This past weekend, the city of Denver hosted the McKenzie Institute Americas Conference. I made the trek to Denver to take part in what was, according to my calculations, my 14th McKenzie conference. Where has all the time gone?
As has become the norm over all of those years, the conference was chock full of current research and insightful presentations. Add to that the thought-provoking and insightful discussions after hours with colleagues from around the world.
Sadly, the 2013 edition was the first conference since the passing of Robin McKenzie. Though the conference began with a moment of silence and tribute to Robin McKenzie, it ended with a powerful reminder that there are a dedicated group of clinicians poised to forge ahead with his legacy.
When clinicians bring up the phrase "Mechanical Diagnosis And Therapy" (MDT), they will often mention things like diagnostic classification, centralization, and directional preference. You might even hear mention of self treatment.
I would suggest that we can add one more phrase to the mix: public health.
MDT clinicians are uniquely qualified to contribute favorably to a public health initiative. Though that may sound like a pretty significant value proposition for the future of health care, it comes with some substantial rationale to support it. There are a number of reasons why MDT can provide the foundation for a public health initiative that could truly be a game-changer.
The logical fallacy exists on a daily basis in the orthopedic world. Perhaps more importantly, it costs the health care world millions of dollars and a tremendous unnecessary burden psychologically.
Orthopedic patients are referred for countless imaging studies as a first line of assessment. An MRI is a detailed image which patients are told will provide all the answers to the diagnosis of their problem.
Technology is a wonderful thing, right?
But there are some significant problems with this that begin with the initial line of thinking.
Should we trust pathoanatomy?
It is a simple decision that stands in our way to the promised land of health care reform. When do we finally get to the point in which health care consumers just say no?
Imagine, if you will, a world without Big Medicine, Big Pharma, Big Insurance, and Big Hospitals. Imagine, again, that same world with legislators who made decisions based on the needs of their constituents, and not the needs of the Bigs. I know, I am creating a world of science fiction here, but work with me for a moment.
When do consumers finally decide that the status quo - and its currently accepted "standards" of health care - is no longer acceptable? And when will consumers finally choose to take back their health care system once and for all?
Here's a question to anyone who has ever been a patient in the health care world: Are you paying for a service, or for an outcome?
And to all of you clinicians out there, I ask a similar question: Are you charging for a service, for your time, or for an outcome?
I would suggest that patients seek out the guidance of clinicians to attain an outcome.They are searching for a game plan to provide a tangible outcome of some form or another. That tangible outcome may have multiple steps, but it is still a specific outcome.
If there is a patient population that demands an outcome - and promptly - it is the athletic population. It becomes even more important to those athletes who make their living from sport. Health care in general stands to learn a lot from the ways of the injured athlete.
If you listen to the patient, they will tell you what is wrong.
This is a phrase I like to use when I am teaching clinical reasoning and decision-making. Listen to the patient. The patient has one witness, the clinician has none. Our task as clinicians is to ask the right questions and to make sense of the truths offered by the patient and their particular clinical presentation.
Strangely enough, dealing with tech support is no different.
Oh, if only they had listened to me on the first call, let alone the 7th.
Quiz time: What happens when you add one bad bill to one good bill? Answer: California AB 1000.
AB 1000 is Assembly Bill 1000. It began as two separate bills: AB 1000, a patient access bill sponsored by the California Physical Therapy Association, and AB 1003, a bill sponsored by the California Medical Association and the California Orthopedic Association. The latter would allow for any professional corporation listed in the Moscone Knox Act (i.e. physicians) to employ all professions included in the Business and Professions Code (i.e. physical therapists).
As it stands right now, the State of California Legislative Counsel has stated that it is illegal for physical therapists to be employed by any professional corporation except for those owned by physical therapists and naturopaths.
The net result of this legislative wrangling and hoo-haa is a classic example of short-sightedness and attempting to grab the scraps of patient access as they fall from the table. It reeks of permission-based professional "judgment", and it could end up being a long-term nightmare for both patients and physical therapists in the state of California.
Up to 60% of runners will sustain an injury within any given year. Poor running mechanics, in conjunction with poor, ineffective and outdated training methods, can pose a significant injury risk. "RunSmart" was written to address these issues in the running community.
"Running Injuries: Etiology And Recovery- Based Treatment" (co-author Bridget Clark, PT) appears in the third edition and fourth editions of "Clinical Orthopaedic Rehabilitation: A Team Approach" by Charles Giangarra, MD and Robert C. Manske, PT.
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.
Top 5 finalist in three categories: "Best Overall Blog", "Best PT Blog" and "Best Advocacy Blog".
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