Your comments: 20 May 2015

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Sudden blow

I am a retired paediatric physiotherapist, and in June 2014 was diagnosed with idiopathic pulmonary fibrosis (IPF), a progressive, untreatable lung condition, after a wait of six months. This was a devastating blow as my husband has severe chronic obstructive pulmonary disease and I was his carer. Now we are mutual carers! 
The diagnosis is frightening as 5,000 people die from IPF in the UK each year – more than from leukaemia – and the average survival from diagnosis is three years, with only one in five surviving more than five years. On my short, rapid journey, I have discovered that many medical professionals have limited knowledge of this condition and its devastating impact on the lives of patients and their families. 
Most of my help and advice has come from the British Lung Foundation, and I am working with them to help raise awareness of IPF, its prevalence, its unpredictability, lack of funding for research and support for patients and families. I was privileged to be at the Westminster launch of their new publication, Lost in the system, which highlights the patient experience.
I would encourage respiratory physiotherapists  to join BLF Professionals to help raise awareness among their professional colleagues. Visit the BLF website and view other resources here where you can access some useful resources for patients and families.  
  • Ann Bennett

Rigour required

To the correspondents who suggest that ‘anecdotal evidence’ should be given equal importance to evidence-based medicine, I would like to emphasise that anecdotes are not evidence, and therefore are not equally important. 
Our ‘intuitive awareness and observations’ are unreliable, because we are inherently biased. This is not a slight on physios’ clinical or observational skills, but a fact of life that has been established by research using well-designed methods and carefully-controlled observations. Evidence-based medicine is the result of research in which great effort was taken to remove bias, intuition and observational error from its methods, measurements and results.
In the absence of evidence, a clinician’s experience and observations may give the best available guidance; this is recognised by the levels of evidence which include expert opinion but at a much lower level of importance than that produced by established research methods. 
  • Nick Preston, University of Leeds

Banding anomaly

As a doctor working in the UK, I work with lots of allied health professionals. In recent times, there has been a move for staff to be referred to by their Agenda for Change pay banding. I have therefore worked with band 5 physios, band 6 speech therapists, band 7 occupational therapists and so on. With this change in terminology, it has become clear that there does not seem to be great consistency in what constitutes a particular band across the professions. Physios in particular often seem to have been sold short when it comes to their pay band. 
Being accepted on to a university course to study physiotherapy is a highly-competitive process with demanding entrance requirements. Graduates undergo extensive postgraduate training and are highly-regarded members of hospital and community teams. Their treatment can be life-saving (chest physio for aspiration pneumonia) and can reduce disability (rehab after a stroke). Despite this, it appears that highly- skilled and experienced physios can be restricted to band 5 positions.
By contrast, clinical scientists automatically progress from band 5 to band 6 posts when they prove to their professional body that they have reached a certain standard.
  • Kevin Hamilton, MD
Various and Frontline

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