Patient advocacy is naturally at odds with professional tribalism and boosterism

Patient advocacy is naturally at odds with professional tribalism and boosterism. This has been pissing me off for 20 years now and has at least partially motivated everything I have ever written about musculoskeletal medicine.

Far too many healthcare professionals, especially the freelance manual therapists, place a higher value on their professional pride than their patients’ needs. This shows up most clearly in public debates (social media arguments) about best practices, when they aggressively circle their wagons to defend their deep investments in obsolete and bogus tools, methods, and ideas. Of course they think they are defending what’s best for patients, and they will frame it that way, but they are actually defending what’s best for their career and reputation. For instance, that trademarked modality they are certified in — five grand for a series of weekend workshops — is mostly good for their reputation and bottom line, not patients.

It’s more important to them to seem effective than to be effective.

For more on this theme, see these articles about:

• alternative medicine’s identity
• structuralism, the strong tendency to define pain problems in terms of “mechanical” problems for which therapists can sell solutions
• why I had to remove an article that was clearly of benefit to patients
• my alleged negativity
• medical training versus chiropractor and naturopath training