Modern Patient Education Tools with Dr. Jerome Fryer

Founder of Dynamic Disc Designs

Dr. Fryer’s patient-centered approach focuses on improving health by carefully investigating the anatomy in question to reduce pain and symptoms. He believes in an integrated approach, bringing together the knowledge learned from all aspects.

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Episode Transcript

Dr. Jeff Langmaid: Hey Docs, I’m Dr. Jeff Langmaid here with my co-host, Dr. Jason Deitch, for our featured guest today, and we are lucky to sit down, have a conversation with an entrepreneur, a Chiropractor, a man of many talents, Dr. Jerome Friar of Dynamic Chiropractic and Dynamic Disc Designs. Jerome, thanks for taking some time and coming on today, man.

Dr. Jerome Fryer: Oh, it’s an absolute pleasure to make the cut here.

Dr. Jeff Langmaid: It is our pleasure to talk and one of the things that has been fascinating. I know we’ve chatted at a variety of conferences throughout the last few years and in my opinion what you’ve been able to create with Dynamic Disc Designs is, you know, top of the class. I’d love for you to just trace it back a little bit and let everybody know, how did you get started in such an endeavor?

Dr. Jerome Fryer: Oh, well, you know, I had moved practices and locations because of I saw that it wasn’t. We had children and we needed to move to a different location to give them more bells and whistles. So I was basically I had dead space in my schedule. And it was very uncomfortable for me, right? So I thought, OK, here’s like you can’t just sit there and do nothing. So I so I fired up some research ideas and I got that moving. And then at the same time, I thought, You know what I want to create? And at the same time, when I was researching how dynamic a disk is, how diurnal it is, the changes of symptoms and that sort of thing, I knew that, you know, disks are diurnal. They change the form. They move, they shear. They compress they herniate. And I thought, Well, you know what? Why don’t I just want to build something for myself to build my anemic practice? Something that was more realistic to help like just step up patient education, because I know when you invest in patient education, the referrals just come right because you’re teaching them what is going on with their bodies, with the patients bodies. And I’ve always felt that the best, best investment. So with my previous clinic, I had that degeneration phase model and I use that and then I had a full skeleton that our full spine that I’d constantly break and I’d have to send it in for repair.

Dr. Jerome Fryer: And it was just annoying. And then I thought, You know what? So I started creating, you know, create a disk with foam, and I just dipped it in water. And I just put it in between two retrieval bodies. And I just saw compressed in the water would kind of dribble out around it. You started drinking. You know what we can do better here, because models are static and symptoms are dynamic. So. I got to work, I just started, you know, with dead space, I started getting creative. I started researching, you know? And next thing you know, I’ve got I created this model and it was for my own purpose and the guy across the hallway that I was, you know, an associate with. He’d said. Could I could I get one of those? You want what? And then it was like, Oh. If I have something here for the greater masses. So, yeah, and then, you know, it was interesting. So I went to a guy I remember going to a conference and I was like, OK, what’s what are people going to pay for this price point? What are people actually going to pay for this? So I went to this conference. It’s PCD Chiropractor, and I don’t want and I put it, you know, I was at a roundtable, I put it in the middle and I said, OK? I said, What do you what would you guys pay for that right in the first guy goes.

Dr. Jerome Fryer: Zero bucks. Like, Oh. Ok, go to the next guy goes, woo. When I showed them here at home, I’d pay seven hundred, oh, seven hundred zero to 700. I’m getting quite the rent. So anyways, I went around and I got some sort of average and I went, OK, what’s the market going to bear? Then I kind of backtracked and figured out how much anatomy I could pack into this thing at that price point and still make a bit of a profit and then give the the, you know, the doctor the best model they could have at that price point. And I don’t have distribution, so it’s all just shipped right out of warehouse. So then I have to worry about the 30 percent on top of that so I can invest that back into the products. That’s the start of it. And then I started going to conferences and the oohs and ahs and the lineups and the and then it’s just, you know, do you have a stenosis model? So the next year I would come I develop a stenosis model. Do you have a spinal? This thesis model, you have this. So every year I would just listen to my customers. Next thing I know, I’ve got this portfolio of models now and they’re being sold all over the world.

Dr. Jason Deitch: Jerome is a great story. As they say, necessity is the mother of invention, and it sounds like there’s been a need for that. Would you mind? I know you keep moving that around, but would you sort of show everybody kind of, what is it? How do you use it to teach people about what they need to know?

Dr. Jerome Fryer: It really is case specific, right? So this one was the first model that I ever created, and I’ve added new features as time has gone on this right. But this one is everyone likes this one because it actually has an annulus, a nucleus, it has innovation on the outer third of the annulus, it’s got a radial fissure, it’s got it’s got concentric fissures, it’s got a new cotaquinoa with the actual rootlets to scale a number and you can show how you can get stenosis type of symptoms associated with encroachment on the on the rootlets. You can see that. So, you know, this one, you could see it actually herniates under load. So there’s a nucleus that actually intrudes. You could see that right under flexion load if someone has symptoms as it relates, you know, I was shoveling and next thing, you know, oh, I felt something in my back, right? And then, you know, you suspect. There’s a herniation, you can show them the mechanism and then you can show them the solution and what we need to do to solve the situation, right? Whether it’s a large extrusion that will in time resort. Or is a protrusion on this side? That’s a little bit tricky in management sometimes. So this one designed with the circumferential disk bulge, and they’re all created from real cadaveric specimens, so they’re to scale to, I think scale is important. I’ve gone to shows and people are like, Oh, why don’t you scale this thing up, right? You know, four times as big, so I could show, well, guess what, when you lose scale you, you lose as an aspect of of realism, you lose.

Dr. Jerome Fryer: People need to understand that discs are that big. Not this big. So they can start to get a sense of when you load it, they go, Oh, OK, so. So at the end of the day, my back starts to hurt a little bit. Is it because maybe my sets are coming closer together when I sit? There’s a little bit of relief. Or maybe there’s a symptomatic Bessette. And as the day goes on, it’s like, Oh, it hurts more. Or, you know, when I walk, it hurts. Or when I get out of a chair, it hurts. So it’s just so important. Like, I’ll give you an example. Yesterday, I had a patient that had shoulder pain, and she also had, she said, she was having calf pain, right left calf pain. And I said, well, how is your back, right? Oh, yeah, you know, I used to get sciatica a lot on the right, you know? You know, there’s problems on the right, but that seemed to resolve. I used to see Chiropractic about five or six years ago, but then I went to the yoga mat and it’s kind of replaced that a little bit, right? So it’s been five or six years. So you have to think that there has been this height loss over five to six years. There, right time, gravity load, there’s a little bit there’s a little bit of heat loss, it’s got to be a little bit of compressive load. Plus, she said she really didn’t have any back pain. So I began evaluating her shoulder, but then when I got into her lower back prone, I started to do to evaluation.

Dr. Jerome Fryer: She’s like, Oh, really sore, right? Really sore. So I was like, Whoa, OK. It’s actually symptomatic back, but it wasn’t really presenting presenting down the leg, so I’ll just move this along. I did some gentle flexion distraction. It is gentle because I can tell she’s like, Oh, that feels good. Oh oh, oh, oh right. And I know that there are tissues moving in there. So I backed off. I I’ve been down this road before, so I was doing some flexion distraction. And guess what? And often I’ll do leg extensions to kind of set the back again because sometimes people get off, it’s a bit sore. Well, she was very symptomatic and I’m like, Oh darn, she came in without back pain. Now she has back pain. And how do we how do I manage this now? Now she’s all of a sudden the mood changed. We’ve all been there, but I was able to grab my hyper mobility model. I don’t have. It’s in my room, but I was able to show the patient that, you know what? Very likely what you have there. You’ve got a hyper mobile segment, right? And. All of a sudden, she’s like, Oh, you revealed something in there that I didn’t know. So so when you ask me about how to use it, every case is specific and you have to be adaptable and you have to be ready to explain symptoms that patients have even when they’re they’re not expected. And when you get into those tough situations where you need to explain why some patients are even maybe a little bit more sensitive and then it creates a framework moving forward.

Dr. Jeff Langmaid: So, Jerome, that’s I appreciate you sharing sharing that story because I know we have all been there. We’ve all, you know, we’ve all had those patients. And, you know, I’ll say, every single time that I’ve taught across every single platform. And if docs are watching this thing and probably, you know, scout out one of your models sitting right right next to me here, always an arm’s length away. I find it to be an invaluable teaching tool, and one thing you mentioned was cadaveric specimens. I think I pronounce that correctly. What’s the production process like on these? I think that’s just fascinating that you’ve been able to bring something to market. How do you how do you do it in a nutshell? And where do you start? And obviously until that shipment point, going out to a doc to be able to use in his community?

Dr. Jerome Fryer: Yeah, that one’s proprietary. Sorry, Jeff, I can’t explain I. It’s something that I’ve worked on for a long, long time and I want to keep that kind of held close. But it was. It’s a challenge, right? It’s not easy to produce these things right? And it took a lot of R&D and it took probably about, well to get it really, really developed. You know, it was like three years of R&D, right? So but it all starts with real catalytic specimens. That’s kind of where the framework starts. The, you know, like once I purchase these real catalytic specimens, I go and look for specific pathology within the bony anatomy. Gotcha. Like this one, for example, this one has. You can see that there is significant this is this is significant, not osteoarthritis there here. Yeah, right. And there’s sub sclerosis here on this facet joint and this has a spinal canal with a thickened ligament and flavin. So then what I do is I go on and I create the soft tissues to match. The Bonny story I do my best, I do my best to look at what k- what has caused that great versus that? Yeah. With my understanding of anatomy, I begin to craft. The vessel elastic structures, this one of just share with you quickly add a patient that came in that had stenosis, right? Stone analysis.

Dr. Jerome Fryer: She’s been to countless other people. There’s been, you know, symptoms have been going up and down and up and down, and now they’re getting worse. And she just wants an understanding understanding of an understanding, excuse me, of of her symptoms. I said, OK, this is stenosis. You see, Canal feel the friction, so I got her to grab the pen and she could actually feel the friction. You get her to slide it back and forth because nerves are moving when we’re walking. And then I squeeze the finest processes together, and all of a sudden the pen got tight. And then I explained to her that when she sits is flexion and the pen got loose. And I told her, We’re dealing with these spaces are small, but there is hope when you understand what the holes do when you move your back a certain way. So all of a sudden she came back the second visit. She goes, I just can’t believe it. After all these years, I totally, I totally understand. And she wasn’t looking for like a necessary solution, but a strategy moving forward into her next few decades. So now she has a clear idea about the stenosis, and it was the model that actually helped her understand her own anatomy.

Dr. Jason Deitch: They do say a picture is worth a thousand words that’s got to be worth even more than the picture. What I want to ask you about is if people are watching, if they notice above your head behind you, there you go. That looks like it’s more than a model you created. You want to give us a quick understanding of what is that?

Dr. Jerome Fryer: Well, what do you think it is? Looks kind of bony, doesn’t it? Looks like somebody’s got bony with Moby Dick. Yeah, exactly. So this is actually. These are 11 vertebrae of a blue whale. And this these and this one was out of sequence, I just didn’t feel right, this was this, this last vertebrae here, I just couldn’t match it up with this one because there’s a trough here where the main artery sits, and you could tell that that one was up to mammal a little further. But this is of a blue whale with doing it to me. Back in two thousand three and dragged up off the bottom of a of the ocean about 40 kilometers off the coast of British Columbia, and they were donated to me, so I thought I’d string them up.

Dr. Jeff Langmaid: I think it is one of the best and most unique office accouterments I have seen today. I think I think it’s awesome with with your models that are, I’m going to say, much more scaled down realistic size of a human slightly smaller than a blue whale out there. What’s maybe the most popular? I’ll ask you two questions here. What’s the most popular model that you see dogs picking up and what’s maybe either currently available in the product line that you’re super excited about or something docks could look forward to over the course of this year? Because I know you’re always kind of scouting out and, you know, new opportunities to showcase again patient education through dynamic disk designs.

Dr. Jerome Fryer: So the most popular ones still remains the very first model that I ever created now with up grades, but it’s the one to your left right. It’s that one right there. It’s the professional model. Yeah, that one I’ve packed in as much as I can to give people as much patient education experience. It’s like a, you know, like an SUV or a utility of all the models, right? I tried to. So that’s got good despite, you know, it doesn’t have any osteo fights on the on the facet joint. So that one’s the most popular and it continues to be the most value. You can get the quintet with the new route lets and the momentum flavor, and you can get options of spineless thesis on that. So that one is kind of the still the most popular one if you’re thinking about just purchasing one. You know, I’ve just been hired by a company to build knees, so that one’s kind of excited. Exciting. It’s for a knee implant company, so that one’s coming out soon. But that was that was a task, you know, getting all to scale all the ACL, PCL and the ACL, LCL and then the sky all to scale and the highland cartilage. So but now it actually has dynamic movement. You can see the shear and feel it, and you can see how the approximation of the of the femur and the tibia. Anyways, it’s just it comes to life. Yeah. And you know, my hyper mobility model, I think the research is starting to show that, you know, we’re dealing with the often, you know, segments that have uneven motion sharing or one segments moving a little too much and not enough. So now now we can talk a little bit about that with patients a little bit more accurately. So yeah, it’s absolutely awesome.

Dr. Jason Deitch: It’s have you found it to be rewarding? I mean, what kind of feedback do you get from docs besides your own patients? Obviously, many of them are going, I finally understand my problem. Thank you, doc docs.

Dr. Jerome Fryer: Yeah, they say it revolutionized the way they practice because it’s all of a sudden they’re like, you know, it’s just changed. It’s changed their patient education delivery. It’s really quick for them to saves them so much time and it’s long lasting. You show the patient once and then all of a sudden often they’re like, I’ve never seen that before, and they’re like. Kind of lifers, yeah, right, because no one showed them. The accuracy of what is going on in their own spine, so, yeah, you know, it’s awesome. I got people that just like, you know, these are the best things. Jerome, thanks for making it. She cheered me on. They got their pom poms out and they’re cheering me on. And it’s great, you know, but I want to just make sure I continue to deliver a great product for all the docs out there.

Dr. Jeff Langmaid: Jerome, you certainly have done that. And then some we appreciate you taking some time today. We encourage everybody listening and watching. Please check out dynamic disk designs will drop that link down below and on behalf of Dr. Jason myself. Dr. Jeff Jerome, thanks so much for taking some time. Sounds like you have patients coming in right now, so we’ll catch you very, very soon. Bye bye.

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