We caught up with the brilliant and insightful Aidan Houlihan a few weeks ago and have shared our conversation below.

Aidan, looking forward to hearing all of your stories today. Have you ever experienced a times when your entire field felt like it was taking a U-Turn?

The paradigm for scoliosis treatment in the United States is shifting. 3-dimensional bracing and Schroth Exercise, which have been mainstays of scoliosis treatment in Europe for decades, are finally proliferating in the U.S. Schroth Therapy was only introduced in the U.S. in 2004, Rigo-Cheneau style bracing was introduced shortly afterwards in 2005, but establishing these practices as the standard of care has been a long road. For decades, including the 2000’s, and 2010’s, our treatment options for scoliosis have been “do nothing until the curve is big enough to brace”, “wear a brace”, and “spinal fusion surgery”, with NOTHING in between. Beginning around 2010, studies started popping up in the literature investigating the efficacy Schroth Therapy. Now, it is the most thoroughly studied non-operative scoliosis treatment method available. Many providers still don’t think of recommending physical therapy for scoliosis patients because for so long, it wasn’t even an option. Larger metro areas like New York, LA, and Seattle all have a dozen or so Schroth trained therapists now, but Phoenix has been behind the curve (as has the Southwest as a whole). Thankfully, more and more therapists are becoming certified in the Phoenix area, and Schroth Therapy is starting to trickle into smaller, previously desolate regions for scoliosis treatment. Providers of all types who want to stay up-to-date with best practices for scoliosis should familiarize themselves with the robust body of research, find Schroth trained therapists in their area, and offer physical therapy as an option to their patients.

Aidan, before we move on to more of these sorts of questions, can you take some time to bring our readers up to speed on you and what you do?

Scottsdale Scoliosis & Spine Therapy is the largest provider of Schroth Therapy in Arizona. The Schroth Method is the gold standard globally for non-surgical intervention. It differs from traditional physical therapy in that each exercise is designed specifically to address a person’s individual curve. Stock photos cannot represent the detail, the intricacies, and the customization involved in a Schroth Exercise. I spend a lot of time doing education with patients so they understand WHY they are doing their exercises, not just aimlessly reading from a list. This ensures a more comprehensive understanding of your curve pattern, which is essential for autonomy with your scoliosis care. My goal for patients is for me to be the last provider they ever have to see about their scoliosis. I want my patient’s to have an understanding so thorough, so detailed, and so advanced, that they can avoid complications of their scoliosis in the future, and if complications are unavailable, they will understand how to address the problems by themselves.

One thing I want patient’s to understand about me is how much I care and how invested I am in their success. I text back and forth with patients every day to answer questions. I spend time making sure my clinic is clean, calm, and comfortable. I work off the clock 10-20 hours per week answering phone calls, answering emails, scheduling consultations, organizing our bracing clinics, operating our social media, reaching out to previous patients for progress updates, and tailoring home exercise programs. I spend time researching treatment outcomes, brace types and protocols, exercise dosage, efficacy of other common treatment techniques, etc. When you work with me, you are not working with a burnt-out, fighting-to-survive, clock-puncher in a mill clinic, you are getting the best version of what our profession has to offer.

Are there any books, videos or other content that you feel have meaningfully impacted your thinking?

As cliche as it may sound, I found a turning point in my productivity after reading David Goggins “Can’t Hurt Me” and “Never Finished”. I was inspired by what the human potential could be. A quote from one of the books that stuck with me was “David Goggins couldn’t do it, so I just created someone who could”. The only difference between me and the business owner/clinician I aspired to be was I hadn’t decided to put the work in yet. I asked myself “what would the best version of me be doing right now” and then I started doing it. I started waking up earlier, putting in more work before I clocked in and after I clocked out, networking more, getting more active on social media, reorganizing our website, and in one month we increased our clinic revenue by almost 40%. The best part was that we didn’t have to compromise on any of the values that define our practice. We didn’t schedule 4 patients per hour, we didn’t contract with every major insurance carrier to get as many people in the door as possible, we didn’t cut corners on low-quality generic home exercise programs, we didn’t cram to get as many billable units per visit as possible, we just continue providing the high-quality service that our patients have always expected from us. Quality will always outweigh quantity, and there will always be a patient population who appreciates it.

Putting training and knowledge aside, what else do you think really matters in terms of succeeding in your field?

As a physical therapist, one thing that I think is essential to the success of your patients and your business is setting yourself up to be able to give your whole self to each patient. One of my clinical rotations in PT school was in a therapy mill, and it was a nightmare. How can a therapist possibly operate at their best while treating 3-4 patients simultaneously? We are experiencing horrifically low (and dropping) insurance reimbursement rates that have fueled the growth of mega-corporation PT practices that profit by shoving as many people in the clinic simultaneously as fire regulations will allow. That creates a situation where a therapist has to operate way outside their capacity day in and day out, guaranteeing that quality of care will drop (as research has demonstrated). Imagine if surgeons had to perform 2-3 surgeries at a time? It would be a massacre, and our patient’s are getting massacred out here. I can’t tell you how many times I have had a patient come from a therapy-mill clinic, and they didn’t know what exercises they were doing or why they were doing them, did not improve, and are now seeing me for a second bout of treatment for the same problem. Therapist burnout is at an all-time high, and to set ourselves and our profession up for success, we have to push back against unethical businesses that unequivocally and inexcusably sacrifice patient care for money. Do not take that job, do not settle for that salary, and remember why you started this journey to begin with! Every PT I know got in this business because we want to help others- do not lay down your morals and become another gear in a machine that is grinding quality patient care to a bloody pulp. The best therapist you know probably isn’t treating 30 patients a day, because an expert clinician knows that their time is worth more than that.

Contact Info:

• Website: ScottsdaleSST.com
• Instagram: Aidanhoulihan
• Facebook: Scottsdale Scoliosis & Spine Therapy
• Youtube: /@DrHoulihan
• Other: TikTok @doctorhoulihan