The Lehman effect.
This can be summarised with the question: “What would Greg do?”
Reflection is an important component of clinical practice. It was drummed into me as a student but it wasn’t something that I felt I was very good at. I certainly didn’t enjoy it much, mostly because I didn’t see any real value in it back then.
What should we reflect upon and how do we know it’s the right thing to be reflecting?
If I reflected my clinical practice now, against what I was learning as a student, it would be a very poor reflection because what I’m learning now is completely different.
Every month I post a list of Top 10 favourite international clinicians (last one here) and there’s good reason for that. Clinical practice is both complex and easy. It’s complex because humans are immeasurably complicated creatures, and it’s easy because oftentimes when you cut through the deep layers of crap, some of the most basic interventions, based on sound contemporary evidence, can have profound effects in helping those who seek our guidance. Historically, we have over-complicated the bejesus out of so much of what we do. There are many reasons for that, but the result is that we lose sight of what’s most important, which Dr Bronnie Thompson discusses in the blog she posted here this morning.
I work independently in private practice so the internet is my source of clinical guidance now. Thankfully for me, many of the leaders in what I do provide us with their knowledge and clinical guidance via blogs, podcasts, posts, and through discussion forums. If I have a specific question about pretty much anything, a discussion with those at the forefront is just a Facebook post or Tweet away.
So what’s Greg Lehman got to do with it? I use Greg in this example only because he’s occupied the No.1 spot on our Top 10 list continuously for almost two years. This Pain workbook released over the weekend is an example why. Depending upon the person in front of me and why they’re seeking my help, I may be asking myself the same question but replace ‘Greg’ with ‘Bronnie’ or ‘Peter’, or any one of the other wonderful people who influence our practice.
Gary Vaynerchuck talks about self-awareness as one of the single most important factors in achieving success, whatever we define ‘success’ to be.
Aside from helping the patient, and for the moment I won’t go down that avenue of determining what’s important and valuable and to whom, what’s important to *me* is that I’m doing what my peers would consider to be ‘right’ or correct. ‘Correct’ in terms of contemporary best practice, and ‘right’ for the individual in front of me. As a student, we might have educators watching over our shoulder and then giving feedback. Now, I might be imagining Greg, Peter, Bronnie or maybe even Adam – “Did you just say what I thought you said!? You f*cking dip-shit. Tell him there aren’t any adhesions” – watching me from a chair in the corner, taking notes, sometimes nodding, occasionally tutting.
Apparently Lady Gaga said this: “Only value the opinion of those you respect”. I’d heard something very similar more than a decade ago, and I’m pretty sure it wasn’t from Lady Gaga, but whatever. If internet memes are accurate, then Samuel L Jackson said this: “In order for you to insult me, I would first have to value your opinion”. I recently shared some feedback I’d been given that I was letting the promotion of self-efficacy and patient independence dominate my clinical practice, like that was not the right thing to do.
Well that opinion doesn’t match my own moral, ethical and clinical values as a Physiotherapist, and it’s not what my peers and contemporary evidence suggest I should be doing either. At first I felt a little offended by that comment, but I quickly realised that it was the best compliment I could have received because that *is* what Greg would do, or at least that’s what I think Greg would do! Hopefully that means I’m heading in the right direction. For now at least.
Everyone has an opinion, but in my mind if Greg, Bronnie, Peter and Adam are sitting in the corner of my consulting room or gym-floor quietly observing with nods of approval (we have an internal dialogue afterwards too by the way), then I’m happy with that and it works for me.
I’ll leave you with a handful of comments from memes about opinions.
- Opinions are like wrist watches, everyone’s shows different time from the other. But all believe theirs is accurate.
- Try being informed instead of just opinionated.
- Remember when I asked for your opinion? Yeah, me neither.
- Opinions are like orgasms….mine matters most and I really don’t care if you have one.
- Opinions are like peepholes. You only have a limited view out of your tiny window.
- My opinions are like farts, so hard to hold em in. When one slips, everyone’s gonna know it and at least one person is gonna leave the room.