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Complacency Alert

David Fitzgerald

In today’s episode of his weekly vlog, chartered physician David Fitzgerald talks about “complacency” and what this term means in the physiotherapy industry.

Make sure you watch the video below if you want to hear more of what David has to say.

So, what does this term mean in clinical practice? We’re talking about an issue that presents itself when simple problems seem to have more than one plausible cause. David gives the example of a common ankle sprain. There are in fact many different types of ankle sprains and they all look similar during physical examinations. A simple ankle sprain caused by a damaged ligament might look very similar to an “avulsion fracture”, a situation that presents a small piece of bone being pulled away with the ligament.

Of course, there are ways of differentiating various issues and conditions and a series of simple tests would be enough for any professional clinician to identify the real issue behind the patient’s symptoms. In instances like this, x-rays are extremely important, as they’re the perfect tool to differentiate whether there’s a suspicion of broken bone or it’s just something that involves the ligaments.

Different conditions require different management and, depending on the gravity of the situation, the clinician decides to opt for physiotherapy or suggest a surgical solution.

Although professionals should all be aware of the many conditions that share symptoms, it’s now become common practice for many of them to request an x-ray for ankle sprains in order to be 100% sure to exclude the possibility of bone involvement.

Other common issues

Another common issue, just like a sprained ankle, is a fall onto an outstretched hand.

There is a bone called scaphoid and located between the thumb and wrist that very frequently produces a small fracture when impacted. Other mechanisms that can cause this fracture are punching or falls (for instance off a bicycle), all things that damage the already tender area around the scaphoid.

This fracture very rarely presents itself as being particularly sever, so people are almost never suspicious that the cause could be a fracture. For this reason, this is a type of injury that often sneaks under the net, as David says, and x-rays can’t even help with this. The fracture is in fact so small that it might take weeks to finally show up in an x-ray, therefore it’s always a good idea when clinicians decide to take some precautionary measures like immobilising the wrist and hand for anywhere between two to four weeks.

Another important thing all clinicians should do is being honest with patients, making sure that the recovery times are clear enough so that there won’t be any expectations of a fast recovery for serious issues like a hip replacement. Things like this, in fact, take longer to recover and patients will only start feeling substantial improvements over a long term time frame.

Back to the complacency issue

With these very specific examples, David wanted to give you an insight on a clinician’s mind and he concludes his video with an important message to his colleagues and patients. When things aren’t going to plan, it’s important for professional to be alert and critical of their own performance, making the patient’s wellbeing their priority.

Once again, David discussed a very controversial topic in his video and this is just a brief extract of the many things he had to say, so make sure to watch the full video!

Hopefully, you found this article informative and helpful however, if you would like to know more about “Ethics in clinical practice” make sure you check out David’s video and article. It’s always better to be informed about the common practices that clinicians should follow so, next time you go to an appointment and you think that something isn’t right, make sure you speak up and ask plenty of questions to reassure you that the practitioner is doing his or her job in the most ethical and professional way possible.

This is everything from David for today, make sure you keep an eye out for his next video and article next week.

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