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PT on the Run

'Knowledge is Power'

Published July 17, 2013 5:54 PM by Michael Kelley

The English philosopher and scientist Sir Francis Bacon is credited with coining the phrase, "Scientia Potestas Est" or "Knowledge is Power." Three words that are as true today as they were in 1597 when he first uttered them. To me, being an educated individual means more than being minimally competent at something. It means demonstrating a true understanding of whatever subject matter is at hand.

Way back in 2008, when I was but a lowly PT student, I recall treating a 5-year-old boy who had been in a car accident and suffered a high cervical spinal cord injury. He was in the hospital for nearly two months recovering before he transferred to a subacute facility, and throughout his stay, his parents would often ask questions like, "When will he breathe on his own again?" or "When should we expect him to be walking again?"

It broke my heart that this innocent little child's life had been so rapidly altered. However, it was almost even more unnerving that even after weeks in the hospital, no one had answered the parents' basic questions. As a PT student, I knew the answer to many of these questions, but was told that I should defer them to the physicians at this particular hospital. Needless to say, the family left for the subacute facility having had none of their questions answered.

Knowledge is power, right? And if I have knowledge that would benefit my patients, shouldn't I offer it to them, so they can make the best decisions possible for themselves? I have seen quite often in acute care, therapists or other healthcare professionals (and yes even I am guilty of this) brush off patients' questions and say things like, "Sometimes that just happens" or "Well, you are getting older."

In such an information-hungry age, this can no longer be acceptable. So, I'm issuing a challenge to all the therapists and healthcare professionals out there, myself included. Don't just be a therapist, nurse or physician. Be a teacher too. Be humble and take the time to educate your patients so they can not only make the most informed decisions possible, but also take that information and hopefully make better decisions about their health in the future. Knowledge is power, and when we talk about healthcare, shouldn't the power lie with the patient?

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3 comments

Hey Mike, Actually you hit the nail on the head. It is important to find out who is the primary decision maker in the situation and to ensure that appropriate permissions are obtained to speak to them.

When it comes to informed consent, you are also correct. We must explain to patients and / or proxies the intent of our interventions and the risks and benefits associated with them. The grey areas arise when we start contemplating prognoses, such as in your example of the child with the spinal injury. Perhaps the severity of the injury and available knowledge at the time provided a grim prognosis, but we never know what tomorrow may bring...ever. Spinal shock resolves, methods of stabilization improve, who knows? Perhaps the family should have been told...they did ask after all. I suppose I'm only encouraging cultural sensitivity so that these situations are handled as adeptly as one's PT treatments.

I look forward to more of your posts.

Dean Metz July 20, 2013 12:11 PM

Hey Dean,

Thanks for your comments!  And great point about being culturally sensitive to our patient's needs.  While I agree that an indivudual's values as they relate to health care may be different from our own, I still wonder if we aren't obligated to be educators to those making the medical decisions (whether it be the patient, family member, caregiver or other HCPOA).  Although patient's may not share our own values, they are still a part of our health care system, which by law requires informed consent for pretty much everything (including PT evaluation and treatment).  I would be curious to know where you would draw the line between a patient being properly informed vs. deferring on educating a patient based on their cultural beliefs?  Any thoughts?

Thanks!

Mike

Michael Kelley July 19, 2013 4:46 PM

I appreciate your earnest desire to educate your patients. Might I offer a word of caution? Depending on the cultural background of the patient, this may or may not be appreciated. Some cultures absolutely do not want bad news relayed to the patient. In some cultures, all information is filtered through the eldest son who makes the decision on what to share with the rest of the family. Through our western eyes this may seem inappropriate, but we must ask ourselves how appropriate is it to thrust our own values on someone else?

It is obvious your post comes from a place of caring, and I applaud that. I only hope that you will care enough to learn the social norms of patients who may not share the same value system.

Dean Metz July 17, 2013 9:19 PM

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