#PhysioTalk Transcript

Healthcare social media transcript of the #PhysioTalk hashtag.
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physiotalk @physiotalk
Good evening and welcome to tonights #physiotalk Tonight we will be chatting all about #risk with @NicolaLauchlan
Joe Middleton @_JoeMiddleton
RT @physiotalk: Good evening and welcome to tonights #physiotalk Tonight we will be chatting all about #risk with @NicolaLauchlan
physiotalk @physiotalk
Before we get started with the questions - if you are taking part can you say hello and where you are joining us from! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk Hi everyone! Looking forward to an interesting discussion #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @physiotalk: Good evening and welcome to tonights #physiotalk Tonight we will be chatting all about #risk with @NicolaLauchlan
Janet Thomas @JanetThomas47
I'm on the #physiotalk account tonight - looking forwards to the chat from a very sodden Edinburgh
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 Yes Paisley is much the same Janet #physiotalk
KB @KBNeuroinfo
@physiotalk Good evening from a muggy South Wales! #physiotalk
Liz Cowan @liziophysio1
hi #physiotalk I am Liz Cowan ,independent children's physio based in sunny, warm,Warrington.
Nicola Lauchlan @NicolaLauchlan
@KBNeuroinfo @physiotalk Hello! Thanks for joining #physiotalk
physiotalk @physiotalk
@KBNeuroinfo Welcome! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@liziophysio1 Hi Liz Thanks for joining us #physiotalk
Janet Thomas @JanetThomas47
@liziophysio1 What - Warrington is sunny and warm! I'm moving back.... #physiotalk
physiotalk @physiotalk
So - lets get started with our first question of tonights #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @physiotalk: So - lets get started with our first question of tonights #physiotalk
physiotalk @physiotalk
Q: What does ‘risk’ look like to you? #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @physiotalk: Q: What does ‘risk’ look like to you? #physiotalk
Liz Cowan @liziophysio1
@physiotalk #physiotalk unfortunately "risk" in the paediatric world can often be used to put restrictions on children with disabilities that restrict their opportunities to learn by risk taking.
Nicola Lauchlan @NicolaLauchlan
@physiotalk For me, the word 'risk' suggests the chance of an adverse outcome. For patients this could be anything from suffering side effects of medication to serious injury or harm. #physiotalk
Janet Thomas @JanetThomas47
Yes- definitely linked to the chance of something happening that would be detrimental to the patient our outcome #physiotalk
Nicola Lauchlan @NicolaLauchlan
@liziophysio1 @physiotalk I think this is common in every specialism Liz and is really interesting that you lead with this #physiotalk
KB @KBNeuroinfo
@physiotalk #physiotalk Risk is about balance, challenging boundaries within a framework of clinical reasoning
Janet Thomas @JanetThomas47
So a very negative term really?! #physiotalk
Liz Cowan @liziophysio1
@NicolaLauchlan @physiotalk thinking "what's the worse that could happen" and taking steps to make sure that doesn't happen. #physiotalk
Nicola Lauchlan @NicolaLauchlan
Definitely Liz! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 Unfortunately, yes #physiotalk
physiotalk @physiotalk
Ahead of tonights chat I looked up the dictionary definitions (both a verb and a noun...) Noun: a situation involving exposure to danger Verb: expose (someone or something valued) to danger, harm, or loss. #physiotalk
#hellomynameis Adele @ABNeurophysio
#physiotalk helo from South Wales!
physiotalk @physiotalk
@ABNeurophysio Welcome! #physiotalk
Nicola Lauchlan @NicolaLauchlan
No wonder risk assessments are generally negatively slanted.... #physiotalk
physiotalk @physiotalk
RT @NicolaLauchlan: No wonder risk assessments are generally negatively slanted.... #physiotalk https://t.co/S4XBTPiCIk
Nicola Lauchlan @NicolaLauchlan
@ABNeurophysio Hello! Thanks for joining #physiotalk
Jon Room @JonRoom
What about the risk of not taking any risks? Sounds pretty risky to me! #physiotalk
Jo Kitchen @J0Physio
@physiotalk Risk: the chance of harm vs the chance of success #physiotalk
physiotalk @physiotalk
A more positive view of risk - anyone else have anything? #physiotalk
physiotalk @physiotalk
@JonRoom Indeed! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JonRoom Definitely! As I said in the blurb for tonights chat- the risk of muscle wasting, pressure sores, malnutrition..... #physiotalk
#hellomynameis Adele @ABNeurophysio
RT @KBNeuroinfo: @physiotalk #physiotalk Risk is about balance, challenging boundaries within a framework of clinical reasoning
Nicola Lauchlan @NicolaLauchlan
@J0Physio @physiotalk Ooooh I like this Jo! #physiotalk
physiotalk @physiotalk
So - lets go onto our next question, to delve a little more into #risk and what it means to us clinically #physiotalk
Jon Room @JonRoom
@physiotalk Sorry late to the party. Been trying to get a 1 year old with a cold to sleep 😩 #physiotalk
Jon Room @JonRoom
RT @NicolaLauchlan: @JonRoom Definitely! As I said in the blurb for tonights chat- the risk of muscle wasting, pressure sores, malnutrition…
physiotalk @physiotalk
@JonRoom Good luck ?!?! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JonRoom @physiotalk Awww bless! Nothing worse hope the wee soul feels better soon #physiotalk
#hellomynameis Adele @ABNeurophysio
@JonRoom @physiotalk I think there's a risk you may not conclude the #physiotalk this evening
physiotalk @physiotalk
Q: How do you assess risk? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk For me, most of you have already hit the nail on the head. Without risk, there can be no development, progression or, ultimately quality of life. #physiotalk
Jon Room @JonRoom
@ABNeurophysio @physiotalk 🤣 I think you are right! #physiotalk
Jo Kitchen @J0Physio
@liziophysio1 @NicolaLauchlan @physiotalk E.g. Driving a car- chance of death made less with seatbelts, car design, car seats, but there is higher chance of some form of less catastrophic accident occurring which we accept for the convenience & speed of travelling by car #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @J0Physio: @liziophysio1 @NicolaLauchlan @physiotalk E.g. Driving a car- chance of death made less with seatbelts, car design, car seats…
physiotalk @physiotalk
Or even perhaps - do you assess risk? #physiotalk
Liz Cowan @liziophysio1
@physiotalk #physiotalk yes - formally for recognised risk areas such as aquatic therapy, or when giving formal instructions/advice, and less formally during each treatment session.
Nicola Lauchlan @NicolaLauchlan
@physiotalk I use outcome measures such as Tinetti assessment to try and evidence risk, but I don't feel that's as helpful sometimes as using subtle nuances in clinical judgment to allow patients to take calculated risk. It worries me that this is difficult to document, though #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @liziophysio1: @physiotalk #physiotalk yes - formally for recognised risk areas such as aquatic therapy, or when giving formal instructi…
Janet Thomas @JanetThomas47
@physiotalk I think this is tricky! We do have formal written assessments for manual handling for example, but this needs to be weighed against clinical reasoning and person centred care #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @JanetThomas47: @physiotalk I think this is tricky! We do have formal written assessments for manual handling for example, but this ne…
Jo Kitchen @J0Physio
@physiotalk Every second of my patient interactions, as it constantly changes! Mostly visual- looking for fatigue, breathing, temp, eye focus, cognition, environment hazards. For kids activities (non-physio) I use something like this chart & then action plan to minimise risks #physiotalk https://t.co/ATmLno8ngH
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk How would you record this - certain cut points I presume, but then what?? How would it direct your input? #physiotalk
Liz Cowan @liziophysio1
@JanetThomas47 @physiotalk #physiotalk I often have discussions about acceptable risks and about the consequences of making unsafe choices or not taking risks. Sometimes families and child may have different opinions, that is tricky.
Nicola Lauchlan @NicolaLauchlan
@J0Physio @physiotalk Do you use this for every individual activity Jo? #physiotalk
KB @KBNeuroinfo
@physiotalk its about supporting or providing patients with an experience they may not otherwise have outside of physiotherapy intervention #physiotalk
#hellomynameis Adele @ABNeurophysio
#physiotalk: we do assess,& discuss risk but shared decision should be made with the people we work with is :who is holding the risk? We can take steps to moderate the risk but ultimately it should be a co=produced outcome - I accept paeds may differ
latísh @tis7ha
RT @J0Physio: @physiotalk Risk: the chance of harm vs the chance of success #physiotalk
Nicola Lauchlan @NicolaLauchlan
@liziophysio1 @JanetThomas47 @physiotalk Oh I can imagine that being really difficult, but find it's the same for elderly patients whose relatives are perhaps informal carers #physiotalk
Janet Thomas @JanetThomas47
@J0Physio @physiotalk Yes - I have something similar that we have to use for a children's / youth group activities (not work!) - to show that we have thought through risk and how to minimise #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 @J0Physio @physiotalk Interesting that you use this outside work- do you think it should be used in the clinical environment too? #physiotalk
physiotalk @physiotalk
@KBNeuroinfo Can you give more details - how would you decide if it is 'too risky' for example? #physiotalk
Liz Cowan @liziophysio1
@NicolaLauchlan @JanetThomas47 @physiotalk #physiotalk yep in the same way that we all have elderly relatives, or teenage children etc I guess risk itself is very subjective depending on ourselves. I am a bungee jumping biker who may have a high risk=fun=human right expectation...
Janet Thomas @JanetThomas47
@NicolaLauchlan @J0Physio @physiotalk In a sense we have - as we have completed generic risk assessments for a whole host of activities within our department- from walking with patients to applying cold / heat etc #physiotalk
physiotalk @physiotalk
As we have started to veer into this topic - next question coming up! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@J0Physio @physiotalk So this is how we record it for ourselves as persons responsible for the activity- how do we translate that risk assessment into terms a patient can easily weigh up/judge for themselves? #physiotalk
physiotalk @physiotalk
Q: Do you use particular risk-focused assessments? #physiotalk
C Harris @CHarrisPhysio
@physiotalk I think, like others have said, that it’s as important to be doing an ongoing assessment throughout the time you are with a patient, as it is to be using formal tools, but I agree that this can be harder to document #physiotalk
Jo Kitchen @J0Physio
@NicolaLauchlan @JanetThomas47 @physiotalk Possibly, but it’s the process of doing them that is useful. If they are done by a team lead & sit in a file then that isn’t useful. And the participant in the activity changes the level of risk so I’m not sure if they can be done genetically #physiotalk
Janet Thomas @JanetThomas47
@physiotalk And I would ask as well, if so are they scored? Most places, for example, have moved away from a scored risk assessment for falls on wards. What about other areas? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk I find it really interesting that patients might be aware they cannot do something in ward environment due to 'health and safety' - and they'll quote this- but they can do it themselves when they go home. I wonder how to get these to 'marry up'? #physiotalk
KB @KBNeuroinfo
@physiotalk Assess and then discussion within team and with individual. Weighing up the potential gain versus harm #physiotalk
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk If I only knew.... I'm sure most of my patients do things at home that they know I would be concerned about if I saw them doing it. They are prepared to take the risk though... #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 @physiotalk We use the Tinetti assessment to determine if patients are mobile enough to participate in our community exercise classes, but we are told the 'high, medium, low' categories do not correlate with actual risk. #physiotalk
Nicola Lauchlan @NicolaLauchlan
@ABNeurophysio @physiotalk Absolutely- as though making the most of their 'freedom'!! #physiotalk
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk Yes - risk is such a multifactorial thing that it is difficult to quantify? #physiotalk
physiotalk @physiotalk
#physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 @physiotalk Exactly this! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@ABNeurophysio @physiotalk Should we stop 'telling them off?' #physiotalk
physiotalk @physiotalk
A few tweets slipping through without the hashtag So a half way through gentle reminder to include #physiotalk in all of your tweets please Otherwise you run the risk (certainty) of not being in the chat or transcript!
physiotalk @physiotalk
Better move onto the next question - only 20 minutes left! #physiotalk
physiotalk @physiotalk
Q: What input do your patients have into their own risk assessments? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk I usually find there is scope to include a discussion on risk within the goal setting part of assessment. Many of my patients with osteoporosis are a great example of this- wanting to continue activity in spite of fragile bones #physiotalk
C Harris @CHarrisPhysio
@physiotalk It can also depend on what risk you’re focusing on (probably more than 1!), and where you expect it to be - eg. assessing somebody’s risk of falling or getting a hosp-acquired infection if they are admitted vs the risks of being treated acutely at home, or in ESD #physiotalk
Janet Thomas @JanetThomas47
They don't really - and I wonder why? This is a quote from one of the resources in the #physiotalk blog posting for tonight - worth thinking about. https://t.co/Ygx8HUZD7F
Pamela Kipps Hansford @PamKHphysio
Uh oh, apologies, I forgot #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @CHarrisPhysio: @physiotalk It can also depend on what risk you’re focusing on (probably more than 1!), and where you expect it to be -…
Sophie Pomfrey @sophm14
@physiotalk late to the party! i find most risk is around discharge. i think we under use d/c assessments but that’s more financial, time and staffing pressures in the acute setting #physiotalk
KB @KBNeuroinfo
@ABNeurophysio @NicolaLauchlan @physiotalk Agree. Do you think familiarity of home environment reduces ‘risk’? #physiotalk
Liz Cowan @liziophysio1
@physiotalk #physiotalk Discussions formal or informal. MDT meetings, school reviews. I often feel like the pushy physio who is trying to make schools/nurseries "take more risks" than they want. Got to be a balance and dependant on carer/support worker's abilities as well as client's.
Janet Thomas @JanetThomas47
@KBNeuroinfo @ABNeurophysio @NicolaLauchlan @physiotalk Perhaps not familiarity as much as they have been able to set up their home environment to suit / personalise to what they can (or can't) do? #physiotalk
physiotalk @physiotalk
@sophm14 So do we discharge too soon, or not soon enough? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@KBNeuroinfo @ABNeurophysio @physiotalk I think it reduces some and increases others! A double-edged sword! I do think there needs to be more dovetailing between activities in hospital and normal activity at home. #physiotalk
physiotalk @physiotalk
@PamKHphysio Welcome! To take up your comment further - how do we make the impossible possible? That is something we would all strive for but its difficult? #physiotalk
Nicola Lauchlan @NicolaLauchlan
RT @physiotalk: @PamKHphysio Welcome! To take up your comment further - how do we make the impossible possible? That is something we would…
#hellomynameis Adele @ABNeurophysio
@NicolaLauchlan @physiotalk absolutely! however, this will take a system change at a huge level - the language of hospitals can be very controlling - not in everyone but it only takes 1 "telling off person" per shift for a lot of telling off to happen. #physiotalk
Sophie Pomfrey @sophm14
@physiotalk respiratory wise it’s that balance with certain treatments, if deteriorating it could make them better but might make them worse and that ethical dilemma, depending on the clinical scenario, do you try it so you can say you tried your best for pt #physiotalk
Nicola Lauchlan @NicolaLauchlan
Love this reply! #physiotalk
Jo Kitchen @J0Physio
@physiotalk In deciding different treatment options we weigh up risks/benefits. Very much when recommending home adaptations & equipment. E.g. a half step outside a front door looks more visually appealing but might be more risky depending on patients balance #physiotalk
C Harris @CHarrisPhysio
@liziophysio1 @physiotalk I think that can sometimes be the physio’s role - to be a bit pushy and give people the confidence to try and take more risks, as part of the discussion with patient / family / MDT #physiotalk
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk And the 'permission' to do this is reinforced echoed through the Strong, Steady, Straight guidelines now :) #physiotalk
Nicola Lauchlan @NicolaLauchlan
Yes! This!
Sophie Pomfrey @sophm14
@physiotalk sometimes both, often it’s “safety between care calls” because we’re worried about further falls for example or we trying to get absolutely everything in place to find patient was fine when they got home but waited 3 weeks for care and they stopped after 3 days #physiotalk
Nicola Lauchlan @NicolaLauchlan
Thankfully yes- this is what we pushed for when putting the consensus statement together! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 @physiotalk Perhaps we need more underpinning policy which grants us 'permission'??? #physiotalk
#hellomynameis Adele @ABNeurophysio
@KBNeuroinfo @NicolaLauchlan @physiotalk good question @KBNeuroinfo #physiotalk - yes on so many levels, familiarity on a physical level, emotional level and deep subconscious level too. In many cases [ though not all] a reduced fear of being criticised [ or told off] for taking the risk
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk A bit old now, but I do like the ‘Nothing Ventured, Nothing Gained' risk guidance for people with dementia for a sensible pragmatic, permissive approach #physiotalk
Liz Cowan @liziophysio1
@CHarrisPhysio @physiotalk in terms of children,there's 2 often the desire 2 love them,help them,keep them safe rather than give opportunity 2 develop.Much of that is accepting risk as part of life/how children actually learn = grow. Disabled kids are no different 2 able bodied in that respect #physiotalk
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk Worth a look (not sure if its been updated or superseded though?) #physiotalk https://t.co/bFc6aD6jBD
Pamela Kipps Hansford @PamKHphysio
Again please let me add #physiotalk #GlobalPT
Janet Thomas @JanetThomas47
@NicolaLauchlan @physiotalk And the personal 'heat map' is useful if thinking through risk with an individual #physiotalk https://t.co/oyQjDqUAuG
KarenPhysioCoUk @karenphysiocouk
@physiotalk In adult neuro risk takes two forms. My treatment naturally pushes physical boundaries, trying a transfer or a new position for the first time. Constant weigh up of risk to patient - can they do this, is it safe, will It fail and be a negative outcome for them /1 #physiotalk
physiotalk @physiotalk
Looking towards our next question now #physiotalk
physiotalk @physiotalk
Q: How do you promote risk enablement within your working environment? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@JanetThomas47 @physiotalk I like this! #physiotalk
KarenPhysioCoUk @karenphysiocouk
@physiotalk #physiotalk I also have to judge risk to myself. Physically, if supporting a patient and something goes wrong am I capable of protecting patient, myself and any colleagues. Also when working with the disinhibited I have to manage risk of their behaviour /2
Pamela Kipps Hansford @PamKHphysio
#physiotalk #RiskManagement can then be seen as #Optimising the chance of #Success whilst #Minimising the chance of #harm
physiotalk @physiotalk
RT @PamKHphysio: #physiotalk #RiskManagement can then be seen as #Optimising the chance of #Success whilst #Minimising the chance of #harm
Sophie Pomfrey @sophm14
@physiotalk probably doesn’t promote risk but i think reminding us all that patients have the right to make their decisions, even if we feel it’s not necessarily the right choice, think capacity is overlooked frequently and their own acceptance of risk #physiotalk
KB @KBNeuroinfo
RT @PamKHphysio: #physiotalk #RiskManagement can then be seen as #Optimising the chance of #Success whilst #Minimising the chance of #harm
physiotalk @physiotalk
@sophm14 It is perhaps that we don't explicitly ask? Or do we ask is such a way to emphasise not taking the risk is preferable? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@sophm14 @physiotalk I think this is essential to risk-enabling practice- great point! #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk I think we do this all the time by encouraging patients to walk a bit further, push the boundaries a bit more, think about how they'll manage independently at home #physiotalk
physiotalk @physiotalk
With two minutes to go - one final question for you all Whose risk is it anyway? #physiotalk
Sophie Pomfrey @sophm14
@physiotalk i think the way we converse with patients, often the more we push the more upset they can become and maybe even lose faith in the system. usually difficult with families too but maybe more patient advocates needed as it can be lonely for it to be the patient va family #physiotalk
#hellomynameis Adele @ABNeurophysio
@physiotalk to do something or to do nothing? #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk To me, it will always be the patient's risk. Even in our huge NHS systems, those patients always have to go home and manage in their own lives with their own beliefs and abilities. I feel losing sight of this is the most disabling factor in the care equation #physiotalk
physiotalk @physiotalk
RT @NicolaLauchlan: @physiotalk To me, it will always be the patient's risk. Even in our huge NHS systems, those patients always have to go…
physiotalk @physiotalk
Well - that's the hour up! #physiotalk
physiotalk @physiotalk
Feel free to keep on chatting and we'll collect the transcript later on #physiotalk
#hellomynameis Adele @ABNeurophysio
thank you #physiotalk interesting topic
Liz Cowan @liziophysio1
@NicolaLauchlan @physiotalk Risk to ourselves of playing safe and not finding out what might have been. We need to challenge to get the most out of our clients, with the benefit of clinical reasoning and even hindsight. #physiotalk
physiotalk @physiotalk
Thanks so much to @NicolaLauchlan for hosting our chat tonight - definitely lots of food for thought! #physiotalk
Janet Thomas @JanetThomas47
@liziophysio1 @NicolaLauchlan @physiotalk I wonder if we take more 'risks' the more experienced we are? But they are calculated based on experience (accumulated hindsight) #physiotalk
Nicola Lauchlan @NicolaLauchlan
@physiotalk Wow that was quick! Thanks so much to everyone who participated and didn't leave me talking to myself 😀#physiotalk
Sophie Pomfrey @sophm14
@NicolaLauchlan @physiotalk this small element of risk can then reap rewards; patients see progress, builds relationship, builds confidence and trust. even with more unpredictable patient following with wheelchair so you have a calculated risk so patient is safe but still being pushed #physiotalk
physiotalk @physiotalk
Our next chat is in two weeks time on Myth busting in Low Back pain #physiotalk https://t.co/EjFB9E0YLM
physiotalk @physiotalk
@NicolaLauchlan Its the fastest hour of the week! Thanks so much for the chat tonight - lots to go and think about... #physiotalk
C Harris @CHarrisPhysio
@physiotalk #physiotalk
Liz Cowan @liziophysio1
@JanetThomas47 @NicolaLauchlan @physiotalk Yes we may build confidence in our strategies based on experience. But that can have dangers if we have just been very lucky all along. Good to network and gain different perspectives. Getting together with professionals at conferences etc helps #physiotalk
Jo Kitchen @J0Physio
RT @PamKHphysio: #physiotalk #RiskManagement can then be seen as #Optimising the chance of #Success whilst #Minimising the chance of #harm
Pamela Kipps Hansford @PamKHphysio
#physiotalk Exactly, so to minimize huge risk in taking medication, do everything possible to enhance body, mind & spirit for health & wellbeing & engage in social interaction @ every opportunity to minimise/avoid need fo medication (& research any meds you do take fully)
Liz Cowan @liziophysio1
RT @physiotalk: Our next chat is in two weeks time on Myth busting in Low Back pain #physiotalk https://t.co/EjFB9E0YLM
Nicola Lauchlan @NicolaLauchlan
@physiotalk Really enjoyed it- thanks @physiotalk for organising it and keeping control of the questions- I lost track of time with chatting! Thanks all for joining! #physiotalk
physiotalk @physiotalk
Sounds like an interesting #OTalk if you are a #stroke physio (actually they all are of course, just like #physiotalk)
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