World Physiotherapy: Briefing paper 9: Long COVID, physical activity and exercise

I have seen over a dozen doctors and specialists in my 30 years with ME, not one has ever advised or suggested I see a physio therapist. I was told to rest.

 

Thank you. I won't comment on the rest, as NICE business hasn't quite wrapped, but I hope we see more people take note of what's in the new guideline.

 

It could of course be to stand on a piece of paper and ....

 

it appears that they don't know either

Highly Specialist Clinical Psychologist in Long COVID/Post
COVID

https://www.jobs.nhs.uk/xi/vacancy/916562032

 

Good thing that the main BPS cabal are unlikely to apply. From the Person Specification.

"Ability to manage effectively verbal aggression and abuse from patients, carers etc.."

Willingness to negotiate and ability to handle confrontation effectively and professionally."

file:///C:/Users/debbi/Downloads/3196422_293_IMRS1_1208PS.pdf

Salary:
£52,643 - £58,558 p.a. incl pro rata

 

I think the point is that physios are going to get involved anyway, whatever anyone might otherwise think. This paper makes it clear such involvement must not just be the usual same-old same-old, but that physios need to do a brain reset and digest what the paper is saying. Personally I think it could be highly beneficial.

 

They'd better!

 

Sounds like a suitably trained plumber, bricklayer, carpenter, etc might find it worthwhile applying - pretty much everyone else is in there.

 

Ultimately it's a bit of a "can't beat them so join them" thing. The change is not going to be sudden and 100% good, it's going to be piece-meal, like this, actually better than nothing, even if it's not perfect.

Personally I don't think there's any need for that but it's not true of everyone. Ideally over time people would be referred to this less and less but let's not kid ourselves, there will be physicians sending "fatigued" people to physical therapy for the next several decades, it will take at least a generational replacement to remove all the existing zealotry over this. Training people wrong has consequences, who knew?

Better is not perfect but it's definitely better than worse and worse than nothing is all we've had to deal with so far so one bit of progress at a time. At least if records are actually kept, as otherwise it remains too easy to attribute that 90% natural recovery to whatever.

 

I am sorry but I actually think physios need to take their ethical responsibilities seriously like anyone else and admit that they have no role here.

In a way I think it is condescending to suggest that it is OK for physios to 'get involved but gently' because after all they are only physios and what do they know. As I have said before, 'First do no harm' applies to all of us. We bang on about bad science and how terrible these professors are. Why is it OK for physios to claim to have a role when there is no evidence?

It seems to me a bit like saying OK we know about climate change but we have to let the airlines fly twice as much as before as long as they don't use plastic cups.

 

Mine too, overwhelmingly so.

Absolutely. The first thing all employers say is 'what does the doctor say?' and 'not much/waiting for tests' is simply not seen as good enough.

For sure, i mean as far as my bosses were concerned if i didnt have antibiotics for it then it didnt exist.

 

So the bureaucracy is putting it self and its own benefit ahead of the patients and their health. What a surprise.

 

This is the Iron law of institutions:

By institution it mostly means the institutions' original aims and goals, it's fine if the organization continues to exist undetached from the original mission, as long as those with power within the institution consolidate it. An institution is defined first by its decision-makers and their self-interest.

Everything is political, medicine especially so.

 

https://twitter.com/user/status/1406663892277895172

 

I actually think this is appalling that these biases against patients are built into the JD for the role…

 

This reminded me so much of my experiences with the HR department assistant literally jumping up and down in front of me shouting at me to DO something.
I explained as clearly/ calmly as could I could muster that I would have happily given my right arm if I could have got back to work again. (!….. I know I didn’t manage un-emotional I’m afraid )

 

It really is.

In my student days I once worked in a busy fast food restaurant and usually worked the tills on the busiest shifts covering pub closing times especially at the weekend. The salary is significantly higher but the job description sounds a bit like that.

Except, within a week or so, you learn that life runs much more smoothly if you learn to spot the signs of someone about to get lairy and descalate.

With that price tag I would expect the person to be able to pick up early signs of deep distress and worry, have a good understanding of the problems that person might be facing, use their own communication skills to allow/enable the patient to express how they feel in a constructive way.

The therapist and patient should be and feel like they're on the same side. The only reason for the patient to become confrontational is if they feel dismissed, ignored and that the therapist isn't listening to them or on their side. In that case the therapy is probably less likely to be effective anyway.