One answer, as I was hoping to hear (homework: revisit hindsight bias) was outcomes. We have got to critically analyze our treatments and their outcomes as a GROUP, and hastily discontinue treatments that don’t yeild meaningful results – or as a practice we should be left behind. Stop trying to explain the mechanism because it is very poorly understood. Focus on what works, and be certain you are truly quantifying it.
I started reading Doctors: A Biography of Medicine. I haven’t finished (thanks, self, for sucking at modalities and cardio/pulm). There were two main schools of thought regarding medicine. Both wanted to help patients. One school of thought was Hippocrates, who, as the father of medicine, and, as I understand it from the book, discusses change in patient condition and patients getting better as the focus of his practice. The other school of thought in Pergamon focused on pathology, and, ultimately, did not produce a father of medicine. Galen was more like an uncle of medicine. Brilliant, to be certain, but wrong frequently about anatomy and physiology. Understanding of pathology, cell models, etc… was too primitive to be meaningful then, and in many cases today, too primitive to be meaningful now. I like the clinical prediction rules as a starting point for treatment because, while ignoring the ever elusive question of “why are you in pain?” it still offers solutions which have documented improvements compared to older methods of treatment.
We are officially being published in Clinical Biomechanics for our graduate research. This is great news! Adding it to my CV.
Article title: Altered Muscle Recruitment During Extension from Trunk Flexion in Low Back Pain Developers
Journal title: Clinical Biomechanics
Corresponding author: Dr. Erika Nelson-Wong
First author: Dr. Erika Nelson-Wong
Dear Dr. Nelson-Wong,
Please find attached a copy of the “Journal Publishing Agreement” which you completed online on 25-JUL-2012.
If you have any questions, please do not hesitate to contact us. To help us assist you, please quote our reference ******** in all correspondence.
We are committed to publishing your article as quickly as possible.
Elsevier Author Support
First and last time I’ll ever engage in this conversation (I hope).
My friend @RGWooderson, sent me a link to a post by a physical therapist who has been in the profession a long time, and done a lot of cool stuff. You can read his CV on his website. He has been the CRO: Chief Revolutionary Officer since 2011 for a company he started – The Smart Life Project. Thank you Allen, for your insight into damned future of our profession. But who are you mad at? All I did was start applying to PT schools in 2008/2009.
You can read his post here: Was the DPT The Right Direction?
Here’s the problem I have with it, more than anything. We’re, as a profession, trying to elevate ourselves in the public’s eyes and through legislation. Blog posts like his only hurt our profession. While he is spending an evening trying to start an interprofessional pissing contest (which I’m sure won’t interest people in his “institute”), others among us will be working together to move forward.
Thomas Kuhn wrote a great book int he 60’s and coined the term paradigm shift, discussing the history of science and how exactly competing ideologies came about, and came to die in the face of new world views. He quoted Max Plank (long story) in the book The Structure of Scientific Revolutions, saying “a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”
The conversation over the presence of DPT in the profession ended a while ago (whenever, I don’t know). Taking time away to engage people who have already made up their mind about a topic isn’t going to do anything but stir the professional pot, if you will. He’s an old guy. He’s treated 10,000 patients! He, and the rest like him, will be out of the profession and dead before I can even afford to retire.
Have a great week.