On Public Facing Physical Therapy

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This view might not be too popular among some but it is something that I think is worth mentioning.
I wish more people in our profession dedicated their efforts to creating content that targets the public or is public facing. As someone who oversees some of the largest groups for physical therapists (PTs) (here, here and here) it never ceases to disappointment me by how often PTs create new accounts which basically just repackage previously created content or ideas and then share them to other PTs.
While it is important that we discuss and share information among ourselves as PTs, how many accounts do we need that share the same information and content with dissemination strategies that are really limited just to PT groups? Come on man, at least be original or at least share content beyond the confines of the same PT groups! The real battle is educating and motivating the public (and other professions) to address the many problems facing our healthcare system upstream. It is not creating another for-profit or self-serving PT mentoring group etc.
This is not to lambaste people for creating such groups, accounts or content. Instead it is a call to action to use your creative efforts to take on a larger and more pressing challenge. It also might be to your benefit, the most successful pages and personalities in our profession are those that are more public facing (KStarr, Prehab Guys and Rehab Science just to name a few). From a business and marketing standpoint (in most instances) it is better if your content reaches or is more relatable to a broader audience. Think about it, there are only about ~250K PTs in the USA, while there are 325 million people in the USA (and 3.9 billion internet users worldwide). There is a rather smaller carrying capacity for marketing or sharing content just to other PTs.
You would be surprised by how many people are looking for information related to their health and health related problems online and through social media; and how often. And then we wonder why the collective mindset of the public retains outdated, outmoded or incorrect views/beliefs about the human body, health and disease; think of some of the things patients say about their back pain, or “toxins” etc. Those aren’t ideas or beliefs that they came up with on their own, it is likely something they read online or social media (or heard from a clinician). Because the people that most often realize the benefit of being public facing are the nonsense peddlers who prey on the staggering healthcare and scientific illiteracy rates in this country (and around the world). They have been successful because they have gone UNOPPOSED for years.

To quote the Physiological Society who in 2017 made a similar call to action to scientists:
In an era of ‘alternative facts’, it is our responsibility that the true (scientifically-evidenced) message is made public rather than allowing rampant myths to be propagated and not challenged by those with access to the wider public, who are, in the end, our target audience. We are in a privileged position whereby a lot of our research can and does have direct application pipelines and as such should reach the end-user directly from us.”

In summary, not only is this more public facing or direct to consumer approach beneficial for improving the status of our profession and potentially your own finances, it will help our patients by offering a discerning voice to the overwhelming amount of nonsense that exists. A light in a world of darkness. A compass in a chaotic healthcare system!

On Argument: Quick Tips

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A little advice regarding the nature of discussions in this forum and elsewhere:

If one posts anything publicly, or really anywhere to a broad audience, one must realize and understand that individuals will offer both support and criticism. It’s part of the process and not everyone will view things the same way, for many reasons i.e. Knowledge base, biases, experiences etc. Few things in life are dichotomous in nature, where there is an absolute truth and false. Public discussion in any setting is NOT for the meek of heart. If one doesn’t possess the gumption to handle criticisms or contrarian views, they should perhaps reconsider participation in public discussion. Furthermore, if what one posts is so easily criticized, perhaps one should consider heeding the criticisms offered or at least reconsider the merits of what one one has posted. I would also wager (no empirical data to support this, this is based on the multitude of professional discussions and arguments I’ve participated in) that most people who decide to criticize (especially peers) do so out of genuine concern and a desire to improve.

Now I do agree that there should be some ground rules to discussion/argumentation for the sake of decency and purposeful argument, ex. criticisms should be purposeful, valid and follow a sound logical framework. One should also consider how incredibly difficult it is to change someone’s views on any topic, much less when those opposing are steadfast in believing their views to be true and when argument is done via textual mediums of communication. Being outright rude makes that task even more challenging. Why work against yourself? However, not everyone agrees with the same ground rules as I or anyone else; which one must also understand. However, one doesn’t have to respond to criticisms offered either, there’s always a choice.

You could heed this advice or not and continue to become overly offended and attempt to silence others who offer views that differ or continue to be unprofessional in discussions with peers. Ultimately it makes no difference to me, I will still continue to go about how I have regarding discussions. Just some advice. We accomplish little with categorical and unconditional agreement, iron sharpens iron. However, nor do we with shouting matches instead of purposeful, respectful yet incisive discussion.

Also, one should consider entering discussion or argument under the condition that what they argue may be wrong. One should be prepared to argue their point vigorously but be willing to concede when what they argue is shown to not likely be true. If one is not willing to make that concession, there is little point to engage in argument. This is actually a cardinal rule of formal argumentation. This cardinal rule is also something to consider, before posting publicly or one will have a hard time due to the nature of public discussion described above. One should also consider realizing their limits to the value of their opinion and degree of expertise, ie, acknowledge what you know, what you don’t know and that there are people who might be more versed on a given topic. Quick tip, if I engage with someone, I haven’t encountered previously, I usually do a quick search on who they are so I know who I’m discussing with and if I might be out of my league. That’s not to say that we should view the thoughts and opinions of experts dogmatically but it should be in the back of one’s mind that perhaps their opposition might know a bit more on a topic than oneself.

10 Quick Tips for Staying Up To Date

Following some of the conversations that came out the #SocialPT talk I gave at CSM 2017 with Ben Fung, Greg Todd and Brett Kestenbaum(video via UpDoc Media), I felt it would be useful to create a resource to help students and clinicians stay up to date with the evidence. As an emerging researcher and academic, I am passionate about serving this profession as both a purveyor and guide of knowledge to help inform the care provided in our communities. No more ivory towers and no more “knowledge obscura”. We are all our profession’s keeper and the better informed we all are individually, the better off our profession will be collectively. In the list below, I have provided 10 easy tips to help clinicians and students stay current through a variety of different methods, many of which only require a small addition to a typical day. 90% of them are completely free and 100% are of no additional cost for APTA members. Choose one or choose all 10!

1) Use the APTA PTNow website ($)

PT Now is a resource designed for APTA members which provides summary findings on clinical questions, access to clinical practice guidelines, validated outcome measures and an article search function. Also be sure to check out the APTA PT Outcomes Registry. This project will allow clinicians to participate in the research process by contributing outcomes data to a national registry. The data from this project will be instrumental in advancing care for our patients and creating leverage with legislators and policy makers.

2) Create a PubMed MyNCBI account and create saved searches (free)

This will allows users to track research topics, questions or relationships that interest them. Users can then schedule email reminders on these topics as new papers are published. Though these are only abstracts, it’s a good start and often once the PubMed link is obtained most people have an easier time finding the manuscript. There are also many articles available through PubMed Central, a database designed to host biomedical information free to the public. I have included a YouTube video of how to set up a MyNCBI account and saved searches as well as a step by step instruction with pictures.

YouTube Demo

How to set up “saved searches”

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Step 1. Create a MyNCBI account

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Step 2. After creating a MyNCBI account, log in and perform a search on a topic that interests you; i.e. “Back Pain”

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Step 3. After the search is performed, click on “Create Alert”

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Step 4. Create a saved search with scheduled reminders delivered to your email at a frequency of your choosing.

3) Push notifications” from Journal Twitter accounts

This will push notifications to your phone whenever the Twitter account for a selected journal posts. Many  of these Twitter accounts also have public “lists” of journals, clinicians and researchers they follow which may help structure your search, as an examples the Cardiopulmonary Section’s Twitter Account has two (one cardiac and one pulmonary/critical care). I have included a step by step instruction with pictures for both.

How to “Push Notifications on Twitter”

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Step 1. Click/tap on the notifications icon

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Step 2. Select “All Tweets”

How to subscribe to a “list” on a Twitter account

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Step 1. Click/tap on the settings button.

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Step 2. Select view lists

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Step 3. Select a list you would like to subscribe to.

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Step 4. Click/tap “subscribe”

4) Subscribe YouTube channels and Podcasts (free)

These platforms provide synthesized content on research or clinical topics. The content on podcasts will generally be audio only and Youtube Channels will usually use both visual and audio. These resources are great since they can be listened to while doing something else, such as the ride to and from work or while exercising. Podcasts are particularly great because if users have the podcast app for iTunes, updates to podcasts they subscribe to are automatically pushed to their phone. I have compiled a good list of YouTube Channels and Podcasts for physical therapists here but be sure to perform your own search to find channels or podcasts that interest you. A few of the YouTube channels I subscribe to are the New England Journal of Medicine, British Journal of Sports Medicine and Heart by the British Medical Journal. Also don’t forget to check out the Cardiopulmonary Physical Therapy Journal Podcast!

5) Register/Subscribe to a journal email list (free)

This allows users to receive an updates on new publications and papers published ahead of print. I have provided a step by step example for how to do it through the New England Journal of Medicine, a journal that also often publishes open access (free) manuscripts.

How to “Register/Subscribe to a journal email list”

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Step 1. Click “Register”

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Step 2. Fill in your email and select a password to register. A confirmation email will be sent to you.

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Step 3. Select the “content alerts” and specialty areas you would like to receive emails about. Some journals may not have multiple options.

6) Follow Facebook pages for journals (free)

This tip is similar to “pushing notifications” for twitter. However, an advantage of doing this through Facebook is that more people both have Facebook accounts and check them daily than Twitter. One of the easiest ways to keep up to date with the evidence is make it a component of your daily life.

How to “Push Notifications on For a Facebook Page”

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Step 1. Click on the “Following” button

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Step 2. Click/Tap the notifications tab, then under “Posts” select receive notifications from “All Posts”

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Step 3. Click/Tap the “News Feed” Tab and choose “see notifications from this page on your timeline first”. This places posts from this page at the top of your timeline (not necessary but useful for many)

7) Follow individual researchers (free)

Many researchers have social media accounts and a large portion of them are fairly active, especially on Twitter I actually made a list of some of these accounts worth checking out. Users can also, “push notifications” from their accounts too! I would also recommend signing up for researchgate, this site is increasingly being used by both researchers and clinicians alike. On this site many researchers provide full texts of their papers that can be downloaded, usually 1 year post publication. Users can also request papers from researchers that aren’t publicly available yet on researchgate.

8) Join in the discussions on twitter (free)

To join in these discussions follow hashtags such as #solvePT or #BackPain. To be more specific, I would also recommend using Symplur , a free healthcare hashtag aggregator to help find topics that interest you and even monthly twitter journal clubs such as BMJ Heart’s “Heart Journal Club” #HeartJC .

9) Join in discussions on Facebook groups (free)

One of the best ways to stay informed is to regularly participate in professional discourse. This allows clinicians to appreciate different perspectives from colleagues and to have their biases potentially challenged. Even if you don’t participate, observing some of the discussions from a distance can be useful too! Doctor of Physical Therapy Students or Physical Therapy Practice Education and Networking are two of the largest and most active groups. These groups are also great for asking questions and sharing information.

10) Create a system to manage your citations (free)

As you begin to accumulate resources, especially published work it is important to keep track of them in an organized fashion. This allows you to quickly reference papers and to search for them later. I use Mendeley and Google Drive; both are free to use and excellent software solutions! Mendeley also offers a google chrome extension that allows me to cite resources as I browse. Google Drive has a desktop app that allows me to save files locally on my hard-drive while also continuously and simultaneously pushing files to a cloud based folder which can be accessed anywhere with internet access; even on my phone with the Google Drive App.


I hope these quick tips will provide a better infrastructure for both finding research papers and regularly consuming evidence. If we are all individually more up to date with the scientific literature, better informed decisions can be made for the people and communities we serve!