Physiotherapist versus Physician

[helenlegs 11]

I found this new article interesting http://www.biomedcentral.com/content/pd ... 13-107.pdf

Although it isn't specific to PN it definitely states what many of us have already discovered.
Here is part this scholarly reviews conclusion

The emerging evidence suggests that physiotherapists in APP roles provide equal or better
usual care in comparison to physicians in terms of diagnostic accuracy, treatment
effectiveness, use of healthcare resources, economic costs and patient satisfaction. There is a
need for more methodologically sound studies to evaluate the effectiveness APP care.

I had such a difficult time finding a correct diagnosis, as many of us do. My first correct indication of what the problem may be was initially diagnosed by a physiotherapist. I do think that in cases like ours a knowledge of the (pelvic) anatomy is so necessary and a PT often gets it right where many much more highly paid and respected doctors and consultants don't. However, In the medical community the diagnosis or findings of a PT would be dismissed in favour of a 'proper doctors diagnosis'. I'm glad that peer reviewed articles like this are addressing the balance.

[Violet M]

I have to agree with you Helen. I was correctly diagnosed by a PT after seeing numerous docs who didn't know what was wrong but wrote things in my medical record that were not very flattering and told me to see a psychiatrist. But with that said, it took a doctor to actually release the nerve which a PT could not have done -- so both roles are important.

[TriMaverick]

I do think that in cases like ours a knowledge of the (pelvic) anatomy is so necessary and a PT often gets it right where many much more highly paid and respected doctors and consultants don't.

I think the indispensable role of a physician would be in ruling out more profound cellular pathology (e.g. cancer). Beyond that yes, I think the consumer had best be fairly aggressive in getting referrals to the right PT. Considering the way medical school rotations and residencies/internships are here in the USA I'm not sure where expertise in PN would be gained. But, considering the diverse role of the pudendal nerve and the varied anatomy of individuals the physician should keep an open mind. My understanding of sports medicine in Australia is the residents do rotations with Olympic teams and are expected to be skilled with all levels of athletes. I would guess experience with cyclists would teach them something. Here in the USA sports medicine only exists as a subspecialty and no such residency exists, if I'm not mistaken. I believe andrology in the USA exists only as an interdisciplinary collaboration.

[TriMaverick]

I have to agree with you Helen. I was correctly diagnosed by a PT after seeing numerous docs who didn't know what was wrong but wrote things in my medical record that were not very flattering and told me to see a psychiatrist. But with that said, it took a doctor to actually release the nerve which a PT could not have done -- so both roles are important.

Maybe that's common. I wondered if my previous primary care physician wasn't taking me seriously. With the urologist I saw the cycling aspect of patient history never registered with him; but, he wasn't that far off with the diagnosis and I felt it was more genuine respect from him. I could write a book on what's wrong with psychiatry.

[helenlegs 11]

the physician should keep an open mind.

This is is the key Tri. The problem arises when they are blinkered within their own speciality and then sometimes have an infinite ego, so of course they can't be wrong.
The system over here (NHS) can be so dysfunctional because of this, it's almost Dickensian, unfortunately, I'm Oliver asking for more.
I'm not really shocked by this although it is shocking. Different folks etc. I am shocked however, because medicine is an ever evolving science. No one knows it all, yet they think they do. Clever people should know that surely?? There is no bigger wall to climb than one constructed by a powerful bigot. (OOooh do you think I'm jaded? Thankfully tenacious too )
Thankfully physicians who have a PN speciality are already looking out side the box and seem to have a greater empathy. We need greater recognition of the problem.
Take care
Helen

[Aussie-m]

Well it was a doctor who diagnosed it for me and that was after seeing a number of them all the physios well all hopeless but then again so were that doctors , i just got LUCKY , he gave me the best advice and that was learn as much as i can about my condition that way you have some control .