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What a pain

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Sunil Singh, 65, didn’t know what he was in for when his orthopaedist’s assistant showed him some lumber exercises and asked him to do them every day. After a few days of doing the exercises, Singh, who suffers from multiple slip discs of the lumber region, suddenly found that he couldn’t control his bowel movement. He figured that his problem was something to do with the exercises and changed his orthopaedist.

It turned out that he was right. The doctor diagnosed his problem as bowel dysfunction, a condition where a spinal nerve gets compressed and leads to a disturbed bowel. He gave Singh some medicines to treat the problem and told him that the malady had been brought on by incorrect and harmful exercises.

Singh is not alone. Forty-five-year old Firoza Sultana, a homemaker in Calcutta, had visited a local physiotherapist to treat her lumber pain. But after taking spinal traction for a few days, her pain increased. Or take the case of Simran Takral, 22, who was suffering from a shoulder pain. Takral underwent physiotherapy for her problem, but instead of getting better, it was severely aggravated. She had to finally go to a reputed physiotherapy clinic and undergo eight months of treatment for her problem.

Singh, Sultana and Takral are all victims of incompetent physiotherapists who, instead of treating their condition, only ended up aggravating it. Experts say that inept physiotherapists can cause serious harm to patients.

Explains Ravi Ranganathan, a physiotherapist with Pain and Stroke Rehab Centre, Chennai, “Identifying the problem is a major issue. It is post identification that the physiotherapist administers the desired therapy. If your therapist is not qualified enough to diagnose your problem, then you might end up getting the wrong treatment or be prescribed wrong exercises.”

The bad news is that with the proliferation of physiotherapy clinics, the chances of that happening have increased. Many of these clinics are manned by ill-trained physios who are simply not qualified to help their patients in the right way. Shabnam Agarwal, chief physiotherapist at Belle Vue Clinic, Calcutta, says, “We get many cases where patients complain of aggravated problems in movement after undergoing a wrong physiotherapy treatment.”

Physiotherapy is a specialised discipline aimed at rehabilitating and improving the quality of life of a person by using treatments like exercises to improve mobility and strengthen muscles. Often, adapted treatments such as ultrasound therapy, shortwave diathermy or traction are also used.

Qualified physiotherapists are those who undergo the four-and-a-half-year degree course in physiotherapy from colleges registered under the Indian Association of Physiotherapists (IAP), a body representing more than 26,000 physiotherapists in the country. However, many people simply do a six-month diploma course and start calling themselves physiotherapists when, in point of fact, they are totally ill-equipped to practise and treat patients.

Ali Irani, head of the department of physiotherapy, Dr B. Nanavati Hospital, Mumbai, and president of IAP, points out that physiotherapists with a diploma are as good as quacks. “With no practical experience or internship, how can they give quality treatment? Going to a diploma holder is as good as going to a quack.”

So what can you as a consumer do if you are the victim of wrong treatment at the hands of an under-qualified or negligent physiotherapist?

According to Mumbai-based consumer activist Jehangir Gai, the hapless consumer could consult another doctor and get a medical certificate describing his condition post treatment. Using that as evidence, he could claim compensation by filing a case against the practitioner in the consumer court. However, says Gai, “Often the physiotherapist prescribes exercises based on the orthopaedist’s suggestion. So it's best to file a case against both the orthopaedist and the physiotherapist.”

If a complaint is registered against a physiotherapist with a prescribed bachelors degree, he or she could also come under the IAP scanner and in extreme cases, his or her degree could be derecognised.

However, Dr M.S. Kamath, medico-legal consultant and honorary secretary of the Mumbai-based Consumer Guidance Society of India, says that consumers do not usually go to the trouble of complaining against negligent physios. “No consumer has ever lodged a complaint against a physiotherapist in a consumer court. It could be due to lack of awareness.”

Of course, the best way to guard oneself against wrong treatment at the hands of a physiotherapist is to make sure that the practitioner is a properly qualified one and not a quack. More so because proving a case of wrong treatment against a quack is doubly difficult. According to Agarwal, most of them do not give receipts for their services and hence bringing them to book is not easy. Besides, she says, “Qualified physiotherapists know that if they administer wrong treatment and the patient complains, they would be hauled up by the IAP and would have to face charges. But the quacks have no such fear.”

Experts feel that it’s the lack of a proper regulatory body that has led to the mushrooming of physiotherapy clinics with under-qualified therapists. But that could change if the Paramedical and Physiotherapy Central Council Bill, that was introduced in Parliament in December 2007, and has since lapsed, were to be revived. The bill had proposed to set up a central regulatory council to formulate uniform standards of education and the development of new diagnostic and therapeutic techniques in physiotherapy. It would have also looked into the registration of qualified physiotherapists and brought in a measure of accountability.

However, with the government evincing no interest in reviving the bill or introducing an updated version of it, it is up to the consumer to be careful about choosing a physiotherapist. And in case you receive wrong treatment that exacerbates your problem, you could always exercise your right as a consumer to file a case against the person in the consumer court.

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