.
Catherine:Uh, so curiosity has been a big part of what I do and how I do it.
Catherine:And I would encourage your listeners to, to also be curious, and it's okay to ask questions or to wonder, and in many cases, it, it engages a discussion , or an understanding of another viewpoint.
Catherine:It opens up your mind to consider alternatives and challenges.
Catherine:And so that's been a really, , guiding principle for me and then the other part that I'd like to share with your listeners, and it kind of goes along with the be curious I've not just adopted these on my own
Catherine:, these were principles that were devised and decided by, by really smart people before me.
Catherine:And one of those smart people before me was Einstein I don't know the exact quote, but it was something to the effect of if you're not learning, you're dying.
Catherine:But , I would tweak that just a little bit because you can learn in a lot of ways, but it may not necessarily be, , favorable or it may be damaging to your psyche or your behavior.
Catherine:So I tweaked the statement and I adopted a revised version of that statement, which is, if you're not learning, and having fun.
Catherine:You're dying.
Catherine:There you go.
Catherine:Chris, thank you so much for engaging in science.
Chris Hovorka:You bet.
Chris Hovorka:It's been a lot of fun.
Chris Hovorka:. Catherine: I can tell.
Chris Hovorka:Thank you for the contributions.
Chris Hovorka:.
Chris Hovorka:And you might find this article interesting, the orthotics and prosthetics edge, March 22 on guiding the transition to client centric training.
Chris Hovorka:Something you can Google and you know, really the need to move on to this is so imperative.
Chris Hovorka:Thank you to Chris again for pushing this to an international level.
Chris Hovorka:To find his peer reviewed research and articles just Google Chris Hovorka C H R I S H O V O R K a.
Chris Hovorka:Or Google client centric approaches.
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Chris Hovorka:See you in February with more exciting, positive imprints.
Chris Hovorka:Until then safe journeys.
Chris Hovorka:Your positive imprint.