I've been following the "therapy & science"-discussion with interest. I must
say that this is a difficult subject. 

When I was a student and later on a PT I thought: "I must be able to prove
everything I do with research...". It was a thought that sometimes
completely paralysed me. It is like one of you people said: in PT we know
very few things for sure. Should we therefore return to our patients and
say: "Sorry... Can't treat you because of lack of evidence for the
treatment...See ya...". No, not because we CAN prove everything we're doing,
but because we don't have a choice. The patient demands treatment and we
need money to pay our rent. Simple as that.

Secondly I have discovered that a considerable part of what we do is
(un)fortunately placebo-effect: if you can sell your product/treatment and
the patient feels relaxed with you, many patients will (think they) improve.

With that many people underestimate the healing power of the human body
without any intervention. Sometimes it happens that friends of me ask me for
advice for back-ache, knee-ache... the simple stuff. More and more I advice
them to just take it easy for 1 or 2 weeks before going to a PT. In most
cases the body heals itself and no PT is needed. Of course when a person
like that becomes a patient of mine, I treat them with all the modalities
to, let's say, speed up the healingprocess. Morally wrong to give a patient
a treatment that he MAYBE does not need? Mmmm, maybe, maybe not... 

About the religious aspect that Mel adressed.
The shitty thing with religion is that you can't prove anything, not for
other persons that is to say. Definition of believing is: KNOWING without
proof. 
Three years ago I had the ambitious plan of making a paper about
antroposofical physiotherapy. I went to a PT who knew everything about this
subject and who also practised it. Great guy. Convincing, calm, down to
earth. He treated his patients averagely 8 times and than they got better
(in many cases). What kind of treatment?... Massage without even touching
the person! Massage of the astral body and stuff like that. Mmmm, mmmm.
Scientifically a big joke. Was he a bad PT? No. The patient got better and
were satisfied. And that's what is all about, isn't it... (or?). Placebo?
Maybe, maybe not. Salestechnique? 
Are religion and science the opposite of eachother? Mmmm.
Anyway... I never met anyone quite like this guy. He was what I would like
to call SPIRITUAL. I had and still have great respect for him. 

Sometimes it's difficult to combine evidence based PT with experiences like
this, don't you think.

Isaac

-----Opprinnelig melding-----
Fra: [log in to unmask] [mailto:[log in to unmask]]
Sendt: 8. november 2000 02:18
Til: [log in to unmask]
Emne: THERAPY & SCIENCE


Mel Siff:

<Maybe you also recall reading a research article which disclosed that 
something like 85 percent of all medical procedures also lack solid 
scientific evidence.  What does that tell us?>

[log in to unmask] writes:

<< I heard this from another physio about medical procedures lacking hard 
evidence, and this is why so many people are lacking trust in the medical 
profession at the moment. This probably explains why most orthopaedic 
surgeons in particular are undergoing a lot of research to prove that their 
procedures are effective. >>

***Belief in anything is not simply determined by the existence of
scientific 
proof.  Probably a much greater percentage than 85 percent of all religious 
belief is not corroborated by science, yet this fact hardly affects  
believers in myriads of different faiths.  

Maybe people find it a lot easier to believe in the unseen and the mystical 
than the tangible and verifiable.  Maybe that is why there are so many 
believers who follow the way of alternative healing, which is replete with 
various evangelists who market their ideas in a quasi-religious manner.   
Maybe the laying on of hands in the form of simple "laying on" or in the
form 
of mobilisation, manipulation, touch therapy, structural reintegration  and 
so forth is sometimes successful because it appeals to  some very primal 
instinct in humans.  Maybe humankind has an instinct which makes this mode
of 
operating so appealing and successful.  

For those who enjoy the sensuous and sensual nature of caring touch, we have

the more tender methods; for those who prefer the more masochistic methods
we 
have transverse cross frictions, Rolfing and so on.  Even the perceived 
affects of electrostimulation may serve as some sort of touch therapy in
some 
cases.  We thus have all the ingredients for gentle and masochistic placebo 
effects.  On top of that, there is the outside chance that some of these 
therapies actually may directly address the problem.  What more could we
wish 
for?  Even a modest success rate and absence of any major treatment
disasters 
decrees that almost anyone in the therapy business can make a "killing", 
especially if they know a bit about marketing and human needs!

I'm off to take my shaman's course tomorrow!

Dr Mel C Siff
Denver, USA
[log in to unmask]
http://www.egroups.com/group/supertraining


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