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Allan Besselink

The Bell Curve Of Clinical Excellence

Monday, 07 November 2011 11:52 Written by Allan Besselink

Elmo's PointThere is a lot of finger pointing that goes on in health care.

As a physical therapist, I have to look no further than members of my own profession. Many physical therapists point their fingers at chiropractors, claiming that they see patients more frequently and far longer than they need to be seen. Or that they use passive approaches and dis-empower patients. Or that all they do is manipulate, and that chiropractors think it is a solution for everything.

I have heard the diatribe many times before, and I am sure I will hear it many times again.

Of course, when you point a finger at someone, three point back at you. As for what happens to the thumb, we can discuss that later.

What this amounts to is that there is crap to be found in every profession. It is not just in someone else’s profession, not just on the other side of the fence. It is in your own backyard. The bell curve of clinical excellence has outliers on both sides. It is where we put the focus that is the problem.

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Sunday, 14 February 2010 23:25 Written by Allan Besselink

Vancouver 2010, IlanaaqThe Olympics represent something special in the sports world. For all of the disputes related to performance enhancing drugs, figure skating “judges”, and the like, the Olympics represent a time when people come together in the spirit of competition. Wars don’t matter. Races and religions don’t matter. The Olympics bring the world together.

There is nothing quite like the feeling you have when your athlete, your team, your nation, stands atop the highest level of the podium. When you hear the opening strains of your national anthem, it will always bring a tear to your eye, regardless of what country you were born in (and where home is now). You could be from the United States, or Croatia, or Australia – that sense of pride, that feeling of “home” – exists deep within each of us, almost to the core of our being.

In the three times that Canada has hosted the Olympics, they have not won a gold medal on their home soil. Through the 1976 Summer Olympics in Montreal, the 1988 Winter Olympics in Calgary, and now the 2010 Winter Olympics in Vancouver, Canada has yet to strike gold in their own backyard.

When I was growing up, Canadians were always a little shy about being overtly proud of their nationality. Unless it comes to hockey - our national pastime. But even the Canadian men’s hockey team had a 50 year gold medal drought at the Olympics until 2002. As a Canadian living in the United States, the Olympics are always an interesting psychosocial challenge. I am always reminded of the Canadian medal count, and how it compares to that of the United States. Our Olympics sport self-image has almost become a bit of a Canadian inferiority complex.

I think I really started to notice a collective change sometime around, well, 2002 – the year that the men’s hockey team ended their 50 year drought. When they won – the whole nation cheered. Loudly.

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Friday, 04 November 2011 23:21 Written by Allan Besselink

Spine from Above DownIf there was an Olympic event for back surgery, then the United States would be a gold medalist year in and year out. The United States is not only number one in the world in back surgeries performed annually, but it is also number one in the world in failed back surgeries annually. More than 20,000 lumbar spinal fusions are performed annually in this country. There are eight times as many spinal surgical procedures are carried out in the United States per capita as in Britain. Either the United States just coincidentally happens to have a lot of bad backs, or there are a lot of surgeries being performed needlessly.

There is also a direct relationship between the number of spinal operations performed in any one geographical area and the number of orthopaedic and neurosurgeons in that area. That being the case, the likelihood of you having surgery prescribed for you is related more to the demographics of your locale than it is to "getting the patient better".

Lumbar spinal fusion is costly – from an economic standpoint, and from a societal one as well. This is a consumer issue with some staggering numbers and facts.

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Listen To The Music, Austin

Thursday, 04 February 2010 21:19 Written by Allan Besselink

Commemorative plaque at the site where the Arm...The Live Music Capital of the World. You see it as soon as you fly into Austin Bergstrom International Airport. The City of Austin have been using this as their motto for quite some time now. I’ve never really doubted the truth in it. I discovered Austin because of the music. When I found out that there were more guitar players per capita in Austin than in any other place in the universe (my statistics), how could I not want to visit?

After peeling away the layers upon layers of Austin guitar players, you then discover the vibe, the sound, the feel that is “Austin music”. It is a blend of many musical styles that has grown and evolved organically to create that unmistakable vibe. It’s Joe Ely, live at the Liberty Lunch. It’s Sarah Hickman or Lyle Lovett or David Garza at the Cactus. It’s Stevie Ray Vaughan at Antones. It’s Asleep At The Wheel at the Broken Spoke. Or how about the Arc Angels at the Opera House? Or Soul Hat at the Black Cat Lounge? Or Storyville at Stubbs?

Much of that “Austin sound” has been fostered by the laid-back music scene, where artists could come to play their music amongst others who would appreciate it, groove to it, and cultivate it. You came to Austin to play music in the presence of others who love music. My own personal experience as a musician was reflective of that.

But sadly, we are now faced with yet another Austin music landmark closing. With this week’s announcement of the closing of the Cactus Cafe, I am left to ponder the evolution – or perhaps devolution - of the Live Music Capital of the World.

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Wednesday, 02 November 2011 22:35 Written by Allan Besselink

201107-WMAThis is the third in a series of RunSmart videos. The series is on-going, with a new video released on a monthly basis. These videos complement the material presented in the book “RunSmart: A Comprehensive Approach To Injury-Free Running”. The full series of videos can be found here. A transcription of the video will also be available with each post.

For those of you that are interested in a more interactive learning environment, consider attending a four hour RunSmart Level One program. You can further your education with the Level Two and Level Three programs which will focus on the application of RunSmart principles to both coaching and training program development and running injury recovery.

In this video, I will discuss the three keys to running mechanics. There are a number of simple cues that can foster an improvement in your running mechanics.

I hope you enjoy the video series. If you would like me to address any specific aspect of the RunSmart approach, drop me an email or add a comment to this article.

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RunSmart Book

Where To Buy RunSmartUp 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.

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Clinical Orthopaedic Rehabilitation "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.

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Allan Besselink

Allan Besselink, PT, DPT, Dip.MDTAllan 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.

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