Rose Wiles and
Sue Barnard (2001) 'Physiotherapists and Evidence
Based Practice: An Opportunity or Threat to the
Sociological Research Online, vol. 6, no. 1, <http://www.socresonline.org.uk/6/1/wiles.html>
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Received: 6/3/2001 Accepted: 10/5/2001 Published:
P4: 'The need [for EBP] has come out of vying and jockeying for attention and we are being bombarded from different angles, from medical, chiropractic and osteopathic and everyone is coming out with their research and saying "we are bigger and better than everyone else"'
P1: 'If your services are being bought, then people want to know that they are buying good practice and good services don't they? We have to prove that in order to get the business'
(Superintendent physiotherapists, focus group 9)
P3: 'It has to be the direction the profession moves in'
P1: 'Oh I would totally agree'
P3: 'I think otherwise our jobs are really and truly on the line, our profession is on the line unless we can actually say "yes this helps this particular type of condition in these circumstances"'
(Senior physiotherapists, focus group 7)
P3: 'I feel like even on ITU [intensive therapy unit] here, I mean the nurses are quite often on these ITU courses and they know more about patients than I do. They know more about ventilation and they're suctioning all the time and bagging and I'm going up twice a day to do what they're doing'
P6: 'We've got a really good senior who's just come in and has been doing lots of research and she can give the evidence and she can say "well this is what I found and we should be doing this" and now they're actually saying "OK" but then again with me I won't argue so strongly because I haven't seen it'
P4: 'If you've got the research behind you you're a lot more respected aren't you?'
P6: 'I think this is one of the problems in respiratory. Some people say "why have we got respiratory physios when some of the nurses are becoming so, you know?"... We do need to get the research evidence'
(Junior physiotherapists, focus group 3).
'I think often on the wards, doctors tend to think, you know, oh we'll just tell the physio to go and do this type of thing and it becomes more of a technician's role and one of the doctors can be quite bad at that, and I think we just need to, you know, be a bit more assertive sometimes and I think if there is more evidence, more research in certain areas, we will be more assertive definitely in that area and probably gain more respect I think as physios'
(Junior physiotherapist, individual interview 2.1)
P4: 'I think it comes down to how the profession is respected ... I know that some medical staff really seriously criticise us because we haven't got enough research evidence and they perhaps would respect us better if we did'
P2: 'I think they probably would too'
P4: 'It would be much more of a powerful argument wouldn't it?'
(Senior physiotherapists, focus group 7)
P1: 'Whatever we write down in our notes is gonna be evidence towards your goals, your aims, in looking towards evidence based practice'
P6: 'It doesn't have to be research'
P1: 'A lot of emphasis has been put on research recently ... and we look at it [research evidence] and we go "hah, that doesn't fit into any kind of clinical form" and they're just proving that it doesn't work but we know it does 'cos we've seen it on our patients. So I think from the research point of view we sort of seem to be disproving ourselves, yet we know it works'
P4: 'And from the outside looking in the purchasers are going to be looking at the research … and they may base what they want on the research which might not necessarily be you know what you felt helped, like you were saying'
(Senior physiotherapists, focus group 6)
'Those guidelines, if you just followed that you'd manipulate every patient in the first six weeks and we all know that not every patient responds well to manip[ulation] and there's a lot of other factors again so you can't just follow evidence based practice.'
(Senior physiotherapist, focus group 7).
P6: 'There's quite a lot of placebo in our work and if a patient's convinced such and such is gonna help them 'cos that's what they had twenty years ago and you've got no definite reason for not doing it then we all know with some patients it's easier just to do what they want and they're going to get better, than do what you think is best that they don't think is gonna help them'
P2: 'It's part of the skill of dealing with the patient isn't it?'
Res: 'so you wouldn't want to see physio going down a road where that couldn't happen?'
P1: 'We'd be out of a job'
P2: 'Well you could hand it to a physio assistant and say you do this with that patient and almost walk away couldn't you?'
P1: 'We would become technicians'
P6: 'Physios wouldn't do it, we're not like that'
(Senior physiotherapists, focus group 6).
P1: 'my biggest worry is if everything does become evidence based we're going to go back to the old technician thing.'
P3: 'You are straitened, you are blinkered then, you would lose your flexibility, your autonomy as a practitioner'
P1: 'Which we've fought so hard for really haven't we?'
P3: 'It's full circle isn't it?'
(Senior physiotherapists, focus group 7).
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