How to Fail Miserably

Charles T. Munger’s 1986 Harvard School commencement speech was inspired by a prior commencement speech given by Johnny Carson. Carson’s sarcastic speech provided a blueprint for guaranteed misery in life. Carson’s prescription included:

  1. Ingesting chemicals in an effort to alter mood or prescription
  2. Envy, and
  3. Resentment

Munger commented on Carson’s recommendations, and then added four more prescriptions:

  1. Be unreliable
  2. Learn everything you possibly can from your own personal experience, minimizing what you learn vicariously
  3. Go down and stay down when you get your first, second, or third severe reverse in the battle of life
  4. Ignore the advice of a rustic who said: “I wish I knew where I was going to die, and the I’d never go there.”

Following suit, let’s consider some prerequisites for guaranteed failure and professional burnout. I will skew this towards the Physical Therapist, but can be applied to any profession.

First, resist change. Graduated with a DPT, you are now equipped with enough moxy to delegate patient care. Still drenched in research and free from the wisdom of an evaluated experience, begin entertaining the thought that you are now the international filter of ideal patient care and physical therapy treatment. Continuing education courses are merely confirmation of what you already know; a checkmark to maintain your licensure. This applies to you too; yes you, the seasoned physical therapist. Don’t risk professional evolution by assimilating new and relevant research, or by learning from the very individual you are attempting to treat. A surefire recipe for failure is holding onto the past; hold fast.

Second, fly solo. If history is any guide, then you must not risk attaining a rewarding career by collaborating with those around you. Do not, by any means, aid or abet the very organization that represents and preserves your profession. Also, related to change avoidance (see above), beware social collaboration. It would serve you well to abstain from the wisdom distilled from the following quote by Stephen Landauer:

In Plato’s Republic, guards were taught by poets. Views contrary to your own are always helpful, as sometimes you will see truth in them and effect change, and, if not, you will be stress-testing and ultimately strengthening your own convictions.

Your desire for failure may hit a roadblock as closely held ideas and perspectives could be challenged, and errors exposed. Remain steadfast in your resilience for professional atrophy; stay inside.

And, finally, stop focusing on solutions. Given the dedication to failure, one must avoid solutions; instead, spin the wheel of status quo by repeatedly underlining problems without suggesting creative alternatives. Maintain a purely subjective point of view, avoid objectivity. In fact, it might be easier to simply beat the drums of your favorite dogma. Becoming an agent of change could put you at risk of developing a meaningful and impactful career. Embrace cognitive ossification; stop exploring.

Ladies and Gentlemen, Boys and Girls, keep staring at your feet.

Find me on Twitter @Cinema_Air

Sources:                                                                                                                      “Seeking Wisdom: From Darwin to Munger” by Peter Bevelin                                                “Maximize Your Potential” edited by Jocelyn K Glei

Interview with Nick Nordvedt, DPT, Cert MDT

I had the pleasure of interviewing Nick Nordvedt, DPT, Cert MDT. Many of you have met him on twitter via @nicktnpt. First, a little background on Nick; then we’ll jump right in to the fun stuff.

Nick graduated from the University of Tennessee Health Science Center in Memphis with a Doctorate of Physical Therapy in 2007.  He has worked as an outpatient physical therapist focusing on manual therapy in Memphis and Jackson since graduating, and he completed his certification in the McKenzie Method of Mechanical Diagnosis & Therapy in 2012.

All of us go through professional growth and evolution. Describe your progression through the years.

I think an insatiable desire to learn and grow professionally has been the backbone to my evolution as a physical therapist.  Being happy with the satus quo is something that has never felt right to me, so I believe this has given me the desire to grow professionally.  The biggest influence on my thinking and treatment of patients has been the mentors I have had over the years.  I have had several mentors emphasizing different aspects of physical therapy along the way: everything from scientific reasoning to patient satisfaction to business, but all leading to a patient centered approach to care.  Providing mentorship to students and new grads is naturally the next part of this process, which again, helps me grow professionally as well.

What hobbies or extra-professional interests have impacted you as a PT? And how?

I am a very motivated person, so I always love treating patients who are motivated to return to function.  I love to run, and I’ve always been interested in sports/sport injuries, so I really enjoy treating patients rehabbing from injury.  While I’ve never had a serious sporting injury, it keeps me grounded talking to patients about how & why they got injured. It can be quite a challenge to treat the non-motivated patient, but the feeling of accomplishment for both the pt and the PT can be quite rewarding.

How do you tackle the non-motivated patient?

Every patient has some sort of motivation.  It is a matter of determining what is important to that patient and helping them achieve these goals.  If they are still in the pre-contemplative phase of whether they will use physical therapy services, you have to do a lot of education of what you can do to help this patient.  Ultimately, it is up to him/her to make that decision, but sometimes the therapist needs to put his beliefs and needs secondary to the potential patient’s.

How is the PT business climate in Tennessee?

The private practice PT business is tough, as I would imagine it to be in any market.  But I believe that hard work will pay off in any market as well.  It is a matter of defining and going after your market (this could be defined as your niche).  The ugly is just how little I think PTs know about how a practice is run from a business perspective.  Even if a PT works for a POPTs, HOPTs, or large corporate practice, I think it is his or her duty to know their personal value.  Basic value of an employee is production/cost (production and the quality of production could be discussed further, but even this basic value is not understood by most employees).

What big ideas/simple ideas/basic concepts do you believe will help all Physical Therapists become better/smarter/wiser?

Critical thinking & listening.  I see too often PTs who want a protocol or a road map for every patient which inherently decreases the PTs critical thinking and clinical decision making.  Simplifying patient care should be something we all strive for (“Make everything as simple as possible, but not simpler” – Einstein), but we must remember how complex each individual person is!  Listening (not hearing!) also seems to be a lost art not only in PT, but healthcare in general.  How many more people would get better just from having someone they believe listened to their story?  As Robin McKenzie said, “Everything I know, I learned from my patients.”

Favorite books and/or authors? Any recommendations?

I read To Sell is Human by Daniel Pink earlier in the year. A great book that ll physical therapists should read (he even Mentions PT!). Simple by Alan Siegel & Irene Etzkorn is another great book I read earlier this year. Right now I’m reading Movement by Gray Cook, Lore of Running by Timothy Noakes, and The Hit by David Baldacci.

Give the benefit of hindsight and your accumulated perspective, what’s your advice to new PT graduates?

LEARN and find a mentor. PT students and new grads that I meet are frequently surprised by the vast amount of knowledge still to learn after graduation. We graduate as generalists, but must find our practice niche after graduation. I think the best way to do this is through taking advantage of every learning opportunity available and find a great mentor that shares core practice values with you.

What advice would you give to seasoned PT’s?

Continue to seek and embrace a mentor, but pay it forward.  Share what you’ve learned with anyone willing to listen, PT or non-PT.

What advice would you give to yourself?

I try to give myself the same mentorship advice.  I am always telling people that if I didn’t enjoy doing what I do, I would change.

Do you (or your clinic) offer clinical internships or mentorship opportunities? If so, then how what is the best way to get DPT students in touch with you?

I do accept physical therapist students for clinical internships.  The best way to get in touch with me to set up a contract with a school is to email me at or get in touch with me on Twitter @nicktnpt

Life is an adventure. Describe one of your most memorable adventures so far.

Starting a family has by far been the biggest and best adventure I’ve had!  I have a 2 year old son who keeps my wife and me busy 24/7, but I wouldn’t change it for anything!

Nick, thanks for the interview! It was a pleasure. I hope you enjoyed it as much as I did.

Really enjoyed it! Thanks!

Find me on Twitter @Cinema_Air