Spotted Owls, Take II

Famously in 1990, the Spotted Owl was declared an endangered species. It is generally assumed by some that this ruling and the subsequent ban on logging old growth public forests contributed to a decline of the entire northwest logging industry.

Last week, the U.S. Fish and Wildlife Service proposed to reduce the size of protected land by 22%. While the issue of opening ANY old growth forest up to logging bothers me, I’m not an expert. I know nothing about forests, logging, or owl habitat and so my opinion matters little. Here is a commentary of the issue that I liked.
But, this follow-up article, which outlines the questionably close relationship between Fish and Wildlife Officials and logging powerhouse Weyerhaeuser, made me angry enough to blog about it.
Apparently, the US officials let the logging company edit their proposal to reduce the ban on logging. Why didn’t they let the environmental groups edit the proposal as well? This quote from the article sums up the way that Weyerhaeuser conducts business:
"In the mid-1990s, Weyerhaeuser told federal officials it would create a "habitat conservation plan" to guide its Southwest Washington logging. Because of that, the state did not take special efforts to protect owls there, as it did elsewhere. But Weyerhaeuser never produced the promised plan."
As annoying as environmental groups can be sometimes, I think instances like this are exactly what they exist for. Ironically, the Spotted Owl might be on the verge of extinction, but a large part of that has to do with the fact that it is "hybridizing" with the very closely related and thriving Barred Owls. In other words, perhaps the logging isn’t the biggest threat to the species. Maybe nature is.
"The barred owl either eats [spotted owls], kicks them out of their habitat, or mates with them—and sometimes the offspring are fertile…"
 
Sparred Owls???

6/27/07:  Update:  Today’s CSM has a great article on this issue.  They obviously read my blog and considered it big news!

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What should we do with this window?

Rockefeller Plaza is some pretty valuable real estate. It looks like the APTA has got their hands on 115 square feet of it for the month of June in the form of a picture window. The window’s content is about Physical Therapists’ ability to help prevent diabetes:

"The oversized panels also explain how physical therapists can help people with type 2 diabetes by designing a safe and thorough physical activity regimen that meets individual needs. The centerpiece of the window display is a life-sized female mannequin, who demonstrates the proper "fit walking," technique. She is standing in front of a video illustrating the various ways people incorporate physical activity into their daily lives."

Fit Walking Technique??? Well, at least my membership dues didn’t pay for this. The window space was donated by Executive Health Exams International. Which is also interesting.

In other news, an angry mob of internists was seen accosting a group of APTA members near Alexandria, VA. As the attack was taking place, the internists could be heard chanting, "You’re experts in muscles and bones, leave the diabetes to us…"

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Unfortunate Weekend News Roundup

Browsing through my various news feeds this weekend lead me to the following two instances of Physical Therapists making news headlines:

 

This is about a new facility in Summit County, CO now offering Primal Reflex Release Technique. Click here for a somewhat disturbing video and an opportunity to sign up for a home study course in this technique.

Three individuals, including two Physical Therapists, were arrested and charged with health care fraud, allegedly billing for services not performed and billing for Physical Therapy performed by a massage therapist. At least the FBI knows all about our profession. That’s good, right?

How are we doing policing ourselves as a profession? When instances like these happen, the concept of professional autonomy is undermined as the trust we demand from society is eroded. These are fairly extreme instances (and in one case, criminal,) but how do we do in situations that are not so obviously concerning? Such as: Treating too many people simultaneously to bolster a bottom line, over or misuse of modalities, not keeping up with current evidence on a particular condition or patient type? Do Physical Therapists, or any health care profession for that matter, really have a good system in place to help police the rank and file?

Anyway, perhaps that is too much philosophy. All I really want is some Good Press!

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Smoked Ligaments Not A Good Idea

This study from Washington University in St Louis found that exposing mice to smoke resulted in significantly decreased healing in medial collateral ligaments. While the news bit mentions that smoking among athletes is lower than the population, I can think of one population who suffers ligament injuries quite often, and smokes quite a bit.   Soldiers.
Don’t we pay for their medical care through our taxes?
When will the military decide the costs of smoking are too high to allow it to occur?
This news report from 1995 seems to have been a bunch of smoke and mirrors.

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An Economist Checks In on Health Care

I like to keep a lookout for when the smart economists provide some of their thoughts on health care.  Ultimately, it is these economists that the government consults with to initiate ideas about how to manage our health care system.

Tyler Cowen, a well respected economist, checks in with a piece called, Smart thoughts on health care.  He doesn’t say too much, but it sure sparked a conversation in the comments!

When I read this, I try to read between the lines about what people are saying and see how Physical Therapists might act to fill a need economically.

My favorite line from the comments:

"90% of the time I see a doctor it’s to tell them, "I have X, and I need a prescription for Y." After reviewing my symptoms and medical history they always agree with me and write me the prescription. So why am I paying an extra ~$100 just to get a medication I already knew I needed, for a condition I already knew I had, before seeing the doctor? It’s just a waste of my time and money."

Perhaps it is this lack of perceived value in routine care which prohibits a move to a retail-like system.

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Some News and a Thought

I have been writing my blog, NPA Think Tank for less than one year.  In that short time, I have been fortunate enough to get some good exposure and a fairly loyal audience.  The Evidence in Motion Group has been very helpful in support of my pursuit.

To them, and my readers, I ‘d like to say, "Thank You!"

Today, I’m happy to announce that my blog posts about Physical Therapy will begin co-appearing directly on the Evidence in Motion Blog at MyPhysicalTherapySpace.com.  I’m excited for a new level of exposure and for a new audience.  NPA Think Tank will still have some posts unique to it, which will help fulfill  the "healthy living… and a vast array of seemingly random topics" part of my tag line.

I have also begun helping out with the Physiospot Musculoskeletal Blog, which is working to be a resource to deliver updates of new research as it breaks.  This is part of a collection of sites worth a visit for Physical Therapists.  Their tag line:  "Assisting health practitioners with evidence based practice and continued professional development."  Physio implying a Canadian-based site in this case.

Finally, and hopefully your still with me, I will direct you to an interesting editorial that appeared in this month’s issue of Contraception, An International Reproductive Health Journal.  (Please, do not read into this…visiting just by chance!)  Anyway, the editorial entitled, "Why We Need to Truly Understand the Medical Literature", lets the audience in on "One of the best kept secrets among health care providers…"

The secret: Many healthcare providers— especially medical doctors — do not have the ability to understand and interpret the medical literature.  I liked the article because it brings up some good questions about training future providers in topics of critical appraisal and evidence-based practice principles. 

Eric

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Oh Brother! "PT's Do Research?"

Teaser: Find out what one MD thinks of Physical Therapy! Please read the whole story: Kind of longish, but entertaining never-the-less.

Recently, my work environment has changed. I’m no longer in the traditional outpatient setting. I have been shifted to a clinic that exclusively treats military trainees. I’m still deciding if I enjoy it or not, but my new office mate has proven to be rather thought provoking.
I now share an office with a Physician. The simple fact that I share an office in this way speaks about how Physical Therapists are perceived differently in the Army vs. civilian life, where I would never be allowed to have a key to the proverbial "Physician’s Lounge." Anyway, this guy, an elder fellow who’s a Family Practice doc, has taken it upon himself to challenge my brain every few minutes. For some, this might be tortuous. For me: Game On!
We have each had our share of victories and defeats thus far. He usually sets me up for wrong answers, so I expect my winning % to increase once I recognize his lead-ins more quickly. Anyway, he loves to impress me with his medical knowledge base. Occasionally, I get to teach him something.
I was reading this very useful case series from the latest JMMT issue. The article is a good representation of how back pain is treated in the hands of expert Physical Therapists. Included is a nice chart about how certain symptoms lead to certain treatments and so forth. I explained this chart to my office mate and answered some of his questions about the research supporting it. His response was mostly quiet, which I have come to take as a sign of my victory in our virtual battle of wits. I sat back happy and gave myself a pat on the back. Unaware that his greatest and most vicious attack yet was pending.
Several hours later over lunch he states, "That article was pretty interesting."
Still I think I’m winning.
He continues, "You know, I never new Physical Therapists did that."
I smirk, "What, classify types of back impairments and treat accordingly with specific, focused treatments because they are backed by scientific evidence?"
"No. I didn’t think you guys did research."  He was being totally serious.
I walked away in stinging defeat. This story is sadly humorous, and of course, limited to this one doctor. But, how many more physicians have the same opinion as my witty office mate? 
Lesson Learned: Talk about the research you read. It not only shows others that you personally are well read, it impresses them about the entire field of Physical Therapy. And, as this points out, we need all the good PR we can get.

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A Sports Cream Fatality

The sad case of Arielle Newman proves that anything taken in excess can be bad.  I have never seen the benefit of sports creams, instead using self-remedies such as stretching and relaxation, maybe an ibuprofen here and there.  I could never imagine that sports creams’ active ingredient could ever cause some one’s death!

In other news, check out my shared items section of the sidebar. I marked a number of New York Times Health articles about healthcare: spending, reform, and risk-benefit calculations.  If your reading this blog via e-mail, this means that you need to click the link at the top of this page and go to the NPA Think Tank website.

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How to Permanently Archive Feed Items

I had the opportunity to present to some faculty and students last week on the relationship between good evidence based practice and internet technology. The topic was mainly about using RSS feeds to collect information that could then be used to improve your clinical practice. i called it, Evidence at Your Fingertips: Leveraging Internet Technology to Improve Evidence-Based Practice Skills.

While the simple fact that you are reading this blog indicates you may know a bit about RSS technology, I was a little surprised that the the vast majority of the audience did not. To techies and bloggers, RSS is part of everyday life and so it was unexpected that a whole room of students and faculty did not use it, but that was the case. I hope that I was able to spread a little RSS interest through my presentation and now there’s a whole pile of new RSS fans out there.

Anyway, to continue my Evidence and Technology topic, I will offer some tips from time to time about using different internet technologies.. Of course, I am no expert on this. If you’re really interested, go check out some posts on the Lifehacker or Lifehack blogs.

My Tip of the Day: Permanently Archiving Feed Items of Interest from Google Reader.

Often I find a post that I really like, but for reasons time or energy related, I just skim the post and pass it by for later reference. Google Reader’s absence of a search component sometimes makes it difficult to find these items for later reference. I have been using a little work around and e-mail creativity to overcome this issue.

  1. E-mail the post to your self: Google Reader nicely integrates e-mail with a single click. I simply send the post item of interest to myself. It’s helpful to add a bit to the subject when sending the item to help in creating a filter in the next step. I add the letters "GR" to remind me that this e-mail is from Google Reader.
  2. Create a Filter: In your e-mail client (for me it’s Gmail,) create a filter.

 

The filter should include both a "to" and "from" address that is your e-mail and whatever you added into the subject field ("GR"). I choose the filter to bypass the in-box and tag it with the term "Google Reader Archive."

I can now freely search all of my saved feeds in G-mail, taking full advantage of Google’s product integration and ample e-mail storage space. Never lose a feed you like again!

By the way, if you use Firefox and Greasemonkey, you can go get the Custom Google Reader Search script.

 

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