It is a common phrase in the world of physical therapy education: you need to have more tools in your toolbox. Frankly, the phrase drives me crazy.
Clinicians learn to use a lot of tools. This isn't exclusive to physical therapy - far from it. Chiropractors, physicians, physical therapists - regardless of clinician, they all learn to utilize a broad range of tools in the care of various clinical conditions.
But what gets lost in the mix is the toolbox - the place you store all your tools and the process of reasoning used to select the correct tool. This becomes all the more readily apparent when discussing MDT (Mechanical Diagnosis And Therapy) with clinicians and students alike.
MDT is the toolbox - not the tools.
The Information Age is now officially a part of the health care conversation. Or vice versa.
In a 2012 national survey by the Pew Research Center’s Internet & American Life Project, it was found that 81% of U.S. adults use the Internet - with 59% seeking out health information online in the past year. Perhaps more importantly, 35% of U.S. adults say they have gone online specifically to try to "figure out what medical condition they or someone else might have". In other words, 35% of U.S. adults are considered "online diagnosers".
Meanwhile, in the year 2013, consumers continue to be faced with issues of access to care. The gatekeeper model continues to regulate a patient's access to care from many health care professionals in many states, including Texas and California.
Toto, we're not in Kansas anymore, and it is definitely not 1950. Now that we are in the Information Age, the model will need to change - and here's why.
It would appear at times that the human condition thrives on complexity. Humans just love to make situations more complex. And when they do, it usually gets them in trouble.
We see it in sport. At times you would think that it requires some modern day rocket scientist to coach a pro football team. At least that's what the pundits would have you believe. We do it in our own daily lives. We somehow find ways to make our days far more complex than they need be. Perhaps a more complex set of problems validates our challenging existence for the benefit of empathy and perhaps even rationalization of our behaviors.
We also do it in health care. Yes, the human body is based on a complex interaction of systems. But it is also operates on some very straightforward principles such as stimulus-response and homeostasis.
Rarely is the best solution the more complex option. Simplicity unto itself could be a prime health care solution. Just ask Albert Einstein.
It is a phrase that has always evoked a raised eyebrow or two. "Fear of success". It is easy to imagine someone having a fear of failure, but success? Really?
Absolutely. It is far more common than we might imagine.
Don't we all want to be successful? Why would anyone have a fear of success?
Your comfort zone has to allow you to embrace it. Fear of success has a best friend: self sabotage. The two co-exist quite nicely.
So how does an athlete, a patient, or a friend have a fear of success? A few examples are in order.
Runners, it's time to put this craziness to rest. I hear it repeated, over and over again: runners seeking treatment from clinicians that relate the running injury to a leg length discrepancy. Worse yet, they then wonder why they aren't getting better.
It is highly unlikely - I repeat, highly unlikely - that your leg length discrepancy has any relevance to your running injury. Period.
It is time for clinicians to get over this "diagnosis of irrelevance" for the vast majority of clinical scenarios. It is utter crap. It does a disservice to both the current sport sciences related to running and the clinical reasoning process. But it pays - handsomely.
Today is a sad day in my world.
This morning I received the news of the passing of Dr. Barb Melzer, PT, PhD, DPT, FAPTA. At this point, I don't think that the phrase "having a heavy heart" will suffice. It certainly doesn’t do justice to the moment either.
There are many of us that are finding today otherworldly. Fellow physical therapist Eric Robertson shared some touching thoughts with the web earlier today. After pondering the meaning of today's events, and trying to make sense of it, I present to you a few words and thoughts: on her presence, and the small piece of her world that, fortunately, intersected mine.
The storyline started a few weeks ago as a simple tweet: physical therapists "are highly educated, doctorate level professionals". Sounds reasonable enough, yes?
However, last time I looked, I am a physical therapist - a highly educated health care professional with 25 years of clinical experience and one of about 350 clinicians in the world with the highest level of training in Mechanical Diagnosis And Therapy. But I am not a doctor.
I replied with a simple "And what are the non-doctorates?". I will admit, I was curious to see what the response would be. Deafening silence awaited me.
It was the Three Musketeers that said "Unus pro omnibus, omnes pro uno", or "All for one, and one for all".
The physical therapy profession would do well to take notes.
Allan Besselink, PT, DPT, Ph.D., Dip.MDT has a unique voice in the world of sports, education, and health care. Read more about Allan here.