Saturday, March 15, 2008

The public view of physiotherapy

I read a review in a newspaper today about complementary therapies. To physiotherapists this probably means things like reflexology and the like but this reviewer lumped together acupuncture, Alexander technique, chiropractic and in with these included physiotherapy. What those outside the profession do not understand is the wide diversity of practice within physiotherapy so that now acupuncture is widely practiced by physiotherapists. And this is one of the contrasts between physiotherapy and other "physical" healthcare practitioners, be they regulated like osteopaths or borderline quacks. Physiotherapy has an expanding sphere of practice whereas the "complementary" professions are often build on theories and practices which are in a fossilised state of stagnation. Often these theories are based on clinical experience and nothing else. I've previously writen about the shortcomings within physiotherapy when it comes to evidence based practice. Go into most "alternative" or "complementary" healthcare and you will find there is next to no evidence underpinning practice and in some cases practices continue after there has been evidence of no effect. Usually the "evidence" of results is what is cited as proof that it works a common story being something along the lines "I has a patient with condition X (fill in this blank with a non-acute condition) who had treatment with drug Y (fill in ccommonly used drug) and saw Z (fill in NHS profession) but it made absolutely no difference so Z said they could not do any more for them but I did (A,B,C- fill in with quack treatments) and now they are completely better thanks to MY treatment". (No doubt the complementatry practitioner's bank balance is a lot better as well).

Recipe for complementary practitioner success :
Long appointment time + convinced practitioner + natural recovery process+ psychological influence on condition = patient gets better

What i want to be sure is that the recipe for physiotherapy uses better ingredients.

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