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Commentary: The Big Potential of Thinking Small

February 21, 2023 by Laurie Watanabe

I have many goals for my personal and professional lives.

Close-up view of small leaves of microgreens.

I would like my desk to be less cluttered. I would like to reach for chocolate less often. I would like to be a faster reader and writer. I would like to be a better interviewer. I would like to procrastinate less (for example, this story was supposed to be a New Year’s resolution article).

But lately, the universe seems to be speaking to me in small ways. More specifically, the universe seems to be telling me that small things can make a big difference.

At home, I’m eating microgreens and have started a five-minute chore regimen, which breaks onerous housecleaning tasks into quick, manageable parts, such as sorting my ever-growing pile of incoming mail or vacuuming just one room. Last night, the chore was scrubbing sinks.

At work, I’m fascinated by the importance of microclimate in seating — that small zone between the wheelchair rider and the seating system, and the heat and humidity that can develop and raise the risk of pressure injury.

I love hearing about microshifting — for example, using small degrees of tilt frequently throughout the day to improve comfort and therefore improve sitting tolerance. In a recent Kalogon Webinar, I heard researcher Evan Call, MS, CSM NRCM, discuss the skin-health benefits of microturning, incrementally repositioning immobile patients who are in bed.

Many “micros” offer new ways to counter big problems or limitations. My condo doesn’t have a yard, but I can grow incredibly nutritious microgreens on my porch. Microshifting can improve sitting tolerance a few tilts at a time, even though the person in the wheelchair isn’t tilting the 45 to 55 degrees we like to see for pressure relief. Folding laundry for five minutes at a time keeps a small pile from growing into a mountain.

I was ruminating with Karen Gallik, Sunrise Medical’s Strategic Global Marketing Manager, about how “micro” the world seems to be these days. The next morning, Karen sent this link to a fascinating Harvard Business Review story, “The Hidden Toll of Microstress.” It was more affirmation that small things add up. 

With CMS’s proposed decision to fund power seat elevation on Group 3 power chairs, 2023 is already a big year for Complex Rehab Technology. Additionally, we anticipate a CMS response on funding for power standing. The right-to-repair movement is gaining steam, as are industry efforts to truly reform service and repair. This spring, we’ll head to our first in-person International Seating Symposium since 2020.

As all this unfolds, big news will often dominate the headlines: large-scale solutions, big swings of activity, dramatic results.

But I’ll also keep in mind that CMS received 3,601 public comments during the first seat elevation public comment period. That means 3,601 people took the time — in some cases, just a few minutes — to contribute their thoughts. And now we have a proposed decision for coverage.

Seemingly small actions can impact our world in very big ways. I like that.

Related Articles Read More >

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Featuring United Spinal Association and InsureMyTrip.
Take Mobility Management’s Survey on Pediatric Seating, Wheeled Mobility
The survey is open to clinicians, ATPs, and other seating and wheeled mobility professionals and service providers.
New CMMI Paper Lists Three ‘Strategic Pillars’ to Guide Medicare, Medicaid Strategies
Center for Medicare and Medicaid Innovation Director Abe Sutton published the paper on May 13.
Reporter’s Notebook: Ingenuity Meets Workability at RESNA’s 2025 Conference at RehabWeek
Assistive technology of all kinds were the focus of the Chicago meeting.

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