Jon Room has his finger in many pies as a Researcher, MSK & Orthopaedic Physio, PhD student and Vice Chair of The ATOCP, yet he still found time to join us in April for #TheBigRs 2.0. Jon contributed to the ‘Reforming Research’ table and shares his thoughts with us here.
It’s been a couple of months since the #TheBigRs 2.0 ‘Reasoning, Responsibility and Reform in MSK Practice’ and I thought it a good time to reflect on events before I forget what happened!
The day started with a welcome and introduction from Jack Chew and Andrew Walton, the main point that struck me in the introduction was a couple of questions asked,
What value do we add? Can we demonstrate it?
These questions highlight the importance of why there is need to discuss reasoning, responsibility and reform in physiotherapy. What do we as physiotherapists bring to the table? Do others know what skills and expertise we have? Do we have the evidence to back up what we are saying? I personally feel that physiotherapists can add great value, but that feeling alone isn’t going to convince people to hand over cold hard cash to fund services, and I agree with the need to measure the impact of what we do, in order to demonstrate effectiveness.
The first panel session was on reasoning. This covered issues such as unwarranted variation, culture change and our undergraduate training. There were two points that really stuck in my mind from this session. The first was made by Matt Low, who outlined (I’m paraphrasing)
…that we can know the best evidence, but it doesn’t mean that we can necessarily facilitate behaviour change…
From my point of view this wasn’t belittling scientific investigation, but a call to remember that we deal with human beings, day in day out. Part of the appeal and challenge of physiotherapy is that we are trying to help improve the lives of all sorts of different people, with different situations, different challenges and different motivations. If we forget the human aspect of the job, surely we are missing something? The second point was discussed by Brad Neal who questioned whether we graduate with enough scientific skills to evaluate research. Perhaps at first glance it may seem like these are opposing thoughts, one focusing on research, one focusing on the person. However, one of the great challenges of physiotherapy is surely taking what we know from the evidence base and applying it to the individual in front of us in all their uniqueness. It is important to have both research skills, such as appraising papers, critical thinking, understanding data, etc. in addition to skills that help us to deal with the human sat in front of us, such as communication, behaviour change, empathy, etc.
The next session was a panel discussion on responsibility. I thought this session covered a lot of ground. Looking at important questions, what is my responsibility? What is the patients’ responsibility? What is our responsibility to each other in physiotherapy? Some of these questions may seem like they have easy answers, but as ever things are rarely black and white. Take the example of what is the patients’ responsibility? It might seem straightforward to say we are all responsible for our own health, and I feel there is a large degree of truth in that. However, we also know that social determinants of health are an important factor in the health of individuals; a quick example would be life expectancy, which varies in the UK depending on location (ONS 2017). When considering these types of factors, questions like this become trickier to answer. There were a couple of points by the panellist that struck me. The first by Andrew Cuff, who mentioned that we have the responsibility to do privately, when we are one to one with the patient, what we tweet about publicly. This is a good point in the age of social media, where it is easy to say stuff publicly. We need to walk the walk as well as talk the talk. The second was by Neil Langridge who emphasised the responsibility we have to the patient. He mentioned (again I paraphrase)
…You might be just the person that the patient needs to see at that moment in time. Can you change behaviour in 20mins/30mins? Maybe…
This comment made me consider the importance of always being ‘on my toes’, always ready to give the best I can to the person sat in front of me, because I might just be the person that they needed to see, at that particular time.
The final session on reform consisted of table discussions. I was sat on a table looking at clinical research. We spent a fair amount of time talking about the clinical academic divide, a subject that is of interest to me as a researcher and a clinician. How do we narrow this divide? Well I guess there needs to be movement on both sides. Although we didn’t find the ‘silver bullet’, we discussed several ideas that might improve the situation. These included having information on available research grants and research training pathways in one easy to access location, e.g. the reform.physio website, finding ways to make clinical academics more visible so people know who might be useful to contact, and for clinicians to take the step to contact researchers if they have questions. On this last point, I’m not aware of ever turning down a phone call or quick catch up when someone has asked about my job, or the training pathways I’ve been on. Also I’ve never met a researcher who doesn’t love talking about their research! Perhaps we just need to talk to each other more, and not just blame the ‘other’ side, because ultimately I think we both want the same thing, to improve peoples’ lives.
Finally, I liked to say thank you to both the Physio Matters Podcast team and also to Connect Health for the time and resources required to put on this event. If there was one suggestion I’d have for the future, it’s that it would be good to hear the patients’ voice in all these matters. Now, it just so happens that this will be the case at the conference in October, so I’m sure it will be a great couple of days!