Letters: 4 March 2015

I agree with Ingela Jacob’s letter (page 5, 4 February). Scientific research and evidence to support what we do as a profession is important and valuable. However, I feel we need to have a mature debate on our current obsession with, and increasing reliance on, so called ‘evidence based medicine’ (EBM) as the sole source of our evidence.

 

Although EBM forms an important foundation for clinical practice, it cannot replace the significant contribution of the practitioner’s intuitive awareness and observations of their patients. Every patient’s body will have a unique presentation and if we diminish the value of anecdotal evidence, or, in other words, observing and learning from our clinical experience, we offer our patients less. Anecdotal evidence should be given equal importance to EBM. 

 

We have to be careful that we do not stifle innovation. Many of the modalities we practise today were born out of clinical necessity, observations and experience. 

 

Scientific research has shown that EBM is not the god of medicine and science that it is cracked up to be. Andrew Mooney

I attended the CSP’s South Central  Physiotherapy Works event in Basingstoke on 26 February. I witnessed a professional body truly stepping into its space, offering intelligent, evidenced support, education and challenge focused on improving people’s lives. The event promoted cost-effective, evidenced practice.

 

The leadership and professionalism shown by the CSP and the role modelling of partnership working was everything I would hope to see from my professional body. I am proud to be a physiotherapist and feel very proud to be part of the CSP. Beverley Harden, associate director organisational and workforce development, Hampshire Hospitals NHS trust.

How long is the NHS sustainable without significant tax rises? We already have more people not working than working in this country, and as the number of non-workers grows so does the financial burden on the working population. This will be particularly irritating for this population group as there will certainly be nothing like the pensions available now as they retire. They’re going to have to fund my retirement and their own later in life. Is this fair? 

 

I‘m very grateful for the pay and retirement conditions I get from the NHS and believe it is more than competitive. It’s still not the money other chartered professionals are getting, but the manner in which we’re funded means I doubt we’ll ever get what we deserve. Many senior physio roles being advertised in the private sector recently are not able to match NHS salaries, and they certainly don’t get my holidays or retirement offer. I work in both sectors and the squeeze on pay in the private sector is driving down available funds for salaries. I’m much better off financially than my full-time physio friends of equal years qualification in the private sector. For that, I’m grateful. Name withheld at writer’s request.

CFCampbell responded to a news item from our last issue, which was also posted on the CSP website (4 February), titled Physio-led service saves money and helps patients get home faster after knee replacements,: Physiotherapists could save the NHS bags more money and the unnecessary increasing number of patients requiring this procedure if it could implement a programme of preventative therapy at a very early age. 

 

This would involve ‘screening’ youngsters eg 8-14 years for poor foot mechanics, the result of which will inevitably lead to years of overload mechanical wear and tear of the knee cartilage. 

 

More to the point: why prevent them, for the sake of a simple biomechanical assessment,enjoying the rest of their life without the potential of this avoidable pathology? 

 

The bonus is potentially preventing future physical/sporting and lifestyle poorer quality of life, and not forgetting the unnecessary surgical waiting lists.

In our Top Tweet item on 21 January we gave an incorrect link to a paper on pain. It should have read : Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories.