2008-08-01 / Columnists

Eye On Physical Therapy

Commentary By Dr. Tim Rohrs, DPT

People were angry today. I don't know whether this is due to the hot weather here in Rockaway, gas prices, the economy or a combination of everything, but people are mad. I happened to mention to some patients that I was going to sit and write my column for The Wave and had no clue about what I was going to write. Did I mention that I had less than 18 hours to complete it?

Some people started calling out ideas: one lady said I should talk about the difference between living "uptown" and "downtown" in Rockaway. As an "outsider" I am not really sure what she meant by that, but I told her my column, in some way, had to relate to physical therapy.

The next woman said I should write about trying to avoid surgery for various ailments, and to avoid surgery at all costs. This idea held some promise. Then she went on to state, "A lot of surgeries are done for the benefit of the surgeon and his bottom line and not the patient." WOW! I thought, this lady is angry! And cynical! To my surprise, some other patients that happened to be listening joined in on the chorus and agreed with her. I really was kind of shocked.

Although I am sure there are some surgeons out there who are too quick with the scalpel, I am reluctant to believe that they are the norm. In addition, to paint all surgeons with that brush is unfair and quite frankly just not true. I have been in practice for over 12 years and have had stories related to me by patients, too many to count or remember, who WANTED surgery but the surgeon thought there would be no benefit or relief for the patient or that the patient was medically at risk.

The truth is that whether one is a surgeon, physical therapist, nurse or any member of the health care team, we do the best that we can with the individual circumstances presented to us. You can ask a master carpenter to build you kitchen cabinets and then supply him with plywood and duct tape. I don't care how great he is, those cabinets are not going to make you happy. A knee that has been destroyed by arthritis or a rotator cuff tear that was torn many years ago will exhibit certain physical challenges to getting the relief for which you are looking. If the surgery did not return you to playing tennis or riding your bike, or you're still in pain, you cannot assume the surgeon jumped in to do the surgery for profit and not for you.

The same holds true for physical therapy. I would like to believe that every patient that walks through my door will get better; but I am not naive. There are some conditions that, whether due to the patient's age, length of time with the condition or the severity of the problem, will limit how much success we are going to have. I am honest with them and tell them we will due our best and then present them with the reasons why I feel that success may elude us. Some, never come back, discouraged by my "negativity"; others press on and give it their best shot. If they are willing to work hard to try to make it happen, so am I. At times, I have been pleasantly surprised that my prognosis was incorrect, happy that they got some relief.

You just can't make great cabinets out of plywood and duct tape, but sometimes you get lucky.

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