Do Your Own Work!

Posted: April 5, 2012 in Uncategorized

Do you remember that time in 3rd grade (or college) when the teacher scolded those wondering eyes? I remember it like yesterday, “Keep your eyes on your own paper, do your own work!” Of course, it was never me they were talking to :).

At the time, it was probably just a stupid geography assignment.

And let’s be honest, who really cares what the capital of South Dakota is anyway?

Little did you know, it really wasn’t about the geography assignment at all. It was about a lesson that needed to be learned for those times when it really matters.

Let me explain…

A few weeks back, I spent the day at a chronic pain clinic shadowing and observing the doctors and interns who worked there. The chiropractor at the clinic had an extensive neurology background and probably gave the most thorough neurologic exam I have seen any doctor do in my life. Often, the patients at this clinic are the ones sent by other doctors because they are either too complicated or no other treatment has worked.

Throughout the entire day, this chiropractor would talk about a case, do an exam, and then finish off almost every thought with, “Do your own work!” About two hours into the day, he must have said this 30 times!

Fast forward a few hours when a new patient walked in. She was typical for that office… Been to other doctors, wasn’t getting better, somebody told her to try the chiropractor and on and on. You know how that goes…

After taking a full history (the patient had a relatively straight forward case), the doctor came in to do the physical exam.

The orthopedic exam didn’t really show anything glaring. The neurologic exam was different however. Based on the muscle strength and sensory loss, this patient was showing clear signs of a nerve impingement or cervical radiculopathy (patients know this as a “pinched nerve”). It was clear as day (clear as night? Idk, one of those). Nobody could argue otherwise.

Just as the exam finished, a funny thing happened. The office assistant knocked on the door and brought in this patient’s narrative report from the other doctor she had seen previously. And  there it was, staring at us right in the face,

All neurologic signs are intact. No sign of muscle weakness, decrease reflexes, or sensation loss

What happened? Well, if I had to guess this patient probably reported to the last doctor with generalized neck pain and said nothing that would indicate otherwise. Without actually checking, this doctor assumed that the patient had nothing else going on.

And if we didn’t do our own exam in the clinic that day? We may have just glanced at the report from the previous doctor and come up with a completely incorrect and ill-informed diagnosis therefore rendering treatment that may not have been indicated for this patient.

It all comes back to the same thing, “Do your own work!”

Doctors are human. They miss things. Was this error an honest mistake or a lazy mistake? I’m not sure, and quite frankly it doesn’t even matter.

Whether you are a doctor, strength coach, or personal trainer, never take someone else’s word for it. When a client comes to you, they deserve a full exam or assessment no matter what the person who refered them wrote down.

I have heard stories of personal trainers who had clients refered to them by a doctor because they were “cleared for physical activity.” Upon evaluation, the trainer send the client right back to the doctor because there was no way this person was ready.

In my opinion, the best thing we as doctors/trainers can do is what I like to call intentional ignorance. When a client is refered to us, avoid reading the medical report or making assumptions based on what the previous doctor/trainer may have said. Do your exam, then compare your findings to what was previously reported.

Every person is a clean slate. Don’t let others who came before you influence your assessment. Just because it was written on a piece of paper does not mean it is true.

I couldn’t think of any fancy conclusion so I will end right here.

Have a great day!

  1. Vadim Farian says:

    Great read! I always say better see it once than hear it ten times.

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