Maths with health science, coming soon Engineering without maths

 Education is learning without "experience". If you learn only through experience you just need apprenticeship.

Sadly most of education in colleges is so useless we cannot learn without experience. One of the reasons for that (in health science) is we dont learn maths or logical thinking or economics. So we cant understand simple things like probability, difference between single event and generalization. When the pandemic hit most of us in the health services had little idea on what the data was telling us.

Everyday some drug was touted to be a "good" for the covid. as we have no understanding of evolutionary biology we were astonished when the virus mutated to one of the treatment. In a idea situation before generalizing the usage we should have done a trial or an experiment. alas as we "know" it might work. as we think it is better to do something than wait, we ended up with all idiotic ideas. moreover none of the people who told us to be at home (remember they all had a fat cheque) told us how will people eat, how will they go home etc. as we have little understanding of sociology and economics- two important eyes of health. the list goes on. So pray tell me what is your point- after ruining health education with useless syllabus without useful science subjects like maths, physics etc, Now it is striking the Engineering education, you dont have to do maths and physics and join Enginerring. I for one in all my 14 years of experience in the world convinced my mother to for go maths in 11 and 12. I do still suffer and had and still have tough time understanding certain maths which is needed to study neurology leave alone research methods. So what will happens to these students when they dont know laws of thermodyanamics or calculus and want to work in a proper engineering company. How will they work big data or AI? I shudder

Meet our new policy- hope this will be scraped soon

https://timesofindia.indiatimes.com/home/education/news/maths-physics-not-a-must-for-engineering-aicte/articleshow/81457412.cms

where are the women?

 as usual let us remember women on only on women's days. in other days we can forget they do everything- especially for lower wages or no wages.
The other day a photos of principals in TN

What is obvious is it has become a mens club. where are the MS. mary chidambarams of my generation? Well i dont know? suddenly all the students in the class are girls and the women in leadership roles have gone. I am open to why that is.

ask IAP

 I heard the TNIAP is going to have a discussion in Coimbatore. even though i think these are absolutely useless as there will be one thing on everyone's mind- why the fuck- not everyone is calling us as "doctor". and then start blaming "others".

But that aside i think it is better idea- even though i am highly skeptical

But if you are attending these meetings- the questions i hope someone will ask?

1. who are the people who pressurized, incentivized students to attend the IAP conference

2. okay the students attended it- did those people give a rats ass the students did not get any food?

3. I am assuming around 1 crore was looted in the name of conference (inviting law suit from criminals who ate the money from the president of IAP to MR. desikamani and Co) has any steps taken any action ?

4, if you will not protect "your" students what the hell are we going to do with a association?

5. what steps are taken to stop this loot in the next conference?

6. Then we can discuss whether we are the royal highness or PTs

7. I sincerely believe if we dont do anything -we will have 300- 500 people voting and no one caring about associations

8. i hope people also discuss beyond the same stale issues - like council and talk real issues

9. if you are young if someone tells you council will change PT is TN - run, run like hell - idiocy is contagious

Question paper setter should start reading other than WhatsApp forwards

 

I wanted to write a elaborate blog on how ridiculous these questions are. however i think most of them are self explanatory. just full of nonsense and tribble with fancy words.

The first rule of assessment is - it is done for a "problem", why else do you want to assess? so we will take questions like TUG, assessment of MS, TB spine or some obscure reflex. what does the question ask the students to write about? assessment of what is MS? by the way MS? TB spine- what are they to write in this one word question. The extremely intelligent "professor" cant even make a sentence of what is a question? 
Some of them are better- but still poorly written- as you know a sentence should have a object, subject and a verb- and what is assessment of mile stones? for what- to find out is the child is in risk of development of  neurological symptoms or .....? just pathetic  

The cherry of the question paper is the first question. What the hell is that got to do with neuro-rehabilitation? I understand you need to understand lymbic system, heck even today i went to a college and taught about that - but do we have a method to assess them in PT? Brainstem issues are complex and needs hype specialist to assess- well the question is not about that anyway in a paper on assessment. who the hell is the "professor" who thinks this should be in assessment paper.

Please if you asked to set a paper- take your time. it is a huge responsibility. dont just words like fine motor assessment- write clearly in what dimension in ICF you want the student to describe, what for? in what condition?. you may be a genius but for other we need those to answer a question. 

if it is TUG- ask us if you want to use that for balance risk assessment, its advantages and disadvantages or for gait prognosis? something specific. 
learning disorders- well i hope i dont see this genius - what the hell is that? some useless therapist some years back wrote about this now every one with a swiss ball is a expert in learning disorders- just, hmmm. learning disorders are complex problems which any OT or PT are poorly educated to handle. I know some people are going to be angry with it- but well i dont care- they have not educated for that. 

please teachers of PT show some self respect for the profession take your time and prepare a question paper.

Questions to ask yourself and "association officials"

 Questions to ask yourself and "association officials"

I know I am going to be in a minority and going to get flack, but who the hell cares.

    From time immemorial from the first human got a low back pain and another human gave IFT, the predominant problem is what should the human call that person? should he call her/him a  doctor or the greatest doctor. It was not an issue she/he was not paid, she/he was worried about how she/he was called. 

2021, the same problem. what should we call a PT? not can we make a living practicing PT?  after 20 years of service can we get a promotion? we cant even move our table in many places without someone telling us - leave alone making a independent decision about patient management. I know people will say, well we do in our department, well for them I say, good for you- but is that the rule or exception?      

    If you join the government services- most of the places including one of the best medical college in India- MMC- you will do traction and ift for patients with LBP. you will do that until you retire. 
In private hospitals- autonomous practice (not independent practice) is a mirage. most of them drudge under a "ortho" who has a blotted ego and poor education on pain management or even the word evidence based physiotherapy.  In city I was born, I know hospitals wherein you need to work for 12 hours- 8 hours is uncommon. I am quoting my city because I have seen it- other places I am sure it is there but I am unaware. For all this- we are paid 10 thousand and a good salary is 18 -20 thousand. just try to rent a house in a city and live in that salary. 

    what it leads to is after you finish your job- you start working- home visits- otherwise we will be poorer than -well most of people in health care other than "doctors". we end up working for 14- 16 hours, for us to make a living income. compounding this many corporate hospitals have started home care for "their" patients employing PTs. and then there are home care companies like portia- which is eating into our source of income. Well that is the nature of market economy.

it just leads to us all feeling as though PTs working in India are just waiting for his/her visa to greener pastures. I once worked in a college, with a bunch of wonderful dedicated PTs- none of them are "here". because, we hardly had a increment, and a selfish bitch as a principal. well I am sure the feeling is widespread in many "colleges". you think-wow they are paying 45 thousand rs. 5 years goes by you are drawing a salary of 45000. 

The people who work in a clinic are just the most pathetic. we either don't pay them or pay a pittance you cant even fill petrol with that. I do understand, it is difficult to pay if you run a clinic to your employees very well, as running a clinic needs serious money, especially in bigger cities. that is that.
      no wonder, every one wants to go into government service, but for 10 thousand PTs there is hardly 500 jobs. PTs get frustrated and move to other avenues, coding and such work. PTs who want to be in health services after few years get a epiphany - fuck it I have to go abroad.

well now the questions:
    

1. is calling ourselves as doctor so important than all our problems?

why is so important to call ourselves that? well other than the ego trip it provides- i dont see any value. are more patients going to come to me if i call that? is your hospital going to pay you better? if your college going to treat you better? are they going to pay you when you  were unable to go to college during a pandemic? is your ortho going to stop writing IFT and traction for every poor guy who comes with pain? has any country moved to autonomous practice then to independent practice by calling themselves something other than PT or by something else? have we asked them how they changed there practice?  

2. have you every fought or raised your voice for "autonomous  practice" ?

3. is our syllabus objective written with autonomous practice as the objective?

have any us talked to or lobbied for changes in the syllabus which are meaningful rather than adding "advances like rubbing and sticking". 

4. have you every gone and referred "cash" or "dena gardiner" when you had doubt in treating a patient?

is not why the do we call it as "basics"  why are we not afraid to change ourselves?  
5. Has any of our associations raise there voice about salary or they always lobbying for "government jobs" and council

I am not against lobbying for that, but remember- we are in thousands and we cannot all get into service, 
about the council- ask Delhi, Gujarat, Maharashtra- have any of there life become better because of the council or some fat cats made money in the name of council.
Council will not change any our life- the medical colleges and Eng. colleges are an example of what will not happen even if you have council. It will have a impact but not everyone- some in teaching may benefit. 

6. is our associations to give a memorandum with a "politician" about the council alone?

from early 90s where i was also stood in line with others to have a audience with the then CM, till now that is what we do. give memorandum and take photo and say we have done something. as we say in my mother tongue- no hair was plucked by that. my salary did not change, my students still study the same nonsense i studied - IFT and traction, the hospitals still make us do what we are prescribed.

I know i have left out many things, i have left out why we think "doctor" is most important and much more. That was deliberate. I did not write about all the lazy idiots who join the Govt, services and sit and do no work, or the useless teachers who are not fit to teach kindergarten, the exploitation of "girl" students and much more. That is because i thought was obvious for everyone 

as i said at the beginning, i know you dont agree, that is alright - let me why i am a wrong and dont understand  

how to make our conference- a conference

How to organize a IAP conference

The last few months have shown us, IAP annual conferences are just bad- really really bad. I dont want to go into details of why it is bad, but this post is how to make it better. Please keep in my these will not make the conference "wonderful" just better.

The first thing to change is to have standard operating procedure (SOP). As this is not codified every organizes just does what the earlier person does and also uses it as an excuse.

So the first SOP should be- 7-6 months prior abstract should be invited and 2- 1.1/2 months prior.
The next date should be before 4 months- the program schedule and marque speakers should be released. before 2 or 3 months all the speaker list, workshop - everything should be completed. it should be like this year wherein we dont know who or what is the program other than where it is happening.

The important point to note is in a conference of 2-5 thousand delegates- we need to have concurrent sessions. so the conference starts every day with a plenary session. a plenary session will be under a specific topic- say for example upper limb stroke rehabilitation. The session should not exceed more than 2 hours. The plenary session is headed by a chairperson and 3-4 speakers- experts and researchers in that area. The plenary session is attended by all the delegates- i mean it is done in one huge hall.

Then the delegates break up for concurrent session. so if you have 2000 delegates we should have at least 10 concurrent sessions. concurrent session can be- 1-2 hours programs- which can be paper presentation, skill workshop (say for example how to search for literature, how to write an abstract, or clinical topics like update on OA knee ) or short CMEs. For presenters of these workshops- we need to invite proposals from all the members or all over the world. These session again are done by a group of people (2-5). again inviting proposals and selecting them makes it transparent- as organizers have to tell us why a proposal has been rejected.

the concurrent system also allows for more interactive sessions as having 2000- 3000 people in a single auditorium is not conducive for listening or participation. 

How to select speakers and scientific committee members:

I believe if we have 10 speakers- 4 of them should be from the area where the conference is held. that said or selection of all speakers we should have a set of criteria.
say for example- they should be researchers with some publication (other than predatory journals) they should have extensive clinical expertise in a specific area. well we have anything- but we should have some criteria

why- well otherwise the same idiots will talk, stay, travel and drink in our money and we will all keep on bending over.

Travel grants

Other important aspect of annual conferences is identifying new good researchers. For that one of the ways to do it via making sure they come to the conference and present there study. For that the association should form a travel grant. which will act as an incentive. 

I am not found of having international faculty, as it is very expensive and very limited value. However, if we want to do, again they should be sellers of products, but researchers, who can through light on areas in which we are lagging.   

The abstract should be revived in 5- 10 themes. so if we assume- we get 500 abstracts we should have a scientific committee which at least has 10 people. Abstracts should be written in a common pattern and the authors should be amend it in accordance with recommendations of the committee findings. This in turn will and should be published in the national journal.

please keep in mind- all of these are just what i think, it has to be debated and a particular SOP has to be adopted.

love


K hariohm

OA knee naa- Non-specific knee pain

1.       Stop taking x-ray to diagnose OA knee- it is just silly- well-read theory of when to use diagnostic test
2.     We now know – there is no correlation between cartilage damage and pain and disability. – so stop looking at the x-ray as though it is giving you some insight into your patients3.       Stop telling your patients not to sit on the floor or walk less – please understand the patient accesses health care to become less disabled not made more disabled by us.
4.       Remember it is exercise therapy- it means exercise is given to reduce pain and disability – so please tell them exercise should be done when they come to you- not at the end of 10 days or when the pain is gone.
5.       Exercise –works and one the few conditions we have high quality evidence to prove it
6.       Waxing and waning are part of diseases like these- educate your patient about  it not knee anatomy and x-ray finding- these can help them in not catastrophsing about the condition.
7.       Remember we are a quasi-mechanical system, even though we cannot run away from physics the biology adapts- so don’t make clinical decision based on mechanics- they are always inadequate- well see what has happened to manual therapy
8.       Don’t use nocebo terms – collect the term which harm them in your vernacular and try to use alternates for that
9.       If you get a chance to write in vernacular don’t – please don’t write – the joint has worn off (or in Tamil thengupochu)- the joint is not a cycle tyre
10.   I believe just like- how we are calling back pain as – nonspecific back pain we should call OA as non-specific knee pain

Love
Hariohm