letters to the editor
Electrical Hazards
what he knows about the hazards than was the 240-word "Letter to the Editor." EUGENE MICHELS
To the Editor: The chief point of Mr. Berger's Letter to the Editor in the July 1975 issue of the Journal (p. 794) was that the Journal has, "over the past twenty-four years," failed to alert its readers to the hazards of serious electrical shock from physical therapy apparatus. Granted that an abundance of papers on the topic has not been published since 1951, a quick search of The Fifty-Year Index of Physical Therapy showed that two relevant papers were recently pub lished ("Fatal Current" in 1966 and "Tiny Flaws in Medical Design Can Kill" in 1968). As a reviewer of manuscripts submitted for publication in the Journal (and putting aside the question of whether or not I was one of the reviewers of Mr. Berger's manuscript which was evidently rejected and subsequently published elsewhere), I cannot leave unanswered the last sentence of Mr. Berger's letter. That sentence implies that the Journal staff and the members who volunteer their services to review manu scripts "hide the truth and facts" from readers (that is, reject manuscripts) in order to protect the Journal's advertisers. Being one of the volunteers, I not only take exception to that accusation but I refer Mr. Berger to the series of papers on "Let's Reduce the Communication Gap," one of which was Mr. Strohm's "What Associate Editors Look At" (March 1975, pp. 266-267). Now that Mr. Berger's paper on potentialshock hazards in physical therapy departments has been published, and because he is rightly concerned about patient-therapist safety, per haps he will consider submitting an abstract of that paper for our readers. Surely that would be a more effective and efficient way of sharing Volume 55 / Number 10, October 1975
Assistant Professor of Physical Therapy School of Allied Medical Professions University of Pennsylvania Philadelphia, PA 19174
More on Electromyography
To the Editor: To "do electromyography" is widely under stood today as performing an examination using an electromyographic instrument for diagnostic purposes. It is, therefore, disturbing to note the conspicuous absence of the word "diagnosis" in Dr. Perry's editorial. The omission may be an oversight. One fears, however, that it is in deference to the oft-heard defense that therapists do not make diagnoses but simply report "findings." Such a defense is either a semantical dodge or an illustration of gross misunderstanding of how such an exami nation must be performed. The study starts with the consideration of the differential diagnosis. Procedures are then selected which will narrow the diagnostic possibilities. The course of the study is continu ously altered, depending upon findings as they bear on excluding or confirming diagnoses. The procedure ends when the diagnostician con cludes he has exhausted his potential for picking up diagnostic clues. This is clearly a" highly intricate diagnostic procedure. The question is not who should be using EMG machines any more than who should be using stethoscopes. The question is whether physical therapists should be performing crucial 1139
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opinions and comments of readers
examinations requiring diagnostic skills. I am not aware that therapists train as diagnosticians, even at the doctoral level. Therefore, the answer to Dr. Perry's question, "Should physi cal therapists do electromyography?" should be, "No, as this is a diagnostic examination, and
physical therapists are not trained as diagnosti cians." ROBERT D. SINE, M.D.
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