The Southwest regional this year was the first time in NCAA history that there was a region with three double-digit seeded teams. And after the dust settled, it was a number 11 seed that was heading to the Final Four – only the third time since 1979 that an eleven seed had done so.

How so, you might ask? Wasn’t it a foregone conclusion that Kansas would advance? With a number one seed in the Southwest, and number two seed overall in the tournament, and seeds numbered 12, 11, and 10 remaining in their region, you had to seriously wonder how Kansas wouldn’t be punching a ticket to Houston for the Final Four.

All the bracketology “experts” in the land must be scratching their heads right now. This is yet another reminder of why they actually play the games. And what a game it was.

Read more...

The American Physical Therapy Association’s Annual Conference is this week. The House of Delegates has a number of hot topics on its agenda today and tomorrow, most notably discussion regarding “Physical Therapist Responsibility and Accountability for the Delivery of Care”. In many other circles, this would be shortened to “professional autonomy”, but it wouldn’t be governance without a long-winded title now would it?

Fortunately, this upcoming discussion has fueled its share of blog posts (great sample here, with some added history lessons here), along with a number of enlightening Twitter discussions (transcripts here and here).

It has been a week since I posted “Vision Now: A Physical Therapist Manifesto”. In the meantime, I continue to be bewildered by some of these discussions. Are physical therapists really ready to own their profession? Or are they spending too much time pondering the meaning of life while health care reform rolls on?

Read more...

It is one of my favorite movie quotes – and now I finally get to use it here. It is attributed to one Nigel Tufnel, lead guitarist for Spinal Tap. When discussing his guitar amplifiers, Nigel notes that “these go to eleven”. And now, Rhubarb Ruminations “go to eleven” in true Tufnelesque fashion.

Episode 11 is another fine mix of some of my favorite topics: music, politics, health, and, in the spirit of March, basketball. Sit back, relax, ponder and chuckle!

1. With music on my mind, let’s sing a belated happy birthday to none other than guitar virtuoso Ry Cooder - who just recently had a birthday on March 15 (the Ides of March, I might add). I know it’s a few days late, but better late than never, no? Cooder is, in my humble opinion, one of the most phenomenal guitarists on the planet. Cooder’s impact on my own musical world is indescribable – and merits a full post of its own (coming soon to a blog near you). Cooder definitely takes slide guitar to an eleven on a ten point scale.

For those who enjoy movies, you’ve probably heard some of his sound tracks (including “Paris, Texas”, “Crossroads”, “The Long Riders” and “Last Man Standing”). For those who are into world music, then you have probably heard “Buena Vista Social Club” – a production that he was intimately involved in.  Happy Birthday, Ry – come back to Austin, please, so I can witness your epic slide guitar once again.

2. Where better to find good rhubarb than, well, Texas politics?

Read more...

Ladies and gentleman, please be seated. Let the emotional debate begin anew.

The U.S. Preventive Services Task Force has provided us with new recommendations regarding PSA-based screening for prostate cancer. Based on the evidence reviewed, they no longer support screening for prostate cancer as “many men are harmed as a result of prostate cancer screening and few, if any, benefit”. In 2009, they had similar thoughts regarding breast cancer, noting that the USPSTF “recommends against routine screening mammography in women aged 40 to 49 years”.

I am sure all of this will have men and women alike up in arms. We should expect more cries of “rationing of care” and the like coming shortly.

Science-based medicine provides us with sound clinical guidelines upon which to build a foundation for care. That assumes, of course, that the science-based medicine in question isn’t simply going to be ignored. But as it stands right now, “although about half of primary care doctors agreed with the guidelines, less than 2% said they planned to actually follow them and completely stop using the PSA.”

Surely you jest. Really?

Read more...