SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > WWW The Wild Wise World > The Rubbish Cube
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

The Rubbish Cube The best place to criticize what is going wrong in health systems and other subjects.

Reply
 
Thread Tools Display Modes
Old 22-03-2004, 09:06 AM   #1
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,590
Thanks: 1,883
Thanked 585 Times in 419 Posts
Default What can we do to gain more autonomy over our treatment?

Hi all

I know this has been mentioned and discussed before; we all know the system sometimes beats our efforts to do what we want to do with clients, because of insurance, dogmatic doctors (?) and other things.

My topic for discussion:

If you find yourself having to follow 'orders' from the doctor or insurance company, (post-surgical protocols aside) and you feel these orders are inappropriate/ineffective/downright silly - what do you do to rectify this?

If your patient demands a certain treatment - and you feel it is not suitable- how do you handle this?

I am, of course, speaking as an Aussie physio, which means full autonomy on all decisions we make; I realise this is not the case in many countries.


Nari

PS If you are puzzling over why I appear as a panda - blame it on Bernard!!!?
nari is offline   Reply With Quote
Old 22-03-2004, 10:44 AM   #2
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

Hi Nari:

Good topic,
you have mentioned two main categories :

First category
let us put under that categroy , insurance company ,other health providers .
I think the issue there in Australia is being governed through good legislation , if you have applied an evidence -based practised approach ,i mean you can reason well by the evidence your choosed approaxch ,you are going legally , and so there is no problem ,
BUT
If (imagine) you are going to lose your work because of that misagreement , for example the doctor will not referr you the case as you are not applying his suggesation BY THE WAY (i hope to ask you the Doctor there applying his views as suggesation ,or as orders ,the issue is completely different )
I think our role as physiotherapist , we had studied to apply our work in an autonomy manner ,we can apply our work perfectly , then that doctor have not studied anything about our work , they are so superficial , no knowledge,
what happens usually ,they ask one consumer what did the physio have done ,for example he said ultrasonic , so the doctro imperssion ,yes ,this ver good ,

they can not reason our work , i think sometimes they do not know that we continously change our role with the patient status ( acute ,sub...)

Regarding this issue is easly considered on the long run , the doctor will be accustomed to avoid entering in these issues , with time the doctor will find himself out of this issue as you do not try to enter within his scope .

Second Categry ;

the patient
if he comed asking me for certain treatment and i feel its outdate , i think i will try to be intellingent ,firstly ,during my subjective history , i can know that consumer personal type , i will try to educate ,tell him....

At the end
i will apply what he wants and what i want at the same time , i think this may be not evidenced .....
Me personally , i lose every day a lot of patients because of that problem ,they need someone listen ,perform certaines.

cheers
emad :lol:
emad is offline   Reply With Quote
Old 22-03-2004, 07:54 PM   #3
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

Hi Bernard:

I was speaking about our clinical approach
e.g.

the doctor can there order you to apply for example short wave , however you want to apply mobilisation

i know there the issue goes under giudelines ,protcols.......
for example our current knowledge of somatic education are not inculded in the guidelines recommandations. The GP could interfere to stop applying that method ...

i think private practice is so easy ...

emad
emad is offline   Reply With Quote
Old 22-03-2004, 11:05 PM   #4
rolf
Senior Member
 
Join Date: Mar 2004
Posts: 116
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Hi all!
Here in Norway its very simple.You do what you want to do.The GP can recomend something,but it up to you to do what youthink is the best for the patient.
I always send the GP a journal of what i am going to do and why! I dont think they always read it, but it might give the GP a clue in my cind of practise.
I think its VERY important that we give the GP feedback on what we are doing as long as they are sendig us the patients!
We can also take the patient "just from the street" but then they have to pay 30% more,then if they were send from a GP; :wink:
rin
rolf is offline   Reply With Quote
Old 23-03-2004, 12:54 AM   #5
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,590
Thanks: 1,883
Thanked 585 Times in 419 Posts
Default

emad and Bernard-

In Egypt and France, the doctor/physio situation must be difficult for you.
I could never work in a situation where somebody else (non-physio)thought they knew more about physiotherapy than I did.

In the USA I believe some states have primary contact rights and full autonomy.

Takao? Would like your comments.


Nari
nari is offline   Reply With Quote
Old 23-03-2004, 08:42 PM   #6
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

Hi Nari:

I can not say the physio/doctor relation is dificult .
the problem is according to importance:
Code:
  value 
                        culture
                        legislation
here there are no chiropractors, but there is physical medicine doctor(s) who brings a nurse in his private clinic and some physio equipements to perform physio for his patients beside to his role as a doctor ( this is not legal).
then this is the most problem for physios here , patients visit the doctor which i have mentioned before.
Not only physio here suffer , all go wrong , are we human beings , i do not think life seems so , more better to rethink before coming to this creation .
:lol: i think some people here i they asked before creation to vote /say there view to come /not ,they will refuse :wink: :evil: :twisted: :evil:

cheers
emad
emad is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
treatment sessions mike General Discussion 6 17-12-2005 05:21 PM
Is professional autonomy the answer? nari The Rubbish Cube 5 28-11-2005 01:06 PM
The ART® of soft tissue treatment oljoha General Discussion 8 19-10-2004 07:38 PM
what is unethical treatment? nari General Discussion 1 26-03-2004 12:04 PM


All times are GMT +2. The time now is 05:56 AM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2014