There is no ‘you’ in physiotherapy

Cast your mind back to your days as a physiotherapy student.  Did any of your lecturers ever change what or how they were taught based on the personalities of the people in the class?  Was the subject of the session changed from the lesson plan to reflect an individual or group’s cultural beliefs and values?  My suspicion is probably not, or if it did happen, it didn’t happen much when you were learning anatomy, physiology, pathology, kinesiology, biomechanics, assessment or treatment techniques, research methods, or any of the other ‘core’ subjects in the physiotherapy curriculum.

I once shared an office with a lecturer who had very devout faith, and I often wondered how she reconciled her beliefs with her practice as a physio.  The profession made no formal acknowledgement of her faith, and nor did it suggest that a person’s faith had any formal place within the profession.  So she never spoke about it with students or staff, or helped others come to understand their physiotherapy through these kinds of personal enrichment.

So what is gained and what is lost from physiotherapy by ignoring these aspects of people’s ‘selves’?  How much richer and more meaningful could physiotherapy be for the communities we served if the profession could find a way to formally embrace the full diversity of its people?

This is not a question of the profession’s respect for cultural diversity, per se, but as much a question about the profession’s approach to individual subjectivity.  Is it possible to claim that the profession is person-centred, for example, if we don’t formally acknowledge – in our curricula, professional scopes, and daily dealings – the very things that make us all unique practitioners?

How can physiotherapy students learn to respect the individual needs of their clients/patients, if their own personalities are sublimated in graduate courses that focus on homogenous and normalised body systems and structures; standardised assessment and treatment techniques; and rigidly applied standards of practice?

There is a lot of work going on within the profession exploring individual subjectivity and people’s cultural values – a lot of it by members of the CPN, WCPT and national professional bodies – but as yet, this doesn’t appear to have penetrated the profession’s mainstream, where the focus still remains heavily on a biomedical, reductive and culturally agnostic approach to practice.

This is interesting to me, because if you’ve been in practice for more than a year or two, you will have had to learn how to be ‘yourself’ as a physiotherapist.  You will have had to learn how to make sense of your own cultural identity as a physiotherapist, regardless of whether you had help to do it or not.  But many people do this despite their training rather than because of it.

Surely the profession could give our students and novice practitioners more guidance in understanding how to express themselves through their craft.  In the end it would surely make for better practitioners and a stronger, more diverse and inclusive profession.

Some readings

Fougner, M., & Horntvedt, A. T. (2012). Perceptions of norwegian physiotherapy students: Cultural diversity in practice. Physiotherapy Theory and Practice, 28(1), 18-25. doi:10.3109/09593985.2011.560238
Norris, M., & Allotey, P. (2008). Culture and physiotherapy. Diversity in Health and Social Care, 5, 151-9.
O’Shaughnessy, D. F., & Tilki, M. (2007). Cultural competency in physiotherapy: A model for training. Physiotherapy, 93(1), 69-77. doi:10.1016/j.physio.2006.07.001
Ramklass, S. (2015). A framework for caring in physiotherapy education and practice. South African Family Practice, 57(2), 126-130. doi:10.1080/20786190.2014.977006