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How predictability limits our future and autonomy

think Mar 08, 2021

My analytical nature in the world of clinical care has been a blessing on many occasions, yet today I see how it kept me entangled in beleifs about how to have a greater impact as a physical therapist.

The fullest breadth of that analytical ability was on display as I was given full autonomy in developing a dashboard of KPIs (Key Performance Indicators).  This tool aimed at providing clinical directors the means to evaluate and mentor their teams, both licensed and non-licensed staff.  I'll spare you the details as I know most PTs don't enjoy conversations around numbers and statistics.

A summary is that our intention was to use objective information to define actual, historical and goal directed (best practice) performance.  Translated it was a clinical predictive rule of sorts, but in numbers.  No seriously, it was!  

We identified certain measures (objective tests), created clusters related to effectiveness and efficiency of care (diagnosis and prognosis), and utilized anticipated outcomes (goals) to determine the need and plan to be implemented (assessment and plan).  

So here's where the problem existed..... it tied every therapist to the past. Patterns and strategies were identified from the collective group of KPIs and clinical leadership was guided in their coaching strategies based on previous performance, and possibly based on others work in a clinic.

Taking information from the past to dictate the future is NOT FREEDOM or AUTONOMY.

It is trying to create certainty and predictability.  Yes, there is logic in that as an owner and even clinician at times, yet I'm certain that every therapist is desperate to re-define our future.  And that requires us to create.

Create new ways in how we connect with clients, in our identity, in our paradigms, in our education, in our way of doing business, in our humility, in our honoring of the complex human body, in how we see our role in health.......

Does that idea overwhelm you or excite you?

Let me translate things into a clinical world.  A clinical prediction rule can guide us as to what medical situation may be taking place based on a cluster of data, but it cannot tell you the special mix of treatment approaches will provide a result nor the driver of the problem.

That is your clinical genius... to create the solution.  Your expereince provides insight, recognition, 'understanding' of the scope of the problem.  Yet your agility in how to best serve that individual's health, their story, their medical status is dynamic and never predictable from person to person.

If we are tied to a paradigm of treatment, we merely are technicians applying a known technique or process.  We are not masters in our freedom of thought.  

If our growth and development is too linear or uniform, again we are saying the past knowledge or ways of seeing the human body is known and therefore the future of how you will approach a client will become quite predictable.  Have you ever had a colleague that you could predict how they would treat a client almost every time?  Is that mastery or complacency?  Freedom or predictability?

The freedom to define best practices by working with the openness of our identity and each unique situation is what will create our future of fulfillment as physical therapists.

I honor those courageous enough to step out into a new arena and define their freedom to create their future.

Live.  Feel.  Think.  DIFFERENTLY.


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