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.

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