When events in life occur in a fashion that demonstrates a connection from one to another event, it has been called karma. I believe that when this karma occurs it makes us want to pay attention to the events and why they occurred. This karma occurred with Sandy Ganz's manuscript. The day I received the manuscript I also received an e-mail from the American Physical Therapy Association telling me that they were planning their annual meeting of the reimbursement chairpersons from all over the country. This year the topics were to focus on how evidence-based outcomes could be used to convince the payer to reconsider payment for denied claims.

To me this joining of the two incidences was wonderful. Here was Sandy's issue filled with information on evidence-based outcomes and here was a national group asking for information on this very subject. How timely for both.

Rehabilitation medicine is recognizing that it is more a science in choosing evaluation and intervention and an art in applying these tools. Because it needs to be a science in choosing modes of evaluations and treatments we desperately need to fill our body of knowledge with studies that show efficacy. The days of anecdotal and empirical examples of care are gone. Personally, when I go to courses and seminars and the speakers still provide this gibberish, I am disappointed. We are now at the stage where all lecturers and providers must support their treatments with scientific evidence.

My favorite story about this occurred many years ago. One morning before my clinic officially opened, a new therapist was telling me about his sick dog. He told me he took his dog to the "greatest veterinarian." I asked why this vet was so superb. He responded that she constantly referenced studies that supported what she was planning to do with his dog. I paused a moment and said, "Just think, if you did the same with your patients you might be considered great by your patients, too." I saw the light go on and from that day on he really tried as we all do, I hope, to provide the scientific evidence to those who need it. It is great for us to have it. However, we need to share it with our peers, patients, and even payers.

It is not just kismet or karma or whatever that brings this issue to you. It is the importance of using evidence-based outcomes every day in our practices. I want to thank Sandy Ganz and all her authors for putting together such a wonderful issue of Topics in Geriatric Rehabilitation. I know how hard Sandy worked on this and how she wanted so badly to share the important information that she and all her authors work on and disseminate on a daily basis.

Thank you for sharing.