Is the doctor's word final?

Replies to This Discussion

Permalink Reply by Jody Jakob on July 1, 2008 at 1:11pm

Hummm....
The medical doctor's word is definately NOT final.....and why should it be? Osteopaths are in a much better position to know if there treatment is indicated or not....
But Kuno..there is a hellava lot of ignorance out there in the public and specifically in the medical world about what an osteopath really does.......many people will tell you that osteopaths just do bones (whatever that means) or just do manipulation and it happens to be painful as well!

Being in practice you get used to remarks like that...but I ususally do not let it pass.....it behooves you to,and is an opportunity to get in touch with the neurologist, GP or whatever specialist said the rubbish remark and kindly inform them of what you really do and what you really think.....you have there attention so its time to strut yer stuff.....and let em know your not just pushing bones around and getting them to go click like some performing seal!!!
Of course you do this with the utmost respect and consideration for their knowledge.....remember any body refering to you or supporting your work will want to have the relected glory of success and will disown you in a minute if you make them lok bad.....so in a way the medic is just protecting himself because he doesn't know if you are good or not and if the medic refers to you by their code of ethics that he has he is still somewhat legally responsible.
Hope that helps

▶ Reply to This

Permalink Reply by Clement Rhein on July 2, 2008 at 7:03am

Well, i guess it depends what they are taught about us!

▶ Reply to This

Permalink Reply by Jody Jakob on July 2, 2008 at 9:55am

Yes AND.....I think there are too many osteopaths/chiropractors out there who do practice the WHAM-BAM-THANK YOU MAM, approach.Its like the GP who doen't bother to do a full case history is only symptom orientated and is writting out the perscription before you finish talking.
So what I am saying is that we can't just always point the finger at the medics and say they don't follow best practice WE have to ensure that we follow best practice and encourage our colleugues to do the same.

▶ Reply to This

Permalink Reply by Ronan O'Brien on July 2, 2008 at 10:26pm

I have experienced many professionals who take the WHAM-BAM-THANK YOU MAM approach. Best practice appears to be an dreamy ideal that many professionals collectively talk about but few individuals attain.

What do you see as osteopathic best practice?

▶ Reply to This

Permalink Reply by Jody Jakob on July 3, 2008 at 7:17am

Best practice.....
This is from a document which can be accessed at... http://www.qaa.ac.uk/academicinfrastructure/benchmark/statements/os...

from a statement of the "Quality Assurance Agency for Higher Education"


Osteopathic practice seeks to blend a philosophical approach with intellectual and practical skills to guide the use of therapeutic intervention to help the patient by using an individual 'package of care' most suited to facilitating a particular person's return to health. It is characterised by the following distinctive philosophical and practical features.

Emphasis is on the patient and not on their disease. This has been a long-standing tenet for osteopathy, and it is a conceptual principle that informs the whole of the osteopathic approach to care of the patient. It is about seeing a person not as someone with a disorder but as someone who is seeking the facilitation of optimum health. It involves viewing the person as having an integrated blend of influences that combine to effect health. Osteopathy seeks to identify and address the key influences that will lead to restored health and well-being.
The intention to enhance the intrinsic health-maintaining and health-restoring capabilities of the individual person. This involves the consideration of a broad range of factors to identify and resolve the causes of impaired health.
Individually tailored intervention and advice encompassing a range of specific technical treatment modalities and approaches. These include specific osteopathic manipulation techniques, exercise advice, lifestyle advice, nutritional advice, coping strategies, and other advice to enable the patient to understand the cause and contributing factors of their impaired well-being.
An approach that emphasises the integration of the musculoskeletal system with other body systems, the reciprocal influences that impairment of function of each may have, and the adverse effects such impairment may have on the health of an individual.
Close collaboration between the patient and osteopath to identify the factors contributing to the patient's impaired well-being, and to determine the clinical and other changes needed for recovery and restoration of health.
Enabling the patient to understand and implement measures to take responsibility for assisting their own recovery and enhancing their health.
The use of critical reasoning to apply knowledge and skills in an integrated and informed manner.

▶ Reply to This

Permalink Reply by Jody Jakob on July 3, 2008 at 7:27am

.....but having said that I think an interesting survey would be to discover how many osteopaths actually do "Best Practice".
Especially when you hear of practitioners seeing upwards of 20 patients a day.
With a large workload osteopaths are forced into being symptom orientated for lack of time.....this is our concern, dude!!!
We stop being osteopaths and become really good physios!! ....and lots of practitioners will settle for that because they are successful...but has the essence of osteopathy been lost.....what do you think?

▶ Reply to This

Permalink Reply by Kuno on July 3, 2008 at 9:36am

Best practice is a political buzzword that scares me - it suggests that the right way of doing something can be worked out in advance of the situation arising that needs it. 'Best' takes away the possibility of 'brilliant' practice, because 'brilliant' suggests adding something else to the mix. I'd settle for all practitioners doing 'good' practice, using their judgement and reasoning to determine what that means in each situation.

That document mentions putting the patient's needs at the centre quite a lot. Walter McKone says we've got that wrong, that we are 'practitioner centred', because we must bring our own framework into the situation. Without that we have no understanding of what the patient needs, as this is based on our expectations, which are our own. It's a bit like a school teachers offering a service, according to their own understanding of good learning, that their pupils receive, but not simply be doing the pupils' bidding.

Do you know what this is?
5.4 The Statement of common purpose for subject benchmark statements for the health and social care professions provides an overview of the generic values, knowledge, understanding and skills associated with practice in health and social care. As well as enabling the placing of learning outcomes for osteopathy in the overall context of health and social care, this also highlights the opportunities for interprofessional and interagency communication and shared learning.

▶ Reply to This

Permalink Reply by Jody Jakob on July 3, 2008 at 10:00am

5.4....sounds like gobbly-gook on first reading!!!
I'll get back to you if I can make sense out of it
Your comments as usual Kuno bringing an interesting way of looking at things....thanks, much appreciated...helps one to get out of the rut of buzz words and usual herd thinking into a more individulistic approach and more autonomous thinking......Maslov said that only 2% of the population ever achieves autonomous think!!!

▶ Reply to This

Permalink Reply by Kuno on July 3, 2008 at 10:26am

It was in that document you linked to. Phrases like '...THE generic values, knowledge, understanding... associated with practice in health and social care' make me shudder a bit.

▶ Reply to This

Permalink Reply by Mary on July 3, 2008 at 11:24am

I feel the need to fight the GP corner a bit here - if only to play Devil's advocate...

While allopathic doctors may or may not get taught to be patient centred (I have no idea what the curriculum actually consists of), graduates must surely become GPs because they want to deal with people as opposed to meat on the operating theatre (etc.). After all, many of the ailments that people visit them for are a) minor, but affect quality of life, and b) related to some lifestyle factor, such as stress.

I went to my GP just yesterday, and after we'd talked about diagnosis and treatment at length, I said to him that regardless of the apparent cause, the ailment came on during periods of stress. He then switched mode and we had a nice chat about what I was doing etc. From having visited a few different doctors recently, it is clear to me that they do look to your emotional state, just as much as an osteopath... but it's called by a different name, or perhaps no name at all. That's not to say I've not been waved away with NSAIDs when I had low back pain, but equally, there are good and bad GPs just as there are more or less wham-bam osteos.

▶ Reply to This

Permalink Reply by Kuno on July 3, 2008 at 12:07pm

I agree wholeheartedly Mary, and I am not anti-GP. I realise I did not paint a balanced picture with his thread, as I also know personally of doctors who speak very highly of our work, and whom I regard highly also; it's not my intention to speak ill of them. My concern here is that there may be a section who do not realise that they are actually not qualified to decide whether or not osteopathic treatment is appropriate.

However, I do take the point that they are able to decide whether a referral is appropriate, which is a subtle but important difference, so it's possible that I am overreacting.

▶ Reply to This

Permalink Reply by Mary on July 3, 2008 at 12:34pm

And I agree with you Kuno. :) The two scenarios you describe above are infuriating! I bet those patients you describe would want someone to "overreact" if it could result in remission from their undoubtedly painful and affecting conditions. There are certainly scenarios where I could have screamed out for a decent bit of joined-up thinking between health professionals. In the end, I had to find my own way, and many (most?) are not able to do that.

I don't know what's being taught about CAM in allopathic schools these days, but I do hope it is effective and not like in American medical schools where DOs often find themselves very little different from MDs. Incidentally, for an interesting insight into this I found this blog called The Spiritual Life of a Medical Student a while back.

▶ Reply to This

• 1
• 2
• 3