There is a moment – a tipping point, you might say – when an opportunity for radical change and bold ideas presents itself. We see this in the turn of the seasons when the long winter slowly unfolds into spring, and after a disaster when people begin to dream again of how their city, town or village might be rebuilt. We see it after personal tragedy too, when hope begins to return, and the merest glimmer of a new life reveals itself.
At such moments, a profession like physiotherapy – like all other institutions and organisations – is given an opportunity that only comes after a long period of stability and a period of critical disruption.
In this short piece from Jonathan Grant titled A positive moment of uncertainty for universities? (highlighted in Stephen Downes’ recent post), Grant equates this moment of uncertainty to John Ralston Saul notion of an ‘interregnum’ or ‘in-between time’.
This ‘interstitial space’ is a space of uncertainty and possibility, when the ‘old ways’ are challenged by radical new ideas, and we give ourselves permission to break convention and dream of a new tomorrow.
Think of journalism and how the Internet created myriad new ways of engaging in news, destabilising not only how we think about the facts of an event, but also the legitimacy of the institutions that bring us these stories.
Perhaps the best example of an interregnum close to physiotherapy is occupational therapy which, some years ago, made a bold move away from the instrumental, pathologically-based medical discipline, towards a radically expanded notion of occupation (Kielhofner 2009).
It is easy in hindsight to retrace these interregna, but is it possible to anticipate them and prepare for them?
Might it be that physiotherapy is approaching its own interregnum?
There is no doubt that the economy of healthcare is changing and that the public now demands much greater choice. We also know that calls for more interprofessional practice, blurring of professional boundaries, and encroachment on physiotherapy’s traditional territory are increasing. We know that technology will have a profound effect on therapy and rehabilitation in the future, and low-cost solutions to long-term care will challenge the profession in the absence of a welfare state. We also know that the volume of critical commentary from within physiotherapy is increasing, and that many physiotherapists are now looking to critically examine the profession’s past, present and future.
Perhaps physiotherapy is on the cusp of its own interregnum? And if this is the case, should we be anxious?
I believe not. And we should take our inspiration from the way we rebuild cities, find love after heartbreak, and recover from a major injury.
Spring always follows winter.
Kielhofner, G. (2009). Conceptual foundations of occupational therapy practice (4th ed). Philadelphia, F. A. Davis.