For a long time now, physiotherapy practice has been becoming increasingly pressured, with less time to spend with clients, tighter regulations about the number of appointments, and unrelenting pressure to demonstrate the effectiveness and efficiency of our interventions.
Where once patients would be in our hands for long enough to enjoy a modicum of rehabilitation or respite, now the emphasis is on the shortest possible contact necessary to cut the cost of care.
I’m not suggesting that there’s anything wrong with efficiency, independence and autonomy per se (well, I am, but that’s for another day), and I’m well aware that the kinds of long-term care experienced by people under the ‘old’ welfare state was anything but arcadian, but I do believe that the net effect of our present health care reforms is resulting in some very bad practices.
Some physiotherapists on hospital wards are now so pressed for time that they no longer really even assess people. They spend their days making sure patients can walk and ‘do’ the stairs so they can pronounce them fit for discharge. Many private practitioners have lost almost all their capacity for clinical decision-making, and have had their judgement replaced by well-costed, standardised care plans. And physiotherapy in areas that used to be our bread-and-butter are now almost non-existent.
The ‘slow’ movement (a physiotherapy concept if ever there was one!), has been a growing phenomenon in recent years, as time pressured people luxuriate in a momentary oasis of calm, that might last a day, an evening, or even an hour. We have slow TV, slow food, slow education, slow parenting, slow travel, slow cinema, and a host of other movement, but, to date, no Slow Physiotherapy.
Perhaps this is because physiotherapy is often the antithesis of a slow movement. We always seem to want people to go faster, harder, be stronger, more agile, less dependent, more energised, less passive…so perhaps this is exactly the time to stop and pause, and think about how your ever increasing speed is affecting you, your family and your clients.
Imagine – even for a brief moment – what it might be like to be just a little slower: to see one patient for twice as long and actually sit and talk to them; to leave a window in your diary to breathe and pause; to go through a normal routine at half the speed; to take your time to do a simple job that you normally rush over; to do just one thing and force yourself to focus and not be distracted by a million other priorities.
Luxuries? Indulgences? Fantasies of people with more time than they know what to do with? Perhaps. But then ask yourself, how well is your current obsession with fast and efficient physiotherapy working out for you?