I am elated to have Dr. Garima Anandani (PT), clinical director at the Qi spine clinic in today’s spotlight. Personally, for me, it was inspiring to know her journey and many other facets of her personality. Her hard work, passion and a drive to be the best in what she does made her a leading spine specialist in India today. Apart from that, she has also been a TedX speaker and National level swimmer! Go ahead and read this spotlight to find out how she discovered her passion. I have also included some questions to give you a sneak peek into the Qi spine clinic.
What is your name, job title and workplace?
Dr. Garima Anandani, (PT)
Clinical Director, Qi spine clinic.
What is your educational background?
Bachelors of physiotherapy (BPTh): Pandit Deendayal Upadhyaya Institute (Delhi), The graduation year 2000.
PGDR (Post graduate diploma in rehabilitation): All India Institute of Physical Medicine and Rehabilitation, (Mumbai). The graduation year 2001.
Certified Mulligan Practitioner from Capri Institute of manual therapy, 2008
Diploma in mechanical diagnosis and therapy: McKenzie institute international and University of Otago (New Zealand), 2011
St David’s spine and sports center, Austin, Texas: 360 hours of practical training under Dip MDT Scott Herbowy.
I pursued many other certifications, diplomas related to the field.
What did you do soon after PGDR?
When I was in AIIPMR, my dissertation got selected as the best dissertation at the time. Hence, they offered me a job at the same institution. I worked there for one and a half years. It was a good experience. It changed the way I used to think. Dr. Vimal Telang (PT), Dr. Karen Pavri (PT) and a few other mentors spent a lot of time to rewire my thinking.
Soon I got the opportunity at Asian Heart Institute. They just opened the hospital in 2003. Being one of the founding team members, and as a team lead, I got exposure to setting up outpatient and inpatient departments at the grass-root level.
Tell us about your professional journey in the US.
I moved to the US and obtained my license. Initially I did a lot of voluntary work at various places. For me, at that time, it was mainly about working in different setups and finding out my real interest.
I completed certification by American College of Sports Medicine as an exercise specialist. For this certification I had to complete a fellowship in cardiopulmonary rehab. I got a good exposure since I had to complete cardiac hours and pulmonary hours separately. Together, it was 260 hours in total.
Alongside that, I started completing my McKenzie certifications. When I started working in McKenzie clinic, I was astonished to see the results. By 2006, I was sure about my passion. In 2007, I became certified MDT.
When did you move to India and what did you do after coming back?
Because of the family mishap, I had to move to India. I was sure, I did not want to work in the hospital. Asian Heart Institute had a collaboration with the Qi clinic at the city center. I was hired as a senior physiotherapist.
It was a small one room center in the Gym. From there, the journey started. From 2008 to the end of 2010 it was just a single center. We moved to the independent space out of the Gym.
I started applying my MDT knowledge and clinical experience from the US. We started seeing stunning results. Patients started coming to us from all over Mumbai. Many of our patients started requesting that we expand to the other areas of the city.
Tell us more about your journey with the Qi spine clinic?
Over the period of three years, patient load increased significantly. Owners of the company decided to take it to the next level. From 2011 Qi spine clinic started expanding.
We had an external CEO join us at that time. Me, along with the CEO and the owners started the work of expansion. We first expanded in Mumbai. In 2014 We started expansion in Delhi. In the coming years, we opened our clinics in Pune and Bangalore.
Overall it has been a very fulfilling journey. We started as one center and a handful of employees. Now we have 21 clinics and 250+ employees. It involved a lot of learning not just in terms of clinical but also administrative work.
We wanted to ensure that the quality of the treatment is the same across all our clinics. I have been an instrumental member to achieve that.
Initially, my title was Head, Clinical Operations. In between I was Chief Operating Officer when I was setting up protocols and doing other non clinical work. Within the next couple of years, I was again re-designated as a Clinical Director since the focus was on clinical excellence and patient satisfaction.
We will be launching our app soon. Right now I am focusing more on our app. It is both a patient and doctor facing app. Everything is algorithm based. We used AI to determine the next steps for the patient. The hope is to expand on a larger scale than ever.
What is the treatment philosophy of the Qi spine clinic?
When we first started, we did not want to restrict ourselves to manual therapy. Since manual therapy application changes from therapist to therapist, maintaining uniformity in treatment protocols is difficult. We wanted to do something that we could scale.
MDT method allows us to scale it up. It is an effective algorithm based method. You can maintain uniformity in the treatment across the different branches of the clinic. I also like mulligan’s method of treatment. Neurodynamics (NDS) also follows an assessment based model.
At Qi spine we always follow an evidence based approach. In the last 10 years we have always looked at evidence based methods that can be scaled up. We try to avoid too much variability in the treatment between the therapists.
We focus a lot on communication, empathy, culture fit and willingness to do what is right for our patients. At Qi spine clinic, we work on a complete rehabilitation of the patient. This includes getting back to the activities of daily living and recreational activities.
What is the typical day of work for a physiotherapist at the Qi spine clinic?
Once you enter the Qi spine clinic, you will be undergoing a training program. Wherein you will learn about the operations of the clinic. It will include hands-on training and you will learn some concepts alongside. It is typically for 6-8 weeks.
First few weeks are about observing, learning, unlearning and relearning. It is very important to unlearn some of what you know and relearn some new concepts.
Once the training is completed, you will start treating patients independently. At Qi spine clinic we are strict about the documentation. For each patient you will need to document everything, right from outcomes such as NPRS, disability and assessment. It is all done in software.
At the Qi spine clinic, we do “Case typing”. For example, based on the assessment, back pain can be classified into derangement, lumbar canal stenosis, ankylosing spondylitis or into many other categories.
We have predesigned treatment plans for all these categories. These plans are designed based on the data of hundreds of patients we have treated over the years.
At the Qi spine clinics, the physiotherapists are expected to use our treatment plan for the patients. If the patient is not responding well to the treatment plan, it can be changed. But you will need to justify the change in the plan with clinical reasoning.
On a typical day a therapist will treat his/her patients, complete documentation, perform assessment using digital spine analysis, email prescription and home exercise program to a patient.
What is a typical career path for a physiotherapist working at the Qi spine clinic?
You will join in on level 1 which is physiotherapist/spine specialist. You can grow up to become a senior spine specialist which is typically level 4 or above. Going ahead you can become a clinic head or a clinic lead.
Clinic head is the person who monitors not only revenue but also carries out administrative responsibilities. Clinical lead is responsible for managing outcome score and net promoter score. We monitor each and every patient in the system.
Post that next level opens up. If you can manage one clinic very well, you can become a zonal head. In this role you will be managing multiple clinics at a time. For this role, a person needs to be really good clinically or management wise or both.
Level 7 is the last level where a person manages clinics in the entire city.
We also have a partnership model. At Qi spine clinic you can become a part owner by investing your own money. This is open to physiotherapists after a certain level and It is by invitation. Wherein you will invest your money in the clinic and you start earning from the profits.
We also have a research wing. If deemed suitable, we send our therapists to conferences. One of our physiotherapists went to the conference in the UK with the part money sponsored by the Qi spine clinic.
We expect our physiotherapists to hone skills such as communication, time management, documentation, patient education alongside clinical skills. If you join the Qi spine clinic you will be using a lot of Excel. You will definitely learn Ms Excel skills with us.
When you work with us you will get a career path without stagnating.
What is a typical journey of a patient at the Qi spine clinic
Qi spine clinic is a leading health- tech organization with over 150 doctors and healthcare professionals. We specialize in diagnosis and treatment of spine problems through conservative non surgical methods.
We start with assessment. Once the assessment is done, diagnosis is reached. Based on the diagnosis, a treatment plan will be determined.
We use digital spine analysis as one of our assessment tools. We use microcurrents to relieve pain and inflammation. For pain relief we also use MDT, Mulligan and NDS.
Patients typically experience pain relief after the first few sessions. Soon they start performing their basic activities of daily living. Gradually they resume their normal activities. And later they move on to the advanced activities. Our treatment plan takes our patients through all these stages.
We do mid report on patients after 6 visits to track their progress. Again on the 12 th visits there will be a discharge or another mid report based on the progress.
With technology, data driven and evidence based approach, we have treated over 1,50,000 patients so far. We have helped to prevent over 10,000 surgeries. During the pandemic we were able to deliver good results over Telehealth.
What is a typical day of work for you?
With the pandemic the work situation has changed a lot. Before the pandemic, I used to spend 3-4 days doing clinical work. I usually handled the tougher cases that the team had been struggling with. I used to keep 2 days for administrative work, for updating the protocols, mentoring and monitoring our patients etc.
Apart from that, I love public speaking. I also corporate workshops, Facebook lives, TV and FM interviews on educating people on preventing and dealing with lifestyle diseases.
What do you enjoy about being a clinical director, Qi spine clinic?
I am very passionate about my work. It comes from an inherent willingness to do whatever it takes to make a patient better. It has been inculcated by my parents to be the best at whatever it is I do. I have been a lifelong learner.
What are the challenges you face?
One of the major challenges is awareness building among patients. I have spent a lot of time and energy in educating about how you can cure your low back pain without modalities.
Personal challenge is work life balance. I can barely say it is balanced. Surely, I try to spend time with my family. But I still lean more towards my work since I am so passionate about it.
For example, in 2011, my son was born. Since we took up the expansion project at around the same time, I barely took any rest post delivery. Responsibility of taking care of a child and expansion work took a toll on my health.
In 2009, I enrolled for the Diploma in MDT. That went on till the end of the year 2011. I had to travel back and forth to the US multiple times. My son was very small at that time. But my family was very supportive throughout this.
Apart from work, what other activities do you enjoy?
I love traveling and being in nature. Trekking in the Himalayas is something I always enjoyed. Ever since my childhood, I have been fond of swimming. I was a national level swimmer.
Since I can’t get the time out for swimming due to work, I practice Yoga everyday. That is something that keeps me sane and fit.
I am also passionate about public speaking. Joining toastmasters club has helped me nurture my public speaking skills.
What other courses and workshops (apart from MDT) helped you shape your career?
Manual therapy, vertebral column, Maitland concept from Prof D. h. Dastoor and Dr. Deepak Kachalia, 2003
Manual therapy for vertebral column from The university of Melbourne, 2004
Movement Impairment Syndromes from Shirley Sahrmann, 2008
Kinetic control: Lumbar, cervical spine, Hip knee and shoulder, 2015 ( 50 hours )
Spinal manual therapy from Manual Concepts, 2018
Neurodynamic solutions, NDS, by Michael Shacklock (14 hours )
What are the books that have helped you in your career
I am an avid reader. Early in my career one of the books that I read which was helpful was “The art of getting things done.”
Another book that has helped me was “One thing”.
My other favorite books are “To kill a mockingbird”, “The Alchemist”, “The monk who sold his Ferrari”, “Blink”.
For back pain I would like to recommend a book called “Crooked”.
What is next for you?
At the Qi spine clinic we want to use our app to expand further. We are also trying to expand internationally.
What is your advice for a new graduate physiotherapist?
In your early years, try to focus on getting the right learning and exposure instead of the money. Also don’t go behind the quick success. Find out what your passion is. My passion is back pain. For me, it took 5 years after graduation to realize that.
Most of the people want to go abroad for masters. Personally I think MPT in India is much better since you get good clinical exposure.
Degrees don’t matter much. What matters is what is your goal and how you shape your career.
Where can people reach you?
They can reach me on my LinkedIn.
They can also reach me on email drgarimaanandani@gmail.com
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Hello, My name is Tejashree Limaye. I am a physiotherapist with 10+ years of experience. I help you go from being stuck in your career to finding a job you love! I provide career guidance about clinical and non clinical PT career in India. I also help you with US PT licensing process. Welcome to my blog, I hope you find the exact guidance you have been looking for!