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Auntie Version - MSKMag's Agony Aunt - January 2026 · MSKMag OutLoud

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  SPEAKER_00: Auntie version, January 2026.
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  SPEAKER_00: With our agony aunt, Joe Turner.
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  SPEAKER_00: Question,
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  SPEAKER_00: dear auntie version,
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  how can I tell if I am suffering from imposter syndrome or if I
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  am indeed just not
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  SPEAKER_00: very good at something?
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  Sometimes I worry that I'm failing at work and when I don't get
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  good outcomes,
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  SPEAKER_00: but then start going around in circles in my head.
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  SPEAKER_00: Could this just be imposter syndrome?
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  SPEAKER_00: Yours, imposter?
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  SPEAKER_00: Dear imposter, such a good question.
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  The difference between imposter syndrome and objectively not
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  being very good at
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  something is whether your feelings and internal narrative marry
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  objective evidence.
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  Imposter syndrome is classically characterised by feeling like
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  a fraud waiting to be found out.
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  SPEAKER_00: and not being able to accept praise,
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  SPEAKER_00: attributing any success either to luck or the actions of others.
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  SPEAKER_00: This is despite evidence that you are in fact capable.
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  SPEAKER_00: If you are genuinely not good at something,
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  then objective evidence or constructive feedback might support
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  your opinion of
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  SPEAKER_00: yourself.
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  SPEAKER_00: You reference times when you don't get good outcomes,
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  and it is probably tempting to conclude that this is supporting
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  evidence for your
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  SPEAKER_00: internal feelings.
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  SPEAKER_00: particularly in healthcare.
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  SPEAKER_00: However, we need to give this context.
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  SPEAKER_00: Are you setting yourself a realistic bar for good outcomes?
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  SPEAKER_00: Are you holding yourself to achievable standards?
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  How do your outcomes relate to those of direct peers with
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  similar levels of experience to you?
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  SPEAKER_00: The problem with imposter syndrome is that it feeds perfectionism.
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  It has us overworking and overwhelmed as we strive to achieve
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  the impossible.
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  SPEAKER_00: Yes,
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  SPEAKER_00: we need to be accountable and work to maintain good standards of care,
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  but imposter syndrome and perfectionism are often evidence of
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  the balance having
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  SPEAKER_00: tipped in an unhelpful direction.
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  SPEAKER_00: So when you look objectively at the evidence,
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  SPEAKER_00: does it genuinely support feelings that you are not good enough?
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  SPEAKER_00: If so, where can you seek good support to gain and improve your skills?
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  SPEAKER_00: If not,
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  the support might be better directed towards helping you
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  challenge those unhelpful
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  SPEAKER_00: thought patterns and behaviors.
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  Question,
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  dear auntie version,
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  how do I know how much I should specialize?
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  SPEAKER_00: I get bored being too general in my clinical work,
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  SPEAKER_00: but worry that I will be less employable if I pick the wrong area.
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  SPEAKER_00: Yours, bored.
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  SPEAKER_00: Dear, bored.
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  SPEAKER_00: My immediate and flippant response is that if you're bored,
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  SPEAKER_00: you're already less employable than someone who loves their job.
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  But I also hear your concern about becoming so specialist that
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  employers may see
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  SPEAKER_00: you will only be able to see a small percentage of their client base.
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  There is a Goldilocks option of specialising but retaining your
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  generalist skills.
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  SPEAKER_00: I've heard this referred to as a T-shape career.
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  SPEAKER_00: You can treat most things that walk through the door,
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  SPEAKER_00: but you are the go-to person for your chosen specialism.
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  That way you get to spend a fair amount of time working on
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  cases that really float
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  SPEAKER_00: your boat,
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  SPEAKER_00: but everyone knows you can treat other conditions.
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  I would say that specialism often increases rather than
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  diminishes employability,
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  SPEAKER_00: particularly if you can pick something that is future-proof.
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  SPEAKER_00: Look at what's going on in the wider world of MSK and outside.
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  If you can offer something that helps an employer offer
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  up-to-date services that
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  are in line with emerging evidence and people's needs in the
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  modern world,
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  SPEAKER_00: you are going to be very popular.
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  SPEAKER_00: And specialism needn't be a trap.
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  SPEAKER_00: Nothing is forever.
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  SPEAKER_00: In a long career now, I've enjoyed many specialism chapters.
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  SPEAKER_00: Question, dear auntie version.
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  I see a lot of people talking about getting their health and
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  fitness in order in
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  SPEAKER_00: the new year,
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  SPEAKER_00: but I feel like such a hypocrite.
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  SPEAKER_00: I'm not in a position to prioritize myself right now health-wise,
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  SPEAKER_00: but still have to play the Mr.
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  SPEAKER_00: Motivator role.
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  SPEAKER_00: How can I walk the walk as well as talk the talk?
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  SPEAKER_00: Yours, Mr. Unmotivated.
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  SPEAKER_00: Dear Mr.
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  SPEAKER_00: Unmotivated,
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  SPEAKER_00: we all know that health and fitness regimes,
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  SPEAKER_00: even in someone with great insight and commitment,
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  SPEAKER_00: are subject to fluctuation or complete derailment.
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  SPEAKER_00: Because life happens.
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  SPEAKER_00: But we perhaps don't talk about that enough as therapists.
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  SPEAKER_00: A colleague used a wonderful phrase on a clinic WhatsApp group recently.
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  SPEAKER_00: She said, we all know each other.
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  We know we are juggling and struggling at times,
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  but we always have the best of intentions.
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  SPEAKER_00: Admittedly,
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  SPEAKER_00: this was clinician to clinician,
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  but I think there is a level of being real we can find with our
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  patients without it
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  SPEAKER_00: being an overshare.
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  I'm a big fan of James Clear's book Atomic Habits and often
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  quote it to patients.
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  SPEAKER_00: Whilst James advocates consistency as the key factor in habit formation,
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  SPEAKER_00: he also allows for variation in output and the acceptance of missed days.
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  SPEAKER_00: His point is that habits are not broken on the first missed day.
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  SPEAKER_00: Instead of thinking we've failed and all is lost,
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  much better to have compassion for ourselves and commit to
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  trying again tomorrow,
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  SPEAKER_00: or maybe even next season.
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  SPEAKER_00: As for being Mr.
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  SPEAKER_00: Motivator,
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  SPEAKER_00: fabulous though he was in the 90s,
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  SPEAKER_00: maybe Mr.
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  SPEAKER_00: or Mrs.
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  SPEAKER_00: Relator is more appropriate icon for our times.
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  SPEAKER_00: Question,
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  SPEAKER_00: dear auntie version,
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  I'm a physio working in an NHS clinic and the wait times for
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  appointments are
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  SPEAKER_00: getting me down.
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  SPEAKER_00: If I see someone today,
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  I'm looking at six weeks before I can book them in for a
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  follow-up appointment.
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  SPEAKER_00: It's not working for them and it's not working for me.
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  SPEAKER_00: How can I stay sane at work whilst doing my best for the patient?
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  SPEAKER_00: Yours, struggling.
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  SPEAKER_00: Answer,
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  SPEAKER_00: dear struggling,
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  I'm certainly not going to try and persuade you that having six
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  weekly follow-ups
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  SPEAKER_00: is the only option for any condition counts as good care.
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  SPEAKER_00: Sadly, it's a situation many readers will recognise all too well.
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  We know the problem is systemic and hopefully most clinicians
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  are not blaming
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  SPEAKER_00: themselves for it,
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  but that doesn't make it any easier when you're the one sitting
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  in front of an
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  SPEAKER_00: understandably frustrated,
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  SPEAKER_00: frightened or desperate patient.
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  SPEAKER_00: So what can you do about it?
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  SPEAKER_00: Some people channel their own frustration into activism.
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  Are there avenues or organisations you can use to advocate for
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  patients and push for change?
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  SPEAKER_00: Even small actions may help you reclaim some sense of agency.
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  SPEAKER_00: Others decide to vote with their feet.
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  SPEAKER_00: If they can't see any prospect of change,
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  SPEAKER_00: they choose to work in a different environment,
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  maybe for an employer whose model better aligns with the care
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  they want to provide,
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  SPEAKER_00: or they take the leap and set up their own service.
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  SPEAKER_00: Contrary to the belief of some,
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  SPEAKER_00: most people don't go independent to chase a mythical high salary.
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  They do it so they can practice in a way that feels fulfilling
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  and sustainable.
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  I'm not suggesting that leaving the NHS is the answer and I
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  recognise that for some
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  SPEAKER_00: this is an ethical no-no.
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  It's a tough situation and I don't believe there are any easy
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  solutions right now.
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  You're doing your best in circumstances that would challenge
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  anyone and it's more
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  important than ever to hold on to the parts of your life that
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  exist outside of your
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  SPEAKER_00: work.
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  SPEAKER_00: Interests,
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  relationships and activities that remind you of your identity
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  beyond the therapist
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  SPEAKER_00: trying hard in a struggling system.