Noemi,

I AM happy in my work. I just wonder sometimes. In PT we want break iron
with our hands... we want it all. Yes, we want to make the patient as
satisfied as possible. Or not? Is the patient satisfied if we give him 10
sessions of most wonderful backrubs if he has a bit of backache. Yesss. Who
wouldn't be. Are we satisfied though? No..., the patient has to do exercises
also (what he doesn't like). O, so it isn't: your wish is my command, I will
make you satisfied. Nope... I am you PT and I tell YOU what to do if you
want to get better... this is NOT a bl**dy holiday.
And then we want to have proof of what we're doing is right. We call it
Evidence Based Practice. Than we come into a conflict because we do stuff
that we can't prove (not really). We just experience that the patient
improves and we think that we did that. Maybe, maybe not...

Like I said, I just wonder sometimes and I experience that PT is often like
a bar of soap: you grab it, you think you have it tight in your hands and
the next moment it's gone again. Mmm...

Isaac

From: "Noemi Lee" <[log in to unmask]>
Reply-To: [log in to unmask]
To: <[log in to unmask]>
Subject: Re: THERAPY & SCIENCE
Date: Thu, 9 Nov 2000 16:54:47 -0000

Isaac,

I like the fact that you say out loud what most say to themselves. I
appreciate the fact that you aknowledge the difficult situation where you
(and most) are in : Should you deliver a treatment even if you believe that
the healing process is a matter of time ?
To answer this question maybe we should ask ourselves if we still feel fine,
satisfied, motivated and happy about what we are doing. If part of our work
is to speed the healing process do you still enjoy applying US to a patient
after another, giving the same exercice from a patient to another, pushing
here or pulling there? You might think :" Oh well, if it is good for my
patient I might as well be happy with that".
I strongly believe that you can be more than "happy with that". You can be
happy not because your patient feels good or better but because you,
yourself, find great pleasure and satisfaction with what you are doing. I
hope that if you get a bit bored doing what you do , you will find the
strength to find out what could be done to achieve more satisfaction. One
way is to study what is behind the techniques or modalities that you use and
find out if it simply makes sense. A lot out there do not make a lot of
sense even if academics taught you stuff. Don't presume that they know
themselves what they are teaching.
There are other ways and be confident that you can find them.
You mentioned Anthroposophy. Are you also a fellow from Rudolf Steiner
school? Hold on to your creativity. It's the best treasure they allowed you
to find.

Noemi, PT



-----Original Message-----
From: Neumann Isaac Rutger, Granheim
<[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 08 November 2000 23:50
Subject: SV: THERAPY & SCIENCE


 >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
 >
 >


_________________________________________________________________________
Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

Share information about yourself, create your own public profile at
http://profiles.msn.com.



%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%