The Power of Silence

Image Credit: NASA

It is the space between the notes that make the music.  A wash of sound and pitch and tone does not stir emotion or evoke dance and tears.  It is the time taken, and placed, between to the vibrations that add meaning.

It is the silence and expanse of nature and wilderness that allows the existence of city life.  It must be there, a place to go to, or the mind cannot breathe.

When looking at the earth from space, we do not assume the only activity or important part is the part that is lit up.  The darkened areas are alive as well.  This is also the case with fMRI.  Yes one part is lit up, but this says nothing about the importance of the less active or “silent” areas.  They too are playing an important role.

And so it goes for any meaningful interaction, and in particular, care-based interaction.  Silence is the time when the ideas can settle, when concepts can take root, when importance is emphasized.

Mark Reid MD PTBT

We all know that a good history can yield some superb differential diagnosis choices. This can only happen in environmentally appropriate silence.  We already know what we know.  Therefore we can keep quiet about it.  We don’t know what the patient knows… so we must listen.

Alan Ristic PTBT

Silence has a time component.  Perhaps that’s why it’s so hard to come by…

Give silence a chance.

Matt D

How to start a Journal Club

I had the awesome experience of starting and coordinating the ODU DPT Journal Club over the past year.  I started it wanting to know what was being put out there in research (the First Pillar), and that was certainly valuable.  I found out, however, that the most valuable aspect of Journal Club is the conversation.  Everyone has different perspectives, reads the same line in a different way, asks different questions and can see what you don’t see.  I learned a ton from participating in this process and you certainly will too.

So, without further ado, here are my tips on how to start a PT Journal Club (J-Club): Continue reading

Your Curated Leadership Resource

Information is available everywhere. There is becoming a need to have pertinent info in one spot.  Well, here it is! These are my favorite videos on Leadership, Communication and Interaction. I find that at least weekly I send out one of these videos to someone to share the knowledge of these great presenters. So please scroll through, watch, and be inspired. We can all be leaders.

Let’s start with Simon Sinek’s Start With Why TEDtalk.   Continue reading

The Problem with Preventative Medicine

And so, if we are healthy, then Hospitals/Health System will not see us come through the door, and not get paid.  They thrive, financially, on the sickness.

Truly they survive financially on sickness because health insurance has agreed with the individual, and mandated to the provider, to pay to ‘cure’ sickness.

The health system wants to promote wellness, to avoid sickness, but there is no money in that at the moment.  So it’s lip service at worst, and unbillable time at best. Continue reading

Patients per hour. What’s your speed limit?


Image Credit:

The topic of one-on-one care vs a double-booked/overlapping/>1 care model is one of great emotion and opinion in the physical therapy community.

So, I am a huge fan of the one-on-one treatment model and it really seems to suit me.  Bias warning, I am drawn to this style of care.  This model is not pushed or addressed in school other than to say that most out-patient ortho clinics are >1 treatment model providers.  My experience has been as follows: I was a PT Tech in a clinic for two years that saw 3 pt/hour/PT and I have interned in a clinic with one-on-one care and am currently in a clinic that does 2-3 pt/hour/PT.  I recently posted on Twitter about not feeling I could ask as much from my patients in a >1 care model, since I was wasn’t giving them as much of myself.  I felt (and still feel) that if a patient comes in and I give them divided care, and not my full attention, that I could only expect the same in return from them.

I got some responses that were quite positive for the >1 model of treatment and it got me thinking about some of the pros and cons.  First off, I was happy to get the insights since I may be in a situation in the future (actually, as I am now in this internship) where I am practicing under the double-book model. Also with future health care regulations and changes, a double-book model may be the only way to operate and I want to be able to think positively about it.  So let’s take a look… Continue reading

Cognitive Dissonance? That doesn’t make sense.

man with hand on temple looking at laptop

Photo by bruce mars on

There is some talk and discussion about how to engage the DPT student in a way that encourages higher levels of thinking and not just memorizing and regurgitating info for the Boards.  See here and here, both at  This line of thinking should be pushed from the very beginning of the PT education, perhaps right after that all intensive Anatomy course. Continue reading