Ever wonder who these people are? Why a hand therapist chooses an academic path? Question if partnerships with “academics” will benefit you and your clients (or if they are even connected to the clinical world)? Also wonder about the nature of his or her daily workload? If yes, then it’s my hope that I might have some perspectives to share with you.
Who are these people? By way of introductions, my name is Corey McGee and I am an assistant professor in occupational therapy at the University of Minnesota. I am a 2000 graduate of the University of Minnesota’s program in Occupational therapy (go Gophers!). I have practiced in about every adult rehabilitation context with the bulk of my practice occurring in burn treatment and hand therapy at the University of Iowa and hand therapy in orthopedic/rehab clinics in and around the Minneapolis area. I earned the CHT credentials back in 2006, began work on a PhD in 2007, and finished seven years later (that’s right; I was that slow!).
I followed a meandering path while working on a PhD because, as we all know, life is a balancing act. My progress was “steady” but slow because I maintained my clinical practice, served as an instructor in an entry-level OT program, was a research assistant, took a full-time OT faculty position in 2010 where I also served as a coordinate-campus site coordinator for 4 years, and had a hard time saying “no” to opportunities that arose. My dissertation work was also slowed due to problems with the instrumentation and a loss of engineering support following some staffing changes and the resultant loss of a dissertation committee member. What slowed me down in the best way imaginable was my wife and children. When I began, we had a very busy 4 year-old boy and a 6 month old baby girl and upon earning my PhD, we had a pre-teen son and 2nd grade daughter; as many of you know or can imagine these are busy years! But we stayed connected as a family; I coached both of my children’s soccer teams beginning when they were 4 years old; I was involved with the cub scouts; our kids were enrolled in piano, dance, gymnastics; we took vacations; my wife and I went out (occasionally ;)), and my wife supported me and I her as she began her work on a DNP degree. We were blessed to have the support of my parents though all of this and it truly took a village.
Why am I sharing this with you and how does this relate to the questions posed above? For any of you who are or know, for lack of a better term, an “academic”, this may not come as a surprise but for those of you who do not, it’s been my experience that there may be perceptions about us being married to our work or living lives that are very different those of clinicians. While, I don’t like the idea of lumping anyone into categories because we are shaped and defined by so many things, I wanted to help illustrate that we “academics” aren’t all that different! Do many of us work too much? I’d say the answer is yes, but I’m certain that a hand therapist clinician would likely admit to the same. Why do we work too much? Again, because we love our work and the profession of hand therapy! In addition to being a family-oriented person, I’m just a corn-fed Iowa native, who enjoys Adam Sandler movies, Saturday Night Live, singing in church and on the Smule™ Sing! app, a dark beer, and playing soccer and playing electronics with my kids.
What were (and were not) my reasons for choosing this path? Looking back, I’ve always enjoyed the scientific method. When pursing a biology undergraduate degree, I minored in chemistry and psychology, was a psychology research assistant, and was a teaching assistant in a research methods course. I enjoyed developing a deeper understanding about how the systems of human body and mind operate, human behavior, and how to study such. This, coupled with the fact that I was raised by a social worker who taught me the importance of serving others and understanding the experiences of being human, is why I chose to pursue an entry level master’s degree in occupational therapy. I was subsequently accepted into an OT program at a “Research 1” university in the Midwest where my love of the scientific method was deepened while under the instruction of OT researchers, Dr. Virgil Mathiowetz, Dr. Erica Stern, and Dr. Patricia Schaber. Upon graduating, conducting research was the last thing on my mind. I wanted to practice OT and do well by my clients. I loved my work and I loved my clients (most of them at least) 😉 and, at the end of the day, I may have been exhausted but I almost always felt like I had made a difference. I progressed up clinical ladders, earning “senior” and “clinical specialist” designations because of my patient outcomes, contributions to our department, inter-professional collaborations, and my productivity.
Throughout these years, I began questioning the science of some of the approaches I routinely used and was often challenged by a burn surgeon (who knew the burn rehabilitation literature better than I) to provide him evidence that rehab interventions such as compression garments actually benefited our clients. Our relationship was one of mutual respect and he appreciated that I wanted to do all I could for our clients however he felt an obligation to our clients and the health system to ensure that our practices were evidence-based. As a side note, I did wear on him after a while and he began softening on certain stances; I believe because his confidence in our service/my skills grew.
But, based on these experiences, my drive to do research was awakened. Sometime soon after and serendipitously, Dr. Virgil Mathiowetz offered me a research assistant position to support him in his energy conservation research. The position was paid and would cover 100% of the expenses associated with pursing a PhD in Rehabilitation Science. My wife and I discussed and made the decision to uproot our family from our Iowa home and make our way to Minneapolis, MN. This is where my path into academia began. Throughout this time I remained a practicing therapist because I loved practice and I believe having one foot in academia actually made me a better practitioner. After graduating, I was offered a full-time tenure-track position as an assistant professor in occupational therapy. Because these positions require heavy research and teaching productivity, I was no longer able to maintain a clinical practice. I think that this history is important to share because it helps to illustrate that I didn’t leave practice because I didn’t love my work as a clinician or because I wasn’t suited to do it; I transitioned into an academic role because I also believed I could serve our client populations and our profession in another manner in which I also (perhaps) possessed some aptitude.
A related million-dollar question is “why a tenure-track academic position and not a clinical research position?”. Working in a “Research 1” university provides researchers rich access to research resources and inter-professional collaborations. Additionally, the process of earning Tenure affords a researcher the security to ask and seek to answer research questions without any accountability to or pressure by a health organization (i.e., perhaps some clinicians want to study something but their employer won’t let them because it might contradict that system’s processes and ingrained practice patterns). Having tenured “hand therapy” faculty in a Research 1 University also earns your profession a place at a University’s table when decisions are being made about future directions of related research and educating the next generation of hand therapists. Having tenure-track and tenured faculty also provides stability to therapy programs in a university setting. This is important to our profession in that our program produces a number of entry-level OT hand therapists every year and, without this security, a program closure would impact our pipeline of new graduate ‘hand therapists’.
Although working in a healthcare organization affords hand therapy researchers direct access to client populations for study, these positions are few and far between because most health organizations are mostly about treatment productivity and researchers aren’t often a source of revenue. Many hand therapists who are conducting research as an employee of these health organizations often do not have protected time to do such (i.e., are doing non-paid afterhours research) and, at times might not have enough training or access to consultation and resources to effectively study a topic. It is for these reasons, that this path was right for me. I believe this is a nice segue into the next question.
How will partnerships with “academics” benefit you, your clients, and the profession? I think it’s first important to understand that hand therapy researchers are health professionals just like practicing clinicians. Even if not a practicing clinician, they work to keep their fingers on the pulse of practice, the profession, and the healthcare climate. They value and have deep backgrounds in clinical practice, wish to remain connected to clinical practice, and want to learn from practicing therapists. I love hearing stories about a therapist trying new things and how her or his client responded. I value that evidence-based practice is also dependent upon the learned experience of the hand therapist and not just solely what the literature recommends. Moreover, we understand the constraints of a clinic setting, the pressures to be productive, etc. There are no “ivory towers” in my world; I am as much of a realist as I am an idealist (but I believe the advantage of bringing an academic to the table is that we might offer new perspectives). I, and other hand therapy “academics” like me want to assist you in exploring how to study your questions and how to effectively and rigorously execute the study in a way that best informs other therapists, other professions, our consumers, and our payers, that hand therapists offer a valuable and evidence-based service to the clients they serve.
Many of us have some protected time to conduct research and, as I mentioned earlier, have the training, and access to rich resources and partnerships that enable us to design and carry out research. I believe I speak on the behalf of all academic hand therapists when I state that we want to support you and our profession and implore you to reach out to us.
As an example, I work within a large academic health center at the University of Minnesota which is linked to Fairview Health Services and their hand therapy services. At present, Dr. Virginia O’Brien, Fairview clinical hand therapist and hand therapy residency supervisor, and I are conducting a comparative effectiveness trial funded by the American Hand Therapy Foundation. Virginia, Ann Van Heest, MD, and I worked together to design a hand therapy comparative effectiveness trial for women with closed distal radius fractures. I approached Drs. O’Brien and Van Heest with the question and study design and together, with input from our referral sources and Fairview administration, we worked to refine and protocolize the methods in a way that was best practice yet feasible for all involved. A brief description of our trial can be found here.
What is life like as a Hand therapist “academic”? In short, it depends on the day, week, semester, and year. Because I am on a tenure-track and research productivity is expected, I have, on paper at least, 35% of my annual workload (yes, I have a boss who does ultimately determine my workload) attributed to research. About 40-45% of it is devoted to teaching and the remainder of my workload involves community outreach, professional service, and committee work. I direct and/or instruct in courses on orthotic and prosthetic interventions, practice in “work” settings, biomechanical intervention approaches, musculoskeletal anatomy/kinesiology, and in an inter-professional “introduction to collaborative practice” course. I also serve as a primary academic and research advisor/mentor to a PhD student in our rehabilitation science program and 3 masters in occupational therapy research groups. My days are varied but include in-class teaching, online course management and instruction, meetings with research collaborators, manuscript/presentation development, data collection, student meetings, committee meetings, catching up on a million emails, networking, peer reviewing of manuscripts submitted for publications in a number of journals, travel for research presentations, the list goes on. There is some flexibility in my work which is both a blessing and a curse. This flexibility affords me opportunities to, for example, have lunch with my daughter at school every so often when working from home however this also lends itself to a blurring of work and home life in that I might be writing or catching up on emails into the wee hours. There is no 40 hr. workweek or 9 to 5 schedule. My teaching and student advisement times are often the only recurring events on my calendar and my workweeks commonly exceed 50 hrs.
I was blessed to have the opportunity to share with you a bit about me, my career path, and the many reasons why I believe a hand therapy researcher like me can support and advance the science of what we do. Please get to know a hand therapy researcher. A good place to start might be by reaching out to an ASHT Research Division member to explore who might be best equipped to support you in planning and conducting research where you practice. As I stated earlier, like our practicing clinicians, our roots are in the clinic and we want to learn from and support you. I/We look forward to hearing from you!
Corey McGee, PhD, MS, OTR/L, CHT
Programs in Occupational Therapy and Rehabilitation Science
University of Minnesota