My first month off following graduation was spent interviewing for travel positions. I was looking for a way to pay off some of my six figure loan debt effectively, and travel PT provides that opportunity. I ran into some interesting situations during the interview process.
Many companies wanted to know what skills I could bring to the table (i.e. what hands on skills [i.e. what manual skills]). I may have fumbled through one or two interviews when asked this question, feeling the need to impress my interviewer with the limited yet slightly more advanced manual skill set I possess compared to the likely average new grad. However, looking back, I wonder what’s the point? Actually, I felt that way immediately after the interview. I was actually frustrated. My ability to get the position I was interviewing for was hampered by something that is practically made up and devoid of true scientific grounding (at least in the way most schools teach it.*)
My skills are in differential diagnosis, scientifically/evidence based treatments, communication, being a reflective practitioner, and critical thinking.
Yes, I have learned some helpful manual skills for specific body parts, and I do use them in the right context (Episode 3 of the NAF Physio Podcast), but the question arose in my mind, “what’s the big deal if I know more than I do now?”
If I know one manual technique for every body region, do I need to know more? Is there any benefit to having an array of placebo based interventions vs one placebo based intervention?
And what about down the road? Likely, patients won’t know the difference. The only perceived benefit to obtaining more manual skills is that I get some variety. I won’t be as bored providing these treatments (again, in the right context), if I have a variety of them to choose from. But that’s not really a good motivator for choosing continuing education courses, is it?
So what’s the point?
I guess I’m writing this because I wish I had told that interviewer that my manual skills were sufficient to induce placebo based pain relief on par with those of any of the other PT’s in that clinic; and that more importantly, providing the right context to the patient, I could manipulate any body region for pain reduction in any other body region (if I chose to be so deceptive).
I guess I’m also writing this because, as a new grad, it seems apparent that what employers are looking for is skills sets and all of those skill sets are focused on the intervention side. Sure, the ability to correctly diagnose and communicate are valued, but theres no metric for them..and they are largely intangible items. There’s no good way to impress an interviewer with my skills in these areas. It’s all about “what can I see that you can do for me?”
With this, I still have many questions. Should I spend money on continuing education in manual therapies which will potentially be phased out or largely marginalized in the future? What does our profession’s preoccupation manual skills and loosely science based interventions say about us to the rest of the (informed) healthcare community? Will we ever overcome this hurdle of the 20 year information gap for evidence being incorporated into practice? Will I continue to encounter professionals who have never heard of the BPS model and neuromatrix theory of pain?
PS- Listen to that podcast. It will explain what I mean by “I use manual therapy in the right context.”
*My university taught histological and neurological sciences in regard to these topics above. We were encouraged to think independently and critically about the subject material and never accept information at face value without first questioning its validity. PT programs are hamstrung by CAPTE in regards to what information they teach, and there is certainly limited educational hours available. Many programs willingly or unknowingly forgo the opportunity to impress the best current understanding of evidence in regards to topics of manual therapies and pain science to students. I am fortunate to say my university did not, often at great personal time and effort expense.