Should we teach cult based concepts in universities?

I usually don’t get perturbed by PT syllabus- what is changed and what is not etc. I know from many years of teaching nothing changes in the syllabus – from my observation in the TN MGR University.  As time goes by I understood everything remains the same. A classical example is splitting the exercise therapy syllabus into two into 2 papers but having the same content from that horrible book- Dena Gardeners exercise therapy – keeping PT in the 1980s. And this is still in the syllabus in 2015 but we have 2 papers in exercise therapy.

The other day I saw the new and improved syllabus put forth by the ministry of health. I am not going into the finer details of it as I said earlier nothing is going to change. However, I am going to raise a single issue in the syllabus (proposed) that is inclusion of 2 products as part of the curriculum.

A medical product is usually a drug which can help in treating a disease.  The drugs are developed by a complex process and usually end with someone patenting it and selling it to us. They also have a monopoly for sometime in not allowing others to use the formula.  As time goes by generic variation are done and usually sold in a much cheaper rate. In physiotherapy medical products traditionally was instruments which are extensively used ranging from SWD to the modern lasers. However, along came some PTs who had an ingenious idea of how to treat some neurological and painful conditions. They were pioneers in our field starting from Knott and Voss to Mulligan. They also wanted other PTs to practice their ideas and started teaching it to other leading to newer ideas and discussions.

So, what went wrong? Well PTs with these ideas started forming cults with themselves as leader and adherent followers. Even at this point I am not unhappy even though I think it just ruins science. Some of them started to sort of patenting their have baked ideas and claiming others should not teach them. I am assuming the reasons for it is predominantly fiscal and some amount of thinking others will corrupt their idea- leading to lose of fidelity of the concept. Whatever, their thinking I don’t give a rats a$$. They even send notice to people who teach that- I personally know people who got it for teaching McKenzie treatment. The Mulligan cult is famous for saying in the brochure itself no one can teach the holly shit they have formulated. Well, I still think it is up to them to say it and protect their product. These are not hard science, these are one persons teaching with or without any facts and hence not a problem when all of us don’t know how to do these techniques.

 So pray you ask me, “What is your problem?”  The problem is Mckenzie and Mulligans school of crap is in the draft syllabus prepared by the ministry. How come a product with poor science and which cannot be taught as claimed by product ceos is in the syllabus. OK, even if you say the concept can be taught, the question still remains why? This is like saying you can run the trailer but to see our movie you have to pay us 20000 Rs. As most of you know I hate NDT because they are just lazy, parasites who take the work of others and sell it, but at least they don’t ask other not to teach their useless product. To have in the syllabus – Electrocare IFT rather than IFT is just plain wrong. Likewise, a product with poor science and which cannot be taught by others other than by authorized by the CEOs is just not done in Universities. Already we are selling nonsense like Dry needling to K-tape without any shame to naïve therapist outside the preview of the educational system- but universities should not be helping fat cats sell their crap.
Let universities be where we learn science. 

Word physiotherapy day- How should we call ourselves?

This is a positive blog, which people complain I usually dont write about. Well many of us think we are pain experts, movement science specialist (a term encouraged by Carr and shepard) and so on. However, I think having a restricted definition is not defining us fully.
what should be changed.

What is health?
The WHO defines it as -Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

There are 2 parts to this definition- the most salient part is it does not talk just about physical, hence my contention we should not call ourselves- movement science specialist. We are more than that we make or we ought to make persons with disease function in the world not just change their pain or movement.

It took me some years to understand my patients with cerebral palsy are worried more about toilet training rather than kneeling.  Not just pain relief, but again ride their motor bike back to their job. There are many more examples which I need not point to our community as we all have made a great deal of change in our patients beyond just movement. Hence we need to think ourselves and refer ourselves as health care professionals with unique skills, which cannot be restricted to movement or pain alone.  I am not sure exactly how that “unique “should be defined- maybe we can all opine? but it should be more global than pain and movement.
The second part of the WHO definition is sort of technical- really complete absence- is it really possible.

love 

Hariohm K

My high horse post

As September 8 is fast approaching let’s take an oath to stop some rubbish which has crept into our practice:

We need to stop giving rubbish advice and health educations like:

1.       Don’t sit on the ground if you have OA knee or walk –really, does it look like sound advice? As Prakash V used to say – if you have OA Hip should we give an advice not to sit on a chair? Not to walk because you have OA? Really!

2.       Don’t bend if you LBP- really? Compounded by half baked advice from ortho- this is the new trend. Then what is the joint for and how are they going to function? read

3.       Don’t terrorize you patient into taking treatment- this one is also for the poorly educated health care professionals of all size and shape. If you don’t do the surgery you will be a cripple and die or the joint will be going to dust if you don’t attend my clinic- stop these type of advice

4.       Remember educating the patient is a vital tool as any other- don’t be afraid of honest education and advice of the patient

In neuro-rehabilitation we need to stop:

5.       If your major part of CP or stroke patients management is passive movement and stretching and rolling the child on a ball or a swing- well read become a physiotherapist

6.       Stop using props like Swiss ball, bolsters  and use real world useful things- they have come to rehabilitated themselves and function in the real world not join the circus

7.       In neuro-rehabilitation remember the patient did not come to you to change his trunk or pelvic alignment- stop thinking like a car mechanic and set goals which are valuable for the patient and work towards achieving it. Don’t believe idiots who teach you those are vital

8.       Well my favorite- don’t say you are a  certified NDT therapist it does make you look like a fool when it has been said time and time again it is not a great treatment. The world is moving on –so read and become an educated Physiotherapist

If you are a teacher

9.       If you are a teacher- just throw the notes away- read and prepare for your class.

10.   Stop gossiping – if the boy is not going around the girl then it may be out of the ordinary, so just shut up

11.   Stop telling them how to dress and talk- rather teach them to think and behave ethically with the patients- who cares if I wear I jean, but it hurts when they ask “ where can I get this-professional ethics you are talking about”

12.   Allow them to express- if you don’t know what it mean please learn

If you are in pain management:

13.   If major part of your management strategy of pain is passive techniques including manual therapy, suluku edupathu or electrotherapy- well read

14.   If you think MET, manual therapy is the latest- well read

15.   If you think you should not teach exercise when the patient has pain –just stop practicing PT you are a embarrassment to the great science- Physiotherapy

I know lots of people are going to think I am being an ass and supercilious- well ….

Love

Hariohm