Switching From Autopilot

Abstract

Every commuter knows the feeling. You gaze out the window, recognizing the familiar surroundings, but suddenly it occurs to you that you don't know how you arrived. You are where you think you should be, but you can't recall taking the turns and making the decisions that led you there. Unfortunately, this commuter experience may be all too similar to how we function in other aspects of our lives—including how we practice. Despite an increased focus on patient-specific functional goals, physical therapists (and other health care professionals) lack a general consensus about what constitutes “clinical success.” Like commuters who navigate their way to work unconsciously, we often find ourselves functioning on automatic pilot in the clinic, gravitating toward measurements of impairment or classic measurements of function as indicators of clinical success. For any given patient, however, these types of measurements might not be relevant, particularly when it comes to interventions designed for preventive purposes or to the patient who has a unique lifestyle and values atypical tasks. This month in the Journal, Beattie and colleagues …