Is Physiotherapy becoming a stronger profession or is it being diluted by others?

[stanny]

I also think that physiotherapy is becoming stronger. Just after my accident I noticed how important it is. It gave me strength and hope and it was a big support during the long way of healing after all medical treatments in the hospital was over. I experienced it as something very personal and a mixture between physical help but also having someone to talk to.

[Christopher.pl]

I don't think the situation in Poland is healthy.

The country doesn't have any private health care. Hospitals are drastically underfunded and the government medical scheme doesn't support long term rehabilitation, which means many who can't afford to pay from their pockets, just don't bother with physiotherapy.

Many doctors don't see the need for physiotherapy-there are very few who actually have a referral system going with physiotherapists in clinics.

The government medical fund limits patients to 10 treatments over 3 months. Physiotherapists in many clinics just do what the doctor 'prescribed' without re-evaluating the patient, which leads to poor results and an unimpressed patient.

[gcoe]

that is a bit depressing, Christopher.

Do you think things may improve as the European Union tries to harmonise health services, including allied health?

[Christopher.pl]

I hope so.

I think that Poland needs private health care. There is too much politics in public health care and we all know it.

I think that it will change. Not very quickly though.

[gcoe]

In Australia and New Zealand we have good public health systems although far from perfect and you are right about the politics. Most of Western Europe seem to have excellent systems. Look at the trouble Obama has has introducing a fairer public health system in the USA.

I have observed over the years that one of the hardest jobs for a minister in government is governing Health. However I have known excellent health ministers with real vision who under their governance can achieve fantastic improvements in health care.

In my opinion an effective health system private enterprise can never be the main player. A business model for core health services doesn't work - Effective and fair Health services where everyone has access to will always be a liability. Care costs more than the profits that can be made. If you look at the World Health Organisation statistics on the countries that enjoy the best health that is spread across the whole population- without exception all countries have sound public health systems and many of the top countries have almost exclusive public health systems.

That doesn't mean private health care doesn't have a role. Many countries have very good partnerships between public and private providers. However the countries in the world that have fair equitable and effective health care all have at least core services that are provided by the public purse.

I suppose I will be accused of being a red :=(

[Christopher.pl]

I agree with you. There has to be a compromise and somehow the public system here must find its way out of its hole.

I think people here can't even really imagine what it means to have decent ongoing health care, for the large amount of money that they and employers give toward the public purse. They deserve better.

[chris.metcalfe]

I know in Canada there has been a big push to have physiotherapy more visible to the public. Recently the CPA launched its first ever national television AD campaign.

[bensynergy]

the development of physio profession in malaysia also doesnt seems like growing well, its mushrooming after ppl (educators who making money) keep going organising physio program without controlling n thinking of the disadvantages of overwhelming and poor quality of student physio..

to increase visibility of physio in public, v need to think and act out of the box.. donot always look for patients only (outpatients or ppl with sickness), we should n must, n its our obligation to create and educate public bout health, heart, lung, back, neck, shoulder, etc before they are in sick (pid, shoulder impinged, pelvic floor weak, OA, etc)

im a junior physio, but i hope i can do something diff to enhance our profession's standpoint in public and other professions such as doctors (as i dun think docs are very great too)..

stand up, physio guys and gals.. think positive to achieve positive, as wat we always tell our patients to be positive..

sorry for my misleading statement, if any...

[Dr Damien]

TO ATTIRELAND

Thank you for your post and I agree that specialization is valuable for your above mentioned reasons....however,only when the problem is specific.

Most patients are not clearcut and are complex especially the elderly group who have rich PMHs. With regards specialization, where does that leave the Community therapists who see these patients?

As a respiratory physio, will you wait for an MSK/ortho physio to help you assess for a walking aid for your COPD who you are progressing his/her function simply because this is not technically in your field? or as a neuro physio, your newly diagnosed stroke patient has had a fall and suffered a mnor injured knee, will you refer to MSk services for another 6-8 weeks before you continue your rehabilitation knowing that time spent and intensity is crucial for this client to regain her function?

lay too much emphasis on specialization and lose the ability to manage a patient holistically. When the problem is clear and straightforeward to a field, then a specialist physio in that field can address that problem.

The other point you made was that the emergence of professions has made physiotherapy sit up and sharpen up old practices. I believe the reason why they were considered old was because the were old in the first place. What my take on the whole is, yes physiotherapy is diluted however the profession is dynamic and will continue to evolve as research into its practices and new therapies emerge.

An example is the bobath concept that is changing constantly. acupuncture was never considered a physio tool before but its now part of the practice of many therapists and has been considered one of the major alternatives to back pain management.

The truth is we cannot stay purists and restrict ourslves to what we have always done. As research developes in many areas so would we and physiotherapy now would not be the same tomorrow.

Back to the whole concept of specialization, I have been a physiotherapist for close to a decade now, my core background is MSK, worked in outpatients for many years but I also have experience managing neurological cases. What does that make me? A neuromuscular physiotherapist? who is to say I shouldnt be seeing a stroke patient if I am confident, have the knowledge base and experience in managing these cases.

Specialization is all about your CPD, your ability to pick an interest area and develope on it. Having a masters in sports medicine means you are a sports physiotherapist (because you are developing yourself in that field) you may not just be an experienced one.

You may have only had a diploma in physiotherapy yet you have a wealth of experience in sports, can anyone say you are not a sports physio?

Because we Rehabilitate patients, we need to manage them holistically whether they are an aged gentleman who suffered back trouble while golfing, had a knee replacement eightmonths ago, is diabetic and also suffered a stroke four years ago... or a fit football player who has no real PMH. Which one of these patients do you think a specialist physio will be able to manage?

cheers

[Barbara25]

I think that physiotherapy is becoming stronger. It is really important! It gives the strength and support. I experienced it all after the accident happened to me(I had fallen down the stairs).

[mahfujalmizan]

Yes, Physiotherapy becoming a stronger profession bcoz, Physiotherapists are primary care professionals, meaning you can go directly to them without a doctor’s referral.

[pdoan01]

no the government does not recognize physios as primary care, we are secondary care even if patients come without referall

[mysingy]

no the government does not recognize physios as primary care, we are secondary care even if patients come without referall

Thanks for that, in terms of the poll, every one seems satisfied the profession is progressing, how do you feel about NICE diverting £24 Million from hospital care to Acupuncture in the treatment of Non-specific Low Back Pain, is this what is meant by being diluted by others? Regards Mysingy

[mysingy]

A view from the side line is, Physiotherapy over recent years has ring fenced low back pain as their own in the UK, with many patients going to them before their GP and perhaps to their detriment, as statistics now show a rise in the prevelence of LBP, from 3.9% in 1992 -to 10.2% in 2006 resulting in the rush to adopt Cognitive Therapy. Regards Mysingy