What we do and what we don’t
At Kingsley Physiotherapy we support the use of evidence based medical and physiotherapeutic practices. So what does that mean?
When a treatment technique is first theorised or developed, (it may be a new surgical procedure, a new manipulative technique or a new medication) strict guidelines are in place that allow for standardised testing to validate and confirm the benefit of this new treatment. Just as drug companies must undergo extensive testing procedures before their product can be used on the market, other non-pharmacological treatments such as manual techniques or even surgeries must also be researched. These new treatments must be tested (to ensure the treatment is effective,) validated (reconfirmed and retested) and peer reviewed. This final process of ‘peer review’ is perhaps the most important. It means that other (knowledgeable and trained) people from the same profession (doctors, surgeons, pharmacists or physiotherapists) must be able to independently review and evaluate the merits of this research. Think of it as having the best people in the business double checking and scrutinising your work. It’s a long and often tedious process but it goes towards ensuring only proven, safe and reliable treatment options are offered to patients?
Do all health professionals provide treatments based on evidence?
The short answer is ‘no’. Physiotherapists in this country are governed by the same rules and regulations as doctors. The Australian Medical Association dictates these protocols. Dentists and Veterinarians are in the same boat – we cannot advertise on television (let alone show our face), we must abide by the same Hippocratic principles of patient care and we cannot make claims that are unsubstantiated or coercive. Many other complimentary practitioners are not required to produce evidence to support their treatments (Acupuncturists, Naturopaths etc) and this often allows for huge discrepancies of practice between these health professionals. Your health care professional (doctor, dentist, physiotherapist, chiropractor or naturopath) should be able to detail the amount and level (quality) of evidence that supports the treatments they are implementing or the advice they are giving. Learn to ask questions of your health professional.
Are all physiotherapy treatments based on evidence and research?
Unfortunately not. Whether your physiotherapist chooses to use only validated and substantiated treatment methods is entirely up to the individual clinician. Just like your GP can suggest you try homeopathy, Reiki or even magnetic therapy (all of which have been researched and proven to be ineffectual), your physiotherapist is (sadly) not obliged to strictly adhere to evidence-based therapies. All healthcare providers however are obliged to tell you if the treatment method they are using has not been clinically proven.
Unfortunately, treatments like ultrasound, laser and acupuncture are still widely utilised by physiotherapists in this country and have little or no evidence to support their use. In fact in the case of ultrasound and laser, there is a mountain of evidence that shows these treatment techniques do not outperform placebo interventions. Here is a link to the Australian Physiotherapy Association and to several research databases which outline these research findings.
An additional word of warning. Be cautious of any healthcare provider (irrespective of their discipline) who uses phrases like: “Many people find this treatment helpful”, “This treatment doesn’t work for everyone but it may be worth trying”, “You have nothing to lose by trying this treatment” or “Many of my own patients swear by this treatment”. Such generalised, global statements without specific reference to fact or research can be very misleading and can imply legitimacy where none exists. Also, be extremely cautious of practitioners who use terms like “toxins”, “energy”, “healing”, “power” or “wellbeing”. These are wishy-washy terms and are often bandied about by people who lack a deeper understanding of pathology, physiology, biochemistry or physics.
Kingsley Physiotherapy and evidence based medicine
We are proud to be one of the very first clinics in this country to ban the use of electrotherapy (electrically based treatment modalities such as laser and ultrasound). We believe that in addition to there being very little evidence to support their use, (and often considerable evidence to the contrary,) there is ALWAYS something more beneficial that can be done to treat a patient. We believe that a knowledgeable and experienced physiotherapist should have numerous (and substantiated) treatment options to offer their patients and should never resort to placebo interventions. We are hopeful that other clinics will follow our lead by discontinuing the use of such treatment modalities in their businesses.
What can’t we treat?
At Kingsley Physiotherapy we believe that what makes us so good at doing what we do, is knowing what we can’t. Imagine how refreshing it would be to go to your doctor, your mechanic, your builder or even your lawyer and have them tell you up-front that you would be better to see someone else who is more experienced or better suited to manage the type of problem you have. We believe that this sort of professional honesty is imperative to providing you with the best possible service. Our physiotherapists are well trained and experienced in treating the many musculoskeletal disorders and injuries that present to our clinic every day. They also know what medical and surgical options are available to you and will discuss these with you especially if they are cheaper or will hasten your recovery. But above all, our therapists have an array of specialist referral sites – surgeons, physicians and even other physiotherapists – who have the expertise and knowledge to help you when the service we provide is simply not enough.
If you have any further questions, or you would like to contact the physiotherapist best suited to managing your problem please call oremail us. Alternatively, why not try our online e-Consult service? It’s free and can help you decide if physiotherapy is right for you.