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My brother Bob is a published author and a practicing PT in northern Minnesota. He wrote this funny and relevant piece about a recent MFR continuing-education experience; begging the question "how do we attain professional stature while the profession embraces beyond-the-fringe treatment techniques?"

Comments

[David Penn]

Rick,

I can only think that your brother had some spare time on his hands and instead of going to Vegas and blowing it on a black jack or table he took an even greater risk and went to an MFR course. As for me, I would rather go to the casino since there is more science to gambling than with "unwinding".
I was reading the storyline with humor at first then I realized that this someones line of "physical therapy". I hope that your brother filled up the course evaluation with a similar tone as in his writing.
I had a patient (PTA) tell me that she stopped going to one of these MFR disciples but stopped after she repeated asked her for a massage of the body not the 3 inches of air above her back. She specifically aske for none of the weird !@##xx** ( your word here).
How do we as a profession or individual make the call here. Is this a nice letter to the seminar group,APTA,section? If our state boards continue to endorse it by approvals, we might need to look at how these course get authorized.

[Jason Silvernail]

I remember a smart PT once saying that in the past, there was insufficient evidence to guide practice, and that was the problem. He also said that now the problem wasn't that there wasn't enough evidence, it was that people aren't paying attention to it.

I think this has a corollary here. Now the issue is not IF, but HOW we should address practice variation.
Being prone a confrontational style, (as Dr Kleinkort can attest to from the Laser Therapy Disappointment post) perhaps I'm not the best person to handle this issue.

I know there are a lot of folks who read and post here who are on Editorial Boards of our journals and hold posts and positions in the APTA.

Is anyone aware of any movement to address this issue at the APTA level?
I mean, I'll keep sending sarcastic emails and writing blog posts, but I'm just one guy with an opinion.
Is there, or should there be, an official position on this sort of thing from the APTA?
J

[John Goodrich]

I do think it needs to be at the APTA level. I am new to blogging, and I have watched this site and rehabedge. What continues to impress me, and has for some time, is that we seem to be functioning in parallel patterns (with far more parallels/silos than I'm comfortable with), and it is virtually impossible to move from one pattern to another, because it requires learning a new language, including terms that represent processes that don't exist, or have not been demonstrated to exist (eg, using muscle energy instead of contract-relax). We literally cannot talk to each other, effectively. This suggests to me the need for at least a review process and possibly facilitating a dialogue, and I don't know a better place than APTA. It is hard enough trying to convince referring physicians and non-therapists of the merits of EBP without requiring an interpreter in order to dialogue among ourselves. JG

[Britt Smith]

Continuing education courses endorsed or sponsored by the APTA should demonstrate a minimum standard for evidence. We can't deny the dearth of evidence for much of what we do, but let us not set the bar too low either. I've previously blogged that we could use a system like the SORT documents (Strength of Recommendation Taxonomy) used now by the Journal of Family Practice and American Family Practice (Ebell MH et al. Strength of Recommendation Taxonomy (SORT): A patient oriented approach to grading evidence in the medical literature. J. Fam. Pract.2004.53(2):111-120.) to develop a meaningful 'good housekeeping seal' for the courses that the profession endorses. We need to set some standards, now. I don't know if MFR classes are even on the APTA radar screen, but we can work on 'SORT'-ing out the issues and separate the wheat from the shaft.
Britt