Dear John

Your message cheered me up considerably,  as it reflects so accurately my
sentiments.

I work in the NHS and I feel we are contributing to our own downfall with
the poor time allocations, we work under.


Every physio I have met can do magic, and should be allowed to do so. I also
work in a GP practice and it is clear to me that the GP's like to
superimpose, their work regime on ours. Totally oblivious to the fact that
we are a completely different profession; which predominently treat not
refer.

The passive way we are allowing nurse practioners to invade our work area,
means, I feel, that our days in the NHS are numbered. The medics do not want
autonomously trained clinicians, rather someone to be trained by themselves
to do their bidding, We are going the way of the dentists.

Some examples
1  Most hospitals have pain clinic nurses or practioners applying pain
refief like TNS and Acu
2  I heard of a hospital where the nurses prescribe therapeutic exercise
which sounded like the lumbopelvis stability, muscle balancing exercises.
3  I have heard of a developing trend of nurses being elected as the
alternative, primary clinician in a Trust. As some Trusts see massage as
alternative, physios need nurses permission prior to a massage treatment.
4  I know of a Trust where a nurse practioner is now doing some the duties
previously carried out by the physio on a stroke rehab ward.


Now am I turning into a grumpy old sod or is this madness ?. Would nurses
tolerate us going on to a ward, doing drug rounds and inserting drips and
take it lying down?.

The CSP seem to get wrapped up in ownership issues and friendly
collaboration, but they fail to grasp the reality of the situation,
Chiropractors, Osteopaths, nurses and non Chartered Physios are aggressively
marketing themselves, at our expense. We have a core expertise which we
should defend at all costs. We must not give the impression that our job is
easy, as we all know it certainly is not.

Therefore, easy treatment menus, laminated tennis elbow handouts and ten
minute appt times, give totally the wrong message to our clinical
colleaguues.

Well John I am so pleased I got all that off my chest. I am sure many will
disagree, but it has postponed my pending heart attack by another 6 months.
I hope I have not offended anyone, if I have please understand it was from
the heart and out of concern for a profession I love dearly


             Warm Regards    Kevin
















-----Original Message-----
From: john spencer <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 01 January 1999 20:24
Subject: Re: Physio Caseloads.


>Dear Kevin
>
>Good rant...absolutely true. This is one of the reasons I started my own
>private practice so I can spend the time my patients need with them, not
>what I can afford with HNS restrictions....consequently more of my
>patients benefit and I enjoy my work more.
>
>I think the profession is bound to suffer as a result, what would your
>opinion be as a patient with a 20 minute appt and a feeling that your
>physio hardly had time to draw breath between you and the next body on
>the conveyor belt?
>
>Often, whan I am treating a private patient and I look at the clock,
>I've hardly got into the heart of the technique and I realise in my NHS
>days they would be getting dressesd by now....
>
>Tony Blair says "The NHS treats twice as many patients now as it did 20
>years ago"  what he doesnt say is they are only getting half the
>treatment they deserve.
>
>Having attended a McConnell shoulder course last year the tutor said
>that he didn't belive the treatment could be properly carried out in a
>20 minute slot; assess, tape, feedback, teach exercises in 20
>minutes...it's crazy.
>
>Unless the profession puts it's foot down and does something soon things
>will get even worse..there is a hospital here in the Northwest that has
>15minute appts and one colleague who works in a GP's surgery on a 10
>minute session basis!!!
>
>In message <002201be34c8$76948120$8542a8c2@kevinree>, kevin reese
><[log in to unmask]> writes
>>With the severe weighting list problems in the NHS I understand the
>>pressures of through put. I have always been worried at compromising
quality
>>due to this pressure, which is political problem, ie lack of physio's, not
a
>>physiotherapy problem.
>>
>>I often wonder if when people place pressure on us to change our treatment
>>protocols to increase through put, if they due the same for other
clinicians
>>eg orthopaedic surgeons. I am sure it would be a national scandal if
>>managers said to a surgeon, compromise quality and do 2 x the THR's you
are
>>already doing. So why do we tolerate it?
>>
>>We will be ultimately held responsible for our clinical actions, therefore
I
>>feel it we should make up our own individual judgements as to how many
NP's
>>we see and at what time intervals.
>>
>>Anyway after that short rant I hope this information is of use to you
>>Kind Regards   Kevin
>
>--
>john spencer
>



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