Medical Care Review: Specials Magazine

A personal trainer arrived at his appointment, unable to sit comfortably for five minutes. Imaging had revealed lumbar disc bulges and herniations, and he believed surgery would likely be the next step. Dr. Casey Egan approached the case through a broader functional assessment, looking beyond the imaging findings alone. Within the first session, she identified movement and stability patterns involving the hips and surrounding mechanics that appeared to be contributing to the patient’s symptoms, and the patient’s pain was significantly reduced that same hour. Within two to three weeks, he was back to teaching classes and training clients. Three months later, he was running again. That outcome reflects the model Ripple was built around. Founded by Dr. Egan, Ripple operates as a wellness provider across three locations in the Boston metro area with a clinical approach centered on time, continuity, and full-body assessment. Every appointment is conducted as a full hour, one on-one, with the same therapist throughout a patient’s care. That structure gives therapists uninterrupted time to evaluate movement patterns, understand a patient’s goals, and develop a more comprehensive picture of what may be contributing to pain or limitation. “Our approach allows us to treat the whole person, make sure they understand what caused their pain to begin with, and how to prevent it in the future,” says Egan, CEO and physical therapist. The objective is not only to relieve pain, but also to help patients understand the habits, movement patterns, and physical demands that may affect their long-term health and activity. Ripple’s patients range from high school athletes to people in their seventies and eighties who remain active through golf, tennis, and other daily activities. Many come to the practice looking not only for pain relief, but also for a clearer understanding of how their body is functioning and what may be contributing to recurring symptoms. Before a patient arrives for a first appointment, Ripple matches them with the therapist best suited to their goals and presentation, helping create a more individualized treatment process from the outset.

For 44 years, Irsfeld Pharmacy PC has operated as a family-run pharmacy, but under the leadership of second-generation pharmacist Steve Irsfeld, the practice evolved far beyond a traditional dispensing model. At a time when healthcare is increasingly shaped by speed, volume, and automation, the company built its approach around staying involved with patients long after the prescription is filled. That philosophy is visible in the pharmacy’s work with low-dose naltrexone (LDN), a therapy that supports patients with chronic pain, autoimmune conditions, inflammation, mental health and fertility-related care. After decades in retail pharmacy, Steve grew frustrated with high-volume dispensing models that left little room for patient interaction or follow-up. “I’ve always wanted to have the ability to spend time with patients,” he says. “With the traditional pharmacy model with high volume and low reimbursement, that just wasn’t really possible.” Over nearly two decades, Steve helped the pharmacy transition from insurance-heavy retail workflows toward a consultative compounding practice. Additional training through the American Academy of Anti-Aging Medicine expanded the company’s approach, giving patients access to compounded therapies, supplements, and longer consultations tailored to individual treatment needs.