Premature Accumulation

I once heard a well-known founder of a Physical Therapy specialization certification program state that some clinicians who passed the Certification Exams prepared merely for the exam, and the process of preparation didn’t necessarily make them better clinicians. This made me wonder about those individuals who have accumulated a string of acronyms after their name, but weren’t able to efficiently integrate their achievements. It also reminded me of those clinicians with 1, 2, or no certifications who applied their learnings and are, consequently, more integrated & effective in the clinic.

Letters, titles… For what purpose? Why & for what goal? How has it changed you & your outcomes?

Most clinicians sacrifice time & energy to attain their titles with the intention of sharpening & expanding their clinical skills with the goals of achieving better patient outcomes, and, consequently, greater job satisfaction – among other things.

The decisions of which philosophy and framework of practice to pursue often bottleneck down to whether or not “the juice is worth the squeeze”. “The Juice” is usually some blend of curiosity, cost, continuing education credits (poor reason, but it is unfortunately the only reason for some), and clinical application.

One route some clinicians travel involves certain Clinical Specialties requiring sitting for a computerized exam. One example is the OCS – Orthopedic Clinical Specialist.

Allow me to rant about the OCS for a bit. Feel free to skip ahead…


The OCS is a regurgitation of dated material. I know this to be true because I was preparing for it last year. Although I decided to put it off until some time in the future, I appreciate the amount of time & effort it takes to memorize the required information for the test. Now, why anyone would want an OCS rests mostly on 2 legs: 1. Public Perception 2. Requirement for APTA Credentialed Residency programs. I find both of these reasons false & inadequate. Let me explain.

When it comes to public perception, it misleads the public into thinking those without an OCS are incapable to evaluating and addressing orthopedic concerns. This is blatantly false considering that a majority of our training in PT school is geared toward orthopedic assessment & treatment. Moreover, memorization and regurgitation DO NOT equate to better clinician reasoning skills. This might be one reason many (but, not all) folks are not better clinicians after attaining an OCS.

As it pertains to APTA Credentialed Residency Programs, the last thing you want as a requirement is rote memorization. It should be geared toward clinical reasoning and patient outcomes. An OCS does a mediocre job on this. How can studying for 1 weekend exam compensate or replace the achievements/efforts of year(s) of dedication and practice? It simply can’t. However, it is a nice recurring revenue generator to require Mentors have an OCS in order for a Residency to be APTA credentialed.


Given the benefit of retrospection and conversations with colleagues who have taken a fair number & variety of Continuing Education courses, I feel fairly confident with what I’m about to say.

If the contents of the course do not add to your clinical effectiveness or efficiency, then it probably wasn’t worth your time & investment. Additionally, if it didn’t inspire you to become a better (how ever you define better) Physical Therapist, then it most certainly wasn’t worth your time.

Maybe you’ve just experienced a life-altering Continuing Education course, and you’re excited about representing a movement that drives you to practice at the peak of your licensure. Now you’re nervously excited about the certification exam and are wondering if you really should pursue it.

Ask yourself: What are those letters after your name worth to you? To your patients?

Maybe the answer is, “those letters mean nothing to me. All I want is to learn the content, help my patients, and improve my clinical practice.” If that’s your response, then congratulations! You just saved yourself a shitload of stress and expenses by avoiding the brain-bending experience of studying for a certification exam.

If your response is, “I want to know that I’m applying the content effectively and at the highest level possible” then the letters might be worth the effort. If you believe the letters will provide you with leverage in clinical outcomes and evangelizing the Physical Therapy Gospel of the potential to live functional lives with zero-to-minimal involvement of pharmaceutical drugs and surgery, then the juice might be worth your squeeze.

The practicality of accumulating letters can distill down to a signaling mechanism that shouts “I know what I’m talking about!” Or maybe it says “I still haven’t found what I’m looking for!” (say it again with your best Bono impression). Maybe s/he is a genuinely curious individual with a passion to learn & grow as a professional.

Me? Well, I would go with the “Bono option” – I still haven’t found what I’m looking for… In retrospect, my certifications (so far) have been a boon to my clinical practice and experience. It’s been a cumulative and catalytic accumulation that provided me with a foundational conceptual framework on which I can mold my future professional growth.

I’m sure you’ve met individuals with an alphabet soup of letters after their name who do not practice at the top of their licensure/certifications. Even worse, they might have completely abandoned the teachings of these certifications, but continue to grace their business cards with these aching acronyms. False advertising, perhaps. Or… a premature accumulation of efforts with nothing to show for it other than limp advertisement.

A possible cure for this premature accumulation: finding a framework that you believe can last the test of time. This is significantly more valuable than a random accumulation of certifications.

P.S. – As many of you are well aware, I enjoy reading books. Early March 2016 saw the first edition of my Quarterly Readings Newsletter. It is an update on some of my favorite reads of the quarter. Email me with “I love to read!” in the subject line, and I will add you to the email list. 

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