Anyone with a beating heart is overtly aware that sex sells, but what about items or services that could be referred to as “sexy”? By definition, sexy is something that is sexually suggestive or stimulating OR something that is generally attractive or interesting.
This article will focus more on the second definition of sexy.
Specifically, we will focus on “sexiness” of certain treatments in the physical medicine and rehabilitation world. Sorry guys, no actual sex here in this article!
PTs are attracted to sexy treatments
Does “sexy” sell in the healthcare arena? What classifies as “sexy” in the rehab world? In rehab, just as in any industry, there is a steady ebb and flow of various fads that come in with flying colors and often inevitably fade away.
Each of these fads can usually be described as “sexy” because they are typically accompanied the following:
- Big headlines
- Obtuse marketing
- Continuing education courses
- Gurus and/or medical supply companies getting rich
- Verbose claims.
As a result of this “sexy” marketing, therapists tend to come out in flocks, willing to spend their continuing education budgets on new gadgets and proprietary treatment techniques - even if they are ineffective treatments.
Patients fall for sexy treatments too
On the flip side of this coin, patients often drive this boom in “sexy” treatments. One patient may receive some “sexy” treatment that was sold to them and concurrently experienced improvement in their condition. This inevitably leads a post hoc reasoning on both the part of the patient and the clinician.
The patient then runs and tells all of their friends about said magical “sexy” treatment, which subsequently drives treatment-seeking behavior. The patient eventually sells their physician on the treatment and the happy physician now starts referring specifically for the new “sexy” treatment.
Furthermore, the clinician is now reinforced in their belief in the treatment. This leads them down the road of using the “sexy” treatment more frequently. More patients then start coming to the clinician, driving up their volume and popularity. Inevitably, several patients get better concurrently with the “sexy” treatment, likely due to the natural history of the condition, regression to the mean, and placebo effects. This continues to further feed into confirmation bias.
Marketing boosts attraction
In a different vein, we could have a clinician that has come across evidence that refutes the new “sexy” treatment. Or maybe they have measured outcomes in the clinic demonstrating that the treatment is no more effective than the clinician’s prior practice patterns. However, the “sexy” treatment is still being marketed heavily, or worse, being used by Olympic athletes on an international competition stage.
Now we have a scenario in which patients are seeking a treatment and clinicians feel compelled to provide that treatment to keep their doors open and continue building a therapeutic alliance with their patients. The idea of “a little of what they want paired with a lot of what they need” is born. The treatment paradigm now becomes more complicated because there are layers of incorrect beliefs and even possible thought viruses to sift through while treating the patient.
Rejecting sexy treatments
The final scenario that remains is the one in which a skeptical, reserved, and/or well-read clinician refuses to adopt this sexy treatment. This clinician has covered the evidence and understands that effective treatment is far more centered on a process than any product.
These types of clinicians understand that building a therapeutic alliance, graded exercise, education, and a judicious sprinkling of manual therapy with non-nocebo explanations are the foundation of effective and evidence based treatment. They tell the patient that the new “sexy” treatment they so desperately desire is garbage. The stick to their guns and try (eloquently and diplomatically) to dissuade their colleagues and patients away from the allure of the “sexy” treatment.
This can be a tough situation to be in. The therapist is driven by their morals and doing what they think is the absolute best, however, they tend to overlook the patient’s importance in their own care. The healthcare system can’t cater to give patients whatever they want because the patient simply doesn’t have the same education. But where is the line drawn?
We know sex sells, but should we care?
In time, what is to become of therapists who don’t fall prey to “sexy” treatments and simply stick to tried and true methods, such as exercise, education, and reassurance?
There will always be new fads that sell an abundance of courses, tools, and treatment sessions. Surely, even some of these fads will leave some positive changes in their wake. However, most will die away except among those who cling to these treatments because of the perceived value of the amount of time and money invested into them.
Should the evidence based clinician learn to play off the fads and adjust their practices accordingly within reason? Or should they stick to what they “know” to be best based on the current state of the literature? I don’t know that we will have the answer to this question anytime soon.