Time

Time lapse ptbraintrust

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There is no such thing as Time Management. There is only Self Management, time goes on as it will, no matter your intentions for it.

So what can happen over time? Time is one of these factors that is hard to account for, but does a lot of the treating of a patient for you. (see: It’s not ALL about you).  The biology of tissue healing occurs over a timeline and it occurs at a pace that is affected, but not determined, by us or your patient. Continue reading

Who is Satisfied?

How are we going to do this?

In other industries customer satisfaction is part of the delivery, but not directly tied to product price. Companies are “paid” by happy customers with more business (referral, word of mouth, etc), or market leverage to increase the cost of service (increased value of product) with customers happy to pay that increase due to increased value, to them.

This works in a market system, where individuals are in charge of their monetary decisions. But that isn’t health care.

In a move towards payment for outcomes, where will customer satisfaction have a role? (we don’t know whether we will be paid better for better outcomes, or paid a set fee for an average expected outcome and it’s up to us to beat that average… who knows)

Is there any talk of adding customer satisfaction directly to payment? Sometimes that’s all we have. No significant change in patient status, but a very satisfied customer with the care, service, advise and input given. Perhaps they leave with an understanding of their condition, ways to manage it and strategies to avoid deleterious effects of their disease/dysfunctional process… but no change in ROM, strength or patient reported outcome measures. Continue reading

Experience and the Experiment

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“Dad, let’s do an experience” my 6.5 year old said to me this morning. “Let’s see how far away these walkie-talkies can go and we can still hear each other.”

“Do you mean experiment?” I ask. “Yes, ex-per-i-ment” she says. We go over its pronunciation a few times. It’s a mix between my daughter having no front teeth and that she just gets her word choices mixed up now and then. Experience. Experiment. It’s an easy one to slip up on, plus they could be viewed in the same category in her head. “I will have an experience and learn something.” “I will do an experiment and learn something.” Same thing, basically, to a 1st grader.

So, you can see this question coming: Do you get Experience and Experiment mixed up? Continue reading

Five Days of Fallacies: Day 2, Complex Question

Five Days of Fallacies: Day 1 here, Day 3 here, Day 4 here, Day 5 here. I am discussing some common mistakes we humans make in reasoning, in the hope that you can 1) Understand what they are 2) Recognize them when others speak 3) Recognize them when you think this way 4) Attempt to correct your thinking on old, current and future ideas.

The Complex Question Fallacy is in the family of Fallacies of Presumption. It makes assumptions, thereby defining the conversation and the result of the outcome, when asking a question.

An easy example of this is seen here: “When are you going to admit that you lied?” You cannot say “Right now” because that is an admittance of lying. If you say “Never!” you uphold the assumption that you lied, and that you are just not admitting it. Lose lose.

How does this show up in the clinic? Continue reading

Five Days of Fallacies: Day 1, Post Hoc

Five Days of Fallacies, Day 2 here, Day 3 here, Day 4 here, Day 5 hereI am going to share some common mistakes we humans make in reasoning, in the hope that you can 1) Understand what they are 2) Recognize them when others speak 3) Recognize them when you think this way 4) Attempt to correct your thinking on old, current and future ideas.

Let’s start with one of the biggest logical fallacies: Post Hoc, Ergo Proctor Hoc.  “After this, therefore, because of this.” Affectionately known as Post Hoc, for short.

We make a mistake in seeing a causal connection between things when one action/event follows another certain action or event. This is where you get the “rain dance” from.

You did a rain dance, the next day it rained. Boom! Therefore, your dance caused the rain. Oops…Post Hoc! This is where chiropractic Continue reading

The Thousand Word Image

There is no more credible a thing than an image. Seeing is believing. I’ll have to see it to believe it. A picture is worth a thousand words. Vision trumps other senses (McGurk Effect).

How are the words you choose to use, in the healing context of your presence, going to combat the fact that it has been visually shown that things are “messed up in there” ?

It is not our fault, us humans. Wilhelm Conrad Roentgen developed this lovely technology. About a month later, humans were using it clinically.  It is amazing. And I mean X-ray, CT-scans, MRI, fMRI, UltraSound… it’s all incredible. It was developed so we used it. We used it on people in pain, people with broken limbs, people with ailments of this nature or another, and that is the vantage point from which our opinions were based. We saw people with pain have strange looking images. We therefore conclude, that the changes we saw were the cause of the pain, and here we are today.

Post Hoc, Ergo Proctor Hoc. After this, therefore because of this. It is all in the development of the tool. We pointed our delicate and precise imaging tools at the sick, and we found sickness. Continue reading

Does the weather make pain worse?

People say it all the time: “Oh, it’s gonna rain, I can tell in my knee” or “My knees really hurt over the weekend… they do that with bad weather.” What is it with these magical knees? From my personal vantage point, there is no logic to this… it’s simply psychological mis-attribution of causes… but it is heard so often, is there something to it?

Well, I asked on Twitter and fully enjoyed the convos that occurred…

Matt Dancigers Twitter convo weather

So here is a summary of what was shared: Continue reading

Manual therapy continuing education – What’s the point?

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 Continue reading

V O M I T

VOMIT-Poster-2014-SAMPLE

After a few weeks back in the out patient physical therapy setting I am re-confronted with the pathoanatomical-ness of diagnosis.

The battle for language and context of explanation rages on: full strength, full power, full speed.  Whew, just trying to hang on. Daily I must combat the destructive thoughts of a fragile body, or a decaying joint, a shredded tendon, or a tear from here to there.

Sometimes it is very true. Others not. But trying to de-fixate an individual’s thoughts off of the negativity of their structures is unaided by visual proof that they are internally “disfigured.”

Continue reading