Dear Kevin and All
Don't regret it. Sadly, I have shared your perception of pressure to treat
large numbers in the NHS. Groupwork can be a great environment to encourage,
motivate and educate some patients, and for some this may be enough.
However, indvidual one-to-one assessment and treatment is surely at the
heart of our professional practice and it can cause frustration all round if
patients and therapists feel they are missing out on this. I suspect this is
why many therapists turn to private practice. My own attempt to resolve this
pressure has been to move away from the hospital environment, to the
Community. I can only be in one person's home at any one time. thus
guaranteeing one-to-one contact. I work in a Multidisciplinary team(MDT)
with young adults who have ongoing physical disability, so we're usually
looking at short-term goals and long-term intermittent reassessment. I can
assure you that the job satisfaction is very high, on reflection because of
the quality of the one-to-one therapy interaction and the quality of the
MDT.
The other point in your favour at the moment is that quality is in, big
style, with Clinical Governance and Evidence Based Practice. Lets hope that
someone demonstrates that outcomes are significantly better for one-to-one
interventions for some patients before someone else demonstrates the value
of groups for all patients. The biggest problem is that while everyone is so
busy rushing around treating all these patients either in groups or
individually, it is very hard for ordinary, hardworking, individual
clinicians to do this much needed research, unless they are prepared to use
their own time and kitchen table.
I wonder to what extent this picture of UK NHS hospital pressure is
duplicated elsewhere ?
Nikki Adams [log in to unmask]
-----Original Message-----
From: kevin reese <[log in to unmask]>
To: physio <[log in to unmask]>
Cc: Manual Therapy <[log in to unmask]>
Date: Saturday, August 07, 1999 11:03 AM
Subject: NHS practice
>Dear All
>
>I know I am going to regret this one. It is late Sat a.m. and I have just
>finished the celebration of the completion of a particularly arduous
>dissertation but here goes.
>
>Is there any other, predominantly UK NHS physio who also feels the terrible
>diachotomy facing their hospital practice. The vast majority of physio
>education, especially post grad is aimed at the one to one
therapist/patient
>relationship of rehab and manual therapy. Unfortunately many of the
>hospitals I have worked for want both instructional and rehab classes
>grouping supposedly like patients, into a group where one therapist is
meant
>to give some meaningful help.
>
>Is it that I am rubbish at these groups or that treating 20 people at once
>makes better economics than one at a time. There is a significant amount of
>single malt circulating around my person so be gentle.
>
>Thoughts please Warm Regards Kevin Reese UK
>
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