Brian Hohl MPT OCS
Today I was given a copy of a New York Times article titled “Treat Me, but No Tricks Please”. The article by Gina Kolata was written and printed on January 7, 2010.
The link to the complete article is:
My first reaction was naturally defensive. To read something you find so misleading and so poorly researched on a topic you have devoted years to is, to say the least, disheartening. I knew that I would be hearing about this article for some time so I wrote to Gina Kolata. This is what I wrote:
To Gina Kolata:
“You need a new Physical Therapist.
The same reaction to your article that my colleagues are probably expressing to you was the same as mine. Yet after a few moments I realized that this was actually your personal experience with Physical Therapy – and it does sound on the surface just plain bad. I can go on about the assessments that should have been done for you and the lack of communication between you and your therapist but by now you have heard all that. However, since you wrote and published on your experience and used that to lay doubt on an entire profession I feel obligated to respond.
Your implication that the standard of care within Physical Therapy is hot packs, ultrasound, and massage is just lazy reporting and its wrong. I would be remiss to have your readers believe this without injecting some basics.
Standards and Processes
First, Physical Therapy is a range of specialties. One former classmate is a pediatric specialist, the other works exclusively with women’s health issues, another geriatrics. There are several large divisions dealing with the spectrum of disabilities and ages of which I imagine you have no experience with. From your article you are referring to one such area – Outpatient Orthopedic Physical Therapy.
Good orthopaedic Physical Therapy is part investigation. Along with your physician, we determine the underlying cause of the pain, the weakness, or debilitation. Determining the best course of correction for you as an individual and for that particular fault is the next step. We implement the plan. Finally, we follow up to ensure that the prescribed course of action was indeed providing the intended result.
THAT is the standard of care. Every single day.
THAT is what every person who walks into any PT office should expect. Sometimes that means a single session or multiple sessions. Occasionally, there is not enough progress to warrant continuing care and a person is referred back to the physician. So as not to be misunderstood – not everyone gets all better.
Research and Justification
It is because everyone doesn’t “get all better” that we conduct research. People and the problems they present with can be complex and it is naive to believe otherwise. It is the complex nature and multiple variables which confound research methodology. It is this same complexity which makes unbiased and truly valuable clinical research difficult to produce quickly. The final result of all this difficulty is that clincial decision making advances slowly and methodically. One variable and one hypothesis at a time. It is not some large conspiracy to hide the profession’s secret knowledge of uselessness. Writing an article about the difficulty finding funding for the research you desire and want might be more useful to your readers.
Finally, from time to time products are presented to market that are just plain crazy. And yes there are Physical Therapists out there that have neglected and reject their ethics and now push “voodoo” products. Yet, the vast, overwhelming, and significant majority work hard every day helping solve real world physical problems – from head to toe and everything in between – for all ages. A great website to review next time is www.quackwatch.com. I’m sure you will have a legitimate field day finding VooDoo products.
Gina, I am proud of my profession and I am proud of my colleagues who share the desire to better our clients and patients. We will continue to see our techniques and efforts make difference. We will continue our research and we will always improve.
Good luck with your injury, hopefully you can begin to ask some tougher questions when it comes to receiving care. If you need some recommendations for the New York area let me know. I know many great Physical Therapists there.
Brian Hohl MPT OCS – Director of SportsMed/LA
To all my colleagues and professional friends – You do a great job, my research tells me so!