What makes someone an expert? Is it time? Experience? Knowledge base?
In my first few years of teaching, I attempted to teach people concepts that experience had taught me. Once I tried to draw an algorithm of the clinical decision making that went on during an evaluation. It looked worse than a SFMA breakout. Now I know it is most helpful to teach pattern recognition to cut down on clinical decision making. Here are 5 Qualities that experts have in common.
1) Pattern Recognition
- The more patients you see, the more you start to see that certain conditions have things in common such as
- shoulder impingements tend to have a loss of IR
- true frozen shoulder is limited in all planes
- unilateral UQ issues have a loss of cervical retraction and SB to the ipsilateral side
- these patterns make up a majority of what I teach, as you can't teach what experience has taught you, only the patterns you have recognized
- simply put, traditional OMPT systems and other forms of Tx leave most practitioners struggling on Monday to make sense of 100 ways to assess and treat
- experience must be accumulated over time which leads me to the next quality
2) Over Time, Experts Make Mistakes
- Experience is often attributed to duration in a field of practice
- What being out in the field for a length of time gets you is more time to make mistakes
- mistakes help you see what works and what does not
- this lets you know how to interact with different types of patients in different situations
- what really makes the experts stand out is #3
|these guys learn from mistakes - adaptation is key!|
3) Experts Learn from Their Mistakes
- unlike the pattern of insanity, or doing the same thing over and over and expecting the same result, experts learn what not to do - they adapt
- I have learned just as much from what didn't work or had adverse effects on certain patients or presentations compared to things that seemingly had quick fixes
- I learned if you can use less force and have the same effect, why whallop on someone? Unless you just like to hurt people?
|but what happens when it doesn't? Are you ready?|
4) Experts have a plan B
- experts know there is a chance of failure for many reasons
- patient's lack of understanding or compliance
- you chose the wrong interventions and HEP
- have an alternative system in place
- stick with one system, MDT, PRI etc, and give each some time before you switch
- try to honor each system and not mix and match unless you're experienced in already doing this
- give each system at least 4-5 visits to have an effect and in the end
5) Experts know their limitations
- I have often written about referring out after 4-6 visits and in some cases this year after 2 visits
- despite most cases falling into the 87% rapid responder classfication, you WILL come across someone in the 13%
- the 13% is not always a slow responder, sometimes they are a non responder, or may not have a mechanical problem at all
- don't beat a dead horse, if most of your patients get better in x visits, and you are WAY beyond that, it's very unlikely you are going to make a breakthrough
- patient's often appreciate the try and are even more appreciative if plan C involves appropriate referral to another qualified specialist
- have alternatives lined up
- Some of my plan C's...
- a dietary consultant
- alternative medicine practioner
- psychologist dabbling into pain science
- Plan C is NOT sending them back to the same doc that referred them
- once an upset and frustrated patient said, "You're sending me BACK to the guy who sent me to you in the first place because he didn't know what to do with me? NO THANKS!"
Some of what I stated above (pattern recognition), is based on research identifying expertise. Some of it is my opinion and/or a combination of what I read about successful businesses. Questions? Comments? Post below!
Keeping it Eclectic....