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Raising the Bar in Rehab

First Impressions and Quick Decisions

Published September 8, 2011 1:01 PM by

I finished reading Blink by Malcolm Gladwell, finally, after it sat on my bedside table for a few months. Some nights I am too tired to read, and sometimes I'm just not in the mood for the subject. Anyway, I was able to take away some pretty interesting concepts from the book as it relates to my work and my life.

I've blogged about the subject matter before, but to remind you - the book is about rapid cognition, making decisions and first impressions off the first two seconds that you see something. Gladwell writes, and uses some evidence to prove, that having more information and more time to evaluate a situation does not necessarily result in better outcomes.

So how does this apply to physical therapy?

I think it pertains to us in two big ways - first, in the first impression our patients have of us. In the first minutes of our first interaction with our patients, they process all the information they have about us - including our body shape, posture, the way we speak, our tone of voice, eye contact and the way we greet them. From that point on, their trust in us, in our skills, in handling their pain, is based on those two short seconds when we say "hello."

Secondly, quick decision-making can be an important component in determining a treatment plan or whether to include certain interventions in a patient's care. Yes, it is possible to spend hours, even days, sorting through research articles and reading tons of publications. I enjoy reading research and always look forward to news stories related to physical therapy. But according to Blink, and as thousands of ICU doctors and nurses would testify, sometimes the best decisions to make regarding a patient's care are the ones we make quickly.

I typically overanalyze even the easiest decisions, and then I call my closest friends and family to make sure they agree with my decision-making. And then to finalize my decisions I usually make a list of pros and cons, review it one more time, and then nod happily as I congratulate myself for a well-made decision. Perhaps I should tone it down a bit. Maybe I could go with my gut more often instead of worrying if I'll be wrong. The book is very well-written and was able to convince even me about the benefits of making quick decisions... pick it up and read it, if you have time!

What do you think? Can you make quick decisions?



I'm with you.  I find decision-making a painful process.  It took me decades to figure out that is why I hate sorting clothes' closets.  Whether to change seasons or to make donations, it requires a multitude of microdecisions.  

Good points from you and Al on how quick decisions affect PT.  Thanks!

Janey Goude September 12, 2011 9:29 PM

Lisa - you are so right about first impressions. I read BLINK before it hit the best seller list and it blew me away because it was so true about the way we make decisions. When I was teaching students, one of the areas that I would emphasize (every instuctor has SOMETHING that gets their goat) was that very first encounter with a patient - I would tell them you have to convey confidence and understanding immediately. Also, you should have formulated half of your care plan before you're done with the subjective part - the patient will tell you half of what you need to know IF you give them the chance and don't interrupt them. Lisa, you are doing great and have exceptional insight for as little "experience" as you have. Keep it up, and keep up the writing - AL

Al DiMicco September 8, 2011 2:11 PM

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