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Allan Besselink, PT, Dip.MDT

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    RunSmart Interview - "The Authors"

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    BlogTalkRadio 11/10/09: The Injured Runner

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    The P1 Project PDF Print E-mail
    Monday, 13 July 2009

    Today marks the first formal announcement of the P1 Project - also known as the Physio One Project.

     

    What exactly is the P1 Project? First, a little background is in order.

     

    Physical therapists (otherwise know as physiotherapists or "physios" in most other countries worldwide) are faced with challenging times. In an era of health care reform, physical therapists are, without question, the practitioners of choice for the first line of assessment and treatment of musculoskeletal disorders, and in the prevention of injury and optimization of human performance. In many countries, patients have direct access to a physiotherapist, much as they would a doctor, osteopath, chiropractor, or massage therapy. They practice as autonomous providers in that they do not require a referral to see patients. This is considered the accepted standard of care in most countries. Armed with a unique perspective on health and human function, physical therapists have the education and clinical approach to enhance the health and health care spectrum.

     

    Consumers are also not aware of "evidence-based practice" and how these issues affect their health care. All providers are not created equal - and some utilize evidence-based strategies far more than others. Again, it is in the best interests of the consumer to understand what these strategies are, and how they impact their care and provide better outcomes.

     

    But the consumer simply doesn't know this. Consumer awareness of physical therapy - and the limiters to practice that are imposed on the profession from outside special interest groups - is low. If the consumers don't know the issues - then, well, the issues really don't exist in anyone's minds but our own.Thus begins a virtual cycle of "accepted standards of care" in the community, and the consumer simply doesn't have the information to understand the issues at hand and how they affect their quality of care, access to care, and cost of care.

     

    Professional associations are, quite frankly, too busy putting money towards lobbyists. And lobbyists are too busy accepting these dollars. And while these factions continue to wage legislative battles that are driven by campaign dollars and broken promises, the consumer continues to suffer. A strong consumer voice is necessary.

     

    With this in mind comes the formation of the P1 Project (http://www.p1project.org ). The mission of the Physio One Project is to promote consumer awareness and advocacy regarding the role, evidence, standards, and outcomes of physical therapy in both health and health care, injury recovery and injury prevention.This will focus on 2 key areas - promoting the autonomous practice of and direct access to physical therapists within the health care system (and the limiters that affect this), and promoting evidence-based practice within the scope of practice of physical therapy. The P1 Project will also aim to create a community of both consumers and providers to disucss these issues openly.

     

    The P1 Project will not devote any finances to political campaigns. The P1 Project's primary goal is effective consumer awareness and advocacy, Consumers have votes - and votes decide legislators' fate. Let's make "evidence-based standards of care" the new community standard. 

     

    The next episode of "Consumer's Guide To Health" on Tuesday July 21, 2009 at 8:00 pm will discuss the role of the P1 Project, it's mission, and it's plan for consumer advocacy, The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I hope you will join us in the discussion and in supporting the P1 Project.

     

     
    June: A Hot Month For SSI Athletes PDF Print E-mail
    Monday, 06 July 2009

    June has been a very exciting month for SSI athletes. They have been racing at Ironman Coeur d'Alene, the Buffalo Springs Lake half Ironman, and the Ontario Masters Championships. Here's the lowdown of this month's results:

     

    At Ironman CDA, Rachel Robbins and Christine Jones completed their first Ironman and became members of the Ironman family. Christine's time was 14:06:41, and Rachel's time was 15:38:01. Also of note are the Barretts - Carrie and Shawn - who were interviewed on a recent episode of "Consumer's Guide To Health". Carrie finished in 11:46:29, while Shawn completed his first Ironman in 14:03:17.

     

    Out in Lubbock, more great results appeared at the 20th annual Buffalo Springs Lake 70.3 triathlon. Greg Hogan led the way with a 5:23 - good for 14th place in his age group. This put Greg in a select group of athletes, having completed BSLT a total of 10 times! James Baumann set a personal best 5:45. IronTexans Dorian and Freddy Ramirez both completed their first BSLT - Dorian finishing in 7:03, and Freddy (after losing a significant amount of time surviving two flats on the bike) finishing in 8:09. As many of you know, a finish at BSLT is something special!

     

    And last but not least, SSI athlete (of the Newmarket Huskies TC) Rita Quibell competed in the women's 1500m at the Ontario Masters Track And Field Championships. Rita was competing in the W50 division. Her time of 5:21.55 won her age group and was an age-rated performance of 89.4%! She followed this up with a 5:20.26 at the York University Twilight meet a week later, making her the number one ranked athlete in her age group. Rita will race in the Canadian Masters Championships later this month.

     

    Photos can be found in the Gallery.

     

    Congratulations to everyone!

     
    BlogTalkRadio 7/7/09: Training In The Heat PDF Print E-mail
    Monday, 29 June 2009

    Join me on BlogTalkRadio on Tuesday July 7, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". With the early summer spike in hot temperatures in Austin, there is no more appropriate and timely topic than this episode: "Training In The Heat". This episode will discuss the problems related to training in very challenging conditions, and how you can deal with the heat safely and effectively and remain active in the summetime heat.

     

    The special guest for this epsiode is Meredith Terranova, an Austin sports nutritionist and ultrarunner. Meredith will provide some insights into the issues of hydration and fueling in the heat.

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    Don't sweat it - come join the discussion!

     
    BlogTalkRadio 6/23/09: The Economics Of Back Pain PDF Print E-mail
    Monday, 15 June 2009

    Join me on BlogTalkRadio on Tuesday June 23, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". This episode is entitled "The Economics Of Back Pain". Up to 80% of people will have an episode of back pain this year. A large percentage will have recurrent episodes. There is a vast amount of scientific literature on both the assessment and treatment methods for back pain. Unfortunately, not only is there little support for many methods and approaches to care, there is a huge level of over-utilization. All of this has a huge impact on the cost of care for back pain. This episode will discuss the very real and difficult issues related to back pain, with a focus on the economics of the problem and how it affects you, the consumer.

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I look forward to having you join us!

     
    BlogTalkRadio 6/9/09: The Marshall Burt Interview PDF Print E-mail
    Tuesday, 02 June 2009

    Join me on BlogTalkRadio on Tuesday June 9, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". This episode is entitled "The Marshall Burt Interview". Marshall Burt is an Austin-based track coach and head of the Elite Training Group Track Club. His notoriety stems from his online presence and views on health and training. Though many of his views are well-supported by scientific evidence, it is almost guaranteed that they challenge the beliefs of many. This episode will expose some of Burt's beliefs, his approach to training and health, and why he might not be so crazy after all. 

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I look forward to having you join us!

     
    Big Pharma, Big Tobacco, And ... Big Medicine? PDF Print E-mail
    Wednesday, 27 May 2009

    You've probably heard the names before ... Big Pharma (the pharmaceutical industry), Big Tobacco (the tobacco industry), Big Oil (the oil industry) - and the list goes on. The one thing that all of these industries have in common is a hefty budget for political lobbying and lobbyists.

     

    Let's face it - money and power tend to go hand in hand, and this is exemplified in our legislative process on a local, state, and federal level. Everyone has a political action committee these days. Any and every group that wants to get something done in Washington (or Austin, or any other state capital) has a wing of their group responsible for political action dollars and political campaign contributions.

     

    But with money comes ... bias. Bias is defined as "a term used to described a tendency or preference towards a particular perspective, ideology or result, especially when the tendency interferes with the ability to be impartial, unprejudiced, or objective". Examples of bias - and the impact of that bias on decision-making, can be found everywhere. There is a science version ... and there is most definitely a political equivalent. Much as bias clouds a researcher's ability to draw fair and reasonable conclusions from the data, political lobbyists and financial interests cloud the ability of the legislator to make sound constituent-based decisions.

     

    Gone are the days in which a legislator can truly make a choice based on the needs of his/her constituents. Though they would like us to believe that they can accomplish this, it's become exceedingly hard to believe, especially when you watch the voting patterns of legislators based on who contributes to their political campaign.

     

    Health care already has one of the "Bigs" - Big Pharma. The pharmaceutical industry is a significant political campaign contributor. We're constantly reminded that it costs a lot of money to do pharmaceutical research, which gives them a little slack in the public eye. But when pharma-sponsored research employs ghostwriters , when pharma-sponsored trials rarely produce results that are unfavorable to the companies’ products, when it becomes an issue of researchers having a financial conflict of interest - you really have to wonder where all of this is leading - and how it can possibly benefit anyone but, well, Big Pharma.

     

    A prime example is the research done on Vioxx. From the New York Times (4/2005) :

     

    Dr. Lisse said that while he was listed as the paper's first author, Merck actually wrote the report, an unusual practice. "Merck designed the trial, paid for the trial, ran the trial," Dr. Lisse said. "Merck came to me after the study was completed and said, 'We want your help to work on the paper.' The initial paper was written at Merck, and then it was sent to me for editing."

     

    Where is the accountability? And what happens when Big Pharma has a hefty financial political lobby?

     

    Another fine example that is close to home is the legislation for a smoke-free Texas. Now I know that some will be up in arms about how it's their right to smoke. But the evidence is overwhelming: the risks of smoking are well-documented, and we know that the overall long-term health care costs for this population are elevated. So should the non-smoking population be subjected to the known risk of second-hand smoke, and should they be expected to pay for the inevitable medical bills of the smoker (associated with the risk) when they do in fact occur?

     

    As noted on May 19 by Brendan Burns of the Lance Armstrong Foundation ...

     

    "It is with deep regret we inform you our bill to make Texas smoke-free has died at the hands of big tobacco. While nearly 70 percent of Texans support this measure and there are more than 85 co-sponsors in the Texas House and Senate, we have been unable to gain enough votes in the Texas Senate and the bill has been withdrawn. Big tobacco, their 40 paid lobbyists and millions of dollars might have won this battle, but the fight will go on."

     

    Sound increasingly familiar? It has nothing to do with what is right ... nor how many legislators have known someone that has had or died from cancer. This is a high profile item nationwide ... and it still leaves the same bad taste as Big Pharma.

     

    So we've discussed two of the Bigs: Pharma and Tobacco. But would you ever think of ... Big Medicine?

     

    They are about to be front and center - in a plethora of ways. Let's start with the big ticket item: health care reform. Last week, the "stakeholders" in health care reform all decided to propose some solutions to the current health care issue. Funny how these are the same people that were almost violently opposed to it in the early 1990s. But now that public opinion and consumerism (and perhaps even an awareness of what works in other countries - like France ) have been thrust upon them, they are overjoyed to be taking part in the process. Suddenly they can save the country 1.5% per year. Where were they in 1994?


    But behind the virtue of the concept lies ... a political campaign contribution.

     

    The issue of lobbyists for BigMedicine (tag-teaming with BigInsurance) "running the show" can be heard loud and clear on this Bill Moyers Episode:

    http://www.pbs.org/moyers/journal/05222009/watch.html

    Here are some examples of his interview with Donna Smith (community organizer and legislative advocate for the California Nurses Association), from the show transcript:

    BILL MOYERS: Now, you must have an opinion as to why that is. [why single payer advocates had to protest to get a seat in the discussion]

    DONNA SMITH: Because they've already made a choice. They've already made a choice, I think, to stay with the moneyed interest, the people who fund the campaigns, the people who fuel the government system as we know it now. You know, certainly where Senator Baucus is concerned, he's the third highest recipient of donations from the health insurance and health care industry in general. The third. The highest Democratic recipient. And sometimes I feel so strongly that he ought to have to disclose that at the beginning of every single hearing that he chairs.

    BILL MOYERS: But he says, of course, "That doesn't affect my judgment. This doesn't affect my decision."

    DONNA SMITH: I don't think I'd buy that. And I don't think there's very many people in this country that would buy that. If you have someone who's giving you money to insure that your position to stay in a very powerful role in the United States Senate - that's a prime position politically.

     
    Further into the interview, there is another great quote from Donna Smith:
     
    I sat in a committee meeting with some staff members of Senate Finance some time ago. And somebody gave this argument, it's not politically feasible to do single-payer. So many people who will say, "Don't let the perfect be the enemy of the good."

    And I think, well, that's an interesting analogy, acknowledging that the perfect may be single-payer but that you can't do it 'cause it's politically not feasible. So I sat there and I let this person talk. And he said, there's a visceral reaction to single-payer.

    And I let him talk for a minute. I said, "From whom? Who's the visceral reaction from?" The Congress, he said, because elections are reality. These people have to run for new terms every so often. The money and the power that's exerted in Washington on them from the health insurance and health industry lobbies is very powerful. It's hard for them to break out of that loop. It takes an awful lot of nurses and doctors in the streets and being arrested, apparently, and more than 60 percent of the American public to say to them, "We're behind this. This is what we want you to do."

     

    So there is a lot of financial bias being dished out by "the Bigs". But don't think for a minute that it's just a federal issue.

     

    To show you the impact of health industry lobbyists and political action committees on a statewide level, the Texas Medical Association alone has 26 paid lobbyists registered with the Texas Ethics Commission. That is almost as many as Big Tobacco in the state of Texas. Irony of ironies though ... the Texas Medical Association was in support of the smoking ban - perhaps one set of Big lobbyists were overwhelmed by another set of even Bigger lobbyists?

     

    And that, dear reader, is exactly the point.

     

    I do still believe in the role of government and representation by the people. for the people. This can not be accomplished with lobbyists running around throwing million dollar budgets at legislators. Sure, the dollars must be disclosed through entities like the Texas Ethics Commission - but what might prove more interesting is to know what the PACs are representing, and who they are paying.

     

    And on that note ... the next article will discuss the ramifications of these PACs on health care in states such as Texas and California - and how these entities have a significant impact on your health care.

     
    BlogTalkRadio 5/26/09: The McKenzie Method PDF Print E-mail
    Tuesday, 19 May 2009

    Join me on BlogTalkRadio on Tuesday May 26, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". This episode returns to the issue of competent self care with a discussion of the McKenzie Method. This method of self-care and prevention for musculoskeletal conditions was initially developed by Robin McKenzie of New Zealand. Also known as Mechanical Diagnosis and Therapy, it is a philosophy of active patient involvement and education that is trusted and used by practitioners and patients all over the world for back, neck and extremity problems.

     

    I will have two special guests:

     

    - Robert Medcalf is a graduate of the Georgia State University Physical Therapy program. After advanced studies in New Zealand with The McKenzie Institute in 1991, he was granted the McKenzie Institute International Diploma in Mechanical Diagnosis and Therapy of the Spine. He was subsequently named to the teaching faculty of The McKenzie Institute. He has taught numerous courses on the McKenzie approach to physicians and physical therapists throughout the United States and internationally.

     

    - Curt Rickert is a physical therapist from Kerrville, Texas. Curt completed the McKenzie Diploma program in 2007. He is utilizing the McKenzie Method in an outpatient environment with patients of all ages and a variety of orthopedic problems.

     

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I look forward to having you join us!

     
    BlogTalkRadio 5/12/09: Ultrarunning PDF Print E-mail
    Saturday, 09 May 2009

    Join me on BlogTalkRadio on Tuesday May 12, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". This episode will continue the endurance discussion as I will discuss "Ultrarunning".  It could start off with just a simple trail run for the sheer enjoyment of being off the roads and back to nature. For many, it becomes a natural evolution to run longer - into trail marathons and beyond.

     

    For this episode, I will have three special guests:

     

    - Rob Youngren has completed many 100 mile runs throughout the United States, including multiple trips to the Hardrock 100. In 1998, Rob completed the Grand Slam of Ultrarunning - which consists of officially finishing the Western States 100 Mile Endurance Run, the Vermont 100 Mile Endurance Run, the Leadville Trail 100 Mile Run and the Wasatch Front 100 Mile Endurance Run all in the same year.

     

    - Joe Prusaitis is an Austin ultrarunner, coach, and race director. He has also completed his share of 100 mile and longer runs, including 82 ultras - 26 of which were 100 miles. In July 2003, he completed the Hardrock 100 and Badwater back-to-back. Joe is a race director for many Texas events including the Bandera 100/50/25K and Rocky Raccoon 100/50 mile events.

     

    - Josh Kennedy is an SSI athlete and regular contributor to the SSI discussion forum. He has shared many of his race reports on this site. Most recently, he completed the inaugural Pinhoti 100 along with the Western States 100. Josh recently completed a "Rim To Rim To Rim" run at the Grand Canyon.

     

    This should make for one interesting discussion!

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I look forward to having you join us!

     
    BlogTalkRadio 4/28/09: The Ironman Journey PDF Print E-mail
    Tuesday, 21 April 2009

    Join me on BlogTalkRadio on Tuesday April 28, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health" as I discuss "The Ironman Journey". Training for your first Ironman triathlon is an adventure. The 2.4 mile swim, 112 mile bike, and 26.2 mile run challenges you not only physically, but mentally, emotionally and spiritually. Join me with special guests Shawn and Carrie Barrett as we discuss what it's like to prepare for the adventure, and how it affects you afterwards. This husband-and-wife triathlon combo are preparing for Ironman CDA in June. For physician Shawn, it will be his first, for marketing mastermind (funny gal, and one of my fave bloggers ) Carrie, she's making a return to the Ironman adventure.

     

    The BlogTalkRadio call-in number is 646-929-1567. You can listen online at http://www.blogtalkradio.com/abesselink and also download this and previous episodes here as well.

     

    I look forward to having you join in on the discussion. 

     
    SSI: A Certified McKenzie Clinic PDF Print E-mail
    Tuesday, 21 April 2009

    I am pleased to announce that Smart Sport International is officially a member of the International network of Certified McKenzie Clinics. What does this mean? To put it in perspective, SSI is now one of 67 clinics in the world that are a part of this network. Along with this, there are approximately 300 practitioners worldwide that attained the highest level of training in the McKenzie Method.

     

    This method of musculoskeletal assessment and treatment is applicable to not only back and neck pain - the same principles are utilized for all the other joints as well!

     

    Call us to find out more about the McKenzie Method and how it can help assist you in your injury recovery.

     
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