Dr. Vince Gutierrez

11/01/2026

I asked Google AI who I am and I was impressed with what AI can collect in a short period of time.

Are patients actually googling their PTs?

What would AI say about you?

10/31/2026



This article was pretty straightforward. Avoiding surgery saved a lot of money and time away from work

This is the obvious result when comparing 3 visits of manual therapy vs carpal tunnel surgery.

For me, treating CTS has been hit or miss.

I can either reduce the symptoms quickly, and when I get this result it is typically from a cervical intervention or I can pound my head against the wall for a couple of weeks with nothing but some education given to the patient regarding nerves and what to watch for over time.

Interesting in this study, manual therapy was performed at both the arm and cervical spine. It is hard to discern which intervention seemed to help from the article, but that wasn’t the article’s purpose.

The authors note at least twice in the article that historical research has found surgery to be more effective than PT for CTS, but this article demonstrates that PT was equally effective.

10/31/2026

This meal brings back a lot of memories.

I can remember my Grandma with beans and rice on the stove everyday and it seemed like all day.

She would soak the beans and then boil the beans. Mash the beans and then the beans would simmer all day on the stove.

This with “eggies” and chorizo with homemade flour tortillas would be the staple of the meals everyday.

As an adult, I don’t have the time to prep and mash the beans. Out of the can is the best I am going to do now, but it still brings back memories watching the beans simmer on the stove.

Happy Halloween all and stay safe out there.

10/29/2026

Had a conversation with parents at the bus stop.

In healthcare, we are seeing the rise of AI.

Ten years ago, I had a patient come in with the book “Crooked”

https://link.amazon/B017JnlHb

He asked me very thoughtful questions about Stuart McGill methods, McKenzie Methods and general core stabilization.

He had already read the book and had the information, but he wanted a PT that understood the evidence on back pain.

This patient interviewed 2 other PTs before choosing me.

With AI, all of this information is at a patient’s fingertips.

Tangent: I recently had a third degree heart block, which is a very serious condition that leads to death if not treated as an emergency. While in the hospital, I was having conversations with AI to determine what questions to ask the physicians, clarify the physician’s answers and to give me alternative diagnoses that could’ve prevented the need for a pacemaker.

I had these conversations with the physicians and we held off on the permanent pacemaker for 2 days while waiting for testing for alternative causes that would’ve prevented the need for a pacemaker. The testing came back negative and I was more confident that I needed the pacemaker. I would’ve had regrets had I gone with the pacemaker without knowing the results of the other testing. The physician was good with the discussion and testing to rule out the other possibilities.

As a PT, are you ready for these conversations with patients?

As a PT are you able to clarify AI, CORRECT AI (we know that it’s not all knowing…yet), and listen and converse with patients.

We are no longer the gatekeeper of information.

We will be less and less the gatekeeper of information as AI moves to scale.

The PTs that can continue to get patients on the schedule are going to be those that communicate well, demonstrate empathy, create a strong therapeutic alliance and can work with AI.

Are you at this level or does the coming AI wave make you feel less capable and bring out more imposter syndrome? 🫣

If you get nothing out of this discussion…below is a picture of our chicken, Ralph. He will lighten the discussion.

10/25/2026

As a PT, we sometimes have to look beyond the patient’s complaint in order to positively affect the complaint.

In cases of tendon pain, we have to address the peripheral nerves, the spine and sometimes the brain in order to help the patient.

10/17/2026

This is a great case series.

This demonstrates that pain education in addition to other treatments can be affective at treating localized symptoms, previously believed to be related only to tendinopathies.

I’ll be honest, I tend to space out my pain education over the course of multiple sessions, but this case series has me questioning if I may be overcomplicating the matter or underestimating the patient’s ability to understand the concepts.

The authors spent nearly an entire session focusing on central sensitivity education and ensuring that the patients had an understanding beyond tissue damage and nociception.

It’s hard to argue with the results, especially when considering that the patients had undergone previous PT and the symptoms were chronic in nature.

This reduces the “regression to the mean” argument.

Highly recommend reading the article.

10/14/2026

Give and take.

When a patient expresses concerns or feelings, don’t let it slide by without a response.

It has the potential to redraw a patients pain

10/14/2026

Want to affect a patient’s pain

Listen AND respond

One without the other is not as good.

10/14/2026

You hear me
You see me
You understand me

If I can get some version of this with the patient, which could be head nods, smiles, banter, then I know that this is going to be a good episode of care. I spend the first couple of sessions just trying to get this because this could be more important than the puzzle that is the patient’s symptomatic presentation.

pain

10/14/2026

What I found interesting in the study is the wide range of missed opportunities to provide an empathic response.

I truly believe that therapeutic alliance is one of the best tools that we have in our toolbox.

This could be placebo related.

We aren’t in a militaristic setting and so I have to get the patient to know, like and trust me in order for that patient to follow through on recommendations that I am giving in the session and to follow through with at home.

If I am not building that alliance, then all of the other tools may become useless to me.

To think that patients that have an empathetic response from the PT have less pain, and knowing that a majority of patients are coming to outpatient ortho for pain complaints, this is low hanging fruit.

How many physical therapists believe that the they are providing empathetic care?

If not, why not…

I’ve heard many patients state that:
-the PTs are having hen sessions amongst themselves
-there’s too many patients to focus on one patient
-the PT is always behind a screen

What causes PTs to miss opportunities to provide empathic care and build that alliance with patients?

AbstractImportance. Empathic communication is recommended in chronic pain management, yet few studies have examined the role of provider communication on t