Perhaps the greatest mind in the entire history of the world - well in my estimation anyway - once argued that it is the the things that are the most obvious and seemingly benign that we should focus all of our critical attention upon, because these are the things that are doing the best job of concealing the immense power that allows them to become so seemingly obvious in the first place. (If you hadn't realise already, that man is Michel Foucault). Well of all the seemingly obvious, taken-for-granted and largely unchallenged ideas currently pervading physiotherapy, evidence based practice must surely be one of the most obvious ideas needing critical scrutiny. Fortunately, a few … [Read more...] about Is it time to end the tyranny of evidence based practice?
The Australian Physiotherapy Association (APA) recently pronounced that six interventions commonly used by physiotherapists are useless and were no longer being supported (link). As part of the Choosing Wisely initiative, the APA has decided that requesting imaging for certain instances of non-specific low back pain, cervical pain, and acute ankle trauma; plus the routine use incentive spirometry after upper abdominal and cardiac surgery, electrotherapy in cases of lower back pain, and manual therapy for patients with frozen shoulder, are all now discouraged. There are some interesting aspects to this decision that warrant some more thought. Firstly, there is the … [Read more...] about Six useless treatments
This post comes from CPN member Carley King. Carley is a physiotherapist who has developed an interest in evidence based medicine during her Masters in Clinical Research. Here Carley reports on the recent debate on the value of Evidence based medicine at the CSP Congress. Spoiler alert: I’m not sure that evidence-based medicine (EBM) as we understand it at the moment is fit for purpose. That’s my bias out in the open! But on hearing this opening line, I couldn't help but allow a small part of me to wonder if it was ridiculous to even consider an alternative...a very clever debating ploy there! As the debate progressed, it became clear to me that there were some key issues … [Read more...] about Evidence based medicine: why are we even debating it?
One of the inescapable realities of modern life, or should that be post-modern life, is that we have all become skeptical of authority figures that want to tell us that they know the answers, and that we should follow them compliantly, passively and unquestioningly. There once was a time when people genuinely believed that the church, judges, the police, school teachers, parents, doctors and other authority figures genuinely knew best, but our trust in these authorities has been eroded by scandals, self interest and injurious practices. And while some of us yearn for a simpler time when the world was black and white, we can’t erase the image of child abuse by Catholic priests, medical … [Read more...] about New: Truths
We can already hear the objections. The term fascism represents an emotionally charged concept in both the political and religious arenas; it is the ugliest expression of life in the 20th century (180). Not my words, but those of Dave Holmes and Stuart Murray in their fabulous paper Deconstructing the evidence-based discourse in health sciences: Truth, power and fascism. The author's argument is that we desperately need to unmask the 'the hidden politics of evidence-based discourse' (181). A recent Australian report on the efficacy of homeopathy (link) has shown that "There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health … [Read more...] about Evidence-based medicine or micro-fascism?