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Premature deaths should be the priority for prevention

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c3946 (Published 22 July 2010) Cite this as: BMJ 2010;341:c3946

Less is More : More or Less is More or Less

Thank you Sam for your kind words. However I was specifically not
referring to
‘laying of the hands’.

It is the passive techniques (e.g. massage, manipulation,
acupuncture,
electrotherapy) that particularly fall short when it comes to evidence
based
physiotherapy. The evidence is stronger for providing advice, reassurance,

educating (posture and exercises), and above all, motivating patients (1).

There are of course some situations when ‘passive’ therapy can help a
patient,
but only when self-care by the patient is actively encouraged.

I don’t fear a BMA vote against physiotherapy, because our profession
is slowly
changing in the right direction. Given its lack of resources for funding
high
quality research, it is hardly surprising that it lags behind medicine!

Its good that we both agree that peer pressure can lead to not just
over
treatment, be it medical or therapy based, but a fear of challenging the
status
quo. Very few clinicians want to appear to be out of tune with the herd.

1. BMJ. 2004 Sep 25;329(7468):708. Epub 2004 Sep 17.

Competing interests:
None declared

Competing interests: No competing interests

26 July 2010
Richard Bartley
Physiotherapist
Wales