physiotherapy or physical therapy

Has the time come to change the term for physical therapy within the UK , Canada and Australia to physical therapy? In using the term physiotherapy does it not come with a heap of baggage and assunmptions which are no longer valid or are totally out of date? The term physiotherapy was adopted within the days of the British empire, and has many unspoken values and assumption associated with it. It would be interesting to find out what images the general public get when they hear the term "physiotherapy".

physiotherapy blog

Here's a confession. There's more than 1 blog run by me, the original idea was to provide different aspects , so having a serious one, a fun blog and another with a different perspective. The trouble with the idea is the amount of material it takes to run just 1 so I suspect at the moment I'll only do occasional posts on this one. If you go to the "confessions of an NHS doctor" blog listed on physiotherapyblog your will see how much work goes into writing a really popular blog. It's more like running a magazine. maybe if activity picks up I'll revisit the idea of having 3 blogs doing different things.

time pressure

Do you find that most of the time at work you're juggling what you're doing to get everything done? There's never enough time and there are always patients who interrupt admin time with questions that are so important to them but to us really could have waited to a more convenient time. I has one such interruption today , a patient asking about where she could get different splints, in the middle of me sorting out important e mails. This is something of a clash of priorities, many members of the public would think that "paperwork" is unnecessary but often it forms a vital part of communcation. It's the statistcal paperwork which is the real bind. because we're professionals we're polite and intersted in the trivial problem, although last week I drew the line when a patient wanted to talk about something fairly minor when I was in the middle of a new patient assessment. Sometimes i wish i could hide but like many work places the building design does not allow for that.

reorganisation continued

The NHS reorganisation machine continues to grind on and news out todays reports 100 job losses in Warrington. I can't understand why the health unions are so quiet about all this. The NHs looks to be in the greatest crisis ever but very little protest seems to be going on. Somewhere in all this the local political wrangling is being overlooked, not wrangling between unions but between NHS managers at local level as in the middle of the crisis they are trying to carve out empires or protect their existing empire. It's hard to know how our responses will be judged in the future.

NHS reorganisation

This is the blog today of one person who is getting really tired of NHS reorganisation. The last 12 months where I work there has been nothing but change and I just heard today of yet more change on the way. At work it would be so good to be able to think further ahead than the next few months, but at the moment it's impossible to think long term. It seems that our heyday has now passed and that from now on at least within our profession within our locality our existance is being threatened. And I'll reveal the cause of this. One of the biggest driving forces is not at present the Government (although they hold ultimate responsibility for the terrible state of the NHS) but political wrangling at a local level as different managers seek to build their empires since the NHS changes of the last 12 months [especally PCT changes]. It's down to managers trying to gain control of budgets irrespective of what is best for patients and disregarding the brilllant services which have been developed. And yet the very managers doing politics at local level are one of the perpetual failings of the NHS, that the NHS breeds overpaid empire builders whose existance is totally unnecessary yet who hold sway over large numbers of highly dedicated committed health professionals.

server error

Ok I'm having a moan now for the reason I said earlier but I can do without the Google server errors when I am posting the blog! I really don't think there is the need for everything to go into the blog twice

physio work pressure

There's no news I want to report and i don't have any opinions today as work has been really busy. It's a nice idea about having our set lunch breaks but in reality many times it's impossible through meetings, having to use the gap to catch up with admin or because something unplanned happened and we just can't turn our backs on it and walk away. Phone calls are often the worst thing for this. Don't you just hate them? The patient phoning up with the impossible enquiry about something that matters so much to them but all you want to do is tell them to shut up because you're tired, hungry and longing to sit down. The other time that these dread calls comes at the end of a shift when you are wanting to go home and you have to spend 10 minutes talking to Mrs Smith or her relative when all you want to do is go home or get to the mall before it shuts or anything but stand talking about something which to us is just routine but to the caller is something massive. And what about the thing so important in Britain the tea break (although i hope you realise that most of the world does not share the obsession for the brown liquid) . Forget it's national importance as an institutaion once you start the job as a NHS physio; yes maybe you'll get the tea but you certainly won't get the break. However, something I've noticed is that my last statement is not entirely true. Some physios always seem to have breaks, usually those who do not have a set appointment system.

physio work pressure

There's no news I want to report and i don't have any opinions today as work has been really busy. It's a nice idea about having our set lunch breaks but in reality many times it's impossible through meetings, having to use the gap to catch up with admin or because something unplanned happened and we just can't turn our backs on it and walk away. Phone calls are often the worst thing for this. Don't you just hate them? The patient phoning up with the impossible enquiry about something that matters so much to them but all you want to do is tell them to shut up because you're tired, hungry and longing to sit down. The other time that these dread calls comes at the end of a shift when you are wanting to go home and you have to spend 10 minutes talking to Mrs Smith or her relative when all you want to do is go home or get to the mall before it shuts or anything but stand talking about something which to us is just routine but to the caller is something massive. And what about the thing so important in Britain the tea break (although i hope you realise that most of the world does not share the obsession for the brown liquid) . Forget it's national importance as an institutaion once you start the job as a NHS physio; yes maybe you'll get the tea but you certainly won't get the break. However, something I've noticed is that my last statement is not entirely true. Some physios always seem to have breaks, usually those who do not have a set appointment system.

charging for the NHS

Prescrition charges are going up again . The idea of free healthare at the point of need no longer applies to the NHS on many points so maybe it's time to be more honest about it and make the payments more open rather than having to pretend. The idea of a totally free healthcare system is very nobel but what I've seen in the NHS over the last 18 months makes me really start to think about the advantages that private care could bring. We are told that over the last 2 years the system has seen the biggest investment of cash in its history but as an insider I can see no evidence of this at all. Working in the NHS means that every day there is no spare money for anything including training , upgrading building or new equipment. The NHS in general and physiotherapy in particular is dependent on charitable donations and penny pinching to survive. Because we're coming to the end of the financial year I know of a reliable account of one service where the staff cannot order any stationary until April. I can remember being in the situation in the past where this happened and we could not have any more pens for a few weeks. Anyone working in industry would not believe this happens. Training is another thing. I've been on courses where staff were paying for it themself and doing it in their own time. Everyone knows when it comes to job applications that courses give the applicant an advantage [although job intervies are becoming a forgotten event in the current NHS]. Why should NHS staff have to pay out of their own money to do their jobs? Isn't it time to speak out about the hidden descrimination this creates by favouring those with larger disposable incomes and descriminating against those who cannot afford to do this?

media misinformation and health

An intersting bit of information has just made its way into the media. Copenhagen University has published a study that suggests the use of certain vitamin supplements actually shorten a person's life. Not the sort of unhealthy thing you'd expect when you buy vitamins. However there's a big problem when it comes to the media reporting health. This is typical of the fromt page hyped up story the media love offering lots of short term interest but lacking in substance or serious discussion. The media are the greatest barrrier to successful health promotion because their cherry-picking approach gives a really distorted view of what constitutes a healthy lifestyle. For years there has been promotion of cutting fat and sugar in the diet but a total failure to address the needs for high calorie intake amongst those who are not doing sedentary jobs. Like I once hear said you cannot expect someone who does heavy manual labor to exist on lettuce, but that's exactly what you'd expect if you belive the unbalanced view in most of the media. Things go from bad to worse with the media's image of healthcare which according to them is provided only by doctors and nurses. Never mind the rest of us without whom modern healthcare would collapse overnight.

violence and physiotherapy

There's a lot in the news about violence to NHS staff and tonight the BBC is running a documentary about it. I wonder if it's something that physiotherapists face very often. Perhaps it's more likely to happen in certain clinical areas? Emergency room (A&E) work carries a much higher risk but it tends not to be some where that physical therapy goes on. Mental health is another high risk area but again not one which attracts much physical therapy at least in the UK. If there's a hunt for violent incidents should we be also including the occasional thump from a confused patient or is there some way of classifying it? Is this all being thrown in together to distort the view? Any sort of threat is horrible. I was threatened by a patient's partner for supposedly making the patient worse but with hindsight it became clear that the patient's decision to seek treatment and the partners' reactions were all part of some complex game they were playing within the relationship. I had innocently stumbled apon this but became the object of the aggression. Not nice.

money down the drain?

The London Olympic Games are going to cost loads more than originally though, the sum of £9 billion being quoted and rising. I want to know who is going to benefit from this money? This sort of investment would be a major boost to the NHS and imagine what this sort of money could achieve if put into healthcare research. After it's over all that will be left is a massive area of sports facilities in London which will be of no use to the rest of the UK. All this talk of concern about the environment is rubbish because building the Olympic village will have been achieved at significant environmenal cost both in terms of the materials used, the impact of transporting those materials and the resultant travel required to host the event. Food for thought. In the long run it will be interesting to see if the land being used will be sold off for domestic housing because of the lack of demand for a big sports complex. Will this be a repetition of the poor planning evidenced in the situation with the Millenium Dome?

priorities and physiotherapy research

It said in the news that there's been a switch of funds from research to paying to keep firms going like Rover. This makes me really angry . The UK needs research to support its future. But this is not the full reason I feel angry. 10 years ago I had a passionate interest for physiotherapy reaserch and I went on and did some. However, as time has gone on my interest in research has slowly dwindled away not because I think research is boring or unimportant (I think the opposite on both points) but for another reason. Where I work research is not a priority, and in my appraisals any mention about wanting to do research get treated as a optional extra that I can do myself if I want to but not something which will be supported. Over the years I've become tired of the lack of opportunities and support for an activity which requires significant amounts of one's own time; if I am willing to give up my leisure time for a work related activity why should I have such a struggle in getting it recognised as a priority? The situation at work is also a reflection of the Government short sightedness in cutting research investment to bail out failing businesses. The NHS these days only seems to be concerned about counting costs and has lost sight of long term priorities. It lives for the next financial year and short term local political objectives. Politicians only want to talk about the immediate, the here and now. I think this is a threat to the future of physiotherapy because with so much of physical therapy needing better proof that it works, in the future politicians might justify cuttting physiotherapy services because there is no proof that do what they think they do.

motivation and physiotherapy

One of the major things which is a factor in a patient's recovery is a deep rooted ability to motivate themself. What I am talking about here is the fact that some patients seem to lack the ability to aim towards a goal and then keep going until they have achieved it. Presumably all patients have some motivation to get over a health problem otherwise they would not have comsulted in the first place. What some seem to lack despite encouragement, explanation and persuasion is the ability to help themselves. This will be associated with an endless number of barriers and excuses as to why they cannot make the necessary changes which will help their health improve. The bottom line is that they have an outlook which is very similar to a young child who on the one hand wants something but lack the emotional maturity to understand the requiremets on themself to gain what they desire. For these emotionally immature individuals the greatest attraction in physical therapy is the "passive quick fix" where all they have to do is lie there and the clinician will solve the problem but rarely are they able to become an active paticipant because this would require them to accept responsibility for the health problem rather than blaming it on someone or something else.

patients and their problems

Over the years I've seen load of patients who have problems with clicky joints and there seems to be a widespread anxiety that clicking indicates some other form of serious pathology. As a rule I'd say clicking falls into a number of groups, "benign" intermittent clicking caused ,we are told, by gas formation. This is the sort of click when your knees pop getting up. There's the benign muscle click, which is usually a different sound and feels different on palpation, again unually harmless. But there are some "pathological" clicks. There is the click arising from torn "cartilage" structure as in knee meniscal tear, a labral tear in shoulder or hip. Then there is the click arising from a muscle tear as in rotator cuff. A final one is the click from damaged or altered joint surface as in OA or RA. In addition to these there can also be clicks associated with fractures as the result of high velocity injury. So why have I put this in the blog? Last week there was a BBC programme which showed someone asking a doctor about the problem. In the last few days a queation appeared on an internet questions site which I regulary visit. The answers to the internet questioner reminded me about the general level of ignorance about this.

patients and their problems

Over the years I've seen load of patients who have problems with clicky joints and there seems to be a widespread anxiety that clicking indicates some other form of serious pathology. As a rule I'd say clicking falls into a number of groups, "benign" intermittent clicking caused ,we are told, by gas formation. This is the sort of click when your knees pop getting up. There's the benign muscle click, which is usually a different sound and feels different on palpation, again unually harmless. But there are some "pathological" clicks. There is the click arising from torn "cartilage" structure as in knee meniscal tear, a labral tear in shoulder or hip. Then there is the click arising from a muscle tear as in rotator cuff. A final one is the click from damaged or altered joint surface as in OA or RA. In addition to these there can also be clicks associated with fractures as the result of high velocity injury. So why have I put this in the blog? Last week there was a BBC programme which showed someone asking a doctor about the problem. In the last few days a queation appeared on an internet questions site which I regulary visit. The answers to the internet questioner reminded me about the general level of ignorance about this.

job vacancies

Where have all the Uk physiotherapy jobs gone? What i ope to do in the future is time permitting provide a review of jobs published on the internet, sound a tall order as it would take a lot of time reviewing thing but i might start to review the official NHS site. In view of the lack of jobs it sould not take too long!

physiotherapy blogging

This is a new blog and I want to do a number of things through it. Yes I want to share my expeiences of working in physical therapy but I also want to discuss bigger issues about life the universe and everything. And I'm keen to share good websites when I find them There's so many round that it's hard to know where to go.

So to start with work experiences, we all have those situations which stand out in our minds, like the first day in the job. One of my first days i remember because one member of staff refused to speak to me for a week because she thought I should not have gotten the job. The best first day was when I was first qualified and could finally make my own decisions. It not easy talking about patients because we're not allowed to make personal details public ,but as time goes on I'll share some of the experiences without giving away personal info.

Bye for now

more websites

Just to help you in your musings here is another website wich hassome interesting links-it's a bit basic and home made but leads to some useful sites

www.shortal.com/physiotherapy

starting a new blog

Ok a new blog. What's there to say different from everyone else out there? I'd like to have a site which not only describes what I'm feeling but also to provide information which is useful. This wil be sources of online information. So for starters try the following

www.copac.ac.uk online library search facility
www.health.library.mcgill.ca online library McGill Uni, USA
www.nelh.nhs.uk/home
www.rdinfo.org.uk sources of UK R&D funding

bye for now!