Sheri wrote:
>
>Sophie....You should give yourself more credit...instead of using techniques
>"with little thought" instead you have developed a Clinical Pattern that
>allows you to skip over some of the steps of the clinical reasoning process.
>Clinical reasoning, from my understanding, is the development of multiple
>hypotheses and providing treatments to rule in or out the cause of the
>dysfunction. Your experience has allowed you to see hundreds of patient
>examples and you are aware of what the most likely cause might be (Although
>all patients are a little different) and then you treat appropriately.
>Although all techniques have not been scientifically proven, your experience
>might be seen as an ongoing test/retest experiment. It is my ambition that
>in a few short years I will be able to evaluate a patient and quickly
>determine the most likely cause based on the signs and symptoms so that
>treatments may be provided within the tremendous constraints of third party
>payers.
>
Whilst physiotherapy as an art form has its place there is no doubt that
evidence based medicine is essential if we are to survive within the third
party system. Practitioners can and should integrate clinical experience
and the research literature to provide the most effective intervention. We
should in my view be cautious about enthusiastically adopting latest
techniques/fads unless they make sense in the context of what we know from
the research. If these techniques show anectdotal promise, we should test
them in clinical trials.
We cannot be black and white on this issue. To do so leads to division
within the profession, and ultimately to our marginalisation by the medical
profession/third party payers.
Jon Ford
School of Physiotherapy
The University of Melbourne
200 Berkeley St
Parkville Victoria
Australia 3052
Tel:+61 3 9344 4171
Fax:+61 3 9344 4188
Email:[log in to unmask]
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