Sunday, February 28, 2010

Catching up on catching up

I would be remiss to let a full week go by after CSM without a follow up blog! The event itself was a whirlwind with lots of learning, networking, and a great deal of fun. True to NP form, we rush to prep for it, we cram in as much as humanly possible, and then we drag ourselves through the following week. Basically, in spite of that pesky fatigue business, it's as fast-paced, stimulating, and PT-geeky as a week can be. I had a blast. The following 5 work days, though, oye! Stress almost seems more intense until the next 'real' break. I needed to catch up on sleep and read a distracting book just to reset my brain. I'm afraid I don't have much else to contribute tonight. I am prepping for a panel discussion taking place on Wednesday. More on that after the event, "Is Our Dynamically Changing Health Care Environment Jeopardizing Successful Rehabilitation Outcomes?". Yours truly will be serving as moderator. Good times...


Saturday, February 20, 2010

An expert profession versus a profession of experts

One of the themes from the NCS prep course was that expert clinicians run towards difficult patients not away. Embracing challenge was touted as a sign of excellence. Over the next few days that theme jumped out in a number of other talks. Interestingly, some of the parallels were not actually linked to clinical skills. Specifically, I attended Incubating Innovation which was about coming up with new ways of solving problems, thinking laterally, and overcoming barriers. The thought occurred to me that in some ways we are our own barrier. Specialization in physical therapy is coming and it’s a wonderful thing! But the challenge we face as a profession is to specialize ‘smarter’ than the MDs.

This means two things to me:
1) We should strive to address emergent, growing health issues by “cutting them off at the pass” (i.e. obesity, diabetes, sedentary lifestyle).
And 2) We should focus our expertise around symptom complexes and the skills necessary to address a given constellation of impairments (i.e. bariatrics, metabolic syndrome, community-centered, activity-based wellness).

Our current system, through the APTA/ABPTS, is superb at imparting knowledge but is far from svelte. Where is our Prevention specialty? How about Obesity? Metabolic syndrome? These demographics are where we, as a profession, should be running! PTs should own obesity. We should champion prevention!

Perhaps I’m na├»ve. Perhaps the profession would go bankrupt because no one is paying us to move in that direction yet. But I am willing to bet that our market share, public image, and evolving skill set would be larger, better, and more relevant if we take ourselves there, instead of being led.

We are the movement experts. We should tackle the hardest, most prevalent movement disorders within our scope of practice. Here’s the exciting thing, everyone moves. And movement, framed as exercise or not, changes gene expression and brain structure. We have the capacity help these people change who they are, mentally and physically, for the better, just by doing what we love to do. Our depth of knowledge puts us in a position to have a significantly impact societal needs, if we rise to proactively meet the challenge.

Friday, February 19, 2010

Welcome to Move It

Just wanted to thank everyone that has expressed interest in the blog here at CSM. I'm happy to have some more readers. And I am also looking forward to seeing how this initative evolves with more feedback and suggestions. While it has become an avenue for me to express personal ideas and stories, I really hope that this will be a step towards an established, collaborative community of New Professionals.

Cheers, Ben

ps~ Topics on the horizon include Technology and Vision 2020, Disrupting the Status Quo, what students should be learning from NPs, and what an NP organization would look like. Please add to the list or become a contributor to the blog yourself!

Thursday, February 18, 2010

Intuition shmentuition

I must say that I thoroughly enjoyed my first ever pre-conference course! While it admittedly had a lull here and there, so does my attention span on warm sunny days. I will, briefly, take issue with one assertion from the course. A differentiation was made between "Intuitive" vs "Systematic" decision making. I just want to say that I do not believe in intuitive decisions. (Please argue with me if you disagree.) I believe that all decisions that we make are systematic. We may not have the words, or perhaps the evidence, to support that decision, but in the end, a decision, any decision, is a hypothesis. It is a guess based on something. A gut feeling (the intuitive's cliche) is more than nothing. Perhaps our language has not yet evolved to explain the decision making process, but somewhere, on some level, data is being analyzed and a hypothesis is being tested. Our goal as a profession, for the good of our clients, is to make these hypotheses progressively more standardized. That standardization was the strength of the NCS prep course and I think has important implications for all aspect of practice!

Well, for someone 3 hours 'ahead' of East Coast time, this is the best I can do for one night. I hope anyone coming across Move It for the first time after CSM will find something relevant to themselves. Please comment, contribute, or, by all means, heckle.


Tuesday, February 16, 2010

Mid-air musings

As I write this, I’m somewhere between here and there. On my way to San Diego and also trying to figuring out what it takes to be an expert clinician. The reason for my early departure from Atlanta is a preconference course, Neurologic Practice Essentials: Clinical Decision Making as a Foundation for Expert Practice. As a NP I've practiced in a Geriatric Hospital as an LTAC and outpatient PT and in an Acute Rehabilitation Hospital as a PT on the general rehab floor. The NCS seems like my best choice for advanced certification, should I go for it. It also, of course, matches my obsession with neuroplasticity (seriously, read that book).

So with the goal of adding 3 letters behind my name, and with a year and change left on the NP shot clock, I am rolling the dice on a career focus. While I’m a little behind some of my peers and while I won’t be able to sit for the exam until after I lose my New Professional status, it feels like the right move. The whole process seems like a huge undertaking both from a financial and from a time management standpoint. Nonetheless, getting certified seems like one of the best ways to maximize your clinical skills during the initial stages of our practice. I’m hoping to get a contributor or two to blog on their experience with the Board Certification process from an NP perspective in the near future (ahem, KATE).

I finished an article on the flight about characteristics of expert practice amongst role-model PTs. It makes me wonder what the parallels would be between those individuals and, for instance, NPs that pursue residencies and early (relatively speaking) board certification. Are we “future experts” with pre-existing, similar philosophies or does the philosophy develop concomitantly with the expertise? Maybe this course will let me know.

I’m curious what the makeup of the course will be. I hope to see some other NP faces in the crowd. This type of course really captures an aspect of the “Move It” mentality that I would like to develop within our cohort. One day I hope there will be a clear post-academic track for new professionals seeking involvement, opportunity, and excellence.

Cheers and much more to come as the week goes on!


Monday, February 15, 2010

CSM excitement and a nice idea from Bo

Hello all,

For a little while this morning I am blogging instead of packing. I have about 10 hours before my flight to San Diego, good times!!! I just wanted to share an idea and a website with all of you. which I just learned about from Bo's blog has a very interesting initiative going on. Anyone can submit an idea for positive change within our society. The top 10 most popular ideas will then be presented in Washington to members of the Obama administration. You can go and read my suggestion or vote for it over on the right. Feel free to let me know what you think. And definitely make your own suggestions! This is the kind of participatory governance that democracy is founded on! Finally our technology is catching up to the scale of our population.

Cheers and much more to come in the next few days~ Ben

Tuesday, February 9, 2010

Sweet, sweet (frustrating) simplicity

So, seemingly HR thought better of approving my qualifications. I received today what appeared to be the negative counterpart to their original communication. Rather than confirming that I met the minimum job requirements, this one disputed that prior assertion. No explanation, no personalization, just a recantation. Go figure. I will chalk it up to a second read through by a less open-minded reviewer. (That, or they are one of the dozen or so people to read my blog in the last few weeks.)

Well, It never hurts to take a long shot, well, maybe a little. :o) I'll be prepping for CSM in the next 7 days and hope to post some new hopes before my departure.

Cheers and let me know if anyone has had a similar experience!


Thursday, February 4, 2010

The Waiting game and Valuating our time

A friend of mine recently found out a coworker's salary is nearly 100% more than their own. Should we feel worth 50% less? Do we contribute 50% less, bring in half as much business? How far does go when we are asking questions like these? We all feel we have special traits that make us particularly marketable. We think we know where we should fall within that bell curve. But how do we decide how much to ask for our time? I think this is a frequent question for New Professionals and it's certainly not an easy one. Nor can we be sure that we all gravitate to the appropriately deserved income. Some of us are just better at haggling, negotiating, and schmoozing than others.

Here's what I think. As new professionals we are inherently undervalued. But my reasons for thinking this are a little nontraditional. I don't think we're doing the right jobs. Generally an NP's talent in patient care is developing but we have other immediately helpful, untapped skills. We are coming through a period where critical analysis, studying, and technological resource savvy are paramount. I think that those skills could often be put to use early in employment in meaningful ways across a variety of practice settings. What if we respected those skills enough to allow NPs some time to collaborate on and potentially initiate programmatic change? New grads could be seen as consultants and fresh eyes. To me, that's powerful.

The situation reminds me of politics. The status quo is such that by the time an individual is in a position to enact change, they are so thoroughly vested in the traditional way of working that the risks are too great to rock the boat. Clayton Christensen has talked a lot about this phenomenon as it relates to business and later health care. When someone else is committed to cyclic, ongoing innovation, those less willing to be disrupted always lose in the end.

I would like to think NPs could and should be that injection of creative thinking and of unbiased appraisal without predilection. But perhaps this whole blog is all shallowly subconscious supposition about my worthiness for the Rehab Supervisor position. Regardless, I think valuation of our time and expertise should extend beyond current clinical contributions and incorporate the capacity we have for disruptive innovation. I would like to see what more NPs rocking boats would do to our health care climate, PT and non-PT alike.

To finish, I would like to share an anecdote, courtesy of my mother, about our demographic's potential contribution to society if we were valued a little more highly. During a discussion about stimulus packages a few months ago, my mother made the clearly brilliant suggestion that forgiving graduate student loan debt would be an exceedingly effective way of boosting the economy. This is why my mother might have made a better Senator than Social Worker. She observed that people in their late twenties are usually in the process of accumulating 'stuff' and are often constrained in their purchases by lingering loan debt. I couldn't agree with her more. I, for one, would take many more trips across the country and purchase more goods and services if I weren't climbing out of a giant pit of Emory loans. I'll keep you posted if she decides to come out of retirement and run for office.