Locus of Control

As demonstrated by Dave Gerbarg SPT, CSCS, a simple Twitter search for #PhysicalTherapy provides a plethora of results, both positive and negative. In case you missed his post, here were some of the comments:

I think my physical therapist forgot about me...i've been laying here for like 15 minutes... #soawk

Physical Therapy is #Theworst. I sit here 3x a week and they shock my knee for 30 minutes! #NotHappy

It is easy to get frustrated as a physical therapy student or practicing therapist when negative comments are referenced towards the profession that you have dedicated so much to, both financially and professionally. But, what if some of these negative comments are warranted?

That sounds crazy, doesn’t it?

It goes back to a basic human characteristic taught in Psychology 101: the External Locus of Control. If it has been a while since those 8AM college classes, let me give a refresher. The external locus of control refers to the idea that results or outcomes are determined by forces that lie outside of one’s own personal control. This can serve as a great protective mechanism by which we can better deal with tragedy, failure, or even non-improving patients. However, it can also be harmful and lead to a sense of helplessness or loss of personal control.

Why is this relevant to PT?

I would be willing to bet that those with a negative perception of physical therapy have been involved with PT’s who exhibit an increased external locus of control. After all, it wasn’t the therapist’s fault that the patient was forgotten about while lying on the table; I’m sure the boss kept the clinic and therapists too busy. And, it couldn’t have possibly been the therapist’s fault that the patient’s knee was shocked for 30 minutes every visit; I’m sure the physician was the one who ordered the treatment.

Can you sense the sarcasm? The problem is us, not them!

For years the physical therapy profession has exhibited an imbalance in its locus of control. All that is talked about at national PT conferences is how our profession is not as appreciated in the medical field as it should be, and how we should be better respected by physicians, specialists, etc. The problem is, therapists can be too quick to discount the quality of their services and training, too humble to accept praise and responsibility for improvements in patient outcomes, and too passive to demand respect from other healthcare practitioners.

We can discuss for hours-on-end how poor the public perception of physical therapy can be, but what really needs addressing is the bigger problem, which is why these perceptions exist in the first place!

It needs to be understood that we will not be placed on a pedestal, be provided with increased reimbursement rates, or publicly praised and promoted unless we take the steps necessary to become an active participant in the process.

So, the next time someone calls you a personal trainer, asks if all you do is teach people how to walk, or wants to know how long it took to get your Bachelor’s degree in PT, take it upon yourself to stand up for, and promote, the profession you have worked so hard to be a part of.

If we do that, maybe we will see a few more #Happy comments as we #MoveForward.

Evangelists

Evangelists

In every industry there are individuals who do not work in the field, but play a critical role to the environment and progress of that industry.  These people fall into 3 categories: Trolls, Non-vocals, and Evangelists.  I will explain: these terms:

Trolls
These "creatures" were first described to me by author, speaker, and marketing guru Scott Stratten (@unmarketing) at the APTA Private Practice Section annual conference 2011.  These are the world's a-holes who criticize everything.  The people cannot be reasoned with and do not warrant consideration or efforts.  Thankfully, trolls are not often encountered in Physical Therapy.

Non-vocals
Patients can be transitioned from non-vocal to either troll or evangelist, based on influence of interaction and experiences.  These patients may understand the benefit of PT and have successful interactions with therapists, but are not sharing this with others.

Evangelists
The patients who have the best experiences with a Physical Therapist will often become evangelists.  They don't  just tell others, they proselytize!  Like anyone who consistently finds value in a service or product, they are hell-bent to make sure others have the same experiences.

In my limited experience, PTs are too humble to take advantage of the many Evangelists we create.  If a patient thinks a therapist is God's gift to those with LBP, this should not be discouraged.  Cultivate the enthusiasm!  We need the Evangelists if we are to change public perception.

Thanks for reading!
Please share your thoughts.