In the early 90’s, Sackett published an evidence based approach to medicine which has become the cornerstone of modern health care practice today. The evidence based model combines the use of the current research evidence, with the clinician’s expertise, and the patient values and treatment preferences.

Over the past month I have been hard at work in the clinic whilst also completing assignments for my Master’s degree. During this time, it has been at the forefront of my mind to always provide the best care using this model. I have had numerous patients come into the clinic over the past month asking for interferential treatment for their chronic back pain, massage for balance issues and most recently a miracle cure for gaining significant amounts of strength overnight (I was very tempted to say eat a lot of spinach like Popeye).

Healthcare professionals are constantly being challenged by their patient’s pre-conceived views of treatments available, their expectation of treatment outcomes based on past experiences and their view on who is experienced enough for them. It is our job as clinician’s to advise, educate and empower our patients to make well informed decisions for their optimal healthcare. Using Sackett’s model, we as clinician’s are constantly updating our clinical expertise by reading, analysing and discussing the newest research evidence.

A few years ago, whilst working in the public hospital system, I was in charge of a few physiotherapy students, with one student being 20 years my ‘senior’. As I introduced myself to my patient, I was asked by the patient whether my ‘senior’ could assess and treat them. I agreed and let my student take the lead, and as any student on the first day of their first clinical rotation would do, they mumbled through the patient history and lacked confidence within their treatment. Afterwards I sent my student to go write notes and had a quick chat with the patient, who was later not surprised to hear that the ‘senior’ was actually a student.

The trickier part of Sackett’s model is to influence our patient’s views, values and preferences. One assumption, commonly made within the healthcare system, is that youthfulness automatically means inexperienced and older clinicians are wiser and more experienced. This pre-conceived mindset is quite difficult to overcome within the first treatment session; however, I believe it is the responsibility of the clinician to help shift this perspective, by communicating and self-empowering the patient.

It has been over two decades since Sackett published his evidence based approach to medicine, with many healthcare institutions improving due to adopting this model. It is important for all healthcare professionals to integrate this model into their clinical practice. However, the most influential aspect of this model is the patient’s perspective, as even the most clinically experienced will find difficulty in shifting a patient’s pre-conceived mindset.

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Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.