Sandy,
It is always good to hear from my respected colleague, who know me all too
well. In response - "Faith moves mountains!" Hope all is well
Rege
At 08:41 AM 1/28/2003 -0500, you wrote:
>To my former colleague and those following this discussion, I would add;
> "Those who claim to know in the absence of evidence are,
> at best, proclaiming their faith, not their knowledge."
> Dr. Jules Rothstein
>Lack of evidence, does not automatically imply lack of effectiveness. If
>physical therapy is to survive and evolve as a legitimate profession in
>the 21st century - we must strengthen the foundations of what we claim to
>be about. My 2 cents....
>
>
>Sandy
>
>William S. Quillen,PT,PhD,SCS,FACSM
>Associate Professor & Director
>Doctor of Physical Therapy Program
>Indiana University
>1140 W. Michigan Street, CF 120
>Indianapolis, IN 46202
>317-278-1851 FAX 317-278-1876
>www.dpt.indiana.edu
>
>
>
>
>
>-----Original Message-----
>From: Regis Turocy [mailto:[log in to unmask]]
>Sent: Tuesday, January 28, 2003 8:35 AM
>To: [log in to unmask]
>Subject: Re: evidence based practice
>
>
>Henry,
>
>Good point. I am not enamored with evidence based practice like so many of
>my fellow colleagues. I believe if we continue on this path, we will
>"evidence base" ourselves out of practice. Marcel Proust stated it best -
>"love those who seek the truth, beware of those who have found it." There
>are too many inferences made when interpreting the literature for clinical
>practice. We need to abandon this quest for absolute truth. Instead, we
>need to emphasize clinical research, qualitative and quantitative, as
>methods to develop our unique philosophy about compassionate care
>(Principle 1 - Code of Ethics). As an example, the evidence based
>literature states there is insufficient biophysical evidence for the
>clinical use of ultrasound, and that there is little evidence the
>ultrasound is any more effective than a placebo. However, during my 30+
>years of clinical practice I have found ultrasound to be a very sound
>adjunctive modality. In my hands, for my patients, using the appropriate
>parameters and technique, the selective use of this modality has been very
>beneficial for me and my patients. Do you think for one moment that I will
>stop using it, or for that matter, stop teaching it - I don't think so. I
>would hope there are other clinicians that have had the same experience and
>feel the same way. Just a small example. I'm sure this war and battle will
>rage on. If we are to win this war that we are being forced to fight, then
>we must realize that in this complex world of biology and patient care
>there are very few absolute truths!
>
>Rege
>
>At 08:43 PM 1/25/2003 +1000, you wrote:
> >Hi everyone,
> >
> >Something that came out of Ben's patient with the neurological disorder that
> >I have been thinking. All this discussion on evidence based practice has
> >seen physio's present trials and studies in the literature that either show
> >a particular management's benefits, or show that the management is no better
> >than placebo or no treatment. What I have seen commonly on forums is
> >physiotherapists using the literature to either back or reject a particular
> >therapy.
> >
> >I think I just like to remind everybody that evidence based practice is not
> >just looking at clinical trials and RCT's, but actually incorporating this
> >with clinical expertise and the patient. What comes out of the literature is
> >important, but only when the other two factors are also considered. This is
> >because clinical trials, RCT's, treatment guidelines presume homogeneity
> >with the population... it presumes that everyone with acute right sided low
> >back pain with radiculopathy will respond to a certain management style.
> >Therefore, to merely state a particular approach is the best because there
> >is evidence for it is not evidence based practice... rather, one must
> >clinically reason and decide based on each patient's situation. Too often I
> >see Physio's make this mistake and argue back and forth by throwing
> >literature at each other... in the example of Ben's patient, the Mckenzie
> >Physiotherapy approach was in the lime light. We must remember that there is
> >always individual variability and this I believe makes Physiotherapy a
> >challenging but fulfilling profession.
> >
> >Henry***
> >
> >
> >
> >
> >
> >_________________________________________________________________
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