what is happening to physiotherapy?

[nari]

Thought I would pose this as a reminder that our profession is in some danger of regression to well below the mean.

In the USA, massage therapists are practising 'physical therapy' and some chiropractors are practising 'physical therapy' and these items are being paid for by the insurance companies.

In Australia, chiropractors are mobilising, massaging, treating post-surgical patients, developing software for ergonomics , manipulating, using most forms of EPA, teaching and handing out extensive programs of exercises...

What are we doing to protect our turf? What can we do?

As I posted on another forum, will we be reduced to bashing chests and walking patients in hospitals?
That may be cynical, but can we rise to the competition?
Can we produce cold hard evidence that we can change our ways of thinking, with the backup of science and evidence-based pratice?

I think we may be running out of time.... :roll:

Nari

[emad]

Hi Nari :

you are absolutelt right .

there is nothimg called Scope of practice .

In every country there is laws , legislation , ethics codes ........
And still all overlap each other , there is no the clear thin line which differ this from that .

now we can ask one question .

Can the health provider work within his scope of practice without all those legislations?

I think the law can not at all restrict the human being , only the human being will act ethically from his inside .

cheers
emad

[bernard]

Nari,

Take a look at this link and give us your conlusions and advices?

http://forums.studentdoctor.net/showthread.php?t=121359

[Servaas]

Indeed, times of change are upon us.

I started billing insurance companies under the definition 'Somatic Rehabilitation'. Not 'Physical Therapy'.

Seems to work up to now.

As you know me, I will keep building on that until there is a new fully recognized profession with its own billing code.

Servaas Mes
www.somatichealthcenter.com

[bernard]

Servaas,

In France, they allowed a new reimbursment about an old technique called MEZIERES.
This technique is fairly out to date and based on false theory. Their fans won a battle!

Find an acceptance of neurodynamics or Feldenkreis and Hanna will take a century, even with me! :cry:

It is why, we must begin a kind of clinical study and put results where they can be reachable for everyone => Somasimple? :idea:

[nari]

I enjoyed reading the forum, Bernard and it does echo a lot of my thoughts regarding the PT profession which have been wandering around in my brain at various levels for some years.

I agree that we may price ourselves out of the market with respect to public hospitals in Australia. Who in their right economical senses would pay a physio to take patients for walkies after their surgery? It happens.
Who is going to pay a physio to teach a patient breathing 'exercises' after surgery and give them static quads and upper limb exercises? It happens.

Our assistants are very limited in skills, here in the ACT, anyway. They are not trained in observation, clincial reasoning (if something goes wrong during an exercise) and are not deemed safe to mobilise, say, a post-surgery orthopaedic patient. So there is a big gap- sounds like USA assistants are quite highly trained.

I would like to see physios as consultants - and the work deemed necessary to be done by assistants or nurses. But that is a bit of a dream and a long way off, if change does occur.

Private physios are in a different situation - but they may also need to make changes, due to the influx of many other health professionals.
How does the market handle the situation where the patient prefers a massage over physio when all the physio does is "cause pain"?

I see a lot of persistent pain patients, and their opinions of physiotherapy are, as a rule, not good. They frequently say" physio did not make any difference" or "it just hurt so much I could not stand going back any more"...

We, as a profession have to take a good, hard 'big picture' look at what we do and how we do it.

Or, we might just go down the gurgler...

Maybe your forum can facilitate this hard look at our practices!


Nari