the good ol recipe

Whilst on my musculoskeletal placement I encountered an interesting phenomena within my own activities. I’m not sure if I’ve been doing it all the way through this year, or if I just started doing it while on my musculo placement.
I noticed that, towards the end of the placement, some of my treatments were starting to become very rote-learned. That is to say, that a patient would come in with a condition, and I would already have the treatment plan I intended to do set in my head, before I’d even really assessed them. Ya know, it’d be like “plantar fascitis- ok, treatment is ultra sound to plantar fascia, and soft tissue release to gastroc-soleus”.
I guess I began thinking like this because I’d already seen patients with the condition and I’d kind of established that “this is what I do for this condition” in my head. Initially, when I saw a condition for the first time, I would consider (or try and consider) all possible factors, all possible treatments, and use the ones best for that patient at that time. After seeing a couple of patients with the same condition though, it becomes easy to simply apply the same treatment from the last patient to the current patient. This means you don’t have to think as much, you become faster and more efficient. However, it is a little boring, just using the same old recipe for each condition. More than that though, I realized that it’s not best practice.
I realized that because I already had an idea of the way the treatment would go, I wouldn’t really be paying too much attention to the assessment- I’d really only notice the things that were consistent with my previous patients, thus on a subconscious level justifying my intended treatment plan to myself, I guess. And in so doing, I was failing to notice the intricate little differences (both in the subjective and objective) that are so important to noting the difference between patients, and determining the best treatment.
Anyway, after a while I became conscious of what I was doing- that I was basically reducing each condition into a nice convenient little treatment recipe, and following that without thinking too hard about the assessment findings or considering alternate treatments. I realised that even though some of my patients did have the same condition, that did not necessarily mean that the cause of their condition was the same, and since we want to not only treat the symptoms but also address the cause, treatments between patients should therefore differ. For example, one of my patients’ plantar fascitis was caused by an antalgic gait from a previous Achilles tendinopathy. Another of my patients’ plantar fascitis was caused by recurrent strains from playing soccer. The treatment for the symptoms was similar, however the treatments for the cause was completely different. That is what I was beginning to miss.
Now that I’m aware of my tendencies to reduce treatment for conditions into simple recipes, I can make more of an effort to really analyse each set of assessments, even if I’ve seen a very similar presentation before, and consider all treatment options, thus ensuring best practice. Has anyone experienced this with themselves?