The Power of Confidence by Scott Ward Article Paper

The power of confidence: it’s something to wear and share

Author: R. Scott Ward

Date: Nov. 2007

From: Physical Therapy(Vol. 87, Issue 11)

Publisher: Oxford University Press 

Full Text: 

I have the enviable opportunity in my role as APTA president to meet with many of our colleagues as I travel to meetings around the country. These physical therapists (PTs) and physical therapist assistants (PTAs) are actively engaged in physical therapy in all the ways that keep this a viable and exciting profession. They are busy practicing in a variety of clinical settings and are active in clinical pursuits, health policy, teaching and education, and basic research. Among physical therapy students, as well, I see a high level of commitment and engagement.

The vast majority of PTs and PTAs with whom I come into contact clearly are happy and feel fulfilled in their work. That jibes with poll findings that were cited in April 17issue of the Chicago Tribune. The National Opinion Research Center at the University of Chicago, tallying data on worker job satisfaction collected since 1988 from more than 27,500 randomly selected individuals, found that physical therapy ranked second among the top five occupations. In fact, more than three-quarters of PT respondents reported being “very satisfied” in their career. The study further suggested what you and I know so well that the intrinsic rewards of our helping, healing profession are key to our highly positive outlook toward our jobs.

As I see it, happiness in one’s work and confidence in going about one’s duties go hand in hand. And confidence, in turn, plays an important role in high-quality performance.

For PTs and PTAs, confidence bespeaks an understanding that what we do and how we do it makes a difference. In our case, that difference is betterment of the lives of those we serve. We know that we make a positive contribution toward building a healthier society. True confidence is born of knowledge and experience, and the evidence-based practice of physical therapy benefits from a great deal of both.

Each of us, therefore, must practice, study, and educate with confidence–which translates to a high level of trust in us by those who are under our watch. Solid teaching, high-quality care, and generation of reliable evidence solidify the bond of trust between PTs and PTAS and the patients and clients we serve.

But let me make one thing clear: Confidence must never allow arrogance or cockiness. In fact, I see arrogance as a shield to keep others from discovering one’s flaws in knowledge or character, or as a nasty ploy by those who feel the need to control others. It’s important to note, too, that arrogance just as easily can be directed toward those within as well as outside one’s own profession. There’s a quote I like by author Anthony Beal, who wrote, “For one to expect or ask of others that [which] he himself, if asked, would not be willing to do or give, is the worst kind of arrogance.” Let’s look at that statement in the context of physical therapy.

In our profession, evidence and successful outcomes win the day. Our best public relations “campaign” to patients, clients, and our colleagues in health occupations is simply effective, high-quality care. We can and must always reflect our confidence and pride in what we do in ways that are positive and inviting–never in smug self-satisfaction or belittling of others.

Our confidence in our work should both afford us a comfort level and engender in us a sense of responsibility to receive and give criticism in a professional manner–in the spirit of educating and learning. But I don’t think it’s any secret that PTs and PTAs haven’t and don’t always welcome criticism or impart it in a positive, constructive way. The situation can be particularly sticky when the criticism is peer to peer. That’s why each of us must both be on top of his or her own game and ready and willing to contribute useful and practical suggestions to our colleagues.

To whit: The quality and thoroughness of our documentation of patient care is among the most common subjects of critique in our profession. Often, however, we are upset with outside reviews of our own documentation, and sometimes we are appalled by what our colleagues represent as suitable documentation. There’s nothing wrong with either of those reactions in and of themselves. I’m in no way suggesting we ever should be complacent about substandard documentation. Rather, it’s what we do after we’ve allowed ourselves our initial moments of indignation or righteous fury that’s truly important.

So, if we are told by a payer that we need to change the way we document in order to ensure reimbursement, why not politely and as expeditiously as possible negotiate with that payer a mutually amenable way to provide the needed information? If we find ourselves struggling with consistency in our documentation, why not refer for guidance to APTA’s Defensible Documentation page at www.apta.org? And why not advise our colleagues who are perhaps in some ways “documentation challenged” to do the same, rather than simply criticizing in sharp terms their actions or lack thereof?

Our confidence as PTs and PTAs is anchored in the knowledge that there are clear biological and scientific bases for everything we do. Our use of that evidence, and our collective experience, are powerful tools. Searches of evidentiary databases, most of which are navigable through Open Door (www.apta/open-door), provide research support information for the care we provide. One facet of this strong and growing database is APTA’s Hooked on Evidence, which at this writing features almost 3,700 published extracts, with an average of nearly 60 new extracts added each month. At present, 100 clinical scenarios related to patients with stroke, cerebral palsy, spinal cord injury, low back pain, knee conditions, shoulder conditions, and conditions affecting older adults also are included in the “Hooked” database.

PT researchers continue adding to the number and breadth of these evidence-based clinical scenarios. In addition to tapping these resources, each of us should avail ourselves of opportunities for growth via such offerings as APTA’s advanced clinical practice courses, credentialed residencies and fellowships, clinical specialist certification, and, for PTAs, recognition of advanced proficiency.

Our confidence as PTs and PTAs can be further intensified through advocacy for physical therapy, and by involvement through membership and activity in APTA. Membership affords myriad opportunities to help shape the profession’s future and to network with colleagues from diverse places and practice settings. APTA offers innumerable options for us to enrich ourselves and others, and to contribute to the preservation, improvement, and progress of physical therapy.

It was Marcus Garvey who once said, “If you have noconfidence in self, you are twice defeated in the race of life. With confidence, you have won even before you have started.” PTs and PTAs are in possession of a great deal of evidence and draw from a deep store of knowledge. All we need do to complete our winning formula is honor those facts, resolve to continue refining and expanding our knowledge base, and share with our peers the best of what we have to give.

Let me conclude with one more quote, this one from a legendary football coach. Vince Lombardi once said, “Confidence is contagious. So is lack of confidence.” I, for one, am confident that as long as we employ all of the tools available to us and generously share our knowledge and skills with our colleagues, we will ensure a bright future for this great profession.