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Evidence-Based Practice, Or How The Three-Legged Stool Fails Us

Sunday, 04 May 2014 14:53

Evidence-based. Evidence-informed. Best evidence. These are just a few of the catch phrases that litter the medical community these days. For every phrase, there is probably at least one analogy to best describe it. Perhaps the one that is most bothersome and annoying is that which is used for "evidence-based practice": the three-legged stool.

If you aren't familiar with it, the evidence-based practice stool stands on three legs. Each is considered to be equally important. The legs are best available research evidence, clinical expertise, and the patient's values, needs and preferences.

So how could I not support a model of evidence-based practice such as this? How could I become annoyed with such an analogy?

Memories Of Senna

Thursday, 01 May 2014 13:38

May 1, 1994 is a day that will forever stand in infamy. If I close my eyes and pause for a moment, the memories come flooding back with great clarity. They still remain vivid yet at the same time sad and haunting.

May 1, 1994 is when the world lost Ayrton Senna at Imola.

Time, as we all know, passes us by quickly. It is hard to believe that two decades have passed. Today I share a few thoughts and reflections on the legend that is Senna.

The Lenses Of Our Lives

Sunday, 27 April 2014 12:06

I have been a photographer for many years. It all started with an Instamatic, progressing to a 35 mm SLR, a point-and-shoot digital camera, and now to a digital SLR. I think I had my first camera when I was 9 or 10 years old. Having a camera in my hands is a natural feeling for me.

Photography was almost my chosen profession. It was that or physical therapy. Yes, a strange dichotomy and a very intriguing story to go along with it. I'll share that tale at another time, but suffice it to say we all know which pathway I took.

I appreciate the challenge in taking the best photo possible. It is all about being in the right place, at the right time. Part of it is the creative aspect of putting colors and tones and lines in an image artistically. But part of it is a technical process. You have to select the right lens for the task at hand.

The Right To Choose Revisited

Wednesday, 23 April 2014 22:38

It is a call to action that has resonated with me for years. It is a call to action that I have used repeatedly, having even written a blog post of the same title last year.

The Right To Choose.

It was a great day when physical therapists in Texas adopted this phrase as a rallying cry for consumers. Simple - and to the point. The next legislative session in Texas is in 2015, and consumer awareness can't begin a moment too soon.

In a country founded on free markets, you would expect consumer choice to be a primary element in health care. My question to you, the reader, is simple: does a patient have the freedom and the right to select their health care provider freely and of their own volition? The answer, in the vast majority of states across this great land, is a resounding "no".

Learning From Loss

Sunday, 06 April 2014 20:50

Wise men say that we won't face more adversity in life than we can handle. Wise men say that each moment of our lives prepares us to live life more fully today and tomorrow.

I can say that over the past few weeks, I have been a little hard-pressed to feel or truly appreciate the wisdom of the wise.

Loss. It is something that invariably and eventually appears in our lives. We will all experience loss in some way or another: a friend, a family member, a love. Loss makes an appearance in our world and can challenge us to the core of our being – but there is much to be learned.

In The Zone

Sunday, 16 March 2014 21:43

The zone. It's a magical place to be. The zone is a moment in time when everything is clicking and flowing.

We often think of it in terms of sports. With March Madness upon us, I always think of the point guard who is shooting the lights out. He's in the zone. He can't and doesn't miss. Shots are flowing. There is a rhythm, a tempo, a feeling of insurmountable confidence.

We find ourselves in the zone in all aspects of life at one time or another. It's a place that we all seek, be it in our work lives, our athletic endeavors, or our creative pursuits. But we also find ourselves struggling at times to find it.

The Olympian In All Of Us

Sunday, 23 February 2014 22:30

The 2014 Sochi Winter Olympics are now officially a part of Olympic history. We've witnessed the highs and lows and the tales of victory and defeat with unprecedented clarity through countless cable TV stations and social media outlets.

This year, I didn't get mesmerized by curling (Note: that phrase might actually be an oxymoron, but I digress). But having been born and raised in Canada, I probably don't have to explain my desire to watch hockey.

The beauty of the Olympics every couple of years is that we are exposed to special performances from what we think are special people. However, one quick look around you and you might just find that there is an Olympian in all of us.

The Logical Fallacy And The Curse Of Modern Medicine

Saturday, 08 February 2014 21:11

It occurs in countless clinics and facilities around the world every day. It may, in fact, be the curse of modern medicine as we know it.

The logical fallacy.

It rears its ugly head in any number of ways. Take, for example, the premise underlying the "logical" (yet arbitrary) concept of asymmetry and muscle imbalance. In our world today, there are countless examples of normal anatomic variability being "treated" as a problem when in fact they are, as I mentioned, normal for that individual.

Forget about what you think you witness in the clinic for a moment. Forget about what you were taught about asymmetry and imbalance. Let's step back and take a look.