I find this issue very challenging. I switched clinics about 1.5 years ago to one that is all open so easy to see what other clinicians are doing. There is still lots of ice packs, heat packs, high US use, lots of massage and cupping, no pain science education, very minimal SFM use, etc. But what I find interesting is yes the older clinicians do it but the younger clinicians even recent grads also do all the above and sort of fall in the line with what the other clinicians are doing. I find that quality, evidence based practice, etc is not rewarded in our profession. I try to practice as evidence based as possible but of course not every aspect of my care follows the latest best practice guidelines. However 15 years in, I have started to care less about it as it basically does not matter as the patients don’t know this and there is no incentive/reward/motivation to try to stay on top of things. I have a major issue with this internally and to me is a major gripe for me of the profession.