Our vision and where we want to be… have we thought about this evolution? I accept professionals evolve; I do. I think we all need to have a heart to heart chat with the various changes some seem to be desiring.
Acquiring the ability to order diagnostic tests and prescribe medications seems to be important to many globally. Why is that?
I tend to think we need to sit back and think about gains and losses. (Yes, losses.)
Will acquiring the ability to order diagnostic tests or prescribe medications truly improve our ability to practice? I don’t think so.
For our scope of practice, how often do the results from a diagnostic test alter our treatment plans? When we are interested in having a diagnostic test, how often is it needed so an appropriate referral happens? If the reason for the diagnostic test is to help the patient have the right person intervening, wouldn’t it be better if the right person were involved with the ordering of the diagnostic tests so the right test was ordered and the right intervention can happen as soon as possible? Aren’t our examination and evaluative skills adequate enough to critically think and immediately know when the patient does need to be referred for care that is outside our scope of practice?
Another odd question: Most of the musculoskeletal diagnostic tests have a huge focus on the biomedical model. How has the biomedical model helped society and cost of care? Is the biomedical model proving to have value? Does the biomedical model negatively impact outcomes in certain situations? Do we really want to so readily align ourselves with a broken model?
What happens to our listening ability, our examination skills, our time with the patient when we acquire the ability to order diagnostic tests? I think this is my biggest fear. Will we become a bit lazy? Will we become dependent on the almighty diagnostic test to tell the story versus hearing the story from the patient and verifying the story with our manual and observational skills?
Do we truly want to prescribe medications? Society as a whole is already over-medicated. What is actually gained via prescriptions? Won’t most over the counter medications and education be reasonable enough for most musculoskeletal issues? We have enough patients desiring the quick fix. Our interventions offer a long term solution versus a quick fix.
We are unique professionals. We have the luxury of time with our patients. We have mastered the ability to listen, to show empathy and to problem-solve with the patient. We merge the story we hear with what our hands feel and our eyes see. I don’t think having the ability to order diagnostic tests or to prescribe medications enhances our value. I think by having such ability we unnecessarily increase cost of care. I view the desire to order diagnostic tests and prescribe medications as a venue to stroke our own egos and fall prey to the outdated biomedical model.
I’m sure many of you have thought about this same issue. Does ordering diagnostic tests and prescribing medications enhance our talent and our gift or will it hurt us long term?
Looking forward to your thoughts!
Until next time,