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What Do We Give Into in #Physicaltherapy?

March 15, 2015 • Health Care News • Larry Benz

I read this short article about “Why Doctors Give in on Vaccines” a few times before it really sunk in. The article was based on this study which is from the official journal of the American Academy of Pediatrics.  93% of pediatricians in this large survey say they have been asked by parents to delay vaccines and almost two thirds agree to the delays despite the overwhelming majority of physicians (87%) thought that doing so would put their children at risk for the 14 diseases that can now be successfully vaccinated against.  The most stunning responses to this farce though is the fact that 82% of the physicians thought that agreeing to delay would build trust with families and that if they did not agree, families might leave their practice (80%).  In the conclusion, the authors posit that evidence-based interventions to increase timely immunization are needed to guide primary care and public health practice.  Apparently telling the truth is not yet evidence based-at least in medicine or with the majority of pediatricians.

While we don’t have any analog in physical therapy that competes with the risks of delaying vaccinations, we might just share some common insecurities with our physician counterparts.  Acquiescing to a request that is counter to evidence to “build trust” or fearing that a patient will leave for another provider.

Do we do this when we:

Cave in on a passive modality that is requested yet has no basis of evidence?

Provide some type of intervention when we are not fully trained because the patient might leave to go to a clinic across the street?

Oblige a written prescription by a referring physician despite knowing that it will not help the patient? (thus fearing loss of referrals)

Noted professor and author, Dan Ariely, reports per his research that cheating within a social domain, known as little white lies, is often acceptable. Like when a friend who has made you dinner asks how you liked your food and you respond “great” when you really should say “it sucks”. These white lies generally keep the peace yet we all agree that this is not acceptable in business.  Per the pediatrics study, it seems to now be acceptable in their practices.

Is it an acceptable practice in #physicaltherapy?

Are there other examples of doing something wrong to build trust or do out of fear of a patient fleeing to another practice?

@physicaltherapy

Larry Benz

Dr. Larry Benz, DPT, OCS, MBA, MAPP, is the Executive Chairman of Confluent Health. He is nationally recognized for his expertise in private practice physical therapy and occupational medicine. Dr. Benz’s current areas of interest include conducting research and integrating empathy, compassion, and positive psychology interventions within physical therapy. He released a book on September...

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