Spotlight 6: Physiotherapists’ blessings

It was a busy day: the centre was like a beehive, everyone was running. I was in the hallway heading to my next patient when I overheard a woman shouting at our receptionist. After I saw my patient and while I was charting in the hallway, I could hear the woman still shouting even louder than before. I called the receptionist inside and asked her what was going on, she said: “It is Mrs. Johnson, she wants to see you to discuss what the physiotherapist told her about her son. The physiotherapist told her that her son needs surgery for his back and if he doesn’t do the surgery he will be paralyzed.” READ: Spotlight 5: Specialists’ blessings Mrs. Johnson’s son, Nick, is 10 years old and has been under my care since he was born. Five years ago, during one of his well baby visits, I noticed that he had mild scoliosis: an X-ray showed a 9 degree mild scoliosis. I called the family and explained to them the benign nature of his scoliosis and that he doesn’t need anything at this time but we would have to repeat the X-ray in the future. Two years later the X-ray showed 9 degree mild scoliosis. A year later the scoliosis was 9 degrees too. I asked the receptionist to call Mrs. Johnson in. “What is up Mrs. Johnson?” I asked after I greeted her. After a pause, she said, “The physiotherapist told me that my son needs surgery and he would be paralyzed if we don’t do it and also one of his legs is shorter than the other by 1 cm.” What is the reason you took your son to a physiotherapist in the first place Mrs. Johnson? I curiously asked. “I had told my physiotherapist that my son has scoliosis in the past and he asked me to book an appointment so he could assess him,” she replied with an angry tone. Is your son limping? I asked No, she replied sharply. Is he in pain? No. Mrs. Johnson, your son is not the first one who has unequal length legs according to physiotherapists' assessments, I told her. Based on these assessments alone, a third of Ottawans would be limping in the street. Second I told her: “I discussed the X-ray findings with you and your husband at that time and we repeated them twice with no changes.” I read to her what we exactly discussed up to last year. She didn’t calm down and demanded a referral to an orthopedic surgeon. I went over the X-rays with her again and reassured and advised her that the physiotherapist assessment is not necessarily accurate and that Nick doesn’t need anything at this time. She insisted on the referral which I declined. She stood up, stormed out and slammed the door behind her and that was the last time I saw her and her family. Interestingly, a year or so later I received a letter from an orthopedic surgeon stating that Nick has a mild form of scoliosis and that he doesn’t need a surgical intervention or bracing at this time. So, as per the physiotherapist assessment, Nick’s leg is one centimetre short and because of his assessment I am three patients short. Dr. Jabir Jassam is a family physician who works at Health Treasure Medical Center in Ottawa. Follow him on Twitter: @HtmcMc. This item is called “Spotlight 6” because he’s writing a series of spotlights like this.

Spotlight 6: Physiotherapists’ blessings

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