The good bad and the ugly-2016

The good bad and the ugly-2016

So what did this year bring to us?

The good:

1. More excited students but “I don’t care” colleges and teachers #screweducation

2. More young therapist who are slowly realizing they are losing their soul

3. Still PTs striving to buck the trend and trying to do good for the community and medicine #krishnachandar

4. More PTs interested in research and ethical practice #kudosPT

5. Well can’t resist it – on a personal note lost 7 kgs in 3 months

The bad:

6. Well we are still afraid of evidence and are in deep denial that they exist- what did it bring more -Post evidence treatments # postevidence

7. More awards- Probably everyone in my age group has got an appreciation award (just for being here?) #congrats

8. More internationally certified instructors who can teach us-Post evidence treatment and pseudoscience #post_evidence_instructor

9. More research papers with cooked up data # cooking_evidence or #rat_race

10. As a side note more PhD without a clue of what is medicine or science

The ugly:

11. Still reading books which became outdated when I went to college- Dena Gardnier, cash and what not

12. Still attending course which were never science or outdated when I went to college- #NDT #SI

13. Sticker, needle and tea cup boys are sticking to us like a bad infection #science _resistance

14. Clinicians thinking sticker, scratching, tea cups are the latest- whatever that means

15. More people who are thinking- I should find this guy who is writing these crap and kick him

love

Hariohm

Post- truth

Post truth

The world of the year according to oxford dictionary is post- truth. A sound wonderful isn’t it- post truth. Well if you are too tired to Google post- truth- it means telling a lie repeatedly even when facts are shown and appeal to people’s emotion. Basically demonetization  TV debate in India.  Even though the concept was popularized by people in the right- Brexit, trump campaign, all Indian election- it is right in our ally in PT science and medical science.

Evidence, data and experiments are the hall mark of science and thereby proving something. Medicine and in particular physiotherapy is always afraid of the big bad wolf- the science. There may be socio-political reasons for it but we are slowly changing (I hope).

But the biggest impedance for that change seems to what I call as the post-evidence arguments and our inability to confront it. Let me explain what I mean by post-evidence. Whenever you hear people say things like- well evidence is not there but what do you feel, how does your patient feel after sticking the tape or after moving the sacral joint?
 You answer  "But sir, all the experimental data shows these don’t work"…..
Well do and then tell me… 
You then you add "how can a tape which is in parallel to the skin lift it- it is not physical possible" or "sir that is not a immovable joint"… 
well do it then you will see we have great results in our clinic". That is what I mean by post-evidence.  
You can show them umpteen numbers systematic reviews, trials and physiological reasons- they quickly turn around the argument saying well my patient feels better- certainly my business is booming. These are the latest- is an wonderful argument which touches the emotional nerve of any just- out- of- college PT or well anyone- well who needs evidence when you have the –latest. The sub-argument for that is- well you have not practiced it, learnt it so you don’t know what you are talking about- attach the person who questions the validity of the science. Confusing casual relation with correlation – trigger point argument- well why there is pain- because of trigger point- why is there a trigger point because there is pain. It makes your head spin so much you don’t know whether you or the person who is making the argument is less educated.

Well if you can’t spot it- post- evidence or post-truth arguments then they are here to stay with us. It is difficult to become a proper science. I believe this year the post-evidence argument has attained the peek. From the SI people to the – who want to put children in the dark because they are hyper active to sticker people they have learnt to talk the post truth. They have made inroads into our business practice- I just hope they don’t derail the academics also, well come to think of it they are already have. Case in point the horrible conference of pseudo-science in the name of PT they just had in a college, with full attendance from the world of nonsense experts.
#Post_evidence 

Love 
Hariohm

Climate change denial and physiotherapy

Climate change denial and physiotherapy

                I and my son were hooked on to CNN for the last several months- when the US election was at its full speed. The mudslinging and post truth made it addictive for us. Well this post is not about politics- and I rarely write about politics in social media. Donald Trump in one of his speeches while talking to (it was in the rust belt if I remember correctly) huge crowd ,was complaining- when I wear hair spray in the confines of my room (house) how will that affect the environment and lead to problems in the ozone layer. He had far worse ridiculous things to say (and made him the vijakanth of US politics in my mind) but this is one of his claims- climate change is hocus pocus. Well not only Donald trump whole bunch of people in the right in US are (including the presumptive energy secretary).In spite of overwhelming evidence many politicians, the energy lobby is- climate change deniers. Many groups even produce “research” backed by the energy lobby to say climate change does not happen. There was a senator in US who brought in snow to say well how come we are getting snow when there is global warming. I was shocked to see the amount of stupidity of all these- just because you have seen snow- the globe is not warming?  

Well bear with I am nearly there. Scientist and sane people are taken aback by these climate change deniers, scientist, climatologist and others think these people are crazy and are in the pocket of big money. The climate change deniers are a minority, especially in countries like India, you can hardly see them. The Paris accord which was ratified even by India- but I hope it has lots of trouble implementing it- just have a look at the pollution rate in Delhi-but it is in our collective intrest to do something about the whole mess.

Unlike in climatology science, in medicine evidence deniers are the norm. not the other way around. Everyone thinks – who the hell needs evidence when I have seen the change. PTs usually think research is done by someone who has never seen a patient or the patients what they see is not what the loser researcher saw. They keep on saying my treatment works- why should I change.  Well because like - globe is warming- the health system is in peril. Patients all over the world are getting less than optimal treatment and many a times –harmful treatment- like the idiot who did cupping on child to reduce spasticity, the moron who taught it or the group who invites him to teach it.
We usually think like the senator from Oklahoma, I have seen the snow- so the globe is not warming. What you see is not the truth is the first and foremost thing they taught us in literature not just in science (From The great saint poet Valluvar to Kanadasan sang about it).

I hope heath care workers move away from – see I have a snow ball in my hand- so there is no global warming- to following the evidence. If there is no evidence- get your Paris accord and do something (research) about it and stop complaining

But we still have evidence deniers in medicine and PT specifically. Here is my list of cult group and lobbies who deny evidence:

1.       My all-time favourites- The NDT cult- after 40 years of research and more research- they are the original deniers- they were the last to convert to the weakness cult in UMN lesion

2.       The scientologist of therapy – SI

3.       The K-tape – people who keep on changing the goal post and still can’t find what they are looking for and the people who keep on following them saying others are too ignorant to see what they see.

4.       Stretching and passive movement people- well I am not sure these are evidence deniers are plain ignorant

5.       The manual therapist who are still putting the spine in the right/ normal place. Well, what can I say when pioneers in the field have moved away (Butler comes to mind) people who have learnt from people who have learnt from, people who have learnt from Butler are not changing.  

Not taking about the alternative treatments like needling, chiropractic, osteopathy visceral manipulation and other exotic nonsense- as by definition these are based on faith not on science.

For all the young therapist – don’t fall into the trap of climate science denial, look into the data, critically analyses it- then make your decision. 

https://www.youtube.com/watch?v=9SLbEDMZMAk- watch homers take on global warming and below is the transcript

HOMER: Gee, Lisa, looks like tomorrow, I’ll be shoveling 10 feet of global warming.LISA: Global warming can cause weather at both extremes, hot and cold.
HOMER: I see. So you’re saying warming makes it colder. Well, aren’t you the queen of crazy land! Everything’s the opposite of everything!
(Homer dances, twirling and waving his arms.)
HOMER (singing): La de da de da. I’m Lisa Simpson! La de da de da!
LISA (muttering): Really? Really?

Love
K. Hariohm