Professional conduct

[proud]

So I'm out with the family the other day. I was with my wife taking our daughter to her ballet lessons. We run into another mom and we spark up a conversation. She is a fellow PT working at a private practice in town. Naturally, I engage in some basic "how are things going" discussion.

"Great" she says. Caseload is full. Can barely keep up. She is very excited to be working with a guy in town( a guy I know a bit about....exclusively CST). She is being mentored by him and "learning so much from him...."

She is doing CST.....

So there I am....nodding politely. While inside I want to ask her what she is thinking. But alas...we are out in public with my wife by my side. I say nothing except; "that's great"

Still though, I feel it would be the responsible thing to do to expose the truth about CST to this lady. I mean...perhaps she has no clue?

What do/have others done when faced with this little situation?

[Jon Newman]

I stopped going out in public.

[EricM]

Jon, that's the funniest thing I've heard in ages.

[Jon Newman]

It was meant to be funny but it's also sadly true, at least in part.

[mrupe82]

Cranial-Sacro Therapy huh?
So what is that again?
You can actually feel cerebrospinal fluid move and flow with breathing?
Have you ever had someone who's flow was in line?
How is it you get it back 'in sequence'?
You touch their head and stuff?
The skull moves around?
Have you ever been to www.somasimple.com?
No?
Yeah, there are lots of PT's, and a few osteopaths that would love to help you out and really give you some good information. They are from all over the world, it's a great resource with loads of research.

If that mean ol' John W. starts yelling and scaring at you......(Just joking John, I'm still chuckling about the last chiro that introduced himself here).

[BB]

When it's somebody I know I've sent out links or recommeded an article. Of course my not slobbering all over myself to tell them how great it is that they've found the legendary "easy button" usually stops the conversation in its tracks.

I think Jon's approach makes the most sense.

[Barrett Dorko]

This problem is simply not solvable.

It's why so many here are dead, and proud, welcome to the club.

Unlike Jon I still go out in public.

I just don't talk to any of my fellow PTs out there.

[Diane]

Yeah, it's best/easiest to become a bit of a recluse.

Somewhere around here we have that New Zealand study in which 13 rabbits were killed to prove that skull bones don't move.

[proud]

I'm out about a fair amount. My wife and I have a fair number of friends in the PT community( my wife being a PT as well). My wife works with the elderly in their homes so is not all that interested in anything other than mobility related issues.

I run into this a fair amount and in the past I would dive into a tirade....it became known to me latter via my wife that I was not well liked. A know it all of sorts....

I like the idea of telling people about Somasimple or another site I go to....but no one reads!

I work with a PT who has taken all the available "ortho" course available( what is it in the USA?...NOAIMT?).

Anyway...I bring research articles to work almost daily. I read them the night before. I was promptly informed that she "does not have the time to read articles".

Odd I thought.....is PT the only "profession" where the idea of remaining current is not a welcome one?

Geesh.

[Jason Silvernail]

Senseless bunnicide - insert standard vegan expression of displeasure.

I find Corys approach of just acknowledging what they say and ending that part of the conversation sends he best message. When pressed I just say that I'm glad it's working for them and wish them the best of luck.

[nari]

.....is PT the only "profession" where the idea of remaining current is not a welcome one?

The operative word here is 'current'. To the considerable majority of PTs, being current is being up with the latest ortho-based concepts; the 49 ways to deal with LBP and knee pain, etc. Which doesn't mean it's all that 'wrong', just inefficient and inaccurate perhaps.

I avoid making any useful comments in public; just bland noises like "hope it works" or "it might help". A person's choice of therapy styles is theirs, whether through ignorance or sheer preference. However my family shouts me down and they are far more tricky than the general public to manage.....

Nari

[proud]

Yes Nari....I agree. That's why I chose the word current. My PT collegue could tell you every ortho technique under the sun...but no clue as to "why" the technique would be chosen or even work.

[proud]

I actually thought of a way to respond...

I once contacted our College to ask how I could work towards having CST banned from being billed as PT( It's true).

So I could have said: 'Oh, CST...yes, I tried to have that bunk banned from being billable as PT. Glad your doing well with it though. Good on ya...."

How's that?

Oh ya....that's the kind of behavior my wife informs me results in people not liking me so much....

[John W]

Proud,

You must be my long, lost Canadian twin:
1) My wife is a home health PT.
2) My daughter takes ballet lessons (she's 7)
3) I used to think that I wasn't well-liked in PT circles, but it turns out that I'm just considered a bit weird, opinionated and troublesome (in other words, as Barrett reminded us, "dead").

I also use to work with a PT who was big into the whole CST thing. We were doing this marketing gig for a group of dentists who were known for their work with TMJ patients. She started going off on all of her training in CST and how beneficial it is for TMJ. I was leaning against the counter sipping my coke as she waxed on.

When she was done, partly to preserve my conscience and partly due to the fact that I assumed these were well-educated, rational professionals, I made some subtle disclaimer about the lack of research evidence of the craniosacral rhythm but indicated that some of the techniques associated with CST did seem to have some benefit for patients with TMJ.

Well, the ride home was not so pleasant. She was incensed that I had had the gall to actually question the validity of CST, and, I guess, show her up in front of the dentists. I tried to explain that I didn't want them to think we weren't science-based practitioners, but she didn't seem to care too much about that.

You also, I suspect, are doomed with such people. Welcome to the club.

Jon,

I must ask: Which part of you goes out?

[Barrett Dorko]

Some of the companies that offer one course after another literally "guilt" the students into completing the series though there's no evidence they learn anything that can be defended with evidence or a theory some here could accept without sharp questioning.

But the therapist now has something to brag about, tell others, hang their hat on and discuss with others also infected by the meme they've chosen. They've been abducted by aliens and aren't about to be talked off the mothership. At most, I nod their way. Friendly waving is too much for me.

Of course, you can always say, "It doesn't sound like you've taken a series of courses full of rational information that has made you some sort of special therapist. It sounds more like you've taken part in a pie eating contest."

Good luck with that.

[Frédéric]

Bringing up the subject with fellow PT's has usually gone, well... no so good for me. The discussion usually ending quite abruptly. I am trying to convince myself I will stop bringing it up with PT friends of mine or else, I will end up with very few friends.

[tim St. Onge, D.C., L.M.T.]

Hi, I was surfing the web and ran across this website and found it interesting so I thought I would get into the mix.

[Stuart]

I find it interesting that you list your massage therapy certificate after your chiropractic degree.

[John W]

Tim,

Before you "mix it up" here, you might want to introduce yourself in the Welcome forum.

Trust me.

[Jon Newman]

Originally Posted by John W

Jon,

I must ask: Which part of you goes out?

The anxious part mostly.

[BB]

I am trying to convince myself I will stop bringing it up with PT friends of mine or else, I will end up with very few friends.

Not a bad idea.

For my part, I think most of the several PT friends that I have have begun to realize it unwise to bring up such crap around me since I'll likely kill the conversation that they desired to have anyway. So, that's good for our friendship.

[John W]

The anxious part mostly.

You'll have a hard time expanding the gene pool that way.

[Jon Newman]

I'm afraid I've relegated myself to the meme pool anyway but the same applies. I'm working on it. I read a book.

[Bas Asselbergs]

I can relate, proud, like most of us "dead men" here. Polite. That is what I am.

Until I get asked straight out: "What do you think about that?" (CST, MFR, or manipulation for otitis media etc etc). The I tell them "Well you asked, but do you really want to get into that? Because I am very much in favour of much more scientific approaches".

I have TWO PT friends here in town - one who really gets it, a convert of mine (yes!), and another who does not really talk about PT when we're together.

For the rest (a lot!), I am a weirdo.

[estherderu]

I have solved this "problem" with a counter question namely...

Do you really want to know?

In more than half the cases, people do say no and thats the end of that conversation.

Esther

[emad]

To me the paradigm in practice is like belief.
cheers
Emad

[nari]

The other real difficulty is that people don't care much about evidence - many PTs included - only if a method works for them.

By evidence I mean not how many (dubious) clinical papers have been published, but the evidence that something works because of the evidence of neurophysiology.

Nari

[tim St. Onge, D.C., L.M.T.]

Nari, If somebody has a history of a treatment "working" isn't that evidence.

[Barrett Dorko]

May I Nari?

Tim,

No.

[nari]

Tim, any treatment may work well for a percentage of people due to many complex factors including of course the placebo response.

What needs to be considered is the most simple, efficient and effective method to deal with the majority of patients on a long term basis without requiring regular visits. However, I would stress that no one concept works well for everyone. We're too complex a species for that outcome.

Nari

I just read Barrett's post which was posted simultaneously. Tim, have a good look around the site for 'evidence-based' or similar phrase.

[John W]

If somebody has a history of a treatment "working" isn't that evidence.

It's anecdote and, therefore, non-evidentiary.

What many of us decry here, Tim, is that too often conservative practitioners utilize the "well it works" justification for just about anything under the sun that they'll do to a patient.

The consequence of this has been an acculturation of the masses to a need for some kind of "treatment" for just about everything.

We've come up with all kinds of fancy terms for these ailments, too, like "subluxations," "myofascial restrictions, " "trigger points," etc., with a matching treatment to "correct" the problem.

I've heard it referred to here as "perceptual fantasy."

[Diane]

John, you forgot conceptual hallucination.

[paulingraham]

Originally Posted by proud

What do/have others done when faced with this little situation?

(Jon’s original reply: laugh of the day. Maybe the week!)

My much less pithy/witty answer to this important question ...

I generally do not waste my time with ideologues. If I realize I’ve fallen into that trap, I simply scramble out of it ASAP.

As a skeptical activist, my communications efforts are reserved for fence-sitters and casual believers — the only place I really have a hope in hell of accomplishing anything. In every interaction where questionable interventions are trotted out for consideration, I ask a few probing questions to figure out where they are on that spectrum. A few questions are all that’s needed to establish it beyond a reasonable doubt.

If it’s apparent that a person is heavily invested in their beliefs, I mostly veer away. (Occasionally I will fire a warning shot across their bow, for the same reason that I am inclined to publicly challenge racism.)

But if I’ve found a fence-sitter, I dive in, mostly using the socratic method. Don’t tell them that they’re wrong or tell what to believe: ask them how they know what they know! Just ask. “Do you think it really works? Why? How do you know? How do you know that?”

Above all, I am nice. It was “nice” skeptics that got to me, people that won me with both brains and decency. I try to do that.

Then I press a copy of Demon-Haunted World into their hands like a bible, look deep into their eyes, and intone the sacred words, “This book will %$@!@* rock your world.”

Cheers,
Paul

[tim St. Onge, D.C., L.M.T.]

[QUOTE=mrupe82;79280]Cranial-Sacro Therapy huh?

You can actually feel cerebrospinal fluid move and flow with breathing?

What, you can't a feel a 2-5 mmHg pressure wave through 1/2 inch of tough, fibrous connective tissue and another 1/2 inch of bone... you just need to work on your palpation skills that's all.

[tim St. Onge, D.C., L.M.T.]

Sorry but can someone tell me how to do that quote box thingy. My sarcasm didn't look so sarcastic.

[nari]

Tim

Highlight the text you want, copy and paste into your new post, then hit the quote thingy - the square yellow bubble next to the hash sign in the toolbox under 'title' and 'message' and highlight your transposed text.

Nari

[Bas Asselbergs]

Tim, no worries - sarcasm got through fine.
Not very nice though: Upledger has spent so many years perfecting this technique, after he discovered this rhythm while holding the dura while assisting in brain surgery. He has taught tens of thousands of therapists, so he MUST be good.

About CST: I have tried to talk with an MT who "interacted with dolphins in a therapeutic way". It did not work - she was only interested in speaking to others about her fabulous and enlightening experiences. Any even carefully worded question was met with: "Trust me, you need to do this yourself".
And that shuts me up. I can't say anything after that without swinging heavily into more pointed questions or even sarcasm or snideness

[tim St. Onge, D.C., L.M.T.]

"interacted with dolphins in a therapeutic way".

Thats really funny. How do you interact with a dolphin in a therapeutic way. It seems that a fish that can kill a shark would scar the pee out of me if I was interacting with them in close enough a proximity to produce a "therapeutic effect" But then I don't swim well.

[tim St. Onge, D.C., L.M.T.]

Nari, Thanks for the help. You give good instructions.

[Diane]

Originally Posted by tim St. Onge, D.C., L.M.T.

Sorry but can someone tell me how to do that quote box thingy. My sarcasm didn't look so sarcastic.

Another way, is to click on "Quote" right beside were it says "QR" and "Edit".
The entire post you want to quote from, including identity of poster, will appear in your writing window. You can take out what you don't want to reply to, but do not delete that final "/ QUOTE" or you will lose the quote box.

[tim St. Onge, D.C., L.M.T.]

Originally Posted by Diane

Thank you Diane.

[smith]

Well at least the PT isn't actually paying $$ for the training. She's smart in that regard.

[Bas Asselbergs]

Ummm no, smith. The MT (if we are talking about the same post here) did pay BIG bucks to be in the pool with dolphins and the therapist who "guided her to feel the energy and positive life-force from the wise creatures' - (not verbatim but close).
Seriously.

This was part of a week long course with "options" - the dolphins were one of those. US$1200 I think. Just for the option.

After dishing out so much money, in addition to the $2000 or so for the week's course, there is STRONG motivation in the gullible to "believe" in the interaction.

Proud, you can see there some doozies out there. My tongue has scars on it from biting....

[Bas Asselbergs]

Check this for more: http://www.healingtherapies.info/Dolphin.htm


and this: (2004) http://www.upledger.com/newsletters/CONSP04.pdf

[Jono]

Dolphin therapy- that is classic!

If some one believes in this kind of thing then I can't see any point talking to them about it. This kind of therapy stems from a totally different idea about the fundamental way the world works. It comes from an ascientific worldview- so how can you even start to have a meaningful conversation?

At ideas about posture, strength, bones out of place etc have had scientific backing at some stage.

[EricM]

How about replying with a 9-minute beat poem?

[Frédéric]

tim,

about your post #28

go read this on inert treatment and you'll find many reasons why Barret answered no.

[JasonE]

Originally Posted by paulingraham

(Jon’s original reply: laugh of the day. Maybe the week!)

My much less pithy/witty answer to this important question ...

I generally do not waste my time with ideologues. If I realize I’ve fallen into that trap, I simply scramble out of it ASAP.

As a skeptical activist, my communications efforts are reserved for fence-sitters and casual believers — the only place I really have a hope in hell of accomplishing anything. In every interaction where questionable interventions are trotted out for consideration, I ask a few probing questions to figure out where they are on that spectrum. A few questions are all that’s needed to establish it beyond a reasonable doubt.

If it’s apparent that a person is heavily invested in their beliefs, I mostly veer away. (Occasionally I will fire a warning shot across their bow, for the same reason that I am inclined to publicly challenge racism.)

But if I’ve found a fence-sitter, I dive in, mostly using the socratic method. Don’t tell them that they’re wrong or tell what to believe: ask them how they know what they know! Just ask. “Do you think it really works? Why? How do you know? How do you know that?”

Above all, I am nice. It was “nice” skeptics that got to me, people that won me with both brains and decency. I try to do that.

Then I press a copy of Demon-Haunted World into their hands like a bible, look deep into their eyes, and intone the sacred words, “This book will %$@!@* rock your world.”

Cheers,
Paul

Sounds like you and I have similar ways of dealing with this.

Demon-Haunted World? Should I know of it?

[EricM]

Demon-Haunted World? Should I know of it?

Google that and you'll find it's one of Carl Sagan's books.

[Mike Hoy]

Nowadays when I hear people tell me about CST or other such therapies I say "I used to do that" hoping that they engage me in conversation. I can then bring up the science and the BS and my departure from that thought process. It may not change any minds, but it hopefully will leave them thinking.

Funny you bring up Demon-Haunted World. Have been reading it the past few weeks. Highly recommend it