Too Many Too Many’s – NSAIDs

We are thirsty in the rain.  We have too much medical care and not enough “health” care.

This is the second in the series of Too Many Too Many’s and today we would like to highlight the overutilization of non-steroidal anti-inflammatory drugs (NSAIDs) both medically prescribed and self-prescribed.   More than 70 million prescriptions for NSAIDs are…

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Too Many Too Many’s – Opioids

As a nation when it comes to medical care we are thirsty in the rain.  We frequently have too much medical care and not enough “health” care.   With this backdrop we are launching a series entitled “Too Many Too Many’s” which focuses on the many areas of overutilization in our medical system. We are beginning the series with the…

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Pain Reframed Podcast Launched This Week

Problems that don’t get discussed don’t get fixed, and we have a serious pain problem in the United States. How bad? A recent report by the Center of Disease Control “CDC Guideline for Prescribing Opioids for Chronic Pain – United States, 2016” informs us that 259 million prescriptions were written for opioid pain medication in 2012 alone, enough for…

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Accelerated Rehab & Accelerated DPT

I distinctly remember when the paper by Shelbourne & Nitz describing an accelerated rehabilitation program after ACL reconstruction was published (yep, I am that old).  Though it would be some time before the RCTs were published that confirmed this observation, the paper nonetheless began a paradigm shift in the postoperative management of patients following reconstructive surgery.  At the time there…

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Fear & Loathing in America

In many ways, there has never been a better time to be alive. In this NY Times piece The Dalai Lama & Arthur C. Brooks do not sugar coat the fact that serious inequalities and violence persist in our world, however, they also describe how fundamentally strange it is to see such anger, political frustration, and anxiety about the future…

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It is more than just harmful, it is wrong!

Frequently on this blog we have discussed the harms inflicted by over-imaging, over-surgerizing, and over-prescribing opioid medications in the management of musculoskeletal disorders.  We have also discussed how care pathways that focus on PT First reduce imaging, surgery, and drugs and result in lower health care costs.  First and foremost as a clinician and researcher I believe…

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Speak Truth to Power

The new vision of the APTA transforming society by optimizing movement to improve the human experience also speaks to our professional role in advocating for our clients and society.  Specifically it states, the physical therapy profession will advocate for patients/clients/consumers both as individuals and as a population, in practice, education, and research settings to manage and promote change…

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The Procedure Is Next To Useless!

Yesterday’s article in the NY Times added one more voice to the unwarranted use of knee arthroscopic surgery in the management of meniscal tears and knee osteoarthritis.  The article focused on the recent BMJ study which showed physical therapy was at least equal to surgery with fewer side effects and superior to surgery in improving thigh muscle strength. The…

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Sustained Excellence- A Better Kind of Happiness

In Will Storr’s recent piece in the New Yorker he writes about emerging research on happiness.  Specifically he cites research that suggests that in individuals lacking eudaemonia, which is in essence a rational mind pursuing excellence, there is increased health risk.  The risk noted in gene expression in those lacking eudaemonia is suggested to be as damaging as smoking…

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