Are physiotherapists flat earthers?

Are physiotherapists flat earthers? This question can be taken in two ways. Are physios people who believe the earth is flat? No. Are physios people who persist in a set of beliefs even though there is evidence to the contrary? Yes, but in physiotherapy this has some interesting dimensions.A major element of believing the earth is flat is the inability to think outside the box and the box I am refering to is the box of belief about the way that the profession does things. The flat earth thinking is unable to see that many of the things which are assumed to be obvious are in fact products of time and place, constructs which are limited in their universality. This applies to professional standards, clinical practices and theoretical models. It is possible to assume that standards, at present upheld as "best practice" might be unrecognised in other parts of the world, or be unrecognised within one's own country at a different time. One of the things which bugs me is the good old pain gate theory, now way past its shelf life but still being promoted. This as an example clarifies my arguement. The reason that physios talk about the pain gate is because they cannot think outside the box, cannot think bigger than this rather creaky old theory.

Sometimes I feel very alone thinking all these ideas (can't you hear those violins?) Looking at Frontline (new out today) I feel the twice monthly heartsink I get from the magazine when I read the course listings. The profession seems very willing to give up large amounts of time and money to learn ideas and techniques which have minimal proof. I might be alone in this belief but it occurred to me a long time ago that the sum of local knowledge and skill is worth more than the majority of courses which are run. It is important to implement ways of capitalising on local skills and knowledge both through effective continious professional development and through effective sharing of knowledge but it is more valuable than most weekend courses. Sometimes on the news you hear that the combined experience of a group of professionals is..... (last time I heard it was in realtion to a team of firefighters). Apply this to physiotherapy. Many physios will be working in teams or orgainisations with the combined experience running into many years yet they want to go on courses to listen to highly polished presentations from someone with only a small fraction of the skill and experience. The assumed authority of the course tutor is the key but this is a false assumption. It's time we stop being intimidated by these self appointed gurus and set up organised ways of both developing our own skills and capitalising on our corporate ability. Lets' stop thinking that the only way to devlop skill is to pay loads of money for a weekend course.