Self-Flagellating Peacocks

Editorial Issue 17

It would be equal parts disturbing and mesmerising to see a peacock lash itself on the tail feathers with a whip. Fortunately I’m speaking metaphorically.

If you take the MSK industry in its fullest, it has clinicians who torture themselves over every clinical decision, every element of professional conduct and every deviation in the evidence. Whilst it is simultaneously home to swaggering narcissists whose self-importance is impenetrable to evidence, ethics and education. I was torn between two flightless birds when reaching for a metaphor for this bunch because these showy peacocks also have their heads in the sand, ostrich style. But I’m sticking with peacocks because the visuals are better and this is a glossy magazine.

To quote my favourite living Philosopher… me… ‘All we have as safeguards are the ethical scruples of individual clinicians aspiring to do better for their patients’. This is from my Feb MSKMag editorial entitled ‘Quality Control’ and it provoked some lovely reflections from many of you and your networks throughout which it was shared widely. But it inevitably got the self-flagellators reaching for the whip and didn’t even hit the radar of the peacocks. In fact several pieces of content at our events, in MSKMag and on the podcast have provoked some to beat themselves up about what they could do better, how they could do more and to ask where they could be examined against a credible standard. Let me be clear, if when consuming CPD content in your own time you feel any of these feelings, YOU ARE HIGHLY UNLIKELY TO BE THE PROBLEM. Mainly because you’re engaging in the critical reflection that would protect you from the excesses being described. Admittedly, you are going further down that road than is necessary and demoralising yourself. It’s not you, cut yourself some slack.

By design, the peacocks aren’t engaging in intra and inter-professional dialogue about best-practice or how to improve accessibility to life changing rehab. They’re administering interventions to people ‘because they work’ and on the rare occasions that they feel a need to justify their style of practice, they point to an inconclusive evidence base as if that’s an edgy insight. But what we must ALL grapple with is that the presence of such a bell curve of self-scrutiny means that as a set of professions we are through some lenses; ONE. Whilst it would feel fairer to be judged solely as individuals, it is unrealistic to expect each of our reputations to be untethered to groups, professions and the wider industry by the lay populations. So whilst I’m a little annoyed to be covering some similar ground on this, the reaction to ‘Quality Control’ and the frequency in which I notice our writers and speakers frustratedly hoping for the unwarranted variation in care quality to reduce made it worth a second pass.

Specifically lets think about targeted treatments for the aforementioned extremes. We need content, services and support networks to stop those prone to self-flagellating and excessive self-scrutiny from burning out in the flames of their own neuroticism; whilst also identifying ways to either convince the swaggering peacocks to modernise or isolate and work around them to reduce the drag on our collective reputation.

Our increasingly infamous staff writer Glen O’Humeral has some great points to make on this theme in this issue, which also partly inspired the above ramblings. The statistical reality of averages is damn inconvenient. A less ranty but similarly compelling staff writer called Tom Jesson is back with a lovely piece on Cervical Myelopathy which is very exposing. Our very own editor Felicity Thow has a colourful and varied portfolio career that you’d be wise to learn from. So we took the red pen out of her hand and had her write in black about personalising and diversifying your work. If I had an Aussie twin he would behave, write and meme like Nick Ilić, brace yourself for his take on bracing meniscal injuries. Mehmet Gem is a long time Physio Matters favourite and kindly takes a break from his newer found fame as a TikTok starlet to give his top tips on lateral hip pain and finally Justin Lim is one of the most creative thinkers in the MSK game right now and when given free rein to write a ponder piece for us he blew our minds with a reflection which will make you look at recreational drug use and party balloons rather differently.

So… self-flagellating peacocks…*

What a weird way for me to say ‘don’t beat yourself up too much, don’t give cover to arrogant pricks and let’s work out how to get our collective rep back on track’.

* No peacocks were harmed or harmed themselves in the making of this magazine.

Jack Chew

Editor In Chief