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Shopping and the spread of germs!

I have become increasingly disturbed by my shopping experiences………….not that I do a lot as it is one of my pet hates. Anyway I was in a well known branded store, had collected my food items and proceeded to the checkout to depart with some hard earned cash. The initial part of the transaction went very well and I was thinking ‘ wow, great efficiency’. The checkout lady actually asked me if I wanted some bags and offered to put the purchased items of food in them. What followed next was what I can describe as a scene from a horror show in slow motion. Now, I am not an over the top clean person but what I do object to is taking someone else’s germs home. The checkout lady proceeded to lick her fingers……yes, lick her fingers, you know, like she has just finished eating a kebab, and then picked up my food items and placed them in the bag!! At that point I am thinking ‘OMG!!’, I am going to put some else’s dry saliva (it would have dried before I got home) into my fridge. I, of course declined to take the items home and swapped them for new items and checked my self out with the self checkout facility! With flu and other transmittable diseases what a way to spread an epidemic!?!?! You guys had the norovirus yet?

If the supermarket wanted to force people to check out their own shopping what a great way of doing it? I cannot understand why the checkout ladies/gentlemen cannot be provided with a moist sponge, you know like the ones we used to find on post office counters. Saves a lot of bother and most certainly will make me personally feel more comfortable next time I am eating a loose pear from the fruit basket!

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Language barriers and consent to treatment

One of the fundamental issues in healthcare delivery is the ability to administer treatment with the full consent of the individual after being provided with enough facts to make a sound decision to accept/participate in treatment. Sounds like a very good idea to meet the ethical code of practice. However, the very large elephant in the room is the that fact that as clinicians we are beginning to see an increase in patients who do not have English as their first language. I have begun to wonder what support I would get if such a patient, on reflection, at home after treatment decides that he/she was not entirely sure what was going on because of the communication barrier. What would happen if such a patient decided to raise a complaint because their expectations do not match realistic outcome? What is the realistic outcome of any intervention within the concept of accountability and responsibility? It is a large and ‘ugly’ elephant that I fear is going to make an almighty mess when the ‘you know what’ hits the fan. Help!!!

Colleagues giving freebies

Hi……..was I missed? Its been a long while since I posted my last blog. Its been very busy lately but one thing that continues to stick in the back of my throat is the way in which generic exercise sheets are being dished out like sweets by General Practitioners and the misguided help they get from my colleagues who devise the so called exercise sheets! The problem has always been that as a Musculoskeletal Physiotherapist it is frustrating to not only be referred a patient whose problem has become chronic because of the ‘try these exercise first and if it does not work we’ll refer you to the Physio’ routine but also find out the belief system of the patients has been altered by the delay and the increased discomfort caused by that delay. In other words, they are upset and ‘cranky’ because of the pain/discomfort and irritated if the pace of outcome does not match their expectations which have become over exaggerated.I am not aware of any other profession that would devise self help manuals to prevent/reduce proper access to skilled personnel/clinicians and I certainly don’t know of any GP in particular who would devise a general leaflet on remedies for ailments. That’s right, they will not do this because of the fear of litigation! What’s different for Physiotherapists; we do have autonomy of practice and exercise is not the panacea for all problems!! Its about time we as Physiotherapists stopped believing that we are doing everyone a favour by developing and aiding in the distribution of these silly leaflets and started to take back control of what we do best- restoring human movement or are we saying that our clinical diagnosis is not relevant? As it is most medical diagnoses are not 100% correct; a testimony I can hear most MSK Physiotherapists agreeing to! It’s about time we got a grip!

Life Insurance

Gosh….time has flown by. Just realised I haven’t blogged for quite awhile!! It was not because I had nothing to say but rather that I dare not say it.

One story I can share is about a rant at a life insurance company a few weeks ago! I was being asked to pay an extraordinary uplift on my monthly premiums if I wanted to restart a policy which lapsed because of an almighty b***s up of a direct debit (a couple of months). You would think it easy to restart the premium but no. The underwriters said that they would like me to pay an extra 1/3rd on the original premium and remove my critical illness cover!!!! When I enquired why; I did not get any response other than either take it or leave it. So I left and searched for another provider. That was the beginning of a journey and a half.

 

I found alternative providers who were happy to give me a quote but again I found that my premiums were inflated. When I eventually got a response from one provider as to the reasons why in you it costs so much I was told that my BMI was high! Can you imagine that? Well I was so angry that I wrote back and challenged them as to why they were using such an outdated method to assess risk when the BMI has been proven to be an unreliable measure. As a past academic and an active Chartered Physiotherapist I think I took them by surprise especially when I sent them links to academic papers underlying my point. I am happy to say that my new provider has agreed to a new monthly contribution at a level that I am comfortable with and also included critical cover to my satisfaction!

This just goes to show that there is a possibility that you are being overcharged so ask the question!

X-rays………………do you need one?

This is a common question I get asked a lot in clinic; sometimes it is ‘demanded’. These patients are usually under the impression that by having an X-ray their symptoms will suddenly disappear!

Unfortunately, X-rays are only used to look for problems in joints that are not clear or understood from the description of symptoms as explained by the patient. Thus the better and concise you are in explaining your problems the better the possible treatment outcome will be. Unnecessary exposure to radiation (that is what X-rays are) can be potentially harmful and as it is not known how many you will ever require in your lifetime, therefore the fewer you have the less your chances of contracting a ‘nasty’ which may be caused by radiation exposure later on.

If arthritis or any other form of degenerative condition in a joint has been diagnosed, an X-ray will not reduce the pain caused by the condition and the clinician does not need to get an x-ray to see how bad it is! There are some exceptions to this but these circumstances are rare and the clinician is skilled enough to make that clinical judgement and weigh up the pros and cons of the request. So I say ease off on the requests and concentrate on telling your side of the story; that is to say how to explain your symptoms without getting tongue-tied or worst still embarrassed. Remember we will in all probability, heard it, seen it and dealt with it before!

Rant of the day……………! It was good to get this off my chest!!!!!!!

Monday!………that feeling!!

Woke up this morning feeling positive about the day. This is rather unusaul as I think about the week ahead and the little time that I have to complete all my planned tasks. It was kind of more of a drag as I am still annoyed that I have spent a significant period last week preparing for two assessments last wek only for the clients not to turn up!!! Well I guess they could not been in enough distress to want my help. I just wish they had the courtesy to let me know.

Anyway another week………………….

I have been getting a lot of clients come through the door saying that they had been given an exercise sheet by their Doctor; unfortunately it either did not work or they are of the opinion that it has made their problem worse.

Response to Wee

Impingement syndromes affecting the shoulder are difficult to treat. However a good friend of mine in Australia, Dr Malliaras has done a lot of work involving tendons and I believe he would be able to point you in the most appropriate direction. Try contacting him via his blog http://www.physioeast.com.au