Hello All! I thought I would debut this blog by calling to your attention a provocative article written not too long ago by a colleague.
It seems that the status quo over the last 20 years in the FCE world has not been as “scientific” as many would have you believe. This particular area of the physical therapy we consider our part of “Evidence-based Medicine.” However, unfortunately the evidence points to a continued use of Invalid Validity testing leading to questionable credibility of the FCE process. This information has been known since at least 1998, but most of the suspect methodologies discussed are still in widespread use in FCEs today!
See Detecting Sincerity of Effort; A Summary of Methods and Approaches. Lechner, Bradbury, Bradley, PHYSICAL THERAPY, Vol 78 No 8 Aug 1998 (http://www.ncbi.nlm.nih.gov/pubmed/9711211) and
Simons, G. (2006). “Credibility Crisis in FCEs.” PT Products ONLINE (Oct): 24-26 (http://www.ptproductsonline.com/practice-management/15421-credibility-crisis-in-fces)
It’s against human nature to admit failures and mistakes; certainly as individuals, but apparently much more so for a professional community. In my opinion, it’s about time that we confront this issue directly and attend to it carefully until we find answers that will satisfy our referring physicians, payer-clients and their claimants.
My research suggests there are answers. There are, available now, valid methods of measuring the “illusive” sincerity of effort. Here’s an article that perhaps can open the conversation, further exposing the issue with some recommendations. I will be featuring more articles and other evidence currently available that indicates valid methods of determining sincerity of effort are available now.
Think about this… ”What’s the point of FCE, if you don’t know whether the claimant was providing sincere effort?“
Take a look at
“Three Functional Capacity Evaluation Myths That Have Cost Your Company A Lot of Money”
http://www.selffundingmagazine.com/article/three-functional-capacity-evaluation-myths.html and let me know what you think.