Good Enough vs. The Courage to Innovate in Manual Therapy

I have been going through an interesting stage of my career where I have ended up shifting all aspects of my care and treatment for patients.  I have a different approach, not necessarily by choice, but by evolution.

At one point in my career, Cliff FowlerMCSP, MCPA, FCAMPT taught me a technique that revolutionized my practice. I spoke to him about it two years later and was floored to hear that he had abandoned it. I was so grateful for the gift that he gave me and yet he discarded it. He explained to me that he came up with something better and no longer needed the other treatment. Cliff told me that he changes his practice about every year. Sometimes this means he will abandon everything that he is currently doing. Sometimes he will revisit some old techniques and refine them to fit his current practice.

Cliff Fowler and Rajesh Khemraj

Not everyone is going to be able to advance and grow at the rate that Cliff did in his career, but I feel that there is a significant lesson about the importance of GROWTH. The greatness that Cliff demonstrated was not really anything other than curiosity and the courage to believe in himself. He was curious about problems and was always willing to tinker and adjust his thoughts and techniques to the current situation. He had the courage to try something new and the courage to let go of the safety of the status quo.

Most of us stunt our growth potential with our own self-set limits.  Sometimes we find something that works and satisfies all needs at the moment. It’s “good enough.” Patients get better, they are happy and you are happy. They return to the doctor singing your praises.  Why would there be a need to change?  You don’t want to mess with a good thing, do you?


The greatest advancements that happen in any profession or really any aspect of life tend to grow from a seed of curiosity. Seeing an object or concept and wondering what can be done to make it better, faster, slower or just right. Advancement comes from asking, “How do I adjust the environment to compliment what I want,” or, “How do we adapt the treatment or context to improve overall outcomes?”

Once we start approaching a situation with openness for change, then change will happen. I am striving over the course of my entire career to be one of those therapists with the courage to listen to that voice of curiosity and to never settle for “good enough.”

1428171423– Rajesh KhemrajPT, OCS, COMT, FAAOMPT

Clinical Faculty Instructor at The North American Institute of Orthopaedic Manual Therapy


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