In a previous article, I presented four reasons to reject palpation-based models of care. This is no longer an issue of evidence - or lack thereof. There is plenty of research to debate not only the reliability and validity of palpation-based approaches to care, but also passive approaches to care in general. If you have a passive treatment approach, then the patient runs the risk of becoming dependent upon the care of the health guru in order to attain a resolution of their problem.

Sadly, many of the assessment and treatment approaches found in the current market place are exactly that – palpation-based and passive in nature.

What is truly at stake in all of this is far more elemental. It is the issue of perception – of the role of the clinician in the care of the patient. Is it as a health guru … fixer and healer? – or as a health mentor … problem solver, investigator, teacher, coach,  and educator? The future of effective and optimal health care requires a reality check. The solutions lie in the perceptions of the clinicians, the educators, and the consumers themselves.

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A whopping $700 billion dollars have been approved to bail out Wall Street. President Bush was pretty quick to approve it - though the House and Senate weren't far behind. Now they are all standing in line - the lenders, the Big Three automakers, the airlines - waiting for their hand-outs.

All of this brings up a serious question for me. If my private business fails, will the federal government bail me out? Can I simply do haphazard things with my money and still go to the government for a hand-out? Can I just dump hundreds of thousands of dollars into CEO salaries and then not pay the price for my decisions? Better yet, do I really have to be responsible for my business plan? Or make rational business decisions?

We all know the answer to that - and it's a good, fair answer.

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In 1997, I presented the results of a study on spinal evaluation techniques at the 5th McKenzie Institute International Conference in Philadelphia. The purpose of the study was to survey entry-level physical therapy educational programs regarding the spinal evaluation techniques that were taught to their students. The survey went out to all of the physical therapy educational programs in the United States, Canada, UK, Australia, and New Zealand.

To briefly summarize the results, it was found that most physical therapy programs worldwide place a very heavy emphasis on teaching palpation skills and palpation-based assessment and treatment models. These would include massage, manual mobilization, active release therapies, trigger points, and the like. Not much has changed from my own PT education in the ‘80s all the way to current 2011 educational programs. The same focus on palpation skills holds true for the educational programs of chiropractors, massage therapists, and many other alternative therapies.

But there are some major reasons to debate and reject palpation-based assessment and treatment approaches. The scientific literature on palpation has been very well-documented over the years – and the results will probably surprise you.

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It wasn't enough points.

Yes, Mack, we do need style points. Why? It's name is Oklahoma, and they are breathing down our necks in the BCS.

Bob Stoops understands the BCS. You see, when he has a chance to roll up the score and get a few extra computer and voter style points, a bit more 'wow factor', he takes it. He wrings the living daylights out of any and all opportunities like that. And this season, he's done so - ever since the loss to Texas.

So while Oklahoma is scoring big wins and putting up the big point totals, Mack Brown is playing nice against Baylor and Kansas. Did they win both games? Sure. They beat Baylor 45 - 21, but they didn't pass the ball against them for the last 8:52 of the fourth quarter. They beat Kansas 35 - 7, but squandered a number of scoring opportunities along the way and essentially fell asleeep in the fourth quarter (at least on offense - though kudos to the defense for the goal line stand).

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