Injury forum

[Adam G]

Is there any way we could have a forum dedicated to injury and injury prevention? That's one thing this community is lacking, and I'm sure there's a tremendous amount of communal insight on common hiking problems like plantar fasciitis, blisters, Morton's neuroma, hip bursitis, etc. Thanks.

[Dena Kelley]

I like this idea, as well.

[Valerie E]

Great idea!

[Stephen Barber]

Hear, hear! Excellent idea! How do we get it done?

[Bob Gross]

Submit your proposal to management.

–B.G.–

[Buck Nelson]

I like it. Pertains directly to the forum subject matter and a major issue, especially on long hikes.

[Miguel Arboleda]

Rather than an "injury" forum, what about a "trail health" forum? Injury is a little too specific. Topics like first aid, prevention, sickness, dealing with chronic diseases on the trail, women's and men's specific needs, nutrition, mental health, etc., are all topics that people could contribute to, and which all the members could benefit from. I'd personally like to talk more with other diabetics about how they deal with trail problems. And I'd certainly get a lot of reassurance talking to others who can give me good advice.

[Roger Caffin]

It's a great idea, but there are two problems.

* Legal liability for BPL.

* Distinguishing between those competent to reply and those not. (This affects the previous point.)

My gut feeling is that such an Forum would need serious monitoring. Hum?

Cheers

[Valerie E]

Surely an extremely strongly-worded disclaimer auto-attached to each posting (as well as at the top of the forum page) would take care of liability issues…

You know, the usual stuff, like the opinions expressed are solely those of the person posting to the forum, blah, blah…BPL, its management, employees, and members are not medically trained, and all opinions, suggestions, and recommendations are for entertainment purposes only, blah, blah…Consult your doctor before reading!

[BlackHatGuy]

At the bottom of WebMD there's a small line that says: WebMD does not provide medical advice, diagnosis or treatment.

And then there's a link that says: See additional information.

At the link they have the following:

The contents of the WebMD Site, such as text, graphics, images, and other material contained on the WebMD Site ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD Site!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, or other visitors to the Site is solely at your own risk.

The Site may contain health- or medical-related materials that are sexually explicit. If you find these materials offensive, you may not want to use our Site. The Site and the Content are provided on an "as is" basis.

[Richard Lyon]

They ought to work, and often they do. The problems are:

– Sometimes they don't

– Whether they do or don't depends on state law (i e, law may be different in every state) The state that decides is the one in which the suit is brought. Which means it's a problem unless BPL monitors all fifty state laws.

– We won't discover whether it works or not until someone sues. Even if it works defending a suit is expensive. This is the USA, anyone may sue for just about anything. And plaintiffs' personal injury lawyers sue everyone in sight.

I'd avoid the forum. Too bad, it would be very illuminating.

[David Thomas]

What?!?

Roger, You and I dispense free engineering advice every day. I'm licensed to do so, but only in three states. Not sure about you. I'm pretty darn sure that most people offering opinions about stoves, tents, water treatment, and waste disposal have little formal training and no licensure in the relevant field(s).

I sometimes pass on info from my wife, board-certified in two specialities and licensed in one state, but I see no end of medical advice being given. Some, often the helpful, from forum members who identify as PTs, dentists, etc, but often from people who have had no training.

I see no greater liability with a injury-specific forum area. (But by noting that, am I giving legal advice without having passed the Bar in all states, territories, and countries in which this post might be read?)

[Roger Caffin]

Hi David

> Roger, You and I dispense free engineering advice every day.
No, you dispense qualified free engineering advice, I just blather on. There's a difference :-)

More seriously: I live in NSW, Australia, and you would have to bring the entire case here in NSW, Australia. That is going to cost you big time, especially as we are not in favour of the USA-style tort suits.

What's more, we have two very nice laws here in NSW.

The first is that volunteers are not liable this way. This law was passed in a screaming hurry one year when the entire Red Cross, volunteer St Johns Ambulance, Rural Fires Services (volunteer bush fire fighters) and several other volunteer agencies pointed out that come July-1 they would be withdrawing ALL staff from ALL services if the government did not pass indemnifying legislation before July-1. The pollies nearly wet themselves. I am not paid by BPL; therefore I am a volunteer.

The second is that no company with more than a small number of staff can sue an individual for libel, defamation, or any sort of SLAP suit. I am an individual. I can call the XYZ company a bunch of mindless moronic jerks with impunity.

Hey Ho :-)
Cheers

[Andy Stow]

Wow, some actual sensible laws.

[Jennifer Mitol]

Yeah, as it is I walk a very fine line whenever I even comment on a medical topic. I talked with a lawyer before starting my oft-ignored blog (backpackerPT.com) and frankly, it was a bit disconcerting. What's interesting is you guys can offer all kinds of free advice, no matter how ridiculous, and you'd be totally fine.

Me? If I offer even evidence-based information that you decide hurts you, you could, indeed, sue me. You could also bring action against my license if I were not licensed in your state (and I only hold licenses in Illinois and Texas). You may not necessarily win, but really, does that matter?

I have disclaimers all over my blog, and if you'll notice whenever I offer specific advice to people I always tell them to have a GOOD PT (or whichever clinician is appropriate) examine them.

I've thought about simply writing some articles for BPL – Roger even encouraged me to do so. Maybe that's what I really should do…I mean, there is not a single place online that I have found that offers good, evidence-based, critical advice/information on hiking injuries. The medicine man guy at Backpacking Magazine makes me actually spit out my coffee with laughter and disdain at some of his answers – I mean, what is this, 1982??

Anyway……..

Shall I assume there would be interest in my writing some overall injury/prevention/exercise articles here? Any thoughts on what you'd like to see??? Might as well take this as an opportunity to get my backpackingPT persona back on track…………..

[Ian]

I'm probably jumping the gun and in the wrong forum to boot but since it's on topic…

"Shall I assume there would be interest in my writing some overall injury/prevention/exercise articles here? Any thoughts on what you'd like to see??? Might as well take this as an opportunity to get my backpackingPT persona back on track.."

Dang skippy I would! For example, I'm particularly interested in knee strengthening exercises. I'm on week two of a diet and starting an exercise regimen after an extended hiatus. I had some transient issues with my right knee on the Wonderland last year and am looking to strengthen my knees for when I'm hiking downhill (hope to lose many lbs as well). Seems an article on hiking specific strengthening exercises and techniques would be tremendously helpful for some of us and be of negligible liability.

[jscott]

Jennifer: yes, it would be great if you posted on injury prevention/exercise etc. issues.

Incorporating targeted exercises into a routine is a great way to prevent and even overcome injury and prolong your hiking life. But it's hard to figure out the correct, or best, targeted exercises on your own. So go for it, Jennifer! We'll all benefit.

[David Thomas]

On two points:

Jennifer: I've always appreciated your evidence-based posts and how (like my wife's medical practice or my engineering) you always seem to be asking yourself, "What do we really know, and how do we know it?" I would love to see articles by you about injury prevention.

On legal issues: When anyone asks a lawyer, "Could I get sued for . . . (allowing posts on health topics)?" the answer is of course, Yes. I frame it as "HAS anyone gotten sued for this?" and "Are such suits at all common or ever successful?" And typically the lawyer doesn't know of any such suits being brought or of any in which the plaintiff prevailed.

An interesting article (in a peer-reviewed medical journal) about 12 years ago, found that the risk of being sued for medical malpractice did NOT correlate with poor medical outcomes. It did strongly correlate with the patient's perception of the practitioner being arrogant. I try to be clear with co-workers and clients what I know AND what I don't know. They deserve to know and it helps protect me from misunderstandings.

[Adam G]

I think articles written for a physical therapist would be invaluable. Although there is quite a bit on minimalist running, there is almost no online literature I can find on biomechanics of hiking and backpacking. Even most physical therapists I've talked to seem somewhat baffled by hiking and backpacking injuries. I'd like to see articles on the proper biomechanics of the foot, ankle, knee, and hip as it pertains to hiking and backpacking. I'd also like to see a list of common exercises to do to strengthen the relevant muscles.

[Roger Caffin]

There's rather a good point here. On-line diagnosis for one person is fraught with danger, especially if the writer has any medical qualifications. I don't.

But technical articles on the biomechanics of the whole leg (and back), what sort of injuries can occur, what sorts of treatments may work for these injuries, and what sorts of treatments are more likely to do harm than good – those sorts of articles will be immensely interesting to many people and should not leave you open to legal problems.

Cheers

[Jeremy and Angela]

….And typically the lawyer doesn't know of any such suits being brought or of any in which the plaintiff prevailed.

I suspect winning a malpractice claim based on an internet discussion is rather unlikely, particularly if care is taken to prevent any perception of a doctor/patient relationship, but I have no data on this. On the other hand, general discussion about a topic (e.g. "J" writes articles) might get someone in trouble with state licensing boards, which is a different kettle of fish.

In terms of existing cases, there are currently a few in play that may be worth watching. I had heard of the Cooksey one (a blogger accused of "practicing nutrition without a license" in NC), but the others are interesting because they are licensed within their own states. Note that these particular cases all have to do with state licensing boards rather than individual claims of malpractice.

I believe the Cooksey case is furthest along. While it was initially dismissed for lack of standing, the 4th Circuit declared that there was 1st amendment injury-in-fact and directed the lower court to re-try it on its merits.

It did strongly correlate with the patient's perception of the practitioner being arrogant.

Was that the one that found apologies actually reduced the number of malpractice suits?

Some background: http://www.rcfp.org/browse-media-law-resources/news-media-law/news-media-and-law-summer-2013/dear-abby-need-advice-censo

+1 for a "trail health" forum.

Last year when I suffered an injury I could have really used a resource such as what the BPL community could offer in regards to recovery. Yes, I sought out professional licensed help, but I still took to the internet to help me really understand the greater issues involved with my injury, how common it is, how hikers have both prevented and recovered from the same injury, and even for some moral support.

Yeah, there were some folks telling me things that I knew to be wrong, but I never once thought about a SLAP lawsuit. The whole idea of BPL facing such issues would be paramount to if somebody organized a group hike via BPL and than somebody gets seriously injured on that hike and files a lawsuit against BPL because the hike was posted within the "Group Trip Announcement" forum. Or, if somebody that has never gone packrafting read something within the packrafting forum and then went out and feel out of their packraft and hit their head on a rock, and felt it was the fault of BPL.

[Buck Nelson]

I don't see liability as being much of an issue.

Medical advice is dispensed commonly and freely on this forum as it is: foot care, water treatment (or not,) repetitive use injuries, etc.

[Richard Lyon]

<>

Jennifer, I agree completely.

<< I suspect winning a malpractice claim based on an internet discussion is rather unlikely, particularly if care is taken to prevent any perception of a doctor/patient relationship, but I have no data on this. >>

Jeremy, an advisor's "winning" a malpractice claim may not help if she paid thousands of dollars to defend it. As I stated in my earlier post, in the United States anyone can sue anyone for just about anything, and in many valid malpractice (or other personal injury) cases there are often defendants who "win" ( i e, pay nothing) because they haven't had anything to do with the matter. Plaintiffs' lawyers name as defendants anyone remotely connected with the matter if he or she has a deep pocket or insurance.

So, Jennifer, take into account the remote chance that you'll be sued should you decide to post something. If that remote chance comes to pass you'll have your hands full of trouble and your bank account at risk.

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