Every week for the last few months an ex-student has asked to meet me become they’ve become disillusioned with physiotherapy.
Whilst its true that there’s always been a steady attrition from the profession, the number of recent meetings, and kinds of recent conversations I’ve had with these people, seems surprising.
Working through their personal experiences, their frustrations seem to stem from a desire to do more with the knowledge and skills that they’d acquired. This feeling is often compounded by a sense that the ‘system’ is preventing them from being the therapist they really want to be.
Many want to do further postgraduate study so that they can broaden their horizons. Thankfully, there are more options and support networks available to do them than when I was first trained.
Others just want to know that there’s more to physiotherapy than 15-minute appointments with nameless bodies that parade an endless series of the same unfixable pathologies and complaints for the benefit of clinics and health authorities that put financial bottom-lines above therapeutic integrity.
My answer is to say to some that “Yes, you should pursue your postgraduate study into touch/empathy/care/rehabilitation/pain/ … , but most importantly you should leave the world of physiotherapy for a while and experience the way other people think about these problems.” Follow the example of some of the great pioneers in physiotherapy and engage in some mental travel beyond the borders of what’s familiar and obvious, and ingest a bit of something different.
For others I say “Yes, you should pursue your ideas about practice, but leave your ideas about the boundaries we place around physiotherapy behind … stretch yourself to think of what might be possible with all the kinds of bodily, people and social skills that you’ve worked so hard to develop over the years … Trust that people will always want someone who can use their touch with skill and care, or diagnose the reasons for pain or functional impairment, and think about all the new ways you could make physiotherapy work for the people who really need it.”
Speaking of looking beyond physiotherapy, Georges Batailles talked about needing to transgress conventional boundaries to help us ask critically why we’d decided to place the limits of our tolerance ‘here’ and not ‘over there’. Battailles was interested in sex and the way Christianity governed our morality in the West, but his ideas apply just as much to physiotherapy (see refs).
Physiotherapy, more than ever, needs people to migrate away for a while; to explore worlds previously closed to them by curricula or scopes of practice that are far too restrictive for the unpredictable, complex and rapidly changing world of the 21st century.
We need a new generation of pioneers and bold explorers: people who will shake the foundations of the profession and ensure that the next generation adopts a vision of physiotherapy that perhaps doesn’t need people to leave to find what they’re looking for.
Nicholls, D. A., & Holmes, D. (2012). Discipline, desire, and transgression in physiotherapy practice. Physiotherapy Theory and Practice, 28(6), 454-465.
Williams, S. J. (1998). Health as moral performance: Ritual, transgression and taboo. Health:, 2(4), 435-457.