First published: December 17, 2021 Last edited: March 24, 2025 Is this patient ready for discharge? Care staff, managers, and sometimes the patient themselves must ask this question endlessly. In this blog post, I will argue that it is the wrong question and that we fail to provide the best care to our patients by […]
Ready for discharge? Read More »
Trust is central to all healthcare. A patient trusts the doctor’s diagnosis and recommendations. The doctor relies on a radiologist to read the image correctly. When the doctor refers a patient to a therapist, she trusts the therapist to assess for and provide appropriate intervention. The therapist, in return, relies on the doctor’s medical diagnosis
Assessing Entrustment in Rehabilitation. Read More »
Rehabilitation usually promotes itself as holistic, considering the patient as a whole and being patient-centred. Using the biopsychosocial model should indeed enforce a holistic, patient-centred approach. (here) Nevertheless, there are counter-forces at play, forces that we sometimes encourage. The primary countervailing power is a desire to categorise, classify, and develop small specialise treatment programmes. For
Rehabilitation is holistic, or is it? Read More »
Teams use many different words to describe themselves. A group recently asked me to help them decide whether they are a multidisciplinary or an interdisciplinary team. The background information provided perfectly illustrated the difficulty in defining the team, as illustrated in this figure. (here) The question prompted me to write this blog post to show
Multidisciplinary, Interdisciplinary, or Transdisciplinary? Read More »
Clinical Rehabilitation, the journal I have edited from 1994 to 2021, rejects about 88% of all submissions. Rejections fall into two groups. Many papers are not worth publishing or are entirely outside the scope of a rehabilitation journal. For the remainder, it is a question of relative priority. Some articles are better than others, and
Why are research papers rejected? Read More »
Rehabilitation is not therapy, and therapy is not rehabilitation. Rehabilitation expertise is the second area of expertise acquired by some people working within healthcare. Unfortunately, there is no mechanism to demonstrate that you have specific expertise in rehabilitation unless you happen to be a doctor. In the UK, since 1997, doctors have been able to
Rehabilitation expertise Read More »
The Mental Capacity Act (MCA) is a well-designed, helpful piece of legislation that governs decision-making for people who lack the mental ability to make decisions (in England and Wales). Unfortunately, it has been blown off course by well-meaning but clinically inappropriate guidance, rendering it unused and unusable. The principles of the Act are straightforward –
Using the MCA in health services Read More »
First published: July 30, 2021 Last modified: July 30, 2021 PDOC stands for Prolonged Disorder of Consciousness; the term covers two previously defined states: vegetative and minimally conscious. This post considers the question, “Does a person in a prolonged disorder of consciousness experience pain?” This question covers both pain caused by care or treatment and
Today, 18th July 2021, the UK National Institute for Health Research (NIHR), one of the major health research funding bodies in the UK announced £19.6M had been allocated to research into the late effects of Covid-19 infection (here), commonly known as Long Covid. This is in addition to £18.5 million allocated in February (here), funding
Rehabilitation research news Read More »
Doctors make decisions and are mainly used to making difficult decisions which involve not simply clinical facts but family, ethical, legal and societal factors. Nevertheless, we are lucky to have an ultimate fall-back, the legal system, when decisions are ‘impossible’. In England and Wales, this is the Court of Protection which, fortunately, has some exceptionally
An impossible decision Read More »
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