I often have patients that have had to stop training completely because of pain.
They’ve seen 2 Physios, 2 Chiros, had Cortisone and PRP injections and have stopped training because they can’t seem to get any long term change..
Sometimes it’s because the care has been substandard.. But other times, they’ve actually been doing all the right things, and still no improvement
Regardless, it always leads me to bear the brunt of the patient’s impatience at no fault of my own but then I’m required to help them pivot and create some epiphany-like moment where I can finally give them some hope by helping them make sense of their situation.
Practitioners that are overly evidence based create problems.
They create problems by not thinking laterally.
They don’t individualise management – (simply asking “why did this patient develop this problem?” would suffice.)
They disregard the simple fact that patients are irrational because they are in pain and won’t adhere to a logical framework built by a 25 year old Physio with an IQ of 145 and an EQ of my doormat.
Over the course of my career I have always been pushing to provide the highest level of evidence based healthcare.
What that means to me is providing patients with an accurate diagnosis and the management of that diagnosis based on the latest approaches found effective in the research.
An important part of being a Chiropractor is that your opinion and advice is reflective of what the evidence says.
So over the years a lot of patients and other professionals have called me their “Physio” and even a sports doctor told a patient that “He’s a Chiropractor but thinks like a Physio…”
I’ve been reading a lot lately about people differentiating between Chiro vs Physio almost like a healthcare ‘State of Origin’. It’s always a heated battle even though all the players are on good terms off the field.
As we delve deeper into research and providing evidence for therapy.. we’re all reading and applying the same stuff.
In fact, I had a Physiotherapist in an interview the other day who actually brought to my attention that there is now a study that has showed results that spinal manipulation (a Chiropractors handy pistol) does in fact provide long term results.
We are on the same team..
There are too many influential therapists out there that focus on what the research says ‘works’ as therapy versus what ‘doesn’t work’ as therapy in relation to any condition.
There are too many therapists that try to make healthcare black and white rather than appreciating that healthcare is a big grey mess. Patients will come in as unique complex machines with varying biochemistry and genetic predispositions combined with a varying mental stability and fortitude which could often be likened to Sydney’s current weather conditions.
If only we spent more time reading and learning about understanding why certain problems develop in the first place and then realise that we only need to restore what broke down rather than use only proven methods of pain relief.
What I’m really getting at is.. What do you do when a patient isn’t responding to what the evidence says should work? Practitioners need to think a little deeper about why the problem developed in the first place.
Truly find the cause. Not just the diagnosis.