How to be a physio extremist.

How to be a physio extremist. [applies to EBP-fanatics AND physio astrologers alike]

a. BE ABSOLUTIST. Take a side and commit to it regardless of individuals involved, evidence, or circumstance.

b. FAVOR TRIBALISM. Make Physical Therapy Great Again. Only you & your friends can do it right. Everyone else is completely wrong.

c. LOOK DOWN ON OTHERS. Use words that diminish viewpoints and approaches that disagree with yours. For example, a drastic reductionist perspective is that all “Manual Therapy” is the same. Even worse, use words to demean any “Manual Therapy” such as “tickle, rub, push, poke, prod” and the like. Equally ridiculous is the reduction of the biopsychosocial model to “talk the pain out of the person”.

d. BE SENSATIONALISTIC. Get the attention you know you deserve… because you’re worth it. Use extremist headlines because you know you’re a rebel. Show your rebelliousness to the world!

e. POLISH THE PEDESTAL. Use language that is inconsistent across domains: research vocabulary and clinical practice. Even better, start using arcane and unfamiliar phrases to convey simple ideas. It makes you look so very smart.

f. CLAIM THE ETHICAL HIGH GROUND. Always bring up any and all potential ethical faults to take the conversation away from the central topic of conversation. In fact, bring up your ethical concerns the same way a vegan would, and expect the other side to see things your way. One popular word in the world of Twitter-PT is “nocebo”. It’s the equivalent of dropping “Hitler” into any conversation: an immediate conversation dilutor that re-routes the conversation away from the main topic. You are a connoisseur of conversation killers.

g. LET SELF-PRESERVATION BE YOUR GUIDING LIGHT. A crowd of similar beliefs & opinions offer warm comfort – who cares if those beliefs &/ opinions are weaponized?! Stay warm in your crowd. Never mind the existence of the other crowds who may hold different perspectives than yours – they are wrong. They always have been, and always will be. Enjoy the warmth of your echo chamber.

h. EVIDENCE SCHMEVIDENCE. Arm yourself with a quiver of research papers that you can quote/link in your Twitter arguments… I mean “discussions”. After all, arguing is supposedly nothing but constructive & positive… right? So, why not come prepared. Come prepared to win, not to learn. While you’re at it, feel free to take 1 of 2 opposing sides; either you are a qualified physio who functions in a world of religiously peer-reviewed and statistically approved physical therapy where nothing you do in the clinic is without the complete blessing of the research gods, OR you choose to believe that all research is inherently flawed from beginning to end… and you no longer hold any faith in the existence of math. Go ahead, choose your side and guard it with every fiber of your being whether you’re ultimately right or wrong. And by all means, never ever look up the word falsifiability.

i. ABOVE ALL, FORGET THE MAIN THING: THE PATIENTS. It’s about you being right, not about you being right for the patient in front of you.

Now that you’ve chosen your side, remember: there is no middle ground in the world of an extremist. You’re either with “us” or against “us”.

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