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Portrait_Denis_Pelletier

DENIS PELLETIER, physiothérapeute,M. Sc.
Diplômé en physiothérapie sportive

Dear Members :

Our profession has made great progress through a scientific approach. Through science we slipped the fetters of certain beliefs and fads that have, at times, cast doubt on our members’ excellent work. Bertrand Russell’s remarkable essay,“On the Value of Skepticism,¹”shows how vital skepticism is as a driver of scientific enquiry. Russell believes we must be ready to “admit any well-established result of science, not as certainly true, but as sufficiently probable to afford a basis for rational action.”

Russell’s idea can help us better appreciate Choosing Wisely,² an initiative of the American Board of Internal Medicine (ABIM).

Inspired by the constantly increasing cost of health care, which is becoming a heavy burden on government budgets, Choosing Wisely advocates opting for necessary, effective treatment while avoiding the wasteful overuse of medical resources.

ABIM first asked various American medical associations³ to contribute five recommendations designed to prevent overuse of tests or treatments in their fields. Then ABIM used social media to disseminate this information as widely as possible.

The American Physical Therapy Association (APTA) is the first association of non-physicians to join the initiative. At first glance, their five recommendations4 may be surprising.

  1. Don’t employ passive physical agents except when necessary to facilitate participation in an active treatment program.
  2. Don’t prescribe under-dosed strength training programs for older adults. Instead, match the frequency, intensity, and duration of exercise to the individual’s abilities and goals.
  3. Don’t recommend bed rest following diagnosis of acute deep vein thrombosis (DVT) after the initiation of anti coagulation therapy, unless significant medical concerns are present.
  4. Don’t use continuous passive motion machines for the postoperative management of patients following uncomplicated total knee replacement.
  5. Don’t use whirlpools for wound management.

Source: http://integrity.apta.org/ChoosingWisely/5Things/

Here in Canada, the Canadian Medical Association (CMA) and the University of Toronto joined forces to produce a bilingual Canadian version of Choosing Wisely, which is available online at http://www.choosingwiselycanada.org and http://www.choisiravecsoin.org.

The sites present a wealth of fascinating recommendations, many of which can be applied to the daily work of OPPQ members. Note that we do not yet have any Canadian recommendations drawn specifically from the field of physiotherapy, as in the United States.

In the aim of offering the people who use our services the best possible care, we should applaud such valuable initiatives and share them with our members and the public.

President,

 Signature_manuscrite_Denis_Pelletier_bleue 

Denis Pelletier, pht., M. Sc.
Président

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¹ http://www.users.drew.edu/~jlenz/brtexts.html
² http://www.choosingwisely.org/
³ http://www.choosingwisely.org/partners/