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Stewart: I can understand that a lot of what PTs do in practice doesn't work, but there is a lot that some PTs do that works really well. It depends on your area of practice. In neuro rehab, there is really good research on aggressive neurological interventions for post stroke rehab--people getting dramatic return of function years after their stroke (I believe Steve Wolf has published some of this research). In orthopedics, there is research that shows that total knee replacement can be prevented with PT interventions--sorry, I didn't keep the research. There is published data by Allstate of Arizona(?) that shows that PT interventions are less than the cost of chiro or MD for back injuries. I guess I should add that the reason there is much research that shows benefits is that many of the populations we treat don't lobby very well for research--strokes, pediatrics, and , although musculoskeletal injuries are painful, no one really pushes their congressman to provide money for research on preventing knee replacements. Certainly there are some "buzz word" kinds of research taking place for acupuncture and complementary interventions, but, the funny thing about much of that research (massage, yoga, Tai Chi, acupuncture/pressure, etc.) are interventions that many PTs incorporate into their practice at present. I always thought that if I provided a cost effective outcome, that insurance companies would notice, they would come to me and ask me what I was doing, and eventually I would create a dialogue and get them to help fund research--I sure that sounds quite comical to many and naive to others. Well, it hasn't happened, and will not happen. I will have to form alliances with other PTs and create internally a business model that will support needing to document good outcomes in order to stay in business--this will be a long draw out process. Certainly, I encourage you to look to another profession if you don't see that your interventions are successful or possibly an internship with a group that can demonstrate successful outcomes. Herb Silver, PT At 09:29 AM 8/18/00 -0400, you wrote: >After 5 years as a physio I have hit a wall! It appears that little, if any, >of what we practise is proven to work. It feels that I am selling something >which I no longer believe in. Before I embark on an alternative career does >anyone have any words of comfort [with references please :o) ] > >Stewart Harrison >Physiotherapist >UK %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%