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Bravo! Paul D Andrew wrote: > Mel Siff (don't really know if he's Irish enough to be legitimately > referred to as McSiff) has brought up an interesting topic for > discussion and already (surely contrary to his expectations, > although he must be used to it now) we have people waiting in the > wings for the mudslinging to begin. > > It's interesting, from my own perspective as a PT, to see how an > ample income can buttress a practitioner's feelings that what he or > she is doing is "validated" thereby as something important. The same > sort of financial success, however, can arouse suspicion if the > money is flowing into the pockets of someone else. The issue is > complicated enough that governments attempt to regulate practices in > health care, so obviously politicians and bureaucrats observing the > health care game from the sidelines are not comfortable with letting > free market forces run amok. This can surely generates great fodder > for a magazine with a title like Smart Money. I don't have access to > the article, but somehow the topic doesn't seem to be particularly > novel. > > At the bottom of this mess is chonic pain, a very difficult problem > to deal with properly in a free market economy (not that I suggest > we suddenly switch over to authoritarian rule just to help people > suffering from chronic pain!). It may be easy for PTs to single out > chiropractors for taking advantage of a certain conditioning effect. > That is, a patient with chronic pain who has been inadequately > educated about the nature of chronic pain ends up repeatedly > seeking, as a result of conditioning, a particular treatment to find > short-term relief. Eventually this patient becomes a satisfied > "regular customer", who must indefinitely have his or her little > "fix" of treatment to through the day. Many of these people visit > chiropractors for an "adjustment" without which they would suffer > anxiety attacks. But a number of others depend on "PT" instead for > the same sort of gratification. Such patients are great sources of > "revenue", because their pain is genuine and they must keep > returning for more "treatment", which must be reimbursed in one > fashion or another. > > If the preceding characterization is correct (this is NOT an > original formulation that has just now appeared in print for the > first time!), then shouldn't Mel's question be reduced to the ethics > of looking upon the sufferer of chronic pain as a source of periodic > revenue? I have heard of no legislation in any country (of ANY > political persuasion) that has been able to deal with this problem > head on. Yet there IS an ethically acceptable manner of dealing with > the patient suffering from chronic pain, one in which the patient > learns about gaining greater control of his or her life. > > I thus submit that mudslinging between PTs and chiropractors misses > the point that Mel has brought forward. Can we discuss it rather in > terms of proper management of chronic pain? > > Paul D. Andrew > Hiroshima, Japan %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%