Ethics Principle 2D

Code of Ethics: 2D. Physical therapists shall collaborate with patients/clients to empower them in decisions about their health care.

Empower: To give power or authority to; to enable or permit.

It comes down to this quite often. A patient tells me that they will need [Surgery, Meds, Injections] because a medical authority told them they need [Surgery, Meds, Injections]. Caveat: this is true sometimes, in my opinion.

Once this phrase is uttered by a patient an immediate response is made that includes describing patient rights. Continue reading

False Dichotomies

There are many issues in our profession which seem to present as a division. You are either for or against something, on principle, and that defines you as a practitioner, person, health care provider, etc.

Most of these divisions are un-real. They don’t actually exist and the world is much more nuanced and less black and white. As a part of our superb community of thinking and questioning PTs (Physios) I have been thinking about some of the false dichotomies that exist. Here are 6 of them Continue reading

The Crossroads of Philosophy and Physiology (Part 2): Where We Missed the Mark on Pain Education.



And you’d be surprised… the answer goes further back than you might think.

So if you read Part 1, we left with a series of questions — all boiling around the conundrum of what I will call “the pain education lag.” This can be defined as the time it takes for the education to take an effect (i.e. reduction of aberrant pain). Essentially, you provide a treatment, but it’s possible for no effect to be seen immediately (and its also highly likely for this to occur in such a delayed fashion). And this is something that is significant. Other treatment effects take place immediately. Yet, with pain education Continue reading

Words yield knowledge; knowledge IS power

It is about that time, in the US, that many Physical Therapy programs are about to begin.  I have had the fortune to see many PT techs/aides get accepted and plan to move and start their programs… and they ALL talk about ANATOMY.

God, Anatomy was awesome. It is the hardest class (and justly so) and builds the foundation of your practice, not only in pure facts, but in your ability to learn. The sheer size and volume of terms is unworldly… the Latin, the specific descriptors… the depth and preciseness with which you are expected to describe a part of a bone, or a tubercle on a ramus. It is truly wonderful… for without these descriptors…. the information does not exist.

Without a word for it, Continue reading

Solving Uncertainty

\What does the search for certainty do to us as clinicians?

In searching for answers we are picking up patterns that let us go past that initial uncertainty.

And so Evidenced Based Practice serves this role… to solve the uncertainty.

We look to research to let us know unbiased truths.  Hey, this patient is not responding today, but if I stay the course science supports that I will see some improvement.

We can look to clinical training or algorithms to help us along. For example Continue reading

A Year in Review


I will start by referring you to this statement:

… the reflective process [helps in] becoming a better clinical and critical thinker, thereby providing patients and clients with a better experience and better outcomes.

The exercise in containing and writing a thought succinctly and with brevity is a tool that, in our opinion, should be utilized.

Perhaps the process … will aid the reader in challenging their own current ideas, or perhaps reinforce them.

That was part of the the first post on the #PTBT. Continue reading

The Therapeutic Exam


“But I have               in my spine.”

“Oh I can’t, my                is really bad.”

“I guess I’ll just have to live with this                  .”

Fill in the blank with your own patient comments, but they are all essentially the same. Some gigantic, devastating, destruction is occurring inside of their body…and there’s no hope.

I don’t know if it’s funny or just sad, but the fact that such a large amount of patients respond to such “terminal” (i.e. chronic) conditions with statements like Continue reading

The Punnett System

Oh Lord, I have heard the claims!

I have listened to the persuaders, the charmers, the charismatics.  Most of their ideas make sense and can follow logical patterns. (see How To Fool a Smart Person by Erik Meira)  I have a thirst for knowledge, and for universal truths… so I’m listening!

But I have one helpful tool that I use to quick-check these fantastic claims: The Punnett Square. The marriage of factors combined to make truth babies.  Hypothetical genotypes producing theoretical phenotypes. (I don’t know what all that means…)

The punnet Square is commonly used in biology (I’ll let Khan Academy teach you about that here,) but we can use it in our own evidence based practice.  Here’s how: Let’s take the claim that poor posture = pain and make a Punnet Square. Continue reading