Evidence Based Practice

[wutti]

hi, the problem in my country is, like in most countries i think, money is getting less and less. so the insurances want to know, what they are paying for and if it really works. so EBP is getting bigger and more important.
I think a mixture would be great, give some evidence but never loose common sence. I think that sounds great...! anyhow, especially in paeds EBP is really hard to get, my experience is that a lot of treatment/therapy is based on fun, playing etc. which i thing is the best way to get the childs to improve. and I thing others like bobath for childs and voijta are great, but voijta needs to be prooved more.

cheers

[phunphysio]

Hi Tommy77,
I am absolutley astounded that the majority of the OT department lost their jobs. Is this in the public or private system? John Howard will not be getting my vote this year. My area health service definately pushes for evidence based practice. We have a proffessor associated with a university who oversees all our allied health research and assists us with our financial submissions, ethics approvals and alike. However, I find to get the time to conduct research as well as keeping up with my clinical load is impossible. My bosses say "yes yes" do the research but it seems they expect the majority of the early work to be done in my own time. With a family, this is where my ideas fall through the cracks. I would never be able to substantiate everything I am doing in my clinic by research so if it came down to "prove what you can do or your gone" I'm afraid I would be gone. Are these the same frustrations you share and does your area health service support you in clinical research.

[alophysio]

Hi,

Again, to be fair, do we actually know what the exact situation is regarding how these people lost their jobs or why? Who are the sources? What is the other side of the coin?

Hospitals are run by the STATE government in Australia. ALL the State Governments are Labour Party whereas the Federal Government is Liberal. Therefore, already there is an unlikely situation developing where the state government would not want to be seen doing something that supports a fed govt initiative. Look at how they fight every year about health.

Secondly, the fed govt rules about unfair dismissal are there to help businesses of less than 100 employees. The laws do not apply to those in larger businesses including hospitals. As for the laws regarding enterprise bargaining agreements, the employee CANNOT be worse off than if they were on the state award. Therefore, they shouldn't have a problem.

Lastly, there is evidence that what we do works. It is ourselves. We are Level 4 and 5 evidence. Sure it is not up the food chain of EBM but it is still evidence.

I am not here to defend anyone - i just want to be fair and hear the whole story before i make my mind up about something. Otherwise we are just a bunch of old men and women gossiping about something (which is someone i do not want to become!).

Tommy77 can you give us more information - hospital, state, article, newspaper reference, union bulletin, memo, etc???

Thanks

[estherderu]

dear colleagues,
I'm dutch, grew up in australia, studied to become a physiotherapist (later paed. physio) in holland, worked in germany and now in spain.
Yes in holland and germany the pressure to work in an evidence based manner only is building.
In spain interest is growing.
Yes I agree research is fine and necessary.
Yes I know many of the european FT organisations have agreed to work together to get education on an equal levels (Bologna agreement).
Yes I know that many people preach EBP but do they practise?

I am one of more colleagues who ( having worked 30yrs) have a healthy suspicion of the background of much research ( read What docters don't tell you by Lynne McTaggert )
AND every research doesn't take into account that that my *touching a patient* changes something in that persons being. Therefore the reaction to my therapy will never be the same (compaired to the therapy my colleague gives ) even if we use *the same* technique. The parent's trust, their first impression of you, the way you handle their child are also of imminent importance to the whole process and cannot be easily assessed and compaired.

So I am a firm believer of education and keeping yourself educated. In my opinion in our profession that means following many different post graduate education programmes, reading, visiting colleagues with extra expertise, looking in during treatment and treating together if and when possible. We need to keep the the theoretical knowledge process going without forgetting to keep the practical flow going as well.
I hope our researchers will keep their your feet on the ground and keep using common sence and listening to the many very experienced people our there.

I have the feeling that many people underestimate that the working conditions in different countries are VASTLY different and we have to keep this in mind when we discuss EBP.
esther