Mount Everest stands 29, 028 feet above sea level and is one of the most challenging climbs in the world. Those that know me know that I have been fascinated by Everest and the ability for individuals to overcome physical demands to reach a goal. Over 5,000 people have summited this beast, many with the help of Sherpas. These naturally gifted individuals help guide climbers up the mountain in order to reach the summit. Their job is to get you to the top and do it as safely and quickly as possible.
Seeing patients with persistent pain is something we experience on a daily basis, their journeys at different places with different struggles. We treat them with different therapies, but what is truly needed for many of these patients is a companion in care, a guide—a Sherpa.
Sherpas will meet the climber at base camp, sitting at the foot of Everest. They evaluate each climber’s strengths and weaknesses preparing them for the challenges to come. They guide and protect those working through the difficult terrain of the Khumbu Icefall as well as the camps along the way to the summit. They are there to help in the difficult times in the “death zone” only to celebrate reaching the summit. From here, they assist in the tiring return to basecamp.
As patients enter our clinics we greet them at the foot of their journey to recovery. We evaluate their strengths or challenges to help develop a plan. We guide them through the difficult days of therapy as well as the successes of therapy.
As patients enter our Everest, how will you be the patient’s Sherpa? Will you celebrate the successes? Will you stick with them when they feel hopeless and fearful? Will you make sure the patient gets the right care they deserve? The more patients I see (direct access or not) the more I realize we need to be the Sherpa PT. This has become clear to me when desired outcomes are not met. Do we discharge and “let them go” only to get lost in the cold mountain air or will you stick with them? As the horizon of the primary care physical therapist for musculoskeletal conditions is upon us, it is imperative that we guide the patient even when they are not actively seeing us. When was the last time you have gone with a patient to their doctors appointment to help advocate for them?
It is obvious PTs have a profound role in guiding our patients through their journey to recovery, some easier than others. The effective PT will be the Sherpa, guiding them along the way. The question is: How effective are you as a Sherpa PT?
Dr. Shepherd is a clinician and clinical educator. He practices in the outpatient orthopedic patient population at Johns Hopkins Hospital where he also serves as clinical faculty for the Johns Hopkins/George Washington University Orthopedic Residency Program. He also is adjunct faculty for Evidence in Motion’s Residency and Fellowship programs where he leads regional management courses as well as mentors fellows in training. Dr. Shepherd is also faculty for EIM's new DPT program. His clinical and research interests include chronic and persistent pain disorders, spinal and extremity manual therapies, clinical outcomes assessment and clinical reasoning in physical therapy.