Are You Right or are You Great?

Coordinating care between multiple healthcare providers has the potential to be a powerhouse in terms of providing a patient with what they need. Though it has an equally high potential to sow mistrust, cause confusion, and damage relationships.

A coworker pointed out this week the importance of being wrong, and being happy to be wrong. It's easy to get in a habit of doing the opposite, especially in the world of healthcare, where pretty much everyone is a "doctor" now. We all want to sit on our pedestal with the body of evidence that resonates with us the most and claim to be "right." Maybe it doesn't come out quite that way, but the attitude of "my literature says x, y, z," and "well I don't know why they told you that," or "that treatment shouldn't be used for that," often leaks out in ways more obvious than we'd like.

I had a teacher in PT school who would say "get curious, not furious." If a patient comes in saying that another healthcare provider did something that is contrary to what I typically believe is appropriate for such a condition, I try (I don't always succeed) to ask "was it helpful," "did that give you relief," or something along those lines. It's a tricky situation, because we certainly come across those individuals who have gone to a different therapist to be needled in the same spot over and over for 2 years, and want to keep coming back for exactly just that. Sometimes there has to be education along the way as to why that intervention may not be the most appropriate within the scope of physical therapy. Though at the same time, if it's an intervention that provided short term relief, it may still have it's place in a session with the appropriate education to provide a window of opportunity for a more provocative exercise.

Another example would be incidents of conflicting evidence. Of course such a scenario may be due to flaws in the study(s), though it's hard to tell at times. More often than not, there are nuggets of information within the studies that are applicable, even if the bottom line conclusion is contrary to what we believe. A good example of this is the body of evidence in shoulder rehab that firmly states that the rotator cuff cannot be selectively activated. There are therapists out there that take this and run with it. On the other end of the spectrum, we have evidence that says motor control exercises and neuromuscular re-education is the best treatment early on in shoulder rehab. Right there we have two seemingly conflicting bodies of evidence for the same condition. Fortunately both are right, and both have their place depending on the scenario.

PT operates in the grey, not the black and white. We can choose to dig in and ignore what we don't like, or we can evolve by learning about that which makes us uncomfortable. Evidence is there to help us, not to disprove us. New evidence is VERY seldom there to throw out older evidence. It's most often there to shed more light on an unclear situation. For that reason we now know that while motor control IS in fact an excellent treatment for shoulder pain, less specific loading/strengthening is an equally effective treatment, though for a different purpose and phase of the rehab process.

I'm lucky enough that I work in an environment where I'm challenged by other great clinicians on a daily basis. I've had to accept the fact that if I'm right today, I'll probably be wrong tomorrow. That's the beauty of physical therapy, and that's the beauty of growth. If I'm right, I'm not growing, and if I'm not growing, I'm not evolving.

At evolve we embrace being wrong and use it change lives of clinicians. Learning how to evolve is the key to avoiding burnout. Frequent stimulation and challenge keeps us on point and in the game. Follow us or subscribe for more regular content to continue evolving with the ever changing practice of physical therapy, and to remind you why you chose such a rewarding life changing field!

Written by Chris West, PT, DPT, COMT, Owner of Evolve Education

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