The Fear of Failure Should Influence a Performance Physical Therapist (Physiotherapist)

You can't win if you fail. 

If you want to succeed, you must first be present at the end of the race to fight it out. Falling by the wayside at any time before the end of the race automatically renders you unable to be in the fight to win. 

Simple concepts. Except in physical therapy, because "what does winning look like in physical therapy?" 
These are possible "wins":

1. The patient is free of pain and is discharged on that criteria; 
2. The patient doesn't return and is assumed to be returned to full function and free of pain;
3. The patient is booked for ongoing consultations without a goal for recovery;
4. The patient returns for a final consultation and expresses their content with the process, stating they are happy to resume their usual activities and come back if they feel it is necessary; 
5. The patient is appropriately evaluated for function, using objective measures that are reliable, valid, and sensitive to change, found to be above minimums, meaning at normal or slight risk. Slight risk would be where risk factors are non-modifiable and must be managed. The patient is appropriately referred for ongoing support in their physical pursuits with a follow-up appointment at an appropriate short- or medium-term interval to re-evaluate their function.

Now, any of the above are possible, and there is a bell-curve of likelihood about what physical therapists will do. Most likely, it is the first two in the above  possibilities. The upper shoulder of the bell-curve is number 4. The lower shoulder of the bell-curve of winning is number 3. The outlier is number 5, but it should not be such an outlier.

One problem with not rising above mediocrity, or deciding that a patient "regressing to the mean" is satisfactory, is that there is rarely considered a fail in physical therapy. The PT always has an out. It's not the PT's fault if a patient "fails".
"It's a pyschosocial problem."
"It's non-specific pain."
"I can refer to a medical professional or specialist and be done with them."

Being able to have a patient fail and there be no ramifications for how you operate is a utopian view of being a physical therapist. There's little to no consequence except the sting of discontent.... and that wears off. 

In football, the fear of failure drives excellence. 

The signature of failure in football is that the opposition scores more goals than you. 
The signature of not winning and not failing is a draw. A point is awarded and you advance for another attempt at winning. 

To win a game, first don't let them score. 
To win a game, second, you score. 
To lose a game, let failure occur. 

The concept is simple - be present long enough to score more than your opposition and don't let them do something to fail you. 

There are signatures of failure - letting a forward loose, giving up the ball in your half, an own goal, failing to mark inside the penalty box, giving away a penalty, not being skilled enough to keep the ball (you have to run more when you don't have the ball), not being fit enough to compete when you don't have the ball, being injured and not being able to contribute, having risk factors for injury not recognised, or not addressed, that increase your risk of injury. 

If you fail to recognise signatures of potential failure, are there any ramifications that effect the way you work? 
Why not? 

You might think you do well. Maybe you do. What does "doing well" mean? Because here's a thought, maybe you are good at regional treatment and rehab. And maybe, even when you "do good" at regional rehab and treament, 70% of patients remain at significant risk of re-injury according to new research that reveals "global" risk factors that weren't evaluated (and therefore weren't addressed) in regional treatment and rehab. 

Hustle to not fail. ​

If you need help with any part of your "not failing to succeeding" continuum, reach out. It's what me and my colleagues do - we professionally mentor you.