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  • Science or Marketing?

    "A common statement is hear from these groups is that the reasearch is always decades behind the clinic. I disagree." -Scot Morrison

    I hear this a lot too. My response is that that's fine but the marketing shouldn't be decades AHEAD of the research, and the clinic is often decades behind what we know to be true. Our anecdotal reports of clinical success are not the benchmark by which we judge the worthiness of new methods and products.

    Science says "Use it -> Research it ->Promote and Market it if it makes sense"
    Commercialism says "Promote and Market it if it will sell -> Use it -> Research it if it can be used to support your Marketing"

    There is no way to reconcile these two things. You have to pick one. You're either doing one or you're doing the other. Period.

    Which one are you doing?
    Jason Silvernail DPT, DSc, FAAOMPT
    Board-Certified in Orthopedic Physical Therapy
    Fellowship-Trained in Orthopedic Manual Therapy

    Certified Strength and Conditioning Specialist


    The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

  • #2
    Great Jason.

    This reminds me of something Seth Godin wrote recently about the marketing of sun screen. Once it was determined that it didn't do what the marketers claimed they lobbied to have this hidden from the public.

    It's ugly.
    Barrett L. Dorko

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    • #3
      My favourite recent-history example of putting the excitable treatment horse before the sensible research cart: platelet-rich plasma injection.

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      • #4
        What was that about sunscreen Barrett?
        Byron Selorme -SomaSimpleton and Science Based Yoga Educator
        Shavasana Yoga Center

        "The first principle is that you must not fool yourself - and you are the easiest person to fool" Richard Feynman

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        • #5
          Originally posted by paulingraham View Post
          My favourite recent-history example of putting the excitable treatment horse before the sensible research cart: platelet-rich plasma injection.
          So PRP's Die with Prolotherapy then huh.
          Byron Selorme -SomaSimpleton and Science Based Yoga Educator
          Shavasana Yoga Center

          "The first principle is that you must not fool yourself - and you are the easiest person to fool" Richard Feynman

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          • #6
            Originally posted by Jason Silvernail View Post
            There is no way to reconcile these two things. You have to pick one. You're either doing one or you're doing the other. Period.
            You sure about that Jason?

            [trying to find the tongue-and-cheek emoticon]
            Rod Henderson, PT, ScD, OCS
            It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

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            • #7
              I'm sure about it Rod. I can't vouch for anyone else in that regard however.
              I don't teach or work for EIM currently if that's the question you're asking.
              Jason Silvernail DPT, DSc, FAAOMPT
              Board-Certified in Orthopedic Physical Therapy
              Fellowship-Trained in Orthopedic Manual Therapy

              Certified Strength and Conditioning Specialist


              The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

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              • #8
                Go here and scroll down to The ethics of sunscreen.
                Barrett L. Dorko

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                • #9
                  Originally posted by Jason Silvernail View Post
                  I don't teach or work for EIM currently if that's the question you're asking.
                  Absolutely not. Sorry for that miscommunication.

                  Your post got me thinking about my issue with the gang at EIM. They do good (and sometimes great) work for the profession, but the marketing cart has been pulling a dead horse for a while now. Your post instantly made me think of them.
                  Rod Henderson, PT, ScD, OCS
                  It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                  Comment


                  • #10
                    Probably important to note that marketing itself is a science. In fact, marketing research could be considered more rigorous than much of what we see in physical therapy. That's not meant to be a slam on the work being done by researchers in our field, but it may explain the phenomenon Jason eludes to in his initial post.
                    Rod Henderson, PT, ScD, OCS
                    It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                    Comment


                    • #11
                      Ah, gotcha Rod.

                      I think there's value in aggressively marketed a quality item or service used by many and proven to work. In my mind good science could use more marketing. It's when things are marketed before the claims are justified that we find the problem.
                      I think when people set out to run a business or provide a service, they really have to pick one or the other here.
                      Jason Silvernail DPT, DSc, FAAOMPT
                      Board-Certified in Orthopedic Physical Therapy
                      Fellowship-Trained in Orthopedic Manual Therapy

                      Certified Strength and Conditioning Specialist


                      The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                      Comment


                      • #12
                        another example

                        http://www.sciencebasedmedicine.org/...cebo-medicine/

                        Paul ,another good example I had read about is vertebroplasty for osteoporotic fractures . I was interested in one of the comments by someone who is involved practically in suggesting that injecting lidocaine and then conservative treatment would be a good option. Practically, in many pain syndromes I think this is interesting ...alter perception temporarily , calm the person and perhaps central mechanisms may kick in more strongly ? Re you post on platelet rich injections ...interesting but the best treatment for some of these issues is far the hardest to accept ...(you have a very well written article on it) ...rest!
                        Jason......who would argue with your post given your 'desert storm' avatar ?
                        In our work ,involving often medically unexplainable problems, perhaps people just thrive on influential and forceful personalities promising solutions based on simple paradigms.Basically, in the majority of neuromuscualar benign pain states the model is wrong .....until this changes people will for ever invent more and more of the same .......
                        In N America (and increasingly here) people are drawn to marketing hype , personality cults around treatment acts and clinicians are not particularly interested in the wider influences of health related behaviour . These are my opinions , I have no 'evidence'.
                        Personally , much of the 'evidence' out there seldom has much impact on my daily work, although I am interested in some of it (the lack of it for things like injury screening , back pain inter/intra operator reliability,posture ,alignment to explain pain etc etc). Again, looking at the body in isolation (via typical RCT trials) fails to take any note of the complexity of individual variation and pain behaviour typically found in ongoing pain populations. Researchers should spend more time in more typical GP settings and get to grips with the complexity of pain behaviour in my opinion before making recommendations.

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                        • #13
                          I see Jason you have attempted to label the black(commercialism) and white(science) items as somehow contradictory and therefore 'right'and 'wrong', 'good' and 'bad'. You have used the 'razor' to little advantage in a world where reality is many shades of grey.
                          How is it possible for the "commercialism" line of action to proceed from
                          marketing to using, without using being the first thing to have happened?
                          A small point of order I admit, my point being that science is no more a line of
                          Use-research-promote , than commercialism is a simple linear progression.
                          I believe , just the same , that I get your point. Not sure you have carried it by such simplistic rhetoric.
                          Science, for instance may occur something like
                          Observe- postulate-trial-error-retrial-repostulate-retrial, retrial. retrial-observable effect-reconsider postulation-warily propose-aquire clinical feedback-retrial
                          or
                          eureka moment of theoretical connection-theoretical postulation-trial-immediate success-publish-meltdown due to lack of clinical trial-trials-further postulation,publish,clinical observations ad infinitum-death due to lack of funding.
                          and so on
                          Because science is done by humans, there is an infinite variety of lines of action. We hardly ever find success by doing what others have done, in the same way or order as was previously done. Breakthroughs are often made by ignoring the "black and white" of previous models, by daring to tread in boots not made for the purpose.

                          How meagre would the scientific community be were all to follow the step by step of use-research-promote, rather than offending reason from time to time.
                          "Research", means many things. Exloratory, constructive or empirical?. Primary or secondary?. Is research necessary for the light of reason to be cast with good effect, always, sometimes?.
                          The word "promote" begs the question, does this mean sell?, or share?, aquire copyright or disseminate freely?, put it out there or allow only the inititiates?
                          I'm not sure it matters in the context of understanding real science as the message we all aim for, the crux of the matter, the explainable, the definable, the reproduceable.

                          When black or white decisions are suggested as the only choice, respondents are imbued with a polarity that does not meet reality. Like a badly worded poll, sometimes we opt for the choice that is implied as "correct", rather than a full telling of the facts, or means to tell them.
                          Science is no more a linear formula than life itself, apart from birth , death and taxes of course.
                          :lightbulb vox clamantis in deserto

                          Geoff Fisher
                          Physiotherapist

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                          • #14
                            Huh??

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                            • #15
                              Originally posted by Barrett Dorko View Post
                              Great Jason.

                              This reminds me of something Seth Godin wrote recently about the marketing of sun screen. Once it was determined that it didn't do what the marketers claimed they lobbied to have this hidden from the public.

                              It's ugly.
                              Apparently they want to sell a smoke screen instead of a sunscreen. If you consider this an outcome study of sun protection behavior, it isn't very encouraging.

                              With the fact that vampires are popular now, I think a major marketing opportunity is being missed. A vampiric existence is the new cool.

                              Any PTs working in a place that offers tanning beds? Do we have a role in advising people about their use? That is, is it within our scope of practice since, after all, we're not dermatologists?
                              "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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