Author: zduhamel

As of today I’m more than halfway done with physical therapy school, on the down hill now. It feels like I’ve been in school for a long time (I guess I’m going on my 6 year since high school…) and I have learned some things. This is a reflection upon the last year and a half and somewhat of a brain dump.

10. You have to think for yourself.

I thought school was going to teach me exactly how to treat patients the “right” way. But since starting school I’ve come to find out that there is no one right way. All the things I once thought were unquestionably true are actually hotly debated: modalities (link) and manual therapy (link to one of many long debates on the subject) to name a couple. You have to weigh both sides of the any argument and make a decision on whether or not you will use something clinically.

9. Passion trumps talent

At this level of education we have all proved that we aren’t dummies, or we wouldn’t be here. What sets a student apart now is passion for the profession, our patients and personal development. Talented students may finish school with a 4.0 but passionate students are the ones who impact their patients lives and drive the profession forward. Friends I have made like TJ Janicky, Lauren Kealy and Trent Salo are just a few of those passionate students. (By the way, follow these guys on twitter.)

8. Pain isn’t as simple as we thought.

This could be an ultra long talk but I’ll keep it simple. Pain is an output of the brain, it is NOT an input from the tissues. Here’s a video that sums the point up quite nicely.

7. Physical therapy may be the cure to healthcare.

Healthcare in American is inefficient (link). We pay a ton for chronic pain (link), heart disease (link), and diabetes (link). We are equipped and positioned well to address some of the biggest problems in healthcare, high cost, low quality, and bad preventative care. Physical therapists are experts at movement and getting people moving can effectively decrease risk of heart disease (link), and diabetes (link). We also can make a huge impact on the cost and quality of care for chronic back pain patients (link).

6. There are hundreds of ways to grow as a therapist.

Learning only begins once you graduate from physical therapy school, there are literally hundreds of ways to learn and hone your clinical skills. There are residencies, fellowships, and a host of other certifications (Mckenzie, Maitland, Postural Restoration, International Pain and Spine Institute, IAOM, and NAIOMT just to name a few). There are endless areas to explore and grow.

5. Patients are customers

Healthcare is evolving and so are consumers in general. People are more selective than ever, and everyone cares about what they are getting for their dollar. With that in mind physical therapist, especially those in private practice, must adapt to the changing needs of the consumer and meet them. It starts with the acknowledgment that they are customers. For more on this reach out to Jerry Durham…he’ll set you straight.

4. Mentors are huge.

This can’t be overvalued…get a mentor or 12. Connect with people who are a step ahead of you in life or in practice and LEARN! It is the job of the mentee to seek out a mentor so find people that are interested in the same things and learn from them. If you love pediatrics there are PTs out there who want to mentor you, business, orthopedics, sports, neuro…you name it. One of the best ways to find a mentor is to join a section of APTA.

3. Have hobbies outside of physical therapy

I have found that it is really important to have fun and care about things outside of physical therapy. Maybe you love running, doing triathlons, drinking coffee, painting, volunteering or writing, whatever it is that you love cultivate that passion and grow it. Don’t let your profession be the only thing you care about, it helps you be a more well rounded human.

2. I learn more on Twitter than class

This may be a bit of an exaggeration but I can’t put enough value on being involved with the profession on social media. It puts some of the most brilliant minds in the profession (and in other fields!) in your pocket and allows you to interact with them. Never before could I ask questions and have them answered by such a diverse and qualified bunch. Twitter also allows me to stay up to date on research and hot topics in the field.

1. Loving what you do is paramount.

It doesn’t matter if you are reading the newest research related to the biopsychosocial approach or if you are listening to a breakout session at the private practice annual conference, loving what you do is vitally important. If you love what you do all the other stuff lines up pretty well.

//picture from http://lifeofayouthpastor.com/take-a-brain-dump/ //

Tonight’s #dptstudent chat with Dr. Kyle Ridgeway (@Dr_Ridge_DPT) was geared towards Critical Thinking, what it is and how to do it. Critical thinking is a massive subject that we only brushed the surface of. That being said there were several helpful links to articles and other sites posted that I wanted to collect all in one place. Here is that list.

Hope this is helpful

Helpful Video to start with:

https://t.co/IVEveHHMX5

What is Metacognition?

http://en.wikipedia.org/wiki/Metacognition

http://gse.buffalo.edu/fas/shuell/cep564/metacog.htm

http://edutechwiki.unige.ch/en/Metacognition

http://www.learner.org/courses/learningclassroom/support/09_metacog.pdf

What is Critical Thinking?

http://philosophy.hku.hk/think/critical/ct.php

http://www.criticalthinking.org/pages/defining-critical-thinking/766

A Clinical Reasoning Model:

http://www.ncbi.nlm.nih.gov/pubmed/22276278

Clinical reasoning in health professions (google book)

Science Based Medicine:

http://www.sciencebasedmedicine.org/about-science-based-medicine/

Elements and Standards of Thought:

http://www.criticalthinking.org/ctmodel/logic-model1.htm (this website is dedicated to critical thinking) great resource.

Logical Fallacies:

http://www.logicalfallacies.info/

https://yourlogicalfallacyis.com/

http://en.wikipedia.org/wiki/List_of_fallacies

Cognitive Biases:

http://en.wikipedia.org/wiki/Cognitive_bias

http://en.wikipedia.org/wiki/List_of_cognitive_biases

http://rationalwiki.org/wiki/List_of_cognitive_biases

Don’t be so open minded your brain falls out:

http://skeptico.blogs.com/skeptico/2005/10/the_appeal_to_b.html

Example of Critically Evaluating a Technique:

http://saveyourself.ca/articles/functional-movement-screen.php

A few things from Kyle:

http://ptthinktank.com/2013/11/05/agree-to-disagree-the-less-wrong-way/

http://www.somasimple.com/forums/showpost.php?p=135452&postcount=4

Thanks again to Ben for his continual help to DPT students everywhere.

To MBA, or not to MBA
This topic has come up a LOT in the recent weeks amongst #DPTstudents: Should I get an MBA? These are my thoughts as to the reasons, advantages, and career paths which a leveraged MBA could provide.

First, a little history. Harvard was the birthplace of the world’s first MBA program in 1908. It’s an old degree; recognized, proven, respected. The content in an MBA can be quite extensive – see link. In my mind, I see the content in an MBA to be the study of human behaviors in regards to flow & function of money, services, products, operations, organizations, and perceived value at various levels of social circumstances.

In the end, an MBA is another degree – it confers no license and guarantees only that your mind has been (once again) trained, honed, and shaped specifically for the discipline of making money and administrating business flow.

So then, why is it such a big deal? Why does it seem that at various levels of career paths, upper management is dominated by those who have completed their MBA programs? At the same time, why is it that there are individuals who are filthy rich who seem to have no formal business training at all? And also, how does this fit in with “my goals” as a physical therapist (or physician, or nurse, or entrepreneur, etc.)?

Let’s Break It Down!

To MBA:
If you are interested in quickly moving in directions of:

-A corporation
-A health system
-A hospital administration structure
-Formal business training in economics, finance, marketing, supply chain / operations, information systems, human resources, healthcare administration
Then you should pursue an MBA. Most corporate structures, health systems, and hospitals have the utmost respect for formalized credentials, not necessarily demonstrated acumen or success. These organizations are highly risk adverse and don’t like taking chances on wild cards. Additionally, such structures are usually very slow moving and tend to run behind the cutting edge as a safety mechanism – simply put, they don’t want to be the first -one to test the waters.

Specifically in the health system and hospital structure, physician and nurses dominate the command tree. In fact, the culture in these arenas typically prescribe that unless you are a physician or a nurse, your “understanding” and “ability” to demonstrates success in upper management is negligible – even with a doctorate in physical therapy! The only way one can “prove” the ability is with another advanced degree, typically a masters in business, healthcare administration, or public health.

An MBA trains the mind to process information in a systematic fashion in terms of administrating flow of business, finance, supply, human factors, large scheme operations, and market behaviors. It creates a language which most corporations, health systems, and hospitals appreciate and value.

However, an MBA does not necessarily teach you how to open up your own clinic. It certainly requires more grit than an academic degree to become the next Steve Jobs or Bill Gates.

Not to MBA:
-If your thoughts run more to becoming more self made, then the MBA degree may not be the right one for you. If your passions are more aligned with:
-Private practice
-Entrepreneurial pursuits
-“I care more about clinical excellence”
-Or, if you wish to remain at the lead/supervisor or operational manager’s level on the command tree
If these are true, then there is really no need for you to seek an MBA. To be successful in the above, situations will force you to rely upon creativity, innovation, ingenuity, and the “spark.” The creation of a business (ie. a clinic, online service, product, or specialty education) draws more from learning the right content from the right people – and – having the right mentors, stakeholders, and investors.

While an MBA will teach you all of these things, is it really worth it? Most graduate students already have enough debt, do you really want to go through this again? Is this really worth the debt profile you will further accrue just to learn content you can easily ask your peers and mentors for?

Remember, the MBA credential is one which is respected by corporations and organizations. Investors already have strong business sense; they are interested in the profitability of you – your ideas/products/service/skills, and, your work ethic.

Conclusions:
In a nutshell, if you are interested in acute care, acute rehab, the skill settings, or health systems – and – you wish to rise up the chain of command… become a CEO of a hospital perhaps – you will need an MBA. However, if your dream is to own your own clinic… nay, own a chain of your own clinics and publish the next best book on how to rehab a young athlete, you need to work on YOU, not another degree.

I do have to say one thing, however: the content I have learned and the mental training I’ve received from my MBA program thus far have been some of the most enlightening and useful experiences. In fact, I feel that I’ve learned more from this program about “life” than was gleaned from attaining my DPT. For myself, going through the MBA program has been completely life changing.

So then, the question remains: To MBA, or not to MBA. What will your choice be?