What happened in "Pain Factory" was no surprise
Shane Guna
I help physio clinic owners create purpose-driven practices | Physio Business Coach | Profits Course (see "Featured") | cultureofone.com.au
The thing I can’t get out of my head is the documentary aired on ABC on Monday night.
Pain Factory , is an incredible story by Adele Ferguson.
It spoke to a lot of things, the biggest being that we are still a long way from an ideal health space.
And as physiotherapists, we are still a long way from where we want to be too.
That is at the forefront of the conversation on musculoskeletal (MSK) pain.
In particular, chronic and persistent pain.
It’s an area which is sparsely populated with solid, unequivocal evidence.
Consequently, it remains the most challenging area within MSK.
Those lurking in the shadows
What ‘Pain Factory’, showed was some sinister things out there.
If people are struggling, there will be practitioners happy to take their money.
And the insane promises that go with it.
"Someone comes along and says, 'Trust me, I'm a doctor, I'll take your pain away', you would believe them.".
Only to leave them high and dry.
And sometimes substantially worse off.
Not just scars to prove it, but medico-legal cases to follow up for years.
Or even worse still… the outcomes are as bad as the imagination can take.
If this isn’t the sort of thing that galvanises us as physiotherapists, I’m not sure what would.
Better practices for better practitioners
For starters, we all ought to stop bickering over who does what better.
And start getting behind each other once and for all.
We are going deep into an era of ageing population and persistent pain.
This is bread-and-butter stuff for physiotherapists.
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And our industry needs to step up to this challenge.
It’s one thing to be churning out graduates like nobodies business.
It’s another to be able to retain them in the profession long enough that they can actually make a difference in people’s lives.
When I ran my practice, it was incredibly important to me that I setup my graduates for long careers.
That they left my clinic as better people and better practitioners.
That they had a focal point, a direction to move towards.
And that they would take the best of the profession along with them.
I’ve since worked with several business owners who share this sort of passion.
The rise of the physio first era
Physiotherapy has been good to many of us, providing us an occupation.
Enabling us to setup businesses, and live our lives based on this practice.
What we do as physiotherapists still has so much potential.
And there is so much upside for the community as we continue to push ahead.
We have all seen some of the incredible outcomes we achieve.
We’ve all witnesses the transformations first hand.
And when it comes to our role in primary care.
We ought to be shouting about this from the rooftops until no one can say otherwise.
Shane Guna is the Founder of Gun Physio Academy .
He writes about leadership, personal development and commercial skills for physiotherapists.
When you're ready, here are some ways I can help you.
Retired
7 个月There is growing evidence for a biopsychosocial education and meaningful activity approach to helping people with persistent pain. There are considerable challenges from both within and outside the profession for adoption of this approach including under-graduate and post-graduate training; time and funding challenges and resistance to change. Things are gradually changing though, just slowly. Complex systems at play. Unequivocal evidence as you put is very tricky in the health space due to competing interests but also due to the variability of human beings and hence responses to interventions.
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7 个月Such an eye-opening documentary! Chronic and persistent pain is indeed a complex area in physiotherapy. Keep pushing boundaries! ??
Primary care physiotherapist with a special interest in chronic pain management
7 个月While I definitely agree with your comments that pain presents an opportunity and need in the physiotherapy space, the evidence surrounding pain repeatedly shows that a multidisciplinary, biopsychosocial approach to pain is critical for long-term success. We should be investing in establishing clinics aimed at meeting this need rather than persisting with our outdated model of single-disciplinary clinics and biomedical approaches. It's not about who does what intervention better, it's all about learning the specific drivers of the patient's pain experience and targeting them. The challenge is going to be creating spaces and clinics to facilitate this collaborative approach to practice.
Key Account Manager at IQVIA MedTech
7 个月As someone who has experience in allied health treating chronic pain patients, education and medical devices for chronic pain management, I can say that this topic brings up a range of agendas and biases. Eg private health insurance complains about the cost of surgical devices and hospital stays but doesn't fund allied health management optimally. If you have gold cover you can get a $50k spinal fusion or stimulator surgery but would be lucky to get $1000 of partial reimbursement for allied health treatment to manage the same condition. Physios and allied health will then point to studies and reviews showing low effect sizes for procedures like spinal fusion or SCS without addressing the limitations of these studies, and then typically ignore the studies showing low effect sizes for common interventions like manual therapy and exercise for pain. Surgeons and interventional physicians will often cite poor outcomes from rehab and conservative care are the reason patients see them, while ignoring the patients that don't get good outcomes from their procedures and end up back in conservative care, or worse, doing nothing. These are generalisations based on my experiences, not facts. I think a way forward is better collaboration.