Caleb Ashmore, PT, DPT, Orthopedic Rehabilitation Services Supervisor at Harris Health

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Caleb Ashmore’s Episode

Release Date: August 11, 2025

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Introduction

In this engaging episode of the Becker’s Healthcare Podcast, host Mariah Muhammad converses with Caleb Ashmore, PT, DPT, the Orthopedic Rehabilitation Services Supervisor at Harris Health. Caleb delves into the transformative changes in orthopedic rehabilitation, the challenges of addressing social determinants of health, and invaluable leadership lessons gleaned from working within a safety net healthcare system.

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Background and Role at Harris Health

Caleb Ashmore opens the conversation by sharing his extensive background in physical therapy and his current pursuit of an EMBA with a focus on healthcare leadership at UT Dallas. He highlights his role as a supervisor in the orthopedic rehab department at Harris Health's largest outpatient center in Bel Air, Texas. Caleb emphasizes Harris Health’s significant economic impact, citing:

“For every dollar of tax support that we get from the community, we return six. And so for every $1, we return six in economic benefit. And last year we had $5 billion return to Harris County and almost $6 billion in economic impact to the state of Texas.” (00:20)

He underscores the institution's vital role in serving 1.2 million uninsured individuals in Houston, the highest number in the U.S., with a payer mix of 50% uninsured, 20% Medicaid, 20% Medicare, and 12% private insurance.

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Transformative Changes in Orthopedic Rehabilitation

Mariah Muhammad probes into the recent impactful changes in orthopedic rehabilitation. Caleb responds by outlining the shift from passive treatments to more active, evidence-based practices:

“Over the past couple of years there's been sort of a move away from a manual therapy approach and other types of passive treatment... increasing evidence-based practice by leaning into more treatments that are more active, like exercise, different tissue loading tactics.” (03:04)

He highlights the integration of telehealth, accelerated by the pandemic, as a crucial development:

“We're using it a ton... Telehealth has really helped with that. We have a pretty big push in our system to utilize this because we have Houston is so spread out... we're able to reach many more patients who have difficulty utilizing our services.” (03:04)

Caleb shares success stories such as the FAST (Fit and Strong Together) program, a 12-week course now expanded through telehealth, allowing greater accessibility and participation.

Additionally, Caleb discusses ongoing research initiatives in collaboration with orthopedic surgeons, focusing on novel procedures for treating complex fractures, aiming to contribute valuable data to the field.

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Approach to Rehabilitation Amid Socioeconomic Barriers

Addressing the intersection of complex orthopedic conditions and socioeconomic barriers, Caleb elaborates on how Harris Health tackles social determinants of health:

“There's been several studies... we can only affect about 20% of a person's life. The rest of the 80% of that person's life are affected by social determinants of health.” (07:39)

He explains the institution’s comprehensive strategies, including a dedicated population health team and unique programs like hospital at home, which aims to treat patients in their residences to reduce hospital stays and infection risks.

Caleb details the challenges and innovative solutions, such as:

• Expanding Telehealth: Enhancing patient accessibility despite geographic and transportation barriers.
• Food Pharmacies: Partnering with the Houston Food Bank to provide healthy food for diabetic patients, ensuring holistic care beyond medical treatments.
• Digital Resources: Implementing technology-driven solutions like digitized lists of free and discounted local gyms to support patients' long-term wellness goals.

He emphasizes the importance of meeting patients where they are, both physically and socioeconomically, to ensure effective and sustained rehabilitation:

“We really try to put these clinics out in areas where the patients need them and so that it's more convenient for them.” (07:39)

Caleb also touches upon the inclusion of incarcerated patients through Harris Health’s role as the official medical provider for corrections facilities, highlighting the breadth of their patient demographic.

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Leadership Lessons from a Safety Net System

Transitioning to leadership, Caleb shares profound insights cultivated from his experience at Harris Health. He underscores the significance of granting grace and fostering a supportive environment:

“Just consider that they're most likely doing the best they can that day... afford other people the grace that you would hope that they would afford you.” (13:33)

Caleb advocates for:

• Realistic Expectations: Avoiding the pressure of perfection and embracing human imperfection.
• Positive Intent: Assuming colleagues are acting with good intentions, even in challenging interactions.
• Inclusive Success: Promoting the idea that “when one of us succeeds, we all succeed,” fostering a team-oriented culture.

Drawing parallels from his personal life, Caleb illustrates how these principles apply beyond the workplace, reinforcing the importance of collaboration and mutual support both professionally and personally.

He also advises against comparative thinking, urging professionals to focus on personal growth and incremental improvement:

“Try to get 1% better and grow every day as a person, as a professional, as a healthcare worker...” (13:33)

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Conclusion

Caleb Ashmore’s discussion offers a comprehensive look into the evolving landscape of orthopedic rehabilitation within a large, safety-net healthcare system. From adopting active, evidence-based practices and leveraging telehealth to addressing deep-rooted socioeconomic challenges, Caleb highlights the multifaceted approach required to deliver effective patient care. His leadership philosophy, grounded in grace, support, and continuous personal and professional growth, provides valuable lessons for healthcare professionals navigating complex environments.

This episode serves as an insightful resource for those interested in the intersection of orthopedic rehabilitation, healthcare leadership, and the profound impact of addressing social determinants of health within a major healthcare institution.

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Timestamps:

• Introduction & Background: 00:00 - 02:45
• Changes in Orthopedic Rehabilitation: 03:04 - 07:21
• Approach to Complex Conditions & Socioeconomic Barriers: 07:39 - 16:15
• Leadership Lessons: 13:33 - 16:15

Transcript

[A]

Welcome everyone, to the Beckers Healthcare Podcast series. I'm Mariah Muhammad, writer and moderator with Becker's Healthcare. I'm thrilled to have with me today Caleb Ashmore, orthopedic rehabilitation services supervisor at Harris Health. Caleb, welcome to the podcast. We're very excited to have you join us today to get us started. Would you mind please introducing yourself and telling us a bit about your background?

[B]

Sure. Thank you very much for having me back. I really appreciate it. Yeah. My name is Caleb Ashmore. I'm a physical therapist by training, an ortho specialist, and a manual therapy fellow. And I was both residency and fellowship trained here in Houston, currently working toward an EMBA with an emphasis on healthcare leadership through UT Dallas. I'll be done with that next year. So I've been learning a ton and it's a really cool program. It's a cohort style with leaders from Harris Health and then our two local med schools, Baylor College of Medicine and UT Health as well. And I've been a supervisor in the orthopedic rehab department for four years. And this is the largest outpatient center that we have at Harris Health. That's here in Bel Air, Texas, not Bel Air, California, Bel Air, Texas. It is a small pocket community within Houston. And just a little bit about Harris Health is that we are a teaching hospital. About half of the physicians in Harris county were trained at Harris Health. And there was a recent study that showed for every dollar of tax support that we get from the community, we return six. And so for every $1, we return six in economic benefit. And last year we had $5 billion return to Harris county and almost 6 billion in economic impact to the state of Texas, which was pretty cool and something to be proud of. And currently 1 in 70 jobs within Harris county are at Harris Health. So we're very big employer. We have about 11, almost 11,000 employees at this time. And the reason that we are so important and why I love working here is that the mission and that we have 1.2 million uninsured people in Houston currently, which is the most uninsured individuals in our country. And so that stands to probably increase after the recent legislation over the next couple of years with the Medicaid cuts. But currently our payer mix is about 50% uninsured, 20% Medicaid, 20% Medicare, and then about 12% private insurance. And then finally, we have about 300, almost 300,000 individual patients that we are currently treating at Harris Health.

[A]

Wonderful, wonderful. Well, thank you so much for that background information to jump into the questions, what are some of the most exciting or impactful, impactful changes you've seen recently in the orthopedic rehabilitation area, whether it's new research tools or treatment approaches?

[B]

Yeah, over my 12 plus years of being a physical therapist, a lot of things have changed lately. Over the past couple of years there's been sort of a move away from a manual therapy approach and other other types of passive treatment like modalities, dry needling and things like that. Things that really haven't shown as much support in the literature as they've been studied year after year and then basically increasing evidence based practice by leaning into more treatments that are more active, like exercise, different tissue loading tactics, things with more of a solid support in the research that's out there. Also, patient education is a huge one for our profession. Also, as all other areas of healthcare, telehealth has been huge after, after the pandemic. And so, you know, whereas before the pandemic hardly any pts were utilizing telehealth, we're using it a ton. I know not every organization is just due to constraints with reimbursement and things like that, but since our healthcare system doesn't really have to worry about that as much, we, you know, there's a pretty big push in our system to, to utilize this because we have, you know, Houston is so spread out. It covers, covers so much territory, so many miles that we're able to reach many more patients who have difficulty utilizing our services for a variety of factors like their work schedules, mobility limitations, their financial constraints and also issues that they have with transportation. And so through this expansion of telehealth services, it's been really amazing and we've been able to enroll more people and have better, better patient accessibility for people who might not otherwise be able to finish out a plan of care, for example, and helps not only with our orthorehab team, but also with a class that we have called fast, which stands for fit and strong together. And it's a 12 week course that we have that's led by physical therapists and dietitians and it's twice a week. Before COVID they were all in person and so patients had to commit to coming into our clinic twice a week, which is pretty tough for a lot of folks. But now with telehealth, we're able to expand the class and reach a lot more people and impact a lot more lives. That's been pretty exciting. A few other things too. We have some novel research that we have going on right now with a couple of our orthopedic. So another thing I failed to mention is that Ben Ta we currently have is one of our hospitals. We currently have one level one trauma center and we're currently in the process of building a second level one trauma capable hospital at lbj. And so we get a lot of trauma cases which is kind of different than a lot of other PT settings. And so we have a surgeon who specializes in treating these patients with an external fixator when they've had really traumatic comminuted fractures. And so, and then we, he loves PT and we have a really good relationship with him. So with our, our current and future PT residents, we have research going on with him and then also with another one of the surgeons who is working on a new procedure. He's been, he's been testing it out. And this is a procedure for fixing calcaneal fractures, which we actually see a lot in our system. And it's a novel approach and something that hasn't been tried before. And so in both of these areas there's very little research, little to no research. And so, yeah, we're really looking forward to being able to put our footprint, so to speak, and to just put some stuff out there for other people who do treat these patients as well.

[A]

Yeah, yeah, absolutely. No, that definitely sounds so amazing. And how do you approach rehab for patients with complex orthopedic conditions? We'll also have social economic barriers to care, which I know you spoke a little bit about. And I'm assuming that hair sales likely sees this pretty often.

[B]

Yes, we do. It impacts you on a regular basis and really something that you have to think about with each patient getting into social determinants of health which are non healthcare related factors that affect a person's health and well being. And so there's been several studies that have come out that I learned about in my EMBA program where essentially they look at people and how much health care can actually affect a person's life. And actually what multiple studies have found is that even at our best as healthcare workers, we can only affect about 20% of a person's life. The rest of the 80% of that person's life are affected by social determinants of health. And so it's something that not a lot of folks think about unless you work in a system like this. And I mean, you probably do think about it in other systems, but not on a regular basis like we do. You know, almost every day and all day we have a population health team which works, you know, directly with patients out in the community. We're the currently the only hospital system in Houston that has a hospital at home program where they have patients that would normally be in a hospital, but in order to keep them out of our hospitals and actually treat them more effectively and reduce risk of getting a nosocomial infection, they'll be treated within the confines of their own home, which is really nice. And so people, nurses and other healthcare providers go out to the person's home and. And that's been really successful so far. And what they're looking to expand that program and actually include rehab. So that's pretty exciting. And I was actually talking with them today about potentially including us in that. In that process. So it's pretty. Pretty exciting. Lots of changes coming. We have currently, I believe, 37 clinics throughout Houston outside of our large hospitals. And so we really try to. To put these clinics out in areas where the patients need them and so that it's more convenient for them. A lot of our folks take buses and have different transportation issues that they get rides and don't have their own vehicles and things like that, or maybe their vehicle is not as reliable. And so we really just try to meet these patients where they are and where they need us to be. As I mentioned, Telehealth has really helped with that. We have. We have a lot of patients without stable housing and, you know, they might be living in shelters, and so that presents difficulties. And there's lots of management that goes on at these clinics. We have a. Several actually food pharmacies for patients with diabetes. And it's really cool. They can get referred directly to these pharmacies. And they have high quality, healthy food for patients who would otherwise not be able to afford it. And this is food donated from Houston Food Bank. And so there's a lot of really cool partnerships we have with organizations throughout Houston to help care for these. These patients. And so sometimes patients come in and you don't end up doing a lot of traditional therapy. Yesterday I was having a patient, I was helping him fill out paperwork to get a handicap placard because he really does need it. His hip, he has a really bad hip, arthritis. And so I was like, you know what? Actually, I do think you need this. And so I was helping him with that. And so you just never know on a given day what your job's gonna look like. But it's never boring. It is never boring. And on that note, we actually have. Harris Health is now the official medical provider for the corrections facilities at Harris County. So we're also seeing you know, a fair amount of incarcerated patients as well. And so just trying to provide the best care possible for every single person on your schedule. Some days you got to get creative. If you're doing a telehealth call with somebody and they don't have weights, I'll say, okay, can you grab some water jugs or what do you have handy? One thing that was really cool is that many years ago, a student of ours, as his, his internship project, he came up with a list of all of the local discounted and free gyms throughout Houston. And then last year somebody digitized it. The Gen Z students are really pretty incredible when it comes to technology. They digitized it, attached it to Google Maps, and so all the person has to do is scan this QR code and it will find all of the local free and discounted gems that are close to the person's house. And so that really helps us to have a better long term carryover effect for maybe for folks that don't have access to a gym and might not be able to afford it. And the fast class that I mentioned before really works on our CEO, Dr. Porsche, his overarching goal of disease prevention and health promotion. Because if we're able to affect change on these levels and maybe dip into that 80% a little bit, then we can keep people out of the emergency department and save our system and taxpayers a lot of money.

[A]

Yeah, yeah, absolutely. That definitely makes a lot of sense. And I definitely see a lot of opportunities for growth and a lot of things that you said for you. What's one leadership lesson you've learned while working within a safety net like Harris Health has kind of shaped you to how to show up for your team and your patients.

[B]

There are so many. I had to, I wrote a bunch down and I had to delete a bunch because I wouldn't have time to get to it all. But I'll just, I'll hit the highlights. I think for me, Grace, for not just for your patients, but also those that you work with and also for yourself. Basically the, the saying that I like from the office is called that. They say is that PO Buddy's nerfix, which is a funny way of saying nobody's perfect. But, you know, don't stress out. Don't feel like you have to be living up to insane expectations. Make sure you have realistic expectations. Just assume positive intent. If somebody is rubbing you the wrong way or you feel like maybe a person has it out for you or is trying to make your life miserable, just consider that they're most likely doing the best they can that day and you don't really know what's going on in their lives. As I mentioned previously, when it comes to our patients, but also the people you work with, you really don't know what all is going on in their life. So give people grace. People are complex. We're all going through our, our own trials and tribulations and so, you know, afford other people the grace that you would hope that they would afford you. And just remember that everybody that you work with, no matter what level, be it EBS or Frontline, all the way up to C suite, everybody is important and we can only succeed if we all succeed. So just try to take care of each other, just try to be good to other people in general. That's something that we, that we say in my family a lot is when one of us succeeds with our kids, we've been hammering this. When one of us succeeds, we all succeed that way. I have two little girls, I have a three year old and a five year old and they can get kind of competitive with each other and so will say to each other, hey, just because for example, the other day we were playing a board game randomly, my 3 year old daughter ended up winning the board game and so my 5 year old is getting upset because she's losing. And so we just have to say like, when one of us is winning, we're all winning. Be happy for each other, applaud other people's successes. Comparison is the thief of joy. That's another thing that I like to say a lot is just try not to compare yourself to others. I know our society is very into that with social media, but just, just kind of stay in your own lane and, and keep plugging along. Try to get 1% better and grow every day as a person, as a, as a professional, as a healthcare worker and yeah, you'll be on the right track.

[A]

Yeah, yeah, absolutely. Great words of wisdom there. Thank you so much for those final thoughts. It's definitely been a very informative discussion, so I want to thank you so much. Back on Becker's Healthcare. We really do appreciate it and I look forward to connecting with you again soon.

[B]

Thank you very much. I really appreciate it. Have a good one.