Thinking Outside the Box
Sept, 2016: As I am writing this month’s letter, I am relishing the Gino’s East deep dish pizza I was able to devour 12 hours before my upcoming surgery. Yes, I said Gino’s East, because I am currently located in Chicago awaiting a small surgery to remove the large lumbar disc herniation impacting my bladder (of all things!). Why Chicago you ask? Well, it’s not that I didn’t try to get good care closer to home! In fact, I attempted to get care from several wonderful neurosurgeons in our area, but after looking at my MRI (all before evaluating me and some without evaluating the patient at all), the case was written off as “that can’t possibly be causing that”.
So I traveled down to Milwaukee for some “higher level care” to be evaluated by neurosurgeons and neurologists who did exactly the same thing despite obvious and worsening symptoms. Finally, my last stop was Chicago, for yet another “high level” facility where I met a neurosurgeon who did look at the MRI first, but then also evaluated me, and discussed the course of care with me. And yes, finally some relief from weekly trips to the ER is in my future. Why? Because a physician specialist fully evaluated the patient, and asked the pertinent questions that made him come to the conclusion that while symptoms and imaging do not always match perfectly, you cannot deny logic of clinical symptoms that need to be addressed that corresponded with a new and substantial back injury.
There is more to patient evaluation than the technical aspects of reading a radiological study or MRI. It’s called the art of medicine. The combination of educational background, clinical experience, results of patient evaluation and special tests and imaging, the patient’s loss of function that brought them to the provider, along with a strong desire to help the patient in front of you is what the “art” of medicine really is.
As technology advances to the point of computers being able to “diagnose” patients better than doctors with a live patient in front of them, shortcuts to providing less expensive care is a very real and scary thought. Yes, it may be as good as the evaluation some providers grant to each of their patients, but a computer cannot possibly take into account everything an astute and quality provider considers when making decisions about patient care.
While we here at MotionWorks cannot predict the future of medicine or healthcare even beyond the current election cycle, we do know that we have learned from our experiences, both personal and professional, that providing excellent medical care is not an automated technical process. We consistently seek out information about the patient’s problem and functional limitations from the patient, and utilize our own thorough clinical exam prior to reading the results of any imaging studies or office visits from other providers for the intent purpose to come to our own conclusion about the patient diagnosis. We devise a treatment plan based on the all of the information in front of us, and then utilize other materials as a double check, and if our answers are different, we look further to determine why. It takes more time and thought than other approaches, but we are confident that it is the right approach for patients who are trusting us with their healthcare. It allows us the freedom to think outside the box, to question, to test, and then come to a conclusion and treatment plan based on our actual findings and discussion with the patient. This is the art of medicine in our physical therapy world. And we wouldn’t change this process for anything!