Originally posted by caro
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If they only want chiropractic, then that is what they will get. If they choose both chiropractic and bodywork, then I'll incorporate those as needed for their particular situation. But, if someone only wants soft tissue work, then soft tissue work is what they will get.
In any case, it sounds like you "work on" people. I've moved away from the "operator model"- as it is often referred to on this board-mostly because much of the research on chronic pain recovery identifies restoration of an internal locus as a key to long-term improvement in pain and disability. No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.
As I heard Barrett Dorko say recently, "They're not calling it a neurobiological revolution for nothing," or something like that.
In the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.
This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".
See here for more on the operator versus interactor model of care.John Ware, PT
Fellow of the American Academy of Orthopedic Manual Physical Therapists
"Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
“If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
be carried on to success.” -The Analects of Confucius, Book 13, Verse 3
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Originally posted by Randy Dixon View PostHow long until you get to the third face? It's been 6 or 7 years for me.
FYI...I figure I'm at. Still trying to figure out how I apply what I know to be true, in a healthcare environment that is utterly broken where volume of patients seen is championed and truthful approaches viewed with disdain and often....anger.
Ahhh death. I'm certainly not :teeth: with it yet....
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Originally posted by John W View PostIn the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.
This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".
It didn't go well.
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Originally posted by John W View PostSo the patient dictates what their treatment will be? I would be concerned that this approach might hamper clinical reasoning.
In any case, it sounds like you "work on" people. I've moved away from the "operator model"- as it is often referred to on this board-mostly because much of the research on chronic pain recovery identifies restoration of an internal locus as a key to long-term improvement in pain and disability. No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.
As I heard Barrett Dorko say recently, "They're not calling it a neurobiological revolution for nothing," or something like that.
In the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.
This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".
See here for more on the operator versus interactor model of care.
Some of these suggestions regarding active care may come from me, some may come from other practitioners I refer the patient to (as noted previously regarding Applied Functional Science and Feldenkrais practitioners I refer to).
I also believe if a patient is better and they no longer have pain issues, then I have done well. It happens frequently. Then, new people invariably take their place at some point or other.
My practice is not all chronic pain issues. Some have pain due to specific issues that get resolved.
And on the occasion when I have someone who is not interested in taking their health into their own hands, I will provide palliative care as requested. Generally those tend to be bodywork clients who have personal stress issues.
BTW, thanks for the link.C.O. ( gender: ♀ ) - LMT, BS(Anatomy), DC
Music Fog... pick a song to listen to... you can't go wrong.
Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.
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Originally posted by Curious One View PostAnd on the occasion when I have someone who is not interested in taking their health into their own hands, I will provide palliative care as requested. Generally those tend to be bodywork clients who have personal stress issues.Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page
@dfjpt
SomaSimple on Facebook
@somasimple
"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley
“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial
“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis
"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth
"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
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Originally posted by Diane View PostI suppose this pertains to the chiropractor definition of palliative care, because I seriously doubt you'd be qualified ( as a non-medical human primate social groomer) to provide medical palliative care.
Such a poor choice of wording on my part.
I should have said... In those instances I will provide care which consists of working to relieve pain or tension, in order to make the patient/client comfortable and improve their quality of life.C.O. ( gender: ♀ ) - LMT, BS(Anatomy), DC
Music Fog... pick a song to listen to... you can't go wrong.
Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.
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If I can offer a recommendation at this point. CO has introduced himself...at this point I don't believe it too bold an assumption to assume he is a he.
It looks as though CO has enough posts to get into the Sounds of Silence. If he were to trick around there and read some old posts/threads, I believe there would be a better chance of this not being the last thread on which he participates here.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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Originally posted by Curious One View PostYou would seriously be correct. I am in no way qualified to provide medical palliative care.
Such a poor choice of wording on my part.
I should have said... In those instances I will provide care which consists of working to relieve pain or tension, in order to make the patient/client comfortable and improve their quality of life.Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page
@dfjpt
SomaSimple on Facebook
@somasimple
"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley
“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial
“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis
"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth
"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
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Hi john,
. No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.
GregGreg Lehman BKin, MSc, DC, MScPT
No letters allowed learned on weekends.
Physiotherapist
Chiropractor
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Originally posted by Diane View PostNo prob. It does reveal a tendency I've noted before, though, that chiropractic likes to impersonate the medical profession a lot, including using all the same words but bestowed with untraceable, chiro-only meanings.
I use palliative to mean:
pal·li·ate
/ˈpæliˌeɪt/ Show Spelled[pal-ee-eyt] Show IPA
verb (used with object), pal·li·at·ed, pal·li·at·ing. 1. to relieve or lessen without curing; mitigate; alleviate.C.O. ( gender: ♀ ) - LMT, BS(Anatomy), DC
Music Fog... pick a song to listen to... you can't go wrong.
Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.
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Originally posted by Greg Lehman View PostHi john,
Do you have any research showing a robust, long term positive effect for ANY intervention for persistent pain problems? We are far from establishing long term and powerful improvements with the treatments within the neuroscience revolution framework.
GregDiane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page
@dfjpt
SomaSimple on Facebook
@somasimple
"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley
“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial
“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis
"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth
"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Comment
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Originally posted by TexasOrtho View PostIf I can offer a recommendation at this point. CO has introduced himself...at this point I don't believe it too bold an assumption to assume he is a he.
It looks as though CO has enough posts to get into the Sounds of Silence. If he were to trick around there and read some old posts/threads, I believe there would be a better chance of this not being the last thread on which he participates here.
And, yes, I do agree that it is getting close to the last thread I participate on at the rate this is going. I am wondering why people are even invited to join, at this rate.
The forum might be better off in stating... please... leave, in their welcoming pages.C.O. ( gender: ♀ ) - LMT, BS(Anatomy), DC
Music Fog... pick a song to listen to... you can't go wrong.
Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.
Comment
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People just turn up here, most of the time.Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page
@dfjpt
SomaSimple on Facebook
@somasimple
"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley
“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial
“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis
"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth
"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
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