When texting and tweeting became a part of our daily lives, I can't say that I thought they would have much value in terms of effective communication. Let's face it, they are both, in many ways, highly impersonal and almost passive-aggressive at times. They also contribute to what is rapidly becoming a wide-diameter firehose of digital data that is exceedingly difficult to control.
For many, texts and tweets have become the bane of our existence.
But I have come to appreciate both of them. Their benefit may not lie in the ease of interaction, but in the skills that can be gained. Brevity is everything.
Hey, I know you. You are a rational, logical person. You have followed a series of methodical, logical steps in your clinical decision-making. Your thought processes have brought you to the edge of the proverbial cliff in your thinking.
You glance over the edge. It's a big jump, a bit of a leap of faith if you will, to make the next step.
There is one logical step to make to move forward. But what happens when you walk to the edge? Do you take the step forward and follow your clinical reasoning through to its next logical progression? Or do you step back from the edge?
Welcome to one of the biggest challenges in clinical reasoning - and life in general.
When I listen to clinicians, I sometimes have to wonder how Homo Sapiens ever survived the past 250,000 years. With the clinical minutiae that exist these days, it's a wonder that we haven't become extinct long before now.
Walk into any of countless chiropractic, massage therapy, and physical therapy offices around the world, and you will hear the woeful tales of asymmetries and mal-alignments. You will hear of the maladies of the kinetic chain and the hypothetical relationships and regional interdependence from great toe to TMJ and all points in between. You will hear descriptions of two degrees of varus at the subtalar joint which, since it has been uncorrected for the past 40 years, has now created micro-trauma that has evolved into your back pain, your headaches, your arterial insufficiency, and your eyes being divergent.
I have no idea how we managed to survive the onslaught of those two degrees. I suspect the species is doomed. Who needs an ice age when the scourge of two degrees of varus is upon us?
It's not just a Republican thing. And it's not just a Democrat thing.
When you get right down to it, consumer access to physical therapy could - and should - be an issue with bipartisan support nationwide. Both sides of the aisle should absolutely love it for very different reasons.
But it becomes readily apparent that they don't - at least not consistently from state to state. With a mid-term federal election cycle and plenty of state-wide elections soon to be upon us again, it would be helpful to understand why.
In health care, there is much talk of control. One of the biggest issues is controlling the spiraling cost of care.
In the same breath, we have become transfixed by outcomes for any given episode of care. This is thought to help control costs – the costs that are faced right now, what I call the upstream costs.
But over the long-term, the control we need to discuss is locus of control. This is the control that will ultimately provide health care with true, epic reform.
It may have been one of the worst value propositions ever made. I know you've heard it before -
"Hands-on care is quality care".
I have heard it more than once, be it in a clinical environment, educational program, or on social media. What makes this scenario even worse is how the public has been snowed into believing it. Clinicians have, over time, skillfully trained the public to believe this. While doing so, clinicians continue to perpetuate a myth - that quality care is inherently related to the laying-on off hands.
Clinicians like to think they know what is best for the patient. And oftentimes, that is true. I mean, isn't that why patients come to see us?
But there is a fine, yet distinct, line between patient-centered care and paternalism. You know, the "father knows best" mentality that pervades our health care system right now. It might have been fine in the 1950's, but patients of the 2000's are becoming consumers when it comes to their health care. And rightfully so.
If we don't start paying attention, paternalism will be the demise of health care as we know it. And maybe that's a good thing.
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.