Excellent topic.
Some of you that have read my previous posts will know my opinion on this subject. Unfortunately, in Australia, I am very disappointed with our Associations representation of members on a number of fronts. For a long time, hospital based therapists were better supported, as our representatives came from the public system. There is still an element of this occurring.
The main problem appears to be a reticence to offend any group by demonstrating in a very positive manner to the public that we are better therapists than the opposition. This can be achieved without pointing out the oppositions negative aspects ie being proactive.
The TV advertising using the Hunchback was a very negative step, and our opposition in the market place would have had a good laugh at our expense. I warned the profession in very strong terms against proceeding with the Hunchback, and was ignored. The Association even attempted to defend the advert, but later reluctantly admitted that there were problems. Der.

Marketing is currently a big focus of the APA, but more in relation to obtaining money from suppliers via advertising promotions rather than supporting members in the clinics. There are some moves to provide better information, plus lobbying of Government, which is good, however it is insufficient.

As a vocal member of various groups, my input has not been viewed as welcome, despite the curious fact that I have actually supported 'policy' more than those making the policy. The APA currently does not like criticism, and suggestions to change course or become more aggressive in supporting private therapists is not viewed kindly. APA responses to some of my previous posts are a good example, and I have many more examples outside of this site.

Current policy is moving more quickly toward an inevitable situation where Australian physiotherapists will be unable to compete against our marketplace opposition.Why? Because the APA, with good intent that I understand, is trying to position us as the best evidence based ethically sound therapists. To achieve this position, the APA is putting into place various constraints, rules, guidelines, and penalties that will mean that all therapists will be required to operate at the highest level possible, according to the available research, or be deemed to be unethical. Our opposition in the market place have no such strict compliance rules. WE may be the best, but that will not be of any benefit if we are priced out of the market due to compliance costs, at a time when the market is not even minimally informed of the differences between types of therapists.

In other words, the timing is wrong. Educate the public more fully, then ensure our position regarding optimal performance is maintained. At a time where slapping dead fish or aligning shakra hot stones is paid for by health insurance companies, plus while slipped discs are regularly adjusted into place, we are expected to further upgrade our training, with APA backed accreditation programs etc.

The focus is all wrong, in my opinion, and will cause us to lose market positioning. History needs to be heeded.
There are many examples of the current accepted science being proven incorrect. Evidence based medicine at present is open to being skewed by vested interests (insurance company interference), and the overseeing databases examining research regularly review 200+ research articles, only to throw out 195 of them due to criteria problems, then more closely examine the 5 left, with a decision to accept 3, then state that no conclusion can be drawn, or that the treatment examined cannot be supported on the 'evidence'.

Insurers may then use the lack of evidence base to refuse or restrict payment for the service, or claim that physiotherapists using the technique is ineffective. Logic tells us that a particular treatment, viewed in isolation, can only be excluded when implemented EXACTLY as per the experiment. Variations in treatment application may make a particular therapy relevant. That is why medications have dosage guidelines, which vary according to age, sometimes gender, and whether the medication is used combined with other medications.Much of what we do in the clinic every day is not replicated in a research laboratory. Excluding all therapy unless it has a research support base will stop innovative treatments developing, plus tie our hands behind our backs when attempting treatments we know actually have good effect.

For the APA to tie itself so closely to this paradigm when our competitors do not, is not a market advantage, but potential suicide. The APA is more recently accepting Branch councils (Vic Branch is a case in point), where a significant number of councillors are self confessed professional students. These people are making policy which is inflicted upon those of us working with people everyday. Highbrow impractical policy decisions are the result. The bulk of hardworking therapists cannot be expected to have their abilities 'raised' to that of the professional researcher/ academic, nor would such a change be for the professions greater good.
I am not saying that research is to be ignored. I believe in the scientific method. However, throwing out the baby with the bathwater needs to be resisted.

As this is a long post, I will stop here. Further debate is welcome. A greater fleshing out of my opinions could be undertaken, should forum participants indicate they would like me to do so.
Thanks for the opportunity.
Regards
MrPhysio