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2007 APTA Presidential Address |
RS Ward, PT, PhD, is Professor and Chair, Division of Physical Therapy, College of Health, The University of Utah, 520 Wakara Way, Salt Lake City, UT 84108-1213 (USA)
Address all correspondence to Dr Ward at: scott.ward{at}hsc.utah.edu
 | Introduction |
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Some of our stories may draw a tear. Others can encourage a smile. Like the story that a colleague told me [Figure] about a young high school student. This young man was in an unfortunate accident where he was hit by a car and incurred a fractured femur, a dislocation of his contralateral knee, and many other assorted soft tissue injuries. This 6'8'' patient was brought into the clinic in a wheelchair, and the 5'3'' physical therapist and a physical therapist assistant transferred him to a plinth, far too short for his frame, to begin her examination. The physical therapist wanted to initiate a rapport with this young man. Now, you can imagine this: here is a young man draped off the long ends of a plinth, uncomfortable and with an almost comatose level of interest in any kind of rapport. The physical therapist asked, "Are you a basketball player?" The 6'8'' kid opened his heretofore closed eyes and without hesitation said to the 5'3'' physical therapist, "No, are you a jockey?"
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Whom should we be telling our stories to? There is a broad array of audiences for our stories. At one point we might be found telling a story to a patient or a student; another time, to a neighbor or a politician.
We recount stories about our myriad physical therapy experiences to our patients to console and to motivate them and because the stories we tell can respond to people's desire for hope. Our patients need to know that the basic tools of our profession—like therapeutic exercise—and our contribution to quality of life are founded on rich experience, science, and clinical studies. And increasingly, our research shows that our techniques have as much basis in scientific fact as in professional beliefs. Patients need to know where to turn when they hurt; when they can’t roll over, reach, or walk; when it appears they cannot go back to work or play with their friends.
People need to know what we know about how we can help them. The stories we can tell help people believe: believe in the possibilities before them, believe in their potential, believe in themselves. Our stories support hope. Our work is to change people's stories for the better. What greater story plot line is there? Let your patients hear you.
We tell our stories to our colleagues in health care to improve the care of the patients we all treat. We share case studies, the first and standard form of many heath care stories. We publish original research to help synthesize and transform care. These data tell what we provide and what the results of our work are. Our data and other relevant information are essential in our education efforts directed at our public, colleague, and student audiences. Let our colleagues hear you.
We tell our stories to the students who represent our future. We are all educators in our diverse professional venues, including in traditional classrooms, in clinics, and in laboratories. We tell students our stories, for they are destined to become part of the physical therapy story as well. As teachers, which in some way really includes all of us, we have the opportunity to experience the story of physical therapy firsthand. And, although it may not be possible to tell the story of exactly where we will be in future, through our interactions with students we can play a direct part in how the future story develops. Let our students hear you.
We tell our stories to the public. Our stories to the public should popularize our successes, broadcast our efforts, and enhance respect for the good work we do. We told our story and celebrated the many achievements of the profession and the triumphs of our patients in multiple news outlets, in many ways, and in various media this past year. Our stories are exciting when they hit the national spotlight; however, please know that a potent story on your local level also carries a great power of influence. Let the public hear you.
We tell our stories to politicians and policy makers. Our story tells of the need for equitable access to our good care and makes our appeal to be appropriately reimbursed for that care. APTA's recent Advocacy Academy brought 563 participants from all 50 states to Capitol Hill and covered all Senate offices and more than two thirds of House offices. Since that one day of telling our story, 118 new cosponsors have been added to the 5 bills addressing Medicare Direct Access, repealing the Medicare therapy cap, and including physical therapists in the National Health Service Corps student loan repayment program.
Our system requires that we tell our stories at both a federal and a state level, depending on the issue before us. Those who represent us want to hear from us—and if they don’t, we should make sure they hear from us anyway! Let the policy makers hear you.
The political and policy arenas are also good places to recruit our patients as our associate storytellers. Their experiences can lead to change; they can compel consideration of policy and decision making in a way—as a direct consumer—that we cannot, because sometimes we are seen as only serving our own interest. If a question of "self-service" is raised as we tell our own story to an often skeptical audience, the patient's insight can help improve the perspective of the listener. Let the policy makers hear your patients.
We know that we speak not only for ourselves but also for our patients. Therefore, as we participate in advocacy, we should be active in efforts to improve the accessibility, health, and safety of society in general. The Americans With Disabilities Act provides a great foundation for us in our advocacy efforts for accessibility and a shift in cultural understanding of people with disabilities. We all are better off for the adaptations we take for granted—the lights that accommodate our limited ability to see in the dark; the microphone that projects my voice and makes it easier for you to hear; the stairs, escalators, and elevators that allow us into places that we otherwise could not access. Because the world has already been adapted to some of our common limitations, we should be spirited in helping the world become more accommodating to the needs of those we care for, particularly because we have a deep understanding of their needs.
You should also tell your own good stories to yourself so that you can remind yourself why you like what you do. When you think about your day, allow yourself to be in awe at the good work you are engaged in and how much of an impact you make. Remember that the impact we have on others may not always be earth-shattering from our viewpoint, yet we all know better than most that small steps are nonetheless some of the most important steps anyone might ever take. Let yourself hear you.
There are 2 sides to every story: the telling and the listening. All good stories require a teller and a listener. Sometimes you are the one telling the story, and sometimes you are the one doing the listening. I have mentioned a great deal about telling the story. Listening to the story is equally vital because listening allows us to better understand what a person is thinking and feeling. Thorough listening helps us avoid making mistakes. Good listening is an active, not a passive, skill and one that we know can make a great deal of difference in the success of our decision making.
Why tell our story? Robert McKee1 once said, "Stories are the creative conversion of life itself into a more powerful, clearer, more meaningful experience. They are the currency of human contact."
We tell stories because people want to hear them. We tell them because there are many people who need to hear them! We should tell our stories because we know they are currency of real human contact that matters. Some great stories are fiction; our important stories are real. Our stories are real because the information we base our stories on is from actual data from clinical, research, educational, and social laboratories of many kinds. Our stories are rich with potential impact. They cover a range of emotions from the humorous to the heart rending, from the discouraging to the invigorating. Our stories come from human interaction; our stories are compelling because in our essence we touch the human condition.
I remember the story of a patient with severe upper-extremity, trunk, and chest burns and the effect her story had on me. Her burns were large and deep enough that they required concentrated, high-quality ICU care as she struggled for survival. She was in bandages leading up to and for some weeks following her multiple surgeries. I began working with her on her second day in the burn center. She worked hard; she was one of those patients we easily like: compliant and seemingly resilient about her dire circumstance. She told me the story of her 3 young children, one just an infant. I was deeply touched by her expressions of love and devotion toward them. As we got to know each other better, I found her to be frightened—not about the possibility of scarring and her appearance, as might be expected, but rather of something else that struck my core. She revealed her greatest fear and the focus of her motivation on her rehabilitation when she told me, "I just want to hold my baby and feel him against me again."
It is always important how you tell a story. Tell it honestly, tell it with facts, tell it with enthusiasm, and tell it with heart. In our case, our problem may not be so much in how we tell our stories. It is just important that we get around to telling them.
We have stories to tell of our patients, of our students, of our studies. These stories are based on what they tell us and what we learn from them. These are the stories we should like to tell and must tell to others. We are counted upon to speak for those who cannot speak for themselves. It is important to tell the story of all that physical therapy is. If we—and the "we" is you and me—if we do not tell the story, who will? No one can tell the story as evocatively as we can. We need to tell stories based on our science and on our care. Our stories are compelling, and they can effect changes in a system that needs just as much rehabilitation as the people we serve.
Physical therapy is a good story, and our story is not yet complete—nor, I hope, will it ever be. How boring would it be, to be part of an already finished product with no more questions to answer and no more intrigue or adventure to experience? How lucky are we to be part of this good story, one that gives us something to look forward to, one that gives us something to fight for, one that gives us meaning?
If the profession does not declare our history and our destiny, who will?
If we do not speak for patients, their challenges, and their triumphs, who will?
If we do not influence others with our genuine expression of hope and success, who will?
Tell your stories to all of those who need to and will listen—let them hear you.
| Footnotes |
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| Reference |
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 TopIntroduction Reference |
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