In retrospect, I consider myself very fortunate to have had the opportunity to meet Robin McKenzie and to watch him assess and treat patients live. It was an experience that I look back on fondly and that words fail to describe. I still laugh when I recollect his telling the tale of legendary patient Mr. Smith in such a matter-of-fact and unassuming way.
Today, I can attest that his vision and insights live on stronger than ever. Here are some personal reflections on McKenzie, MDT, and what we really stand to learn from his legacy.
McKenzie was a man ahead of his time. He was truly a "clinical scientist": making astute clinical observations, applying the scientific method along the way, and eventually developing a classification system long before anyone had considered diagnostic categories and sub-groupings. In his first text (1981), he envisioned this as being a system of musculoskeletal care, not just for spinal pain. All the while, he stood steadfast behind the principles underlying his approach even in the face of opposition from the medical community as a whole and physiotherapists specifically. Lo and behold, science has, over the years, "sorted out the details" and started to validate those insights that form the basis for Mechanical Diagnosis and Therapy.
But his legacy is about far more than just an "assessment" or "treatment" algorithm. McKenzie proposed a revolutionary concept in health care: patient self care. Along the way, he got to the root of our health care issues on many levels: cost containment, public health, and clinical outcomes. I don't think it was ever his goal from the start - he just wanted to get patients better, and to promote them doing so with their own efforts.
My personal experiences with MDT have been far-reaching and extensive over the years. My first course in 1994 was, as I have recounted, a world-view-changing life experience. Day one of that course forever impacted my perception not only of my clinical role but of the importance of self care as the central hub in the health care system. I then became the 151st clinician to complete the Diploma program: the highest level of training in the McKenzie Method. I served as the Editor of the McKenzie Institute USA journal for 8 years and the inaugural year of the International Journal of MDT. Fast forward to 2014 and we are on the verge of taking MDT into the digital era with web-based discussion and social media.
Many years ago, he signed copies of his two original texts for me. They are a treasured addition to my library. McKenzie even reviewed my first book when it was released in 2008. It was quite an honor and admittedly a role reversal for me - the mentor reviewing the work of the mentee.
He would often use the phrase "further, further, further" with patients. These words echo in my mind now, but for reasons other than just going further into the range of motion. McKenzie reminds me, on a daily basis, that when you stand on the precipice of something that is radically different from those around you, you WILL face resistance driven more by beliefs than the true value of the concept itself. These are the times in our lives when we must truly press on - to go further, further, further in our thinking.
On this day, Robin, I miss your presence in the world as a guiding light and mentor. I am thankful to have known you, to have experienced your vision, and to know that it changed the way I see the world. It has only just begun, Mr. McKenzie. Further, further, further. Indeed.
Photo credits: Hryck.