PhysiosOnline

Evie and Asaf had this discussion following an interview with Lorimer Moseley by Jack Chew on The Physio Matters Podcast. You can watch that interview here https://youtu.be/xUBA7qQJ6vk

Asaf responds to some points made by Lorimer in the TPMP interview, and we discuss more broadly the topics of nociception, pain science and the treatment of chronic pain by physiotherapists.

Dr. Akhil Bansal is a doctor who set up the effective altruism-inspired organisation "High Impact Medicine" (https://www.highimpactmedicine.org/). Their aim is "bringing together medics who want to have a wide reaching positive impact". He is currently working as a research analyst for Charity Entrepreneurship.

In this interview we discuss

• The concept of Effective Altruism and how this may resonate with healthcare providers such as doctors and physiotherapists
• Charitable giving in general, and the drive to help others
• Akhil's background and upbringing and how this may have impacted his tendency to be drawn to EA
• The reality of what it means for children to die from infectious disease
• Akhil's hopes for Hi-Med and his ambition to build a community where doctors can support and inspire each other to do as much good as possible
• Some book recommendations that have nothing to do with EA

Links and resources: 

HI-Med https://www.highimpactmedicine.org/: "High Impact Medicine, Hi-Med, is a new movement bringing together medical students and doctors to learn more about all the ways medics can help as many people as possible in their careers and engage with opportunities to have a wide-reaching positive impact within medicine".

Charity Entrepreneurship: https://www.charityentrepreneurship.com/akhil-bansal 

The Physios Giving Well fledgling community: https://physiosonline.co.uk/2022/05/why-were-giving-well/ 

GiveWell - How much does it cost to save a life? https://www.givewell.org/cost-to-save-a-life 

Akhil's article on the Effective Altruism Forum: "High Impact Medicine, 6 months later - Update & Key Lessons"https://forum.effectivealtruism.org/posts/TapN3wYhBJPFNBiGN/high-impact-medicine-6-months-later-update-and-key-lessons 

Book Recommendations (not EA-related):

•  "Open" by Andre Agassi
• "Never Let Me Go" by Kazuo Ishiguro
• "Piranesi" by Susanna Clarke

To learn more about High Impact Medicine or join their community, go to highimpactmedicine.org

To learn more about Physios Giving Well and join our community, go to https://physiosonline.co.uk/2022/05/why-were-giving-well/ or find us on twitter @onlinephysios and say something like "I'm in" :)

Marcus Daniell is a professional tennis player and Olympic medallist, whose organisation "High Impact Athletes" connects athletes with the most effective, evidence-based charities in the world

In this chat Evie & Marcus discuss the topic of Effective Altruism and the inspiration behind Marcus's decision to set up High Impact Athletes.
Also available as Vodcast at https://youtu.be/rVNDbT_kJSA

1:20 How Marcus got involved with the effective altruism movement

"It just blew my mind how much sense it made"

3:23 "High Impact Athletes is the vehicle that I've created to try to be the best advocate for EA ideas as possible"

4:00 The significance of GiveWell

"What GiveWell offers us is the most certainty we can possibly have in this space that our dollar is doing exactly what it should".

6:33 Confidence in GiveWell's process including their transparency about making mistakes, and the openness to criticism & new evidence in the EA community generally.

7:30 "If I can donate these amounts of money and it doesn't affect my quality of life or my happiness, then I'm not losing anything really, but that amount of money can be life-saving or life-changing for so many people or animals in the world"

9:58 Peter Singer's "Shallow Pond" thought experiment had Evie feeling pretty bad for a while there. Delighted with the recent focus on giving as an amazing opportunity, rather than a moral obligation (even if it is really a moral obligation)

11:30 The problem of relying on empathy to tell us how to do good. An example might be that vastly more money is donated to pet shelters than to organisations working to improve the lives of factory farm animals.

15:20 Marcus' decision to be vegetarian while at a sushi bar in Japan

17:00 Evie was a bit hazy on the details but got the gist of the scanning eggs example right. More about chick culling here: https://www.smithsonianmag.com/innovation/can-new-technologies-eliminate-grim-practice-of-chick-culling-180977263/

20:30 Evie & Marcus' views on Longtermism.

The podcast episode mentioned by Marcus: https://80000hours.org/podcast/episodes/alexander-berger-improving-global-health-wellbeing-clear-direct-ways/

More about Longtermism here https://www.effectivealtruism.org/articles/longtermism

23:50 An appeal to Messi, Neymar, The Williams Sisters, Lewis Hamilton, and whichever other athletes Evie can name (i.e. the very famous ones) to check out High Impact Athletes! https://highimpactathletes.org/

See the blogpost at https://physiosonline.co.uk/2022/05/high-impact-athletes-with-pro-tennis-player-marcus-daniell/
And the video interview at https://youtu.be/rVNDbT_kJSA

This conversation was inspired by my earlier chat with Asaf Weisman, in one of the previous podcasts or available to view here https://youtu.be/j_0di-4Vaw4.  

In this discussion, we talk about Lee's agreements and disagreements with Asaf's perspective, the debate about whether pain is a sensation or a perception, the predictive processing model, and many other topics.  The conversation was a lot of fun and we rambled all over the place, so there are some jarring cuts/edits in some places. Many thanks Lee. 

For notes and timestamps see the video at https://physiosonline.co.uk/2022/04/a-conversation-about-pain/
You can follow Lee at https://twitter.com/LSchneiderPT

Evie from PhysiosOnline speaks with Asaf Weisman, pain researcher at Tel-Aviv University. We discuss some of Asaf's reflections around the subject of pain and pain science, including:

• Pain is not a thing
• Pain is a sensation, not a perception
• The brain as an "overstressed blue-collar worker"
• Is pain neuroscience education (PNE) based on a fairytale
• His study finding that a majority of people do not like being told "Explain Pain" material
• PNE is metaphysical conjectures, not truth
• The concept of "Coming Back To The Answer". In Judaism, people who are secular and want to go back to religion; they call this process "Coming Back To The Answer" because if you believe in God, you always have an answer for everything.
• The importance of neuroinflammation on human disease and health
• Reductionism
• Asaf's "Doomsday Prophecy" - "Within 5 decades, physiotherapists are not going to treat persistent pain states any more. We've got nothing to offer for these patients."Why am I in pain?" I cannot answer this question, and no-one will ever be able to answer this question. - Asaf Weisman

Evie from PhysiosOnline talks with Dr. Rosemary Sexton. Rosi is an osteopath and Green Party councillor. She has been a professional MMA fighter,  and was the first woman in the UK to fight in the UFC. She is also mathematician having studied maths at Cambridge and received her PhD from Manchester University.

Rosi and Evie connected on twitter over a thread discussing how politics might influence healthcare professionals' decision-making and treatment approaches.  

In this interview, we discuss

• Why, as an osteopath, Rosi became interested in politics and became a local councillor
• Why she chose the Green Party specifically
• Problem-solving as the underlying challenge in both her clinical practice and political work
• Rosi encourages other healthcare professionals to engage in politics, particularly at a local level.  
  

Read the full blogpost at https://physiosonline.co.uk/2021/09/politics-and-healthcare/. You can also view the talk on our YouTube channel at https://youtu.be/RA6pTTZxqWk

To find out more about Dr. Rosi Sexton: 

• Senior Osteopath at Olton Osteopathy 
• Twitter: @RosiSexton
• Political account on twitter: Cllr. Rosemary Sexton @DrSextonGreen

Blogpost at: https://physiosonline.co.uk/2021/07/physiotherapy-in-india-brain-drain-and-other-challenges/

Video at: https://youtu.be/PkZohSUVQHo

Evie talks with Donna Sanderson-Hull - Senior Consultant Sports Medicine Physiotherapist at Blue Sky 

A concussion is a form of brain injury causing a temporary disturbance of brain function. Concussions can occur not only with bumps, hits or blows to the head, but elsewhere on the body, which causes the brain to move back and forth in the skull. There are 22 different signs of concussion and it is an old misconception is that someone generally has to be knocked out to be diagnosed with a concussion. Thankfully, there is a lot more education now in sport on how to recognised a concussion and campaigns to remove people from the field of play should a concussion be suspected. The “if in doubt, sit them out” campaign by Peter Robinson, who’s son Ben died on a rugby pitch after a concussive episode has done much to highlight the need for better recognition of suspected concussion.  

Read the full blogpost: https://physiosonline.co.uk/2021/06/concussion/

Book an appointment with Donna: https://physiosonline.co.uk/physiotherapist/donna-sanderson-hull/

Pelvic health specialist physiotherapist Debbie Dillon talks about her work with patients who are experiencing sexual dysfunction following treatment of gynaecological and prostate cancer.  

Many survivors of gynaecological cancers experience long-term effects on their pelvic health including effects on continence and sexual function, due to treatments such as surgery and radiotherapy. Understandably, while undergoing cancer treatment,  patients and clinicians are very much focused on the curing the disease itself. In Debbie's experience, following successful treatment, many people are then reluctant to seek treatment for sexual and pelvic health issues if they find themselves affected.

Video at https://physiosonline.co.uk/2021/06/sexual-dysfunction-following-cancer-the-role-of-physiotherapists/

Evie talks to Jack March from rheumatology.physio and the PhysioMatters Podcast about producing online learning materials, and how this type of content can be funded.

Jack talks about his work producing learning materials on his own site rheumatology.physio, where he has tried various payment models. He talks about the challenges of earning an income for his work, while at the same time not wanting to limit access to learning materials to those who may not be able to afford it.

05.00:  The different types of people making content. There are obvious differences between for example a person who is making educational material as part of their employment role, compared with those who rely on selling material to generate income.

11.00:  Different models for CPD and content sharing – subscription models versus one-off expenses for standalone products

18.00: The “name your price” model

27.00: “It isn’t fair because you should be able to stand on your quality, but you can’t.”

29.00: Talking about the decision at TPMP to decline sponsorship from drug companies. “You can try to stick to your ideals as much as you can”.

You can book an online appointment with Dr. Noake at https://getbetteronline.co.uk/experts/dr-james-noake/, or contact him at https://puresportsmed.com 

Follow him on twitter at @DrJN_SportsMed

A conversation with physiotherapist David Poulter and Pain Consultant Dr. Deepak Ravindran, consultant in Pain Medicine and lead for the Berkshire LongCovid Integrated Service (BLIS) in Reading, UK.

We discuss:

-The kinds of symptoms and problems people are experiencing when they present to the Long Covid clinic
-The finding that the vast majority - about 90% - of people with Long Covid are those who have had so-called "mild" disease, where they were not hospitalised.
-Theories of the mechanisms underlying development and persistence of LC
-Variability in how people respond to the virus
-The controversy around use of the term "biopsychosocial" as some patients feel that this term has been mis-used
-ME/CFS and other post-viral fatigue syndromes share many similarities with LC
-The hope that the recent public interest in LC may positively effect research and future outcomes for people with with ME
-In the year 2021, will anyone be diagnosed with ME/CFS, or will everyone presenting with these symptoms be diagnosed with Long Covid?
-It's important to validate people's lived experience of Long Covid. At the same time, is there a possibility that exposure to a lot of content about Long Covid may create a  "nocebo effect" for those who catch the virus?
-Activism and its impact on funding
-Pacing; what is it? This term means wildly different things to different people.
-Physical and cognitive rest and "flight mode"

Blogpost and video available at: getbetteronline.co.uk/whats-going-on-with-long-covid/

Blogpost and video: physiosonline.co.uk/2021/04/understanding-and-treating-pelvic-pain-in-men/

Karl Monahan is a clinician with a special interest in treating male pelvic pain.

After experiencing chronic debilitating pelvic pain and managing to successfully treat it himself, he set out to help other men to overcome their pelvic pain.

In addition to running a specialised male pelvic pain clinic in London, Karl also hosts a series of webinars featuring various experts and people with lived experience of pelvic pain, with the aim of helping patients and clinicians to better understand this condition.

More resources available at: physiosonline.co.uk/project/womens-mens-health-pelvic/

In this discussion, physiotherapists Emma Stevenson and Bill Taylor talk about how they think we as physiotherapists can advocate for and protect children and contribute to a safe environment for them.

Bill Taylor is a specialist musculoskeletal physiotherapist and consultant physiotherapist to the Scottish Ballet. He has extensive experience working with performers of all ages including children.

Emma Stevenson is a former college-level competitive gymnast who knows some of the people involved in the recent scandals in US Gymnastics. After completing her DPT (Doctor of Physical Therapy) qualification in the UK, she now works as a physiotherapist in London, and has a particular interest in supporting young athletes.

In this podcast episode, pelvic health specialist Bill Taylor and Evie from PhysiosOnline talks about pelvic pain in men and how it can be helped.

Pelvic pain in men is referred to by many different names. Most often men will have received a diagnosis of “prostatis”, but may also heard a variety of other terms including prostadynia, coccydynia, pudendal neuralgia, levator ani syndome and proctalgia fugax.

Blogpost: https://physiosonline.co.uk/2021/04/pelvic-pain-in-men/

Bill Taylor: https://physiosonline.co.uk/physiotherapist/bill-taylor/

PhysiosOnline members Bill Taylor and Liz Bayley discuss their experiences related to physiotherapy in the world of dance and performance.

Bill Taylor is Consultant Physiotherapist for the Scottish Ballet.

Liz Bayley is a former professional dancer who later trained as a physiotherapist.