Latest / The STA Clinician Podcast / Ep.266 'Should Sports Therapists Diagnose?' with special guest Anna Maria Mazzieri

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Ep.266 'Should Sports Therapists Diagnose?' with special guest Anna Maria Mazzieri · The STA Clinician Podcast

0:00
You're listening to the Sports Therapy Association podcast, putting evidence
0:05
back into soft tissue therapy.
0:21
Therapy Association podcast. My name is Matt Phillips, creditrunchecklive.com.
0:26
And as always, this episode is being recorded live on the Sports Therapy Association
0:30
YouTube channel and Facebook on a Tuesday night at eight o'clock.
0:36
So should sports therapists be allowed to diagnose?
0:40
It's a question that often causes much debate. For example, in a panel debate
0:44
that took recently at Therapy Expo at the NEC in Birmingham.
0:47
And despite sports therapists being trained to assess and identify the cause
0:52
of a musculoskeletal injury,
0:54
some would argue that the giving of a formal diagnosis should be the role of
0:59
a GP or an allied health professional like a physiotherapist, osteopath,
1:03
podiatrist or chiropractor.
1:05
So discuss this topic and share their views. I'm very shortly going to be joined
1:09
by Anna Maria Matsieri, director of the ST School and Gary Benson,
1:14
founder of the Sports Therapy Association.
1:16
If you have managed to join us for this live recording, then do
1:19
please feel free to add your thoughts in the comments section whether
1:23
you're on facebook or youtube for example i can see now
1:26
that sarah jones has joined us that means i can bring
1:28
her comment up onto the screen and sarah says evening actually on
1:31
time for once sarah you're always on time you're perfect there we
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go also emmy's here as well fantastic crowd already
1:37
coming through the door so yeah if you're here this is your time to
1:39
have your say we really want to hear from you the same way as the
1:42
idea therapy expo as we heard from you as well so yeah
1:45
do please speak your mind and if you are listening to the podcast then thank
1:50
you very much please leave a liking and a review just to help us out and if
1:54
you do have a comment or a question then best thing probably is to go to youtube
1:58
sports therapy association youtube channel and leave your thoughts in the comments
2:01
there and we do monitor it and we will respond to that.
2:05
Right let's get the discussion going
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there's lovely more people coming through for the live thank you everyone who
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does join us live we really appreciate it it's amazing to see you giving up
2:14
your time to contribute to this so do appreciate it right let's get the discussion
2:18
going should sports therapists be allowed to diagnose with tonight's special
2:21
guests anna maria matsieri director of the st school and gary benson founder
2:26
of the sports therapy association.
2:43
Good evening. And there with a lighter, more dulcet tones was Anna Maria Mazzieri. Fantastic.
2:49
Right then, so for people who don't know you both, which I'm always hoping,
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obviously, there are people particularly downloading it, Anna Maria Mazzieri,
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would it be possible to give us a brief, brief summary of who you are,
3:02
what you do within our industry?
3:04
Well, tonight I'm wearing my graduate sports therapist hat.
3:09
But I say that because usually I actually identify myself as a soft tissue therapist
3:14
and massage therapist, but I'm actually a graduate sports therapist and I'm
3:18
very passionate about the industry.
3:20
OMI, I am a practitioner, I'm a full-time clinician, but also an educator with
3:30
the ST school, which is a training provider, which I created.
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It's a vocational training provider for vocational courses, which I'm a strong advocate for.
3:43
Thank you. Fantastic. Great to have you along. That was incredibly succinct.
3:47
I'll tell you what, 2026 is going to be the year I'm amazed so far.
3:51
Gary Benson, for people who don't know you, get a little introduction of who you are and what you do.
3:56
Yeah. So as you mentioned, Matt, I'm the founder of the STA.
4:00
I've represented members in various roles within the industry for 18 years now.
4:06
I was, you know, going back until that time, I was part of the General Council
4:11
for Massage Therapists.
4:12
Had a couple of years there I was a profession specific board advisor to one
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of the first voluntary regulators the CNHC I've been advisor to sports therapy
4:22
advisor to a couple of other,
4:24
industry stakeholders if you like and I had another role within the industry I just felt that.
4:30
There needed to be more support you know a membership association
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in my opinion shouldn't be linked to a training provider I think
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that's a conflict of interest so I thought you know how can
4:39
we be better how can we support members better and
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and here we are today 266 episodes since
4:46
covid supporting members and the wider industry
4:49
fantastic thanks gary right i'm really excited
4:52
i'm really excited to have both of you here i'm really looking forward to this
4:55
discussion it's kind of like i mentioned in the introduction a continuation of
4:58
a discussion or presentation or discussion
5:01
that was started therapy expo i've also got to say thank you
5:03
very much to everyone again who's joined us live we've got loads of people there's something going on
5:06
something in the water some maybe it's anna maria's attracted to
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all so it's fantastic but as you're here all of
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you do please please leave some comments it's so useful for us as educators
5:16
and and for example anna maria director of the st school and gary benson the
5:20
founder of sports therapy association just to hear your comments just to hear
5:23
what you feel and what you know and what you don't know and that sort of stuff
5:26
so do please provide us with your experience and skills we'd love to know that.
5:31
Talking of that so the title of this episode should sports therapists be allowed
5:34
to diagnose to get things going maybe let's take that in order can we define
5:38
first of all what a sports therapist is,
5:41
Well, we had a very good and honest collaborative panel discussion at Therapy
5:48
Expo with Sarah Cattlow from the Sports Therapy Organization, Dr.
5:52
Chris Holland, who's the chair of the board of the Society of Sports Therapists,
5:55
and myself, not as academically recognized as my two panel colleagues.
6:00
But there was a kind of an argument, if you like,
6:04
that a sports therapist has a minimum standard of
6:06
education which has to be a graduate qualification i took
6:10
an opposing view that people who trained in the
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in the 80s the 90s and the noughties were diplomas
6:17
advanced diplomas from the likes of the international institute
6:21
of sports therapy from rayworth college from other
6:24
training providers who are no longer with us but
6:27
they had valid diploma vocational qualification
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so at present you know
6:33
we're in an unregulated industry and as such there
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is no minimum standard of education i went on to
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explain that what differentiates the sports therapist
6:42
from a soft tissue therapist are the
6:45
what we call the national occupational competencies the national occupational
6:48
standards which are held usually by
6:51
skills for health the sports therapy ones and soft.
6:55
Tissue therapists are currently held as the the nos
6:57
is currently held by the complementary natural health care council of
7:01
which there are two a sports therapist they
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are 14 competencies so there's a
7:07
difference there a mathematical difference of 12 competencies but
7:11
in an unprotected title industry anyone
7:15
can call themselves a sports therapist what we
7:18
do at the sta is we issue membership categories and
7:21
certification based on the wording of the qualification if
7:24
it's a diploma in soft tissue therapy it will say that on their certificate
7:28
if it's a degree in sports therapy or a degree in sports rehabilitation it will
7:33
say that on their membership category and that then you know we think you know
7:37
explains their title and their scope of practice fantastic thanks for clarifying that gary so.
7:45
So for some, the problem with the question is anybody can use the title sports therapist.
7:51
When we're talking about are sports therapists allowed to diagnose or should
7:54
they be allowed to diagnose, it kind of is understandable why some people say,
7:59
and we had this at Therapy Expo, that the answer is regulate the title.
8:03
Only people who do a certain type of qualification should be allowed to call
8:07
themselves sports therapists.
8:08
But just to get that one out of the way, because that's what probably a lot
8:10
of listeners are thinking, that holds its problems as well, doesn't it?
8:12
Well i think the issue here
8:15
is that sports therapy is a very small industry
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you know 35 years old really if we look at the total number of therapists who
8:24
are registered with a stakeholder somewhere between five and six thousand and
8:29
that includes the less than a hundred registered with the complementary natural
8:32
health care council i don't know if anybody saw social media but the
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FHT have just recently put out an offer of 50% off only for sports therapists.
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They then said that as long as you've got a level three qualification, then you qualify.
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But that's missing the whole point of what we're trying to decide as a sports therapist.
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If we're putting the bar so low that anybody can jump over it, there are no standards.
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The race has been to the bottom. so what we're
9:01
advocating now is that the
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professional associations have a robust eligibility criteria
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and i issued a statement last week saying that i wouldn't
9:11
accept certain qualifications or cpd simply
9:15
because the standard had become so low and and and i'm audited on that so it's
9:20
it was my decision to to to put that out there and i've got some really good
9:24
feedback to say you know we should be stronger a professional association should
9:29
be stronger and say this is not fit for purpose, please don't waste your money.
9:33
Okay, that's cool. So, although the government isn't regulating the title,
9:37
if professional associations, in theory, do their jobs, then they can regulate
9:41
it and make sure that no one's kind of working outside of their scope.
9:45
Anna Maria, you there were kind of nodding your head and shaking your head at
9:47
various moments. Yeah, yeah. As you know, I am quite expressive.
9:53
Matt, you hit the nail in the head. If we have more professional associations like the STA.
10:00
We don't need regulation. If actually the industry is well voluntarily regulated,
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we don't need state regulation that, as we know, comes with quite a lot of a
10:16
zone that we might not like.
10:18
The problem is that, you know, like Gary said, the FHT just released that message
10:26
that it really shows how little they know about the industry.
10:31
So we have those people that they are claiming to represent professionals in
10:37
general, but actually what do they know about the industry?
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Because they say actually it's open to sports therapists, but from level three,
10:46
there is no even care about progressing the industry.
10:49
Nothing wrong with level three therapists, but we're talking here about a profession
10:53
with national occupational standards which the level three therapists will not have.
10:57
So to me, there seems like to be a mismatch between the people that run those
11:04
professional associations, their understanding of what really happens at the level.
11:11
I must say, Gary, I was sitting there with a physiotherapist,
11:14
sitting next to a physiotherapist at the panel,
11:19
at the diagnosis panel, and both of us, we kept saying, every time you said something, we said.
11:27
You know, you're just making so much.
11:31
Because you said, you said, oh, I don't have the academic credential of the
11:34
other people, but you were the one, and both of us, me and this physiotherapist,
11:39
let's say we're quite old,
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you know, but actually what you were saying was reflecting exactly what the industry is.
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But also you're progressive because you're reflecting where you think realistically
11:54
and progressively where the industry should be. So actually,
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I was really proud to be a member of the STA.
12:01
And, you know, I say that all the time. But in that particular case, I thought you held up.
12:06
Really well, because you really represented the reality of who we are and celebrated who we are.
12:12
I think some of the things that, you know, if we take a snapshot of the industry,
12:18
you know, the SST represent the graduate members.
12:21
Historically, they used to represent foundation degrees.
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I think it was in 2014, they issued a statement saying they would no longer represent.
12:29
Fdscs or a two plus one degree and
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yet there was a 20-day diploma and a 10-day distance
12:36
learning diploma that led to membership so there's some
12:38
conflicts there but if you look at the number of
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sports therapists you know in our membership yes we've got some graduate members
12:47
but we've also got some some uniquely skilled experienced mature therapists
12:54
who haven't gone to university and Dr Chris Holland was extolling the benefits of, you know,
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taking the 18 year old, you know, straight from college,
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giving them three years worth of life experience and building them into that,
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you know, robust graduate sports therapist.
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My argument was that somebody who's got three years life experience between
13:15
the ages of 18 and 21 doesn't match the skills that we as experienced therapists,
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as vocationally trained therapists, I did go on to do academic qualifications,
13:26
later in life, but I didn't really feel any benefit from those.
13:31
So the skills that we built up, how to listen, how to communicate,
13:36
how to validate, how to encourage, how to motivate, how to educate –.
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Our clients they're the requisite skills that
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i think we need not the passive intervention training that
13:49
is commercially sort of driven by the industry so
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you know if we look at you know
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the the reason for this is should we diagnose and the
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answer if we google and you're going to come on to that later matt is we should
14:01
be a regulated profession if we look at the history of the applications for
14:04
regulation it's failed three times even though the
14:07
secretary it's been recommended by hcpc to
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the secretary of state to regulate the industry three government
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white papers in 2010 enabling excellence 2017
14:16
reforming regulation in 2021 which was
14:19
something along the lines of i forget it's a health and care
14:22
act they've all said that regulation is
14:26
not fit for purpose in its current guise you know
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the estimated cost in in 2010 for regulating
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a new industry was between three and five million in
14:36
2023-24 it was estimated between 10
14:39
and 15 million and that's just the machinery of government
14:42
you know there are 6.8 billion
14:45
pounds is spent annually across regulation across the the whole of the industries
14:50
you know we're in a crisis at the moment we said we need to be saving money
14:54
and i don't think having five or six thousand registered sports therapists and
14:59
and probably the same number who are not members of any association i don't think we can afford it.
15:05
Even if we could, what does it look like?
15:10
What does the HDPC model look like for sports therapy, which incidentally was
15:14
taken off the aspirant list in 2015?
15:16
Nobody's shown us that. So we're comparing apples against pears.
15:20
We need to know what it's going to look like, and then we can make an informed
15:23
decision whether to pursue that or not.
15:25
Yeah, and I want to pick up a moment to what you said about the comment that
15:29
was made in the panel about,
15:31
yes, we can diagnose because Because our students go through three years of,
15:37
you know, this month of hours of academic study and there is great value in
15:43
university. I love university.
15:45
I'm academic, so I have no problem.
15:48
But there is a certain amount of people. Yeah, that might be very good for those people. Yeah.
15:56
Where is the value on, you know, why don't we put value on people that might come as a second career?
16:03
They already come to, I say me as a vocational educator, they already come with
16:08
the richness and the depth of critical thinking from life.
16:14
They don't have, yeah, they might not have the academic knowledge,
16:18
but again, slowly, slowly, but they have all the other knowledge that the 20-year-old,
16:23
22-year-old might not necessarily have when they start university.
16:27
So this is where we are still, again.
16:32
A bit on the bonnet between this university and vocational that I do really
16:38
believe that in this country we see vocational in a very different way than,
16:42
for example, that in Europe this year because vocational learning it's quite
16:46
highly regarded in Europe but not as a less good, It has a different learning.
16:51
And Gary, you just said it really well.
16:55
Actually, instead of having the training within the three or four years altogether,
16:59
while between 20 and 24, whatever the age is, a vocational therapist have it over 10 years.
17:09
But the beauty of it, actually, they're doing it. They have also the time to
17:13
practice and to live together
17:16
Dull learning. One thing that certainly we can improve, certainly,
17:21
is that eventually we could do with having a, let's say, assessing the learning
17:28
because going to CPDs, some people might do great CPDs and brilliant,
17:34
but the difference is they are not assessed.
17:36
So I do think, and maybe Gary, I'll put in a little bit of something there for you.
17:43
Maybe every few years there could be an assessment, you know,
17:47
a professional association level to assess the knowledge of those therapies
17:53
against some learning outcomes.
17:58
If we look at the National Occupational Standards then,
18:02
which are at the moment a decade out of date
18:05
collaborative discussions we've been having
18:08
is to is to update those you know and all
18:11
of the stakeholders want to be involved in that process but if
18:14
we look at the a lot of the current nos which
18:18
are held by the sector skills council skills for health now a
18:21
lot of those are what i would regard as low risk modalities so
18:25
if it's kinesiology taping you know or taping and
18:28
strapping now that really can
18:31
be learned you know in a variety of ways and
18:34
because it's a low risk modality i don't see much value in having a formal assessment
18:40
of competence i don't know if it's a high risk modality like you know piercing
18:45
the skin with needles or manipulations then there has to be you know an assessment
18:52
of competency And the training providers then,
18:54
instead of dodging the bullet as they do at the moment by issuing certificates of attendance,
18:59
should be issuing certificates of competency.
19:03
So I think there is going to be progress on this, but it's around about how do we categorize.
19:11
And the best way to categorize is speak to the insurance underwriters who manage the risk.
19:15
Yeah, so I would say, I see it also a little bit, what I was saying about maybe
19:22
the professional association could do some assessments, not for modalities,
19:27
for literally knowledge.
19:29
So, for example, because we just said that we want the sports therapists to
19:36
all have the same critical thinking knowledge and theoretical knowledge than
19:43
those ones that go to university.
19:45
So that we are all, you know, we're all the same.
19:49
We're all considered the same. And I will say that actually,
19:53
for example, communication skills or the theory of health care,
19:58
principle of health care.
20:00
Things like that, people find it difficult to cover them on CPDs.
20:05
And actually, those are very, very valuable.
20:08
And that's what I think maybe every few years, there could be somewhere at the
20:14
governance level where the non-university trained therapist can actually have
20:21
their knowledge assessed so they can say, actually, I have my knowledge.
20:27
It's not about modalities, you know, the theory behind,
20:31
I don't know, you know, the theory behind the MSK engineers or things like that,
20:36
so that finally they're not considered any less than the university students.
20:45
If we look at the model from HCPC for their audit and their CPD,
20:49
you've only got to go on social media and see how much anxiety that invokes in therapists.
20:54
Now, I'm going to be devil's advocate. I'm not agreeing with this. Yeah, yeah, yeah.
20:57
No, no, I'm very, very happy to. What I would say is by introducing,
21:02
and some of the associations do have a test.
21:06
Okay, which is taken every so often, that is a barrier to people remaining as members.
21:12
Now, if I can encourage people to stay as members, we can support them,
21:17
you know, we can present them with, as the evidence-based changes,
21:21
we can filter that information through.
21:23
If somebody chooses not to be
21:26
a member of an association because there's that extra barrier of a test,
21:31
then we lose those people and they go
21:34
into the shadows of the industry and and half of
21:37
the people working in the industry are not members of associations that's
21:40
my estimate you know they still might
21:44
be doing you know really aggressive treatments with handlebars and instrument
21:49
assisted you know because they haven't kept up to date as the narrative and
21:53
the evidence has changed to support the application of those modalities so it's
21:59
easier to to police people when they are you know,
22:03
members of an association than it is to let them ride wild.
22:06
Yeah, maybe not a professional. Yeah, you're right, actually,
22:09
Gary. I haven't thought about that, but maybe not a professional association.
22:12
But I do think that one of the ways to match the two between university and
22:18
vocational is that when people, because people have been in the industry for
22:22
20 years, they've done plenty of really good CPD courses.
22:24
They might not have done, you know, the other, they go into the every degree.
22:29
So there has to be somewhere where the knowledge is assessed, you see.
22:36
With our CPD forms now, it has a description of the learning.
22:41
It has the learning outcomes, but it also has a reflection on those outcomes.
22:47
So we're looking at higher level skills to be able to reflect on whether those
22:52
learning outcomes are beneficial to or work against what their biases are or
22:57
what they're doing in clinical practice.
22:58
And we tried to make that reflective practice
23:02
thing as you did at the hands-on hub and the sta conference we
23:05
tried to make that reflective practice part of
23:08
the the sort of policy so that it it
23:11
puts us level with the hcpc model of reflective
23:14
practice and they are skills that they are
23:17
developing at university albeit at a
23:20
younger age and you know my argument and
23:23
in that panel discussion was i'm going to say no we
23:25
shouldn't diagnose and i'm going to try and justify why they were going to say
23:29
yes and they were going to try and justify why and that's that's a that's a
23:32
well-reasoned and balanced debate and i thought it was a really successful debate
23:37
as well well i'm just going to jump in for a second that's i mean for the listeners
23:41
this is i think this is really important because the most common like we said before the most common.
23:45
Answer to should sports therapists be allowed to diagnose is oh
23:49
as long as they're graduates because they've been to university and therefore they've got all
23:51
the experience and the same as a physio and they can do it and it's more
23:54
complicated than that for the reason we've discussed so i think to really
23:57
find a solution for this we need to understand the barriers
24:00
to just following that path of logic that is not the answer there's an awful
24:03
lot of people out there who you'd be eliminating a lot of amazing people out
24:08
there who could work in healthcare who haven't been to university when they're
24:11
younger who it's not appropriate now to go four days a week or something they've
24:15
got kids that maybe they've got elderly people yeah so we've got to find out a.
24:22
That's why we spent nearly half an hour clearing that up.
24:26
I'd like to say that Kate Williams, who's the head of education for the SST
24:31
Society of Sports Therapists, she is going to come on the show after the new year.
24:36
We wanted to get one for this one, but just too busy after Therapy Expo.
24:39
But yeah we appreciate the reply from that and it
24:42
was really nice getting that reply because i think we all agreed after therapy
24:45
expo that there is a exciting theme of
24:48
collaboration the fact that you guys with the sto the sta
24:51
and the sst were on this stage together physically discussing things politely
24:56
and realizing we've probably got more in common here than different was a real
25:00
step forwards and i just want listeners to appreciate that and realize that
25:03
thanks to a lot of work i mean i'm biased a lot of work that gary's been doing
25:07
but i'm sure other people have as well and Anna Maria,
25:10
we are getting closer to having these important discussions and finding solutions
25:14
which look after everybody. So it's good.
25:17
2026 is going to be a very positive year, I think. And I'm the biggest cynic
25:21
and sceptical it is, but I'm really excited about 2026 for our industry. So I want to move on now.
25:26
Let's imagine a sports therapist does, we do have a way of making sure they've
25:31
got the right criteria and the education and that and the reasoning skills.
25:34
We move on to now whether they should be allowed to diagnose now
25:38
one of the things that came out from therapy expo which
25:41
i was surprised at i think we all kind of went really was this
25:45
idea that diagnosis and
25:48
to diagnose is not a protected word the only way you can get wrong is you start
25:53
basically pretending to be have a professional title that you haven't got and
25:57
you're working outside of your scope if you're doing that and you use the word
26:00
diagnosis then then you're going to get into terrible trouble and it's illegal, but to actually say,
26:06
oh, I diagnose it as this technically is not protected.
26:10
This is still to be...
26:12
Debated, isn't it, as far as I know? I'm still not that clear yet.
26:16
No. And during the talk when the legal representative said that,
26:21
I did a quick reflection and thought, well, it doesn't match what I've been
26:27
Googling over the past two weeks in preparation for that panel talk.
26:31
But I said that,
26:34
it would become part of my reflective practice to look at that in more detail.
26:39
Like the SST, I haven't had capacity to do it still on my notebook because we've
26:44
been so busy since Therapy Expo.
26:46
But if we Google, you know, who can diagnose and you've got the screens there
26:51
to show Matt, it's limited to regulated health professions.
26:55
Yeah. Let's have a little look at that because now I understand,
26:58
I'm hoping that people are watching this and going, hold on, hold on.
27:00
This is just co-pilot this is just ai and but i think it's
27:03
important because this is what people will the results people
27:06
will get when when they do google this so for
27:09
example i'm just going to read this out for people listening to the podcast so
27:13
this was a co-pilot search other forms of ai
27:16
are available and it said the word diagnose is a protected title in
27:18
certain contexts particularly in the uk the terms
27:21
associated with regulated professions such as medical practitioners
27:25
and its use is restricted to those who are registered with the
27:28
appropriate regulatory body the medical act 1983
27:31
protects titles like diagnose and requires
27:34
individuals to be registered to use them so when
27:38
you do an ai search it does give you links to where the information comes
27:41
from which is useful i recommend you have a look at those and click on them this actually
27:44
used information it's not a direct quote from the hcpc
27:48
but it used information provided by the hpc.uk.org in
27:53
a in a post they would put about why who we regulate the professional
27:56
but i went on to look at this and it seems
27:59
to me that it's not clear at all sometimes it
28:03
says that you need to you can sports therapists
28:06
and have a working diagnosis and that seems to be okay like the terminology
28:10
but not a medical diagnosis but then it started getting confusing because there
28:14
is something yeah it says here conditions such as fractures or dislocations
28:19
need to be diagnosed by health care providers like doctors or physiotherapists.
28:23
But I would have thought something like a fracture wasn't like,
28:27
it's not as, there's more difficult diagnosis than that I can understand people are worried about.
28:32
You can form a diagnosis, then get it checked, definitely. And you're not 100%
28:36
sure until you've seen it on that x-ray or something has been.
28:39
You form the hypothesis.
28:40
So there is a difference also between medical diagnosis and clinical diagnosis.
28:47
So the medical diagnosis is exactly what you say, you know, the diagnosis that
28:51
can be come from a medical practitioner.
28:54
And that is, I don't know, autoimmune diseases and so on.
28:59
A clinical diagnosis is a diagnosis that comes from, you know,
29:04
assessing, like what you call the working diagnosis.
29:09
So that's different. Certainly the term diagnosis from the medical act is protected.
29:15
I researched that because we're having the same discussions in Italy between
29:20
the physiotherapist and the physiatrist. The physiotherapists are medical doctors.
29:26
The medical doctors, they focus on MSK, specialists in MSK, and physiotherapists.
29:34
Physiotherapists in Italy, they don't diagnose.
29:37
They assess, they have their working diagnosis because it's enough for them to...
29:48
If it's enough for them to treat at the best and then anything that is beyond
29:54
that, if there is anything that changes the treatment plan,
30:00
then it means that they have to refer anyway.
30:05
So what is the function of the diagnosis from that perspective?
30:10
Why do they need to diagnose when actually you got the clinical diagnosis,
30:16
the working diagnosis where you're assessing,
30:20
you're checking if there are red flags, you're checking if there is any contraindication,
30:24
you're checking if it's something that your treatment, your approach is the best suited for.
30:30
And if it's not, then, you know, refer for that more specific,
30:37
you know, more specific diagnosis, personally, I do not think,
30:42
but there are different.
30:44
So there is the term medical diagnosis and clinical diagnosis.
30:48
They're all regulated by the medical act, like you said, 1983.
30:52
I checked before we went to the panel. So that's why I was quite shocked when
30:57
they said it's not protected.
30:59
It is illegal in this country. It's legal that it's health professionals.
31:04
It's strange because.
31:07
Yeah, if you use the word medical diagnosis, if a sports therapist for some
31:10
reason said, oh yes, I'm going to give you a medical diagnosis now that you've
31:13
got this, then we can discuss whether it's worth using that word.
31:17
But that would be wrong because you haven't got that. You haven't got the skills.
31:21
It's outside of your scope. So I think the problem is whether you're working outside your scope.
31:25
If you make a diagnosis and you use the word diagnosis, and then it can be argued
31:29
in court that you are actually diagnosing something that's not in your scope.
31:32
And it could be argued that you don't know if it's definitely a fracture until
31:35
you've actually had it x-rayed and you've seen it and you're as
31:38
close to proof as possible then you shouldn't be using that word but
31:41
this is an interesting one gary what have you found on the
31:44
term diagnosis not should we use it
31:46
or not but is it yeah so what what
31:50
i did before the panel is i just google who can diagnose and and admittedly
31:55
it's you you get the ai version so i read through that and then i i went into
32:02
the links that it provided for me And it said that, you know, only,
32:07
and the word I used to describe it was the diagnosis is the preserve of allied health professions.
32:13
Now, if you look at the HCPC, it recognizes and regulates 14...
32:19
Professions in england scotland ireland
32:23
and 13 in in wales underneath that
32:27
sorry above that in a sort of hierarchical sort
32:30
of pattern is is the professional standards
32:33
authority who oversee the hcpc but they also
32:36
oversee the likes of the general osteopathic council the chiropractic council
32:40
etc etc so you know sports therapy was not even mentioned in there and i know
32:46
that one of the stakeholder website clearly defines their members as allied
32:52
health professions, albeit in lower case.
32:55
But I remember during COVID that, you know, whilst we were taking lots of legal
33:00
and lots of health and safety guidance before issuing,
33:04
you know, support to our members, some of the stakeholder issuing statements
33:09
like, if you've done our qualifications, you're regarded as medical and therefore
33:13
you don't have to go into lockdown.
33:15
You know, I challenged those and they then had to, rather embarrassingly for
33:20
the industry, had to retract those statements.
33:22
So, you know, I like the term clinical reasoning and what we're doing.
33:29
And my industry colleague, Yvonne Blake from the Sports Massage Association,
33:34
she gave a talk straight after our panel discussion, which I couldn't make because
33:37
I was still involved in this discussion outside with the wider public who were there.
33:42
And she talked about differential diagnosis, which is a process of ruling things
33:46
out rather than ruling things in my argument has always been you know when i
33:52
was in clinical practice that if i say to somebody oh you've got a sore heel.
33:56
It de-escalates their symptoms from being told they've got plantar fasciitis
34:01
because if you google plantar fasciitis the first thing that comes up is oh
34:04
you're going to have 18 months worth of intolerable pain and nothing will fix
34:08
it you know but if we say we've got a sore heel and we work through,
34:11
you know, a progressive treatment plan,
34:15
then I think we've de-escalated their symptoms.
34:18
We've not, you know, we've not used Dr. Google.
34:21
And therefore, I think that's better,
34:24
for the client. Sounds good. Makes sense. Yeah.
34:29
It's true what you say. I think sometimes people want to use the word diagnose
34:33
because it makes them feel more empowered.
34:36
It makes them feel that they are closer to the people who they put on a pedestal.
34:41
And we'll probably discuss soon that that's part of the problem because you
34:44
shouldn't be putting others on a pedestal.
34:45
You should be proud of what you're doing and not feel the need to use words like diagnosis.
34:49
It's just going to get you in hot water because if you're using it to kind of
34:52
subconsciously pretend to be something or not, that's where you can get into
34:55
trouble and you've got to kind of consider how you're working.
34:58
There was also an interesting thing which I read online suggesting that,
35:02
where was this about graduates?
35:04
Even AI suggested that, oh, here we go. The ability to diagnose can vary depending
35:09
on the specific training qualifications of the sports therapist.
35:12
Graduate sports therapists who are members of professional organizations, that annoyed me.
35:16
AI thinks that to be a member of a professional organization,
35:19
you need to be a graduate.
35:20
So something's gone wrong there. may have more extensive training that
35:23
annoyed me as well that allows them to assess and manage injuries effectively
35:26
that really annoyed me but they still operate within a framework that does not
35:31
include formal diagnosis so watch out for the argument if you're a graduate
35:34
you can use the word diagnosis because you might find yourself again in hot
35:38
water particularly if you're insinuating that you're doing a medical diagnosis
35:42
but what that does there matt that excludes graduate.
35:47
Sports therapists who choose not to be a
35:50
member of an association of course you know their their benchmark
35:53
their their degree is is a standardized degree
35:56
despite the discussion around you know some of
35:59
the biases towards strength and conditioning or sports trauma or
36:02
or manual therapy that do exist currently but
36:05
i know the sst are doing some work in in standardizing their
36:09
university accredited degrees but there are lots of degrees that
36:12
are not accredited by by the sst who might be credited
36:15
by basrat for example sports rehabilitator
36:18
and sports therapy there are also there's some that are totally unaccredited
36:22
so what we're doing there we say well if you're a graduate and you belong to
36:25
this association which i think is discriminatory then that is the criteria by
36:30
which you can diagnose and if you don't fit that criteria you don't meet the
36:34
eligibility criteria then you can or can't you know it's it's how you read it and for me i think we.
36:42
We are moving the discussion, you know, there is too much effort in a discussion
36:51
that actually can be moved towards somewhere else.
36:54
Why do we feel that we need to diagnose?
36:58
Why do we feel that we have value? Because this is what it's all about,
37:03
isn't it? Let's be absolutely honest.
37:05
People do not feel they have value unless they can diagnose.
37:09
What does so it could be one because they feel that they don't have value and
37:14
plenty to say of that and the other one Matt you again you hit the nail in the head,
37:21
having a diagnosis or being able to provide a diagnosis gives a little bit of power,
37:26
And in health care, well, we're trying to go away from diagnosing because,
37:30
you know, if people are really evidence-based practice, they will see that there
37:35
is this big movement discussing over-diagnosing that actually is creating more of a problem.
37:41
So why we, person-centered care practitioners, like sports therapists or soft
37:49
tissue tests, why would we want to diagnose?
37:53
When actually, the one that they can diagnose, they keep saying,
37:58
actually, we're overdiagnosis. We don't want to diagnose.
38:02
When I was discussing with somebody, I said, oh, but Anna, you know,
38:05
I want to be able to say so-and-so has got a meniscus there. Again, why?
38:10
Why would you want to do that? Because when evidence-based practice is telling
38:14
us that actually, just if you pick up and somebody's got, I don't know,
38:19
let's say a meniscus lesion.
38:22
And it is, you know, there is no red flag symptoms there. That's to be a referral and so on.
38:29
It's not that you're going to be treating the meniscus. You're treating the
38:31
person. So the rehab you've been trained to be given, the treatment you've been
38:35
trained to be given, is about the person because actually we know that the meniscus.
38:41
Is very common to have over the age of 35 to have meniscus lesions.
38:45
It's not the meniscus that is the problem. It's the inflammation and so on and so on.
38:48
So why do we want that? Let's put the focus as governance To actually make the
38:55
vocational qualification a little bit tighter To actually create more cohesion
39:00
within the different professions,
39:02
Interprofessional and multi-professional But let's go away with the fact Oh, and actually,
39:08
you know, people always say People should do like you do, Gary That you really
39:12
show the therapist the value that they have Let's celebrate who we are and what
39:19
our role it is in the injury.
39:20
It is okay if a client comes to us for a long time and then they're going to
39:25
go to see a physiotherapist for an injury that you might have been able to work with them.
39:29
Because actually it's okay if they want to go to a physiotherapist.
39:32
Not because the physiotherapist is higher trained.
39:35
You know, it's because the physiotherapist is somebody different.
39:38
You know, within our scope of practice, what we're saying to our clients and
39:44
to our members is, look, you know, by all means, you know, have your consultation,
39:49
rule out the red flags, you know, do some objective testing.
39:53
And then if you're not getting the, you know, the results that you expected
39:59
within three or four sessions, have a reflection and have you missed something?
40:04
And if you have missed something, where might you be able to signpost?
40:07
And the meniscal lesion that you mentioned.
40:12
You know, I don't think there's any harm in saying, you know,
40:15
after you've done, you know, three or four treatments saying,
40:17
this is not responding in the way that I thought it might.
40:22
Perhaps we need to go for some diagnostic imaging. And, you know,
40:26
we've done some work with Vista Health since Therapy Expo,
40:29
where some of our members, and at the moment their criteria as graduate members,
40:34
are going to be able to refer directly for imaging.
40:39
Historically, they've had a discriminatory process where you had to be a member
40:42
of an alternative organization, but they are now including us and we're going through those.
40:48
We're having to prove our legal status and our policies and procedures,
40:53
et cetera, with regards to qualification and membership eligibility.
40:57
But it's giving us you know an extra step that we can take but be proud of what
41:03
we do and recognize that actually this might be outside of my scope of practice
41:08
you're going to get the respect of the of the patient or the client by referring
41:12
them for imaging they'll come back to you because you built up that trusting relationship.
41:18
I think we get into hot water when we try and work outside of our scope of practice
41:23
and sometimes make promises that we can't keep.
41:27
Yeah. And, you know, I like that because the STA, you provide a lot of training,
41:32
so the STA is very well trained.
41:34
But even I often have to convince, you know, the client might come back to me
41:40
and they say, oh, I went to the doctor and I wanted an MRI and they didn't send me.
41:44
And most of the time I have to actually reassure them and say,
41:47
Actually, there is a reason why they didn't, because evidence is telling us
41:52
very, very clearly only a certain level you need that.
41:55
Only when that treatment will change that we need that. And this is another thing is, you know.
42:03
We are, health care is changing. What we know of health care is changing.
42:07
So we should be much, you know, we should not have to want to be so everybody
42:14
uniform and everybody that can, you know, that use the diagnosing term or diagnosing
42:20
something really, really specific.
42:22
This is where the evidence is telling us that it's not where the problem is.
42:26
So I think that the focus is shifted somewhere where it's not shifted because
42:33
we always kind of, we feel less good than instead of, you know, the sports therapy,
42:40
you know, apart from you guys, the Sports Therapy Association working all together
42:44
to say we are a workforce,
42:47
you know, we are a professional say we can do this and let's all invest the
42:51
money to advertise to the members of the public.
42:56
What we do we seek something that actually is not really even important you
43:02
know I think that's a really good summary and that's kind of it would have been
43:06
really nice at therapy expert to have that conversation afterwards to open up
43:09
to the audience but the answer to that question might be.
43:12
Should we be you know defining ourselves by our
43:15
ability to diagnose or should we is this you know are we missing the
43:18
point with this whole question and Mike James on the
43:21
show last week he was kind of saying he says it's funny because he's obviously
43:24
mixed in between the two worlds and he was saying if you've got this field
43:27
and you've got sports therapists on one side and physios on the other for
43:29
example allied health professionals and a fence in the
43:32
middle they can't see each other but you've got the
43:35
sports therapists on one side going we should be able to diagnose we
43:38
want to diagnose why can't we diagnose and then if they could see
43:40
over the fence they'd see most of the physios and the allied health officials
43:43
going we don't think diagnosis is so important why are we told we need to diagnose
43:47
we're missing the patient and everything around them and misdiagnosis and that
43:50
sort of stuff so really it's a case of just you know lowering that fence which
43:54
started as a metaphor but really now we are hopefully achieving that and just
43:58
talking to each other about what's best for the patient.
44:00
Tom said something actually he explained it much more eloquently than I was.
44:06
Athletes in front of you, something that another therapist said to me this year,
44:10
does the diagnosis changes how you will treat in terms of your rehab?
44:13
Exactly. This is the point. This is where we're going.
44:17
For example, if we look at imaging, the current guidelines, even for NIC guidelines
44:23
for sending somebody for imaging for MSK conditions is you send them for imaging.
44:29
Only if the results will change your treatment plan.
44:39
This is why even if you have very severe, let's say you have a herniated disc,
44:45
very severe symptoms, they wait for six weeks.
44:51
They do the first six weeks, unless there are any red flags,
44:54
i.e., you know, usual parastasias and bowel and blood dysfunctions,
45:00
unless there are red flags.
45:02
The MRI is not called for because we know actually that the MRI can cause maladaptive beliefs.
45:10
After six weeks, like I said, if people don't get better, after six weeks,
45:13
if actually we know that in natural history, this particular herniation,
45:18
after six weeks, the symptoms should be starting going down,
45:21
but the symptoms do not go down,
45:22
then we can because actually
45:25
risk ratio in that six weeks you know is not very high so I mean I do very much
45:32
welcome about the MRI and the sports therapies because actually after a few
45:37
months you know I would say it's 12 weeks is minimum and they cannot,
45:43
nothing can you know nothing is improving then it might be you know a good shout
45:50
instead of having to go through the tram of NHS and,
45:54
I think if we look at treating the client in front of you, and my go-to text was always Dr.
46:01
Chris Norris, fourth edition, Diagnosis and Management of Sports Injuries.
46:06
And Dr. Chris has spoke at our conferences, and he's been on the podcast a number of times.
46:12
His book, I used to use it as a rule of thumb.
46:15
When I was planning a rehab, and it might say, we'll use the meniscal lesion,
46:21
for example, it might say at week two you know the
46:24
the patient is expected to do this at week four is expected to
46:27
do this and at week six expects to do that but that's only a
46:30
you know that's guidance you know some people are
46:33
going to achieve more and some people are going to achieve less
46:36
those people who achieve more may slow down
46:39
their rehab a little bit later on i don't think
46:42
that having that diagnosis ever made you
46:45
know you know from a from a gp or from imaging i
46:48
don't think it ever change my my mo i would
46:51
use this protocol you know my rehab continuum might
46:55
change and when i used to teach this module exercise therapy
46:58
you know there was a lot of focus on progression and
47:02
regression when you're prescribing an exercise i think
47:05
what the more mature therapist has built
47:08
up over a lifetime is the ability to to
47:11
make a judgment on what exercise the person
47:14
would be i i don't think somebody who was
47:17
younger 21 year old coming out although they've got you know
47:20
400 hours of placement i don't think they might have those
47:22
skills i think that's what they're going to develop over the next three to five
47:25
years but having that skill to say okay i'm going to prescribe this exercise
47:30
you demonstrate you observe and notice something that you didn't expect you
47:35
would regress that exercise or if the client did it easier than you expected you'd progress it so So,
47:41
you know, this diagnosis has never really bothered me.
47:45
I just think that the grass is always greener. Definitely.
47:49
I think we've got like nine minutes left. I wanted to also get your thoughts
47:54
on the fact that because we've had loads of guests on the show who have raised
47:58
awareness of the fact of misdiagnosis.
48:02
Because if you're focusing all your attention on getting that diagnosis,
48:05
the danger is once you get a diagnosis and you believe in that,
48:08
then potentially that's it.
48:10
You've got your blinkers on and you're going to not be looking at all the other
48:12
stuff. So we've had shows like, I want to raise awareness, for example,
48:16
we had Deborah Herlo-Rowley, who's going back to 2020, who was talking about
48:19
how the correct diagnosis of endometriosis is commonly around eight years and
48:23
10 months, which is just shocking. It's horrible.
48:25
There's all sorts of reasons like that to do with diagnostic overshadowing and
48:30
kind of gender bias and things like that.
48:31
But nine times out of 10, I think, I suspect, I haven't got any data to prove
48:36
this, that the misdiagnosis is because you're not looking at the whole person
48:39
because you have fixated on just the lower back pain and you've made a diagnosis
48:43
of this or that, or you've fixated on this.
48:44
So sometimes chasing a diagnosis can actually blinker you and forget to address,
48:50
as we've already said, the whole person in front of you.
48:52
And it's only when you look at the whole person in front of you that you can
48:55
start seeing some of these other typically misdiagnoses and things which can
48:59
tragically go off about 10 years.
49:01
So yeah, I mean, you've got Anna Maria Mazzieri, you do a fantastic course on
49:04
red flags and things and how important it is to address the whole person,
49:08
otherwise you're going to miss out on all sorts of terrible masqueraders.
49:10
But that's something which is big on your agenda, and I imagine with your students.
49:14
Yeah, very, very, because massage therapists, we are the ones.
49:20
So when people get, for example, I always say the one that we miss,
49:25
it's the inflammatory conditions.
49:30
Because when people have been feeling really stiff in the morning and they are
49:33
in their 30s or 40s, where are they going to go?
49:36
They're not going to go to the physio. They're going to come to the massage
49:38
therapist. they might not release all the information there and then but once
49:44
they're on the couch and they start to say oh yes you know what you know it takes me one hour.
49:49
To actually start getting a little bit loosened up, I have to wake up an hour
49:53
earlier before I could jump in the car because I'm so stiff.
49:57
So I have to, and then you start thinking, oh, that is a red flag.
50:02
Because they will come to us first. And more and more now, where NHS people,
50:07
people that might have gone to the GP, but now the NHS is overloading.
50:12
And unfortunately, people are becoming disillusioned.
50:15
And they actually don't go even where they should be going. So I've been screening
50:19
quite a bit for people to say, oh, actually, do you know what?
50:23
I really need the massage.
50:25
It never contributes, very, very, very, very contraindicated. So I will always treat.
50:29
But, you know, once they come to me, I can reassure them.
50:32
I say, actually, this is something that, you know, should be going through the
50:35
GP or through the osteopath or whatever.
50:37
So let's write them a letter. And they feel so much in charge and in control.
50:42
You know, there is a client that stays with you then forever because they know
50:46
that you are doing what you're doing. for their best.
50:50
So for me, red flags are important because we're missing them.
50:54
We are, and it's not the codequina that we're missing. We're missing those subtle
50:59
ones that we should not be missing.
51:01
We're missing, we're still too, we're still too worried about when people tick
51:06
the box cancer on their consultation form.
51:09
Massage or sports therapy is not contraindicated for cancer.
51:13
But what it is, is the person that comes to you is because they've got pain.
51:16
Is the pain coming because of MSK issue or is the pain hiding something being
51:24
more sinister? That's what we need to be focusing.
51:27
So knowing more about those red flags, knowing more about those contraindications.
51:32
Because somebody said, oh, yes, one of the comments that they made,
51:36
one of the comments was, We do so many hours.
51:39
We are the sole qualification that has as much hours in MSK injuries,
51:50
and therefore we should diagnose.
51:53
And my query will always, yes, they say they've got more hours than physiotherapists,
51:58
but actually if we only do MSK, we only see MSK.
52:03
When actually if you
52:05
look at Cairo and Osteo they
52:09
don't only do MSK they do many more broader and the same physiotherapist broader
52:17
curriculum that broader curriculum actually gives you ability to critically put together certain,
52:27
condition differential diagnosis that if you only do MSK Eight.
52:34
Yes, you might know a lot about a meniscus, but what about if it's a...
52:38
I think one of the things that's become apparent over the past decade is the
52:43
value of a consultation form.
52:45
And I've discussed this with the insurance underwriters recently.
52:50
If we send out our online consultation form, have you had a history of heart
52:55
disease, cancer, surgical interventions, etc.
52:58
We were presented with a yes and no sort of answer sheet.
53:02
I don't think that elicits the type of
53:05
information we want so if we use the gary mendoza
53:08
daniel williams sort of methodology of a
53:11
sort of an interview and you know if i had a
53:14
client come and see me today i would get them to fill out the contraindicators the
53:18
consultation form because that's an insurance requirement but i'd
53:21
just say then i'm gonna sit here for 10 minutes i want you to explain
53:24
to me everything that you think is relevant you know
53:27
your past medical history you know what you think is
53:30
relevant with your you know whether you're getting nighttime pain whether it's
53:33
pain in the morning you know what exacerbates it
53:36
what makes it easier and then having that supplementary information
53:39
makes it a lot easier to make that clinical judgment earlier on and i'm an advocate
53:45
of having an extra box on your treatment card saying supplementary information
53:50
provided because it's amazing how many people forgot they've had a stroke or
53:53
a shoulder replacement operation until the fourth or fifth treatment.
53:57
So get as much information as you can.
54:00
Have a sort of a conversation rather than a consultation, because we're going
54:06
to get the right amount of... Have a conversation instead of a consultation.
54:10
That is so beautiful, Gary.
54:12
Have a conversation instead of a consultation. That is fantastic.
54:17
The other person then feels more involved anyway, don't they?
54:21
Because that's what we know from narrative medicine, that the healing is in the story.
54:29
The healing is in the narrative of the story.
54:31
If we allow them, like you say, spot on. Yes, I am having the consultation form
54:37
I'd like to send them before because I want them to start reflecting already.
54:41
You know, it's a sense-making process for the person in pain to start writing
54:49
down. But even the consultation can be written in such a positive or non-threatening ways.
54:56
And also like questions like, is there anything else you'd like me to know about your health?
55:02
And then when they come in, I often say, I already read the form that you use.
55:08
I want to hear it from you.
55:10
And then you start that conversation. I can't tell you how powerful it is,
55:14
the word that you use, that conversation and not...
55:19
A consultation. I'll be trying to find, always say, a substitute for subjective
55:24
assessment, but Gary, now I will quote you, but I will call it initial conversation,
55:30
not initial interview, because an interview, again, initial conversation.
55:34
That's it, Gary, you sorted out my conundrum. Ten-year dilemma. Very fantastic.
55:39
Can I just cover the insurance aspect of this matter as well? Yes, certainly.
55:44
And Brian's alluded to it there. You know, if we were allowed to diagnose,
55:47
that gives us a greater sense of responsibility.
55:51
Now, what I have to do, and this is why I spend too much time talking to insurance
55:56
underwriters and Valens Insurance,
55:58
is to understand what can go wrong and understand when your insurance may be
56:05
cancelled or may be void.
56:07
And if we're working outside of our scope of practice, what
56:10
we have to do is we have to look at what's called our overarching qualifications
56:14
that's your your highest qualification in this
56:17
industry specific sort of subject and then
56:20
all of the modules on there are your
56:24
scope of practice if you have done cpd and
56:28
i'm going to use an example if you've got a level three
56:31
qualification that was issued after 2014 but your
56:34
training provider has sold you a dry needling qualification then
56:38
that is not in your scope of practice because it's the
56:41
application of pre-post intravent massage and maintenance massage dry needling
56:45
has a remedial intention therefore you need level four but your overarching
56:49
qualification what makes you insurable cpd is considered underneath the overarching
56:56
qualification if i found myself in court.
57:00
And this is just an example, where I had caused harm to somebody,
57:04
then what the judge will look at is whether I've overstepped my scope of practice.
57:12
And I will have to prove through my note writing what I've done.
57:17
And that's why it's important to have comprehensive notes written down instead
57:20
of just a few abbreviations.
57:21
Because up to seven years' time, somebody can claim against me,
57:25
and I need to know exactly what happened in that session.
57:27
So it's important that we write good quality notes we
57:30
are going to be doing a special podcast with a guest who
57:33
i'm just trying to confirm using artificial intelligence
57:37
to collate notes and also
57:40
record the conversation and and highlight the salient points from that but what
57:45
we don't want to be doing is overstepping our scope of practice because that's
57:51
where we will find ourselves in hot water just because just That's because we
57:57
think we can do something we shouldn't.
58:00
One of the things is for me, you know, working with young children.
58:05
Unless you're trained for it, don't do it.
58:07
They're not, they're not, this is where the most out of scope that I do see
58:12
around actually, working with, working with young children, all missing,
58:17
missing red flags, big red flags.
58:20
Fantastic. Great information, guys. And I think to conclude,
58:25
because I mentioned earlier that sometimes we try and use word diagnosed to
58:28
elevate ourselves and make ourselves more powerful.
58:31
We've had so many guests in the show, physios, surgeons, hugely respected educators saying, yeah.
58:39
Power we've got is the time, particularly working in the private industry,
58:42
we've got that time to establish such an amazing alliance with our patients,
58:46
particularly if there's touch involved, if they enjoy that,
58:49
then they're going to peel off the layers so well that we become hugely important
58:54
in the circle of care for them and then revealing things to us and allowing
58:58
us to potentially signpost them to somebody who can diagnose.
59:01
So in actual fact, we've got a beautiful power. If you're a non-allied health
59:05
professional, you've got the power to be able to help that person without running
59:09
the risk of diagnosing and getting it wrong.
59:12
Yeah. If you can signpost somebody who you suspect might have endometriosis
59:16
or hypermobility or Ehlers-Danlos syndrome or male pelvic health issues,
59:20
or any of these things, which we've learned through good CPD could be happening.
59:26
Refer them onto somebody who can take that burden on their shoulders.
59:29
Now you've done your job and signposting. It might not be right,
59:31
but at least you've helped that person potentially get diagnosed.
59:34
And I think that's where our power needs to lie.
59:36
And if you recognize that, you don't worry about diagnosis you
59:39
don't that's not our role our role is to use the fantastic skills
59:42
we've got of listening and helping our clients feel safe
59:45
and non-judged and tell us what's wrong with them what they think is
59:48
wrong with them and forward them on that's all i think it's also
59:51
important that to consider you know to reconcile with yourself
59:54
as a therapist what your treatment is actually doing
59:57
you know if you're applying massage to support
1:00:00
somebody who's had a recent cancer diagnosis and
1:00:03
is suffering from stress and anxiety then it's
1:00:06
it can be really beneficial you know i've worked with quite a few of my patients
1:00:10
who went on to develop cancer and the support that we were able to give them
1:00:15
whilst they're having their treatment we're not treating the disease we're managing
1:00:20
their symptoms and supporting them through their what is a really stressful journey.
1:00:25
And also the last is that for those of you that are not university trained, please do not feel.
1:00:36
University is wonderful if you enjoy the academic learning and if your brain,
1:00:42
you know, you like the very analytical, superb, you know, I love it, I love it.
1:00:47
But if you are not from a clinical perspective, in fact, going to university
1:00:51
taught me that in our profession, we don't necessarily need a university degree
1:00:58
as long as the vocational training.
1:01:01
So you don't feel that you are any less.
1:01:06
But we need in vocational training, we need to be more, like Gary said,
1:01:11
more reflective, less modality and more reflective.
1:01:15
Fantastic. Wonderful summary. right look at this 905 hopefully
1:01:19
that's been of a useful discussion thank you everybody who joined us live i
1:01:22
really appreciate you appreciate your questions and input everybody and
1:01:25
if you listen to the podcast like i say if it made you
1:01:28
think and you want some more information or leave comments then go to youtube
1:01:31
and even on there we don't want this this subject to mustn't just end tonight
1:01:35
and last for a week it's an ongoing thing and this is still going to be relevant
1:01:38
in half a year a year two years down the line so do whatever you watch if you
1:01:42
listen to this go to youtube and leave a question and keep the conversation
1:01:45
going on this topic and all the other topics we've got there
1:01:48
next week and let's just go back to showing a little picture here next week
1:01:52
we're going to have our christmas party.
1:01:54
2025, Christmas 2025. And we're going to have members from the STA,
1:01:59
from all the hardworking admin team and champions and podcast hosts and all
1:02:04
sorts of wonderful people who are going to be having a look back at 2025 and ahead at 2026.
1:02:09
So it'll be a great time for you to come along and join us live if you can.
1:02:12
Not only STA members, it was a really nice opportunity if you're not an STA
1:02:16
member to come along and listen to what we have done, how we've supported you,
1:02:19
what our plans are for next year to support you, because that's why we're here.
1:02:21
We're here to support you.
1:02:22
It really is we're a non-profit association who is
1:02:25
trying to help the industry and help you guys so do come along and hear how we've
1:02:28
done that what our plans are for next week by coming to youtube
1:02:31
or facebook at eight o'clock and you can join us
1:02:34
for the christmas 2025 episode i nearly put winter festival or something i really
1:02:39
am conscious that not everybody does celebrate christmas but it was just looked
1:02:42
too long and windy but i appreciate not everybody does celebrate christmas and
1:02:45
i respect that and if you just want to come and celebrate the winter festival
1:02:49
with us and that's great or if just december whatever reason come along and
1:02:52
join us for the holiday festivals
1:02:54
my thanks once again to ann maria matsieri for giving up your time and experience
1:02:57
thank you so much ann maria i hope this is,
1:03:00
allowed you to express what you wanted to when you put your hand up and got
1:03:03
25 seconds at the end of the panel debate.
1:03:05
I was. I picked up then with Laura Fino came after and I said that was a little bit unfair.
1:03:12
It's tricky. I think this is the feedback for Therapy Expo, isn't it?
1:03:15
If you're going to have an incredibly amazing panel debate like that,
1:03:19
you've got to plan in at least 10, 15 minutes for reflection afterwards,
1:03:22
for questions, because it's going to help everybody who listened to it take it home better.
1:03:27
So we'll take that to the next year. because the most
1:03:30
important viewpoint in that whole theater was lovely having
1:03:33
the three people on stage but let's turn it around turn
1:03:36
that camera around to the hundred people watching what do you think you know that
1:03:39
would be really useful i think it was a great panel though i have to say it
1:03:41
was amazing panel and seeing them all together was great it's not very gary
1:03:45
we'll talk about this next week on the show looking ahead at 2026 but it was
1:03:49
a great panel was it you you've you've you must be the most cynical and person
1:03:53
in the whole of our industry because you've seen it all you've seen people ripping
1:03:57
your name apart and and but now do you feel slight if you feel optimistic then
1:04:02
we can all feel optimistic that's what i'm saying,
1:04:04
Yeah, I do, you know, recognize that I have been a thorn in the side of many
1:04:10
an industry stakeholder over the years.
1:04:12
But the intention has always been the same, is to get people talking,
1:04:17
you know, get people around the table.
1:04:19
And for the first time in 15 years, that's happened, you know.
1:04:22
And I want to publicly get on record by thanking the SST and the STO for agreeing
1:04:27
and in the SST for organizing our collaborative meetings.
1:04:33
Without a doubt and we will have them on the show we've been speaking to them
1:04:36
and the collaboration will continue it's going to be the word to use in 2026
1:04:39
we're looking forward to having,
1:04:41
members from the different organization associations on the show
1:04:44
so we can have some real great conversations that's what it's all about it's all
1:04:46
about communication not just with our patients but with our colleagues and in
1:04:49
different associations and organizations and that so so if
1:04:52
you have enjoyed this episode episode as always please subscribe to youtube channel
1:04:55
this appears high in google search results
1:04:59
if you leave a good rating and a review so please do
1:05:02
that you'll be helping the industry loads by doing that and if
1:05:05
you do are interested in joining the sta just to remind you you
1:05:08
can use the code podcast 25 and it'll get you three months
1:05:11
extra if you join for a single year so instead of 75 pounds yes i'll repeat
1:05:15
that 75 pounds you will get 15 months instead of the normal 12 months for that
1:05:20
75 pounds and it's only valid for new members and if you're level three and
1:05:24
qualified after 2014 then make sure you opt for associate member when need to join up. There we go.
1:05:29
Right. Thanks again, Maria Matsieri, Gary Benson. Thanks so much.
1:05:32
Thank you for inviting me.
1:05:34
Hopefully see some of you next Tuesday at 8 o'clock. Until then,
1:05:38
take care of yourselves.