Musings on Medical Management

Width Versus Depth?

Adopting a generalist mindset early, and a specialist mindset later, in one's career path is a commonly suggested approach. And a wise one, in my opinion.

Width then Depth. 

Minimize the "you don't know what you don't know" first. Then improve on the "know what you don't know."

Perhaps however, there may even be an advanced level to this.

Mikkelsen and Martin wrote about the Neo-Generalist so if we combine the two, together width AND depth may just be on the other side of the tipping point of one's professional journey.

The neo-generalist is both a generalist and a specialist, switching between the two as required.  They generalize in order to specialize and bring unique perspectives, blended knowledge and experience from diverse disciplines to the specialisms they perform. They are lifelong learners and are inherently curious. They demonstrate the ability to switch specialisms.  They are both fluid and flexible, and when the context shifts, so do they. They are able to cross boundaries. If a specialist lives within a node and a generalist lives within the space on a bridge between nodes, the neo-generalist constantly flows between bridge and node. Neo-generalists are adaptive and responsive. 

Spices

The manual therapies that you use in your treatment sessions are like spices to a recipe. No one spice is more important than the other, but based on the individual in front of you, the plate or the dish, the ratio of the various spices included will differ. 

This is patient-centred care.

Diagnostic Skills

Manual therapy skills, in general, improve over time simply through exposure and repetition.

Diagnostic and assessment skills, on the other hand, often remain stagnant without diligent intent and pursuit of improvement.

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Exercise Categorizations

Vitamins - The "correctives."
Appetizers - Those included within the warm up.
Main Dish - The program.
Dessert - Recovery and cool down exercises.

The Three I's of Sport Medicine

Identification

• Identify the problem. Listen to the athlete's story, assess and test (including imaging and/or lab work if necessary). Provide a diagnosis.

Intervention

• Based on the above, intervene with the most appropriate approach for the individual and for the context at hand.

Integration

• Integrate the athlete back into the "program". This is your dynamic return to play. First on their own, followed by a graded, progressive and seamless merging with the team (if relevant).
  

Simple in theory, yet far too often Identification gets bypassed while Integration neglected. Consistently following this framework as a standard operating procedure fosters management that is more precise and effective.