How to make an informed treatment decision

Now and then I receive a message asking for a session of dry needling or the price thereof. For some reason, it happens far more with this invasive treatment method than any other, and it leaves me wondering where the relationship between informed consent and patient autonomy got lost.

Autonomy is important to me because I need to make sure that each patient is actively involved in their diagnosis and treatment to attain a successful outcome. A patient’s right to determine which investigations and treatment to undergo must be respected by all health professionals. But, for consent to be informed, patients should rely on the information provided by their health professional as it relates to their situation. Health professionals must therefore rely on their assessment of that particular patient to provide such information.

I am thus faced with an ethical and moral dilemma when I receive that email. The person just wants the information but simply providing it would be misleading, creating the impression that it requires no assessment. Including the additional considerations may be well-received by some and interpreted as being obstructive or controlling by others.

Before considering any treatment, I need to understand the patient’s condition and determine the contraindications of certain treatments and the likely result of other options. I need to explain which treatments are not expected to have any effect or which may be counterproductive to assist the patient in making an informed decision regarding their future health care.

As clinicians, we’ll always have a bias for one treatment over another based on our individual experiences and education, but autonomy for the patient comes in after informed consent, where despite everything said, a patient may opt to go against the recommendations of their clinician.

Ordering treatments off a menu at health spas is common practice but doing so from medical professionals before a comprehensive assessment doesn’t equal autonomy. It may in fact be a request for unethical practice, potentially resulting in negligence by the professional and unnecessary or inappropriate treatment for the patient.


Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.