For years I’ve held back on a burning idea in my head. An idea popped into my head 25 years ago and I pushed it back into the dark recesses of my brain. The vision came out of my mouth as a joke with a patient. At the time, what I wanted to do clinically would have been deemed crazy.
As I self-reflect, I let peer pressure hold me back. Evidence-based practice was on the rise. No matter how hard I searched, I could not find a darn thing to support what I knew deep down in my heart and logically in my brain would be beneficial for patients.
For some reason I put “evidence-based practice” way up on a pedestal as a priority for my practice patterns. I wonder how many other ideas have been ignored due to the pressure to conform to strong evidence.
As I type this, my brain is doing flip-flops because it doesn’t seem that both evidence-based practice and innovation can co-exist. As I mentally work through this flip-flop, I can see that innovation can easily exist if we consider a spectrum: strong evidence for, no evidence at all, strong evidence against. Okay, that’s logically speaking… we are humans though. Our human aspect lets feelings, beliefs, self-identity and the need to belong get in the way. Staying in alignment with something that doesn’t necessarily work is far easier than feeling or admitting failure.
A couple years ago, I found one research article that started my real contemplation process to take action. I had quite a bit of fear of failure and fear of being judged by peers holding me back – I was waffling back and forth wanting to go for my vision yet holding back by a lot of fear – and then, for no real apparent reason, my clinic treadmill broke. I blame it on God – He knew what had been burdening me and well, a perfectly good, mildly used treadmill broke (and had no fix). I had to make a decision: either replace the treadmill OR save up and purchase a GaitKeeper 2200 with Gaitsens 2000. I knew the decision would set the course for the direction I would take professionally.
I know research in a laboratory is definitely not clinical reality. At this point in time, there is no feasible way for me to mimic the study. That one article moved the spectrum needle from no evidence at all into the direction toward strong evidence for my buried idea. I finally overcame the fear and took the leap to begin working on an idea I’ve wanted to do 25 years earlier.
Honestly, it’s scary. For every step I’ve made forward, I’ve experienced at least 4 or 5 steps back. My office manager and I have had more laughs with the failures I’ve experienced – so many initial ideas moving this vision forward totally bombed. The first was an adjustable tether that failed to function as I needed. Then a rope block and tackle all of a sudden wouldn’t maintain its locked position. My Dad created a board on wheels for me. My slight failure to consider the amount of force required to overcome inertia led to a hurdle to overcome. The new problem with the contraption Dad made is figuring out how to keep the paint perfect. My most recent problem involves a Go-Pro that refuses to stay exactly where I want it. The multitude of unforeseen obstacles, although frustrating, have kept me on my toes to meet the challenge.
The scary and exciting part of this whole experience is the patients. For each patient, I only have two definite knowns: gravity always pulls down and the location of the patient’s center of mass.
For the first time in my career, I feel freedom: no predetermined steps I need to follow, no treatment-based classifications. I am thoroughly enjoying the freedom to think, observe and problem-solve. I’ve embraced the opportunity to trust my gut and intuition with each patient.
I’ve learned to appreciate the unknowns. Every patient visit, I’m learning to accept the discomfort within myself: am I choosing the right activities for this patient to improve confidence in their balance? What is the best progression for reaching their goals? How hard do I push them? For once in my career, I work with an individual as curious as myself. Although she has no degree or letters in this realm of care, her curiosity, observations and responses to my questions have been refreshingly helpful. Oddly, although I internally feel like a student pretty much every day, I can still put on a confident face with a touch of humility because I accept that every patient is an experiment.
Yes, each patient is an experiment. My patients have to be because at this point in time, I’ve decided that the typical approach with patients who feel unsteady on their feet is not acceptable. From what I am seeing within various reports: my treadmill reports, the Activity-specific Balance Confidence scale scores and my FOTO reports, the trend indicates that I’m on the right track with my vision.
Physiopedia just started their #justkeepmoving campaign. It resonates with me professionally. I know it’s going to take me years of working with these types of patients to feel more comfortable. All I have to do is keep taking one step at a time to overcome the multiple unknowns. I believe the same is true for all of us. Fear held me back and kept me from moving forward with my vision.
How often do you let fear hold you back?
Until next time,