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Raising the Bar in Rehab

Ends Justify the Means

Published April 24, 2014 4:13 PM by Lisa Mueller
I took three courses of philosophy during my undergraduate years and never really got into it. I'm not even completely sure I understood the phrase, "the end justifies the means," until I was a little older. Experiences added up and I learned how to focus on the end result to get through the process, and like an "aha" moment, I finally got it.

I'm in the age of family planning. It seems like every week another acquaintance is sending photos of baby bumps and due dates. I remember working with a patient right after graduation who told me, "Don't worry, there's still time for you," when she learned I didn't have kids, and that was five years ago! I had dinner with friends a few months ago who told me that after years of trying, they wouldn't be able to have kids. My friends had other options, such as adoption, but the bottom line was if she wanted to carry her own children, she would (at the direction of her OB) need to try IVF treatment. And there it was -- the ends justifying the means.

I've seen this happen in physical therapy practice occasionally. I educate my patients on their treatment options, collaborate on a plan of care ("the means") and establish together the goals ("the ends"). Some patients decide that the ends justify the means, and others don't. For example, a patient wanting to walk again may decide the hard work of pain with weight bearing, the challenge of balance training, and the difficulty in learning eccentric control is worth the end goal of ambulation. Another patient may see the same process and determine he cannot tolerate the means to achieve the end.

Our role as physical therapists is simple -- help support, educate and guide our patients during the healing process to get to the end. We have the education and experience to see our patients' goals before they're able to visualize their own success, and our jobs require us to remind, reinforce and facilitate our patients as they work through the difficult processes of changing the way their bodies function.

What do you think? Do you have patients who struggle through the process of change, only to be pleasantly surprised by the outcome? Do you have to educate your patients on why the ends justify the means?

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