First, I think Ingrid paints a picture of how NOT to run a clinic and how NOT to use information.  

Regardless of the measurement "indicator" an assessment MUST include a very full history to get to the root of the problem.  I think it is an example of the one size fits all medical advice that often problematic regardless of whether it is a pill, a surgery, or formula is dispensed in a knee jerk reaction.  I think here of the sometimes needless and stressful breast biopsies (one of which impeded my ability to produce milk from my left breast because the surgeon just assumed I wanted the more cosmetic incision around the areola without ever telling me I had options).  And you can have the same type of knee jerk advice using a very expensive piece of equipment or if the health care practitioner is extremely thoughtful, that extremely expensive piece of equipment can provide information that guides that thoughtful practitioner into life saving decisions as when it properly diagnoses breast cancer in time for treatments to work.  

I think also of my orthopedic surgeons when I broke my wrist snowboarding.  The first was very thoughtful and asked lots of questions about my activity.  He highly recommended surgery based on the X-ray and my responses about my needs.  The second had a negative reaction to my report of what the orthopedist in a community clinic in New Hampshire recommended -- until he saw the X-ray.  In this case, the technology actually saved my wrist mobility because the surgeon was willing to consider what was an appropriate surgery for ME considering MY needs and he scheduled it before my wrist became so set that it would have become a more difficult surgery.  This same orthopedic surgeon saw my husband who had exactly the same type of break when he tried to show our son how to skateboard.  (I'm still not sure why my husband who never skateboarded himself thought he could teach our son how to do this). My husband doesn't use his hands in the same way I do and was perfectly content to spare himself the pain and rehabilitation from surgery.  He doesn't mind that his wrist has less flexibility.  This is how good practitioners work -- gathering evidence and considering the needs of their clients.

Best, Susan

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