Testimonials…ugh
Testimonials are a common way of getting the word out about one’s serves and serve to grab the attention of people. While they can be useful for someone seeking input on another person’s satisfaction with a product or service when used in healthcare environments they tend to grossly overstate outcomes. Patient satisfaction should go no further than that, as someone being helped by another’s services in no way validates the claimed mechanism of action of the intervention or acts as proof (evidence) that the story told about the intervention matches the outcomes achieved. This is a tough one for some, as they are tied to their story being accurate and when someone benefits from their services it is used as proof that their claims and story were true. Unfortunately, satisfaction from interaction and proof of the mechanism of action often get conflated.
The issue is much the same as research papers that are, in essence, outcome-based studies but allow what is perceived to be the mechanism of action to creep in. Helping people satisfied, based on what we do is a nice outcome. However, the tendency is to take a basic premise and create some serious issues of bias and inaccuracy, for instance, myofascial release or trigger point therapy is helpful for symptoms of GERD and design a study around this topic. In most papers, the authors state the problem (GERD) and then state their theory on how GERD may be influenced by myofascial restrictions or trigger points and set out to prove this. In the paper, they write about the theory behind the work, most of which tend toward the historical narrative used to describe the issues and perceptions of the mechanisms of action. Little accurate, up-to-date evidence is provided that shows the issue (usually within the tissue of their preference) is actually a plausible possibility. Having felt t=like they set the tone for the study, they then proceed to state the study design, etc. In a case such as this, if the study has positive outcomes, it proves is that when someone sets up a situation where (in the case of manual therapy) they do a certain thing with their hands and words, the problem is helped. What is does NOT show is that the mechanism of action was correct. Unfortunately, publishers of even credible journals allow these errors to slip past them, seeking that the study methodology itself is credible.
Testimonials are not going away and hucksters will continue to use them to show how darn good they and their work is. We can do our part to point out the low level of proof inherent in these testimonials. Good luck with that.
As a “full disclose”, on my PT practice website I allow patient reviews to be shown. One might view these rightly as testimonials, as in a sense they are. I’ve allowed those to be posted, unfiltered, for years now. There was a time when I held one review back. It was a 3 out of 5 star rating from a person who saw me once and I didn’t “take away” his sciatica. I held that in the review queue for over a year, wondering how it would look in the overall ratings. And then I saw the folly of this. No one can please everyone, ever. So I released it and it now tempers my ratings ever-so-slightly downward.
Cheers,
Walt Fritz, PT
Foundations in Myofascial Release Seminars
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