Is practicing Evidence based Physiotherapy in this system possible?

Practicing evidence-based physiotherapy in India can be challenging due to the prevalent top-down model where medical officers prescribe treatment plans and physiotherapists simply follow them. This approach is common in both private and government hospitals. However, despite these constraints, there are ways to incorporate evidence-based practice into our work:  
I believe we should be “ready” so these are the mind set a novice PT should have. Experts, seniors, PhDs, people who attended workshop with a white person teaching NDT, rubbing, sticker boys, fascia pullers and professors are beyond redemption. This is not for you.    

1. Treat every patient like a VIP: Adopt the mindset that you are providing care to someone as important as your own mother. This perspective will motivate you to find ways to deliver high-value care within the existing system.
2. Embrace the evolving nature of knowledge: Recognize that knowledge in healthcare is constantly evolving, and new research findings emerge over time. Make a habit of reading scientific literature and staying updated with the latest research in your field. This will enable you to stay abreast of current best practices and gradually incorporate new evidence into your treatments. 
3. Understand what constitutes high-value care: Many healthcare professionals complain about a lack of autonomy, but when asked about high-value care for specific conditions like low back pain or osteoarthritis of the knee, Stroke rehabilitation, they often lack awareness beyond what they were taught in school. Educate yourself about the latest evidence-based interventions and techniques for different conditions to provide the best possible care to your patients.
4. A good starting point for high value care is to assume what you learnt in college like special test, IFT, traction, do and don't, dosage, and much more are complete bullocks 
5. Remember you are in home-based rehabilitation- you have lots of autonomy. Don’t be afraid to through away passive low value care. Don’t listen to “seniors” who keep on telling patients “Want” passive treatment. Not really. Everyone wants to achieve something and patients will be happy if you make them achieve goals they want. If you are so afraid to change your whole practice- start small. Spend some time in passive care and majority of the time in high value care 
6. If you have a clinic, continue to incorporate the prescribed treatments, but supplement them with high-value care interventions. Spending more time with patients and providing additional therapy will likely be appreciated. To embrace high-value care, start with small changes while dedicating the majority of your time to interventions that deliver meaningful outcomes. 
7. Learning high value care for around 10 conditions should not be difficult.  So, take some time to learn. Don’t complicate. Clinical medicine is learning some exercise and a ton of common sense. Sadly, our common sense is ruined by college- so unlearn what you learnt- starting with assuming what you learnt in school is bullocks.   
8. Avoid falling into the trap of blaming the system for its shortcomings. While the system may not readily support change, focus on the positive impact you can have on your patients. Celebrate the small changes you make, as they can prevent cynicism from creeping in. Remember that delivering high-value care is challenging but essential. Embrace the difficulty as an opportunity to apply scientific knowledge and make a real difference for your patients.  
9. Change is a marathon. Results take time. Be patient.   
   
   I would like to have a round 10 points- well seems i ran out of ideas or got bored.
   PS- probably you should also not listen to me and not follow these.
   Love
   K Hariom
   
   
   
   

1. 
   I would like to have a round 10 points- well seems i ran out of ideas or got bored.
   PS- probably you should also not listen to me and not follow these.
   Love
   K Hariom