As I get ready to embark on my first week of orthopaedic manual physical therapy fellowship training through AAMT, I know I will be challenged professionally more than I have in the past six years as a clinician.  I will be alongside some of the most ambitious and forward-thinking clinicians in the country and learn from some of the best in the field.  This journey will launch my career into a demanding level of thinking, clinical reasoning, metacognition, and deeply rooted clinical decision making.

The fellowship program is intended to get the student to a higher skill set not only manually, but cognitively.  It will force me to reflect and proceed with greater confidence and knowledge.  It will assist me in teaching interns as furthering our clinical education programs.  I will think about thinking.  I will go back to basics in order to improve clinical outcomes. In short, it will force me to look at the ‘WHY’ we do things more than the ‘WHAT’ or ‘HOW’.

Borrowing from Simon Sinek’s “Start with Why” and the Inner Circle concept, I set out to ask my current intern and two volunteers ‘WHY’ they wanted to be physical therapists.  The results are clear.





As you can see (and no I did not prompt any answers), the ‘WHY’ is : HELPING OTHERS

This concept does not require metacognition, clinical reasoning or hours of instruction on the ‘WHAT’ or ‘HOW’.  Helping others is rooted deep in our brain and is a common thread among ones who are at different levels of their life, but have the same goal in mind.

Sometimes we can forget this concept in the arguments of clinical expertise and research.  As our profession advances as rapidly as it is now, we can get caught up in the riff raff of the ‘WHY’, but in the end, the ‘WHY’ is much more simpler.  It is about helping others.  We can all go home at the end of the day with our head held high if we keep this in mind.  If this concept stays glued as your ‘WHY’, your outcomes and professional relationships will always shine.


  1. Hello Harrison,

    Thanks for sharing your interesting post. Before any mission, there’s always a serving purpose. We ask ourselves, “Why are we doing this?” Without any clear understanding, we can’t proceed any further until our answer is founded upon reasoning’s on “why” we want to achieve. Find a “why” and everything else like, “how and what” will due follow.

    Best wishes to your endeavors!

  2. In the pursuit of higher education and upgrading our skills as a PT, we need to get into the deep with our why. The answer is simple. But like any other pursuit, we need to approach it with passion that stems from motivation.

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