In a message dated 09/01/1999 8:29:36 AM Pacific Daylight Time,
[log in to unmask] writes:
<< but I really don't have any
problem with using techniques with little thought if I've used them a
hundred times before for similar musculoskeletal lesions when I know they
work. I cannot believe that having made your diagnosis of say shin splints
and having decided that one of several elements leading to this problem is
tight gastrocs that you don't go right ahead and do some soft tissue work
to the offending musculature and teach the patient to stretch. I do it every
week and don't think about it.... >>
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.
Sheri Bovard, SPT
Mount St Mary's College
Los Angeles CA
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