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

[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