Thursday, April 26, 2007

Is wi-fi bad for your health?

There's an interesting news report currently on the BBC news website about Canada's Lakehead University,where there's a restiction in the use of wi-fi because of health concerns. If you look around various physiotherapy disussion forums you will see that discussions regulary come up about the safety of electromagnetic energy sources ( in the mainly shortwave spectrum) used within physiotherapy. I'd really like to know if there's a health risk from those things we've all been told are safe. There's probably not been any specific testing of physiotherapy equipment for it's effect on human tissue and definitely no long term studies on it. And what about the other things which are readily practiced in physiotherapy-things like TENS, acupuncture , manipulation ? Has anyone looked at potential for long term harm with these treatments? We're not talking about the immediate effects such as adverse clinical events associated with a neck manipulation or pneumothorax associated with acupuncture but the long term adverse health consequences, such as increased risk of developing certain health problems a long time after the event. Could having repeated acupuncture increase the risk of devloping cancer? Could neck manipulation increase the risk of stroke years after the event?

Monday, April 23, 2007

rescue plan

Appeared on the BBC newspage in the last few days is information suggesting that there will be a new scheme to help doctors who cannot get training places. This just reinforces the longstanding feeling that politicians believe thealthcare consists of just doctors and nurses. Where's the scheme to help the physios who can't get jobs, the 80% unemployed working in fast food outlets and other such jobs?

I'm thinking of changing this blog to one called "Blog on blog" because it's proving hard to keep it going even without problems arising from the computer like a week or so ago. I'm involved in some academic writing and trying to find time to sit down every day to write this blog is proving difficult.

News on the grapevine is that things are not looking good for physios all around the UK as a result of the PCT reorganisation last year. There seems to be a massive amount of restructuring going on all round the UK

rescue plan

Appeared on the BBC newspage in the last few days is information suggesting that there will be a new scheme to help doctors who cannot get training places. This just reinforces the longstanding feeling that politicians believe thealthcare consists of just doctors and nurses. Where's the scheme to help the physios who can't get jobs, the 80% unemployed working in fast food outlets and other such jobs?

I'm thinking of changing this blog to one called "Blog on blog" because it's proving hard to keep it going even without problems arising from the computer like a week or so ago. I'm involved in some academic writing and trying to find time to sit down every day to write this blog is proving difficult.

News on the grapevine is that things are not looking good for physios all around the UK as a result of the PCT reorganisation last year. There seems to be a massive amount of restructuring going on all round the UK

Monday, April 16, 2007

job losses

The RCN conference at Harrogate is being reported in the news as saying that 22 300 nursing posts have been lost in the NHs over the last few years. Inevitably there are the usual denials by the Dept of Health but this whole thing rings true. But that's just a fraction of the picture. Along with the nursing jobs lost there's all the other ones including physio posts. Then there's the uneployment amongst physio graduates, which if it's 80 % for the last 2 years with this next year's graduates should be reaching about the 5000 mark. But rest assured, there's no crisis in the health service! Yea right!

Saturday, April 14, 2007

physiotherapy blog and software

We can only have blogs because of the taken-for-granted effectiveness of the programmes and hardware running the comupters we all use but I get fed up with the repeated errors that both of these make and the inability for the average person to sort the problems out because once we go beneath the surface veneer of pretty colors and pictures we use to make the computer work there's a totally incomprehensible world of meaningless codes and data. I have spend the last week struggling with a number of problems and these still are not resolved. Take virus protection. We're all meant to have it but the down side of this protection is that it clutters up the computer with useless items which i'd rather not have, silly pop up messages which are absolutely no use to me and a subtle forms of blackmail to ensure I keep buying updates. Why can't we have a simple ,fail safe, error free system without constantly having to try to sort out malfunctions? It almost seems as if the whole world has been conned by technology; when it works it can do fantastic things but for large amounts of time we are trying to solve problems in what is only on the surface user friendly but as soon as something goes wrong and we try to work out what to do we are faced with the language and thinking of 1970's computer geeks.

So what about physiotherapy and healthcare? There have been a lot of interesting things in the news. If you do not live in an area of the UK with a Labour MP then the chances are you will not have got a new hospital planned because 85 pence in every £1 spent on new hopsitals is in an area with a Labour MP. I cannot understand why when something like this comes to light there's no serious protest or holding Government ministers to account. It's also come to light that healthcare workers are increasingly unable to buy properties in the majority of the UK because house prices are so much higher than NHS salaries. With the average UK house price about £185 000 and starting salaries for physios in the low £20 000's then there's a massive gap between earnings and the possibility of buying. Rumors of a price collapse have been circulating for a few years but one wonders if things will eventually slow down, because with prices like these there will be no new money coming into the system.

Saturday, April 7, 2007

Evidence and the BBC

An interesting piece of reporting has occurred on the BBC website. A new study is quoted describing the fact that decisions in healthcare are often not made according to the best research. If you read back over the posts in the blog you will realise that this idea runs throughout many of my entries. It bothers me that the physiotherapy profession ,despite making significant progress in it's use of evidence, still remains heavily dependent on subjective opinion rather than seeking to strictly adopt practices for which there is good evidence. And this works both ways. Not only are large amounts of what go on in physiotherapy without sound research to suport it, but there is good evidence to support many things which we don't do. Here I rest my case!

However the point I want to raise today is not the much debated role of clinicians using the best evidence but perhaps what should be called evidence based healthcare reporting. The BBC along with most other parts of the mass media have a biassed, non-evidence based approach to reporting health so that what counts for fact quoted by them is regularly biassed and hysterical, designed to create anger or anxiety in the audience and not to provide accurate analysis of an issue. Reporting of pandemics, climate change and the issues in the NHS all have a hysterical quality and do not let the public understand many of the serious issues behind the stories, nor do they encourage the public to analyse the issues themselves. These media organisations set themselves up as experts when if you look at what they are saying about just one area,health, you will realise that they selectively report those subjects likely to create the biggest reaction. Although we need more evidence based practice in health we need something even more-evidence based healthcare reoprting.

Thursday, April 5, 2007

the eclipse of physiotherapy?

I keep hearing accounts from all round the UK that physiotherapy services are under increasing pressure not from weight of patient numbers (although that always remains a challenge) but from threats to the autonomy of physiotherapists employed in public health services. It feels like we might be witnessing the beginning of the end for physiotherapy as we know it. It's easy to forget that up to 18 months ago physiotherapy was an expanding profession branching out into new clinical areas and increasing in numbers. 6 or 7 years ago there was the emergence of the consultant physiohterapist role which came after at least 10 years of innovation in developing new physiotherapy roles. We now might be seeing a return to the situation which existed in the late 1970s/early 1980s. Pressure is on to gain control of physiotherapy budgets thereby removing professional autonomy and returning things to how they were in the more distant past with everything in hospitals coming under the control of all-powerful doctors and nurses. It seems highly unlikely that the situation in primary care will be better and it could be even worse within practice based commissioning. In an attenpt to maximise partners' profits there might be attempts to cut back on NHS physiotherapy by encouraging patients to go to the private sector. The fiasco of NHS dentistry could be a taste of what is to come with services like physiotherapy and other allied health professions which address quality of life rather than save lives. The thing I cannot understand is why Frontline, the mouthpiece of the CSP, remains so upbeat in what appears the greatest crisis facing the profession at any time in its history. Instead of printing fighting talk it sems to be pretending that everything is OK, that everyone is very happy and that all's well with the profession.

Tuesday, April 3, 2007

The Health Secretary Apologises

The Health Secretary has apologised for the confusion over doctors' training. I suspect that it would be foolish to wait with baited breath for an apology about the bad planning which has led to 80% unemployment amongst physiotherapy graduates. Despite multidisciplinary working in hospitals, despite post graduate research and professional knowledge at times like this is is still possible to believe that the NHS consists of just 2 types of staff, doctors and nurses. The Government jumps every time that the medical profession demands it , suggesting that there is a profound lack of understanding about how healthare works and how interaction in the system is more important than its more prominent (2) parts. It seems likely that the lack of real understanding of the complexity of the NHS together with adherence to old stereotypes is a major factor in NHS difficulties.