A lot is said about physiotherapy being biomedical and following 'the biomedical model', but what exactly is this, how and why does it underpin physiotherapy? Over the next few blog posts, I'll try to explain the idea of the biomedical model in a bit more detail and show why and how it has influenced physiotherapy. I'm going to tackle 7 key aspects of the model. There are more, of course, but these are considered by most people to be the main ones. Specific aetiology Germ theory Cartesian dualism Objectivity and experimentation Reductionism Normalisation Body-as-machine Understanding something about these will give you a stronger sense of why they're so … [Read more...] about What is the biomedical model #1?
The idea that most grabbed people's attention during last week's 1st critical physiotherapy course was slow physiotherapy (you can listen back to the full talk here). Slow physiotherapy - like the slow food and slow TV movements - would be a reaction to the hyperkinetic life that we're now all leading. But more than that, it would force us to focus more on exactly how pervasive questions of time and speed are in physiotherapy today. Paul Virilio - the philosopher we looked at last week - coined the term dromology to refer to the study of speed and time and, especially, how speeded up our lives increasingly feel. Virilio was concerned with the way technology had collapsed the time … [Read more...] about Slow physiotherapy
It's quite common these days to see advocates of a more 'holistic' healthcare practice championing the Biopsychosocial (BPS) Model. In areas where healthcare has become increasingly complex - where people's individual values and beliefs can't be avoided, and where people's social context affects their lives so palpably that a biomechanical approach to assessment and treatment is simply inadequate - the BPS model is promoted as a way forward. But is it as sound as people seem to think? The BPS model was initially proposed by George Engel as a ‘unified concept of health and disability’ (Engel 1960) and was based on a very particular form of positivist psychology called General Systems … [Read more...] about Is the Biopsychosocial Model all it’s cracked up to be?
A very interesting thing has been happening with the CPN blog in recent weeks. After publishing two relatively controversial blogposts - one on Six useless treatments and the other titled There are no new treatments in physiotherapy, we saw a big spike in members and enquiries through our email service. The post There are no new treatments in physiotherapy has been accessed more than 15,000 times on Facebook, and Six useless treatments nearly 13,000 times. These might not be particularly big numbers for Justin Bieber, but they are for most groups in physiotherapy. What is it about these posts that made them so popular? Based on some of the emails we received after they went … [Read more...] about Desperately seeking evidence
In a recent article by titled Listening-touch, Affect and the Crafting of Medical Bodies through Percussion, Anna Harris discusses the effect that technology has had on the loss of doctors' physical assessment and treatment skills. The article focuses on the technique of percussion - the 'listening touch' as she calls it, that comes from percussing the chest to perceive the density of underlying tissues. Here's the abstract for the paper, and here's a link to the paper itself: Abstract The growing abundance of medical technologies has led to laments over doctors’ sensory de-skilling, technologies viewed as replacing diagnosis based on sensory acumen. The technique of percussion has … [Read more...] about What skills are you losing?
Physiotherapists, like all orthodox western health professionals, love endings. Think about it. Every time we begin a new patient assessment, we have got one eye on the patient's discharge. We love goals and outcome measures so that we can measure when milestones have been reached and end-points achieved. It seems every opening to a new episode of care comes with an implicit expiration date. Naturally, funders are eager that packages of care are limited and treatments don't extend on into days, weeks and months, and we seem to have accepted the inherent logic that care must have term limits. Time-limited care suits acute illnesses and injuries that are, by definition, … [Read more...] about New: Openings
For this post, we're linking up with Michael Rowe in South Africa and his excellent site /usr/space. Michael is a physiotherapist and educator in South Africa, with a passion for teaching and learning. He is an active member of the Critical Physiotherapy Network and a regular blogger on health care education, pedagogy and technology-informed learning. Earlier this week, Michael posted a blog exploring the possibilities of assessing teams, not individuals. Assessing teams instead of individuals Patient outcomes are almost always influenced by how well the team works together, yet all of the disciplines conduct assessments of individual students. Yes, we might ask students who … [Read more...] about New: Assessment