My physical therapy career began in Oklahoma City in the summer of 1995. I was hired in June to work at Children’s Hospital, at the OU Medical Center’s Health Sciences Center, also home to the physical therapy school from which I graduated in May of that same year. I was hired to head the new non-operative sports medicine and orthopedics clinic. Specialized, sophisticated, and wonderful equipment had been purchased prior to my arrival. Everything I needed to treat the most complex and challenging cases was ready and waiting. I had even attended special classes to learn about the equipment, treatment techniques, and applications. But there were at least two problems: first, approximately three quarters of my actual case load involved patients with inadequate insurance, or even no insurance. That meant most patients were not seeing me for more than a few visits that they could afford. Sometimes, only one or two. That meant little to no opportunity to realize benefits from use of the clinic’s excellent equipment. That also meant I needed an all-new set of solutions that could be broadly applicable to this patient population, most of whom would be performing the independent rehab activities I prescribed. Second, as a new graduate, I was uncertain of my abilities to treat. A wide gap exists between academic theory, a smattering of real-world clinical experiences in the Big 3 settings (ortho, neuro, acute care), and suddenly being legally responsible for deciding what to actually do to optimize care for each individual patient.

     This dual set of challenges was a problem, but also an opportunity. I decided to reconceptualize these problems as a single new challenge, one with an ultimatum. I gave myself 3 months to figure out if I could help anybody recover, and how much, within this time frame, with or without specialized equipment, and with or without more than a handful of visits. If I could not help anyone substantially, I was finished. Physical therapy was not for me. I would move on with my life. Or, if I did help people recover just a bit, but not as much as I would like, I would simply have to buckle down, study, learn more, and do better. This was not for my benefit, but it was, instead, for the benefit of my patients.

     Physical therapists have a broad scientific education in many disparate, yet related, sciences. And I knew how to do the science that was necessary to answer the fundamental questions. I knew what the published scientific literature indicated. But I did not just want to match best-known results. I wanted to be better. I wanted to know if it was even possible. I already knew this about myself: I want to be better tomorrow than I am today. Patients feel the same way. The better I was at my job, the more people I would be able to help, and the better their recovery would be. Thus began my work in clinical research.

     I met and collaborated with many talented clinicians, researchers, residents, fellows, and instructors along the way. I learned a great many unexpected lessons from patients. I reinforced the lessons of patience, humility, and due diligence. I also changed lives (including my own), saved lives, and I managed to change the practice of two medical departments to improve their care. Each experience, including the astonishing generosity and gratitude of the patients and their families, left me humbled.  

     So, 3 months later, I had my answer.

     Since that time, I have continued to learn as much as I can from each episode of patient care, including from the patients and families themselves, the scientific literature, empirical evidence, and my own metacognitive explorations of the epistemology of  ideas, their origins, and understanding. Much of this is built around the science of mechanobiology. I have organized the lessons in a way that, in addition to helping my patients, helps me do my job as safely, effectively, and efficiently as possible. Implicit in this is the understanding that what we do in physical therapy requires complex, precise, clear thinking. And, often, it must happen quickly. This kind of sustained effort is difficult, especially in a busy clinical setting. Yet the rewards are tremendous. They are realized by us professionally, and they are realized by our individual patients personally. 

     What we -- all of us -- do in the world of physical therapy requires a deep understanding of specific content areas that are unaddressed anywhere else in healthcare. It helps to have this worked out in advance. 

     CEU Resource was created to help bridge the gap between academics and clinical practice, to bring practical application of science to examination and treatment, and to provide new and useful perspectives and solutions for busy clinicians. This has been, and continues to be, a team effort. 

     What we offer is well organized, well structured material, with a clear rationale, that describes the management of the orthopedic patient through all phases of rehabilitation. The rationale we apply is built upon a foundation of evidence from the scientific literature, empirical evidence, patient input, and expert-level professional opinion. We include in this mix (following the same methodology) some neurological as well as gait and balance disorders.

     – Dr. John Mark White, PT, DPT, BA, OCS