Does an Accountant Count Your Change? Editorial: MSKMag Issue 20

In terms of skill set, I can’t think of a professional group better placed to count change than accountants. I bet their familiarity with money, adeptness with arithmetic and baseline intelligence would make them fast, efficient and thorough. Also, if we had a consultation now and again where we emptied our pockets and piggy banks onto their desk, they could use that opportunity to impart their knowledge which could be relevant and helpful.

But we don’t…because it would be mental…and so the example is irritatingly far-fetched…

However the only reason that it seems so fanciful is because the task is so OBVIOUSLY menial for the KNOWN expertise of the profession. Here’s a non-exhaustive list of reasons why it’s daft:

• Change counting is a non-essential, occasional task

• Most people can count their own change

• The upside of an expert counting change is minor

• Paying an accountant to do something so basic would be poor value for money

• An accountant has so much more to offer.

We as MSK Therapists are very well placed to do all sorts of things to, for and with patients presenting with pain and injury. How much are we counting change? How much are we book-keeping? How much are we the consulted experts who are tailoring management?

I’m afraid that this is one of those ponderous pieces which floats such questions but doesn’t give an answer. Mainly because I think we do things that are all of the above whilst not giving much thought to what we could or should be doing as a priority. We don’t have an industry-wide discussion about where we add the most social value, we don’t have good data on how we are perceived, we don’t have unifying principles that govern baseline competence and so instead we ‘debate’ whether needles, manips or deadlifts are best for back pain.

We also love to rue the loss of skills, styles or techniques that were once foundational and have now become less en vogue. I’m VERY guilty of this myself by the way but have recently regretted my indulgence in the genre having recently seen 158 colleagues imply that a new grad physio not being able to rub a calf very well is an irredeemable crime. Ooh I’m glad I just kept typing! Because there’s one example! Calf rubs: that’s counting change is it not?How much better are we than a beautician in a hotel spa or a theragun stocking filler?

I thought about not adding the following caveat in but some of you are especially sensitive to such points so: Of course having the expertise to know when to rub and when not to rub a calf is crucial to consider. As effleuraging a DVT is unwise and giving reassuring touch in the right moment can be important and expert care.

I think we end up counting change more than we should in part because we struggle with the lack of insight the public have about where our actual expertise lies. If we were instinctively consulted as the ‘pain and injury specialists’ as an accountant would be as a ‘financial governance specialist’ then perhaps we would be less likely to imply that our ways of administering manual pain relief and counting reps is where our special sauce is?

Back to my non-exhaustive list of why they don’t count change: ‘An accountant has so much more to offer.’ So do we of course but to the public we’ve implied that the basics are high end skills so they’re not seen as OBVIOUSLY menial and our expertise remains UNKNOWN.

Onto obvious and credible experts that are the best of us! This month’s Mag has two of our glorious staff writers gracing our pages! Sue Julians ponders exercise type and compatibility in a brilliant piece on an increasingly important subject. Tom Jesson returns with ‘Only Nerves Can Hurt Like This’ - a deep dive into neuropathic pain, its similarities and differences with other pain. Speaking of pain, Richmond Stace is a pain coach and physio working on shifting rather than fixing persistent pain states. Eos Active’s Jim Carr has become a great friend of ours in recent years for his thorough and thoughtful take on injectables, their safety, their governance and their utility. His first MSKMag article is a must read, especially if you haven’t looked at the Hyaluronic Acid products and evidence recently. “I’ll buy your clinic…If you’re able to be honest with yourself” says the mighty Steve Hines with his whole chest in our business column this month. A great and timely piece as acquisitions are rife but so are delusions! Finally, a new look for Quizio Matters this month so I hope you enjoy the crossword as it took me ages and if none of you do it, the rest of the team won’t have to face that torture later in the year, which is important to me.

I wonder if in the future we’ll be on street corners taking spare change from passersby for calf rubs? Somehow that seems more likely than accountants being there to count the change for us, despite their role being more obviously automatable. Perhaps we need change.

Jack Chew

Editor In Chief