One of the challenges facing the physiotherapy profession today is not so much what the future might be, but how to get there. Innovation requires creativity and imagination; going beyond oneself and the limits on what might be possible. Georges Bataille called this transgression, and his work explores why our moral codes are set 'here' and not 'over there'. His writings concentrate on some of most sensitive topics, particularly to do with sex, because, he argued, it's here where we choose to apply some of our most stringent social conventions and norms. Bataille's idea was that we need to explore ways of thinking and being that are far beyond our present boundaries of convention if we are to see where our present level of tolerance lies. It's hard to see it without doing this. But from this new position, where everything is … [Read more...] about If you’re looking for innovation, regulatory authorities need to change
Anyone who lives with, knows, or has trained as an artist will be painfully aware of how lacking in creativity a lot of physiotherapy education and practice is. My brother is a photographer and a teacher, and I am frequently reminded of how differently he responds to things. Where he often thinks like an artist, I often default to the kinds of design-thinking that Grace Jeffers talks about when she says that "Design thinking is about solving a problem, but art thinking is about feeling your way to a solution" (link). It's not that there's anything particularly wrong with the way physiotherapists are trained to think - there's certainly a lot to be said for the kinds of deductive reasoning that can work out the specific aetiology of a problem and rationalise a response - it's just that this kind of thinking doesn't work that well … [Read more...] about Creativity in physiotherapy
I read something about critical theory this morning that made me think about a couple of recent posts on the future of physiotherapy. In the piece, the author was taking critical theorists to task for attempting to ‘demystify’ the social world without proposing solutions. People, she argued, want attractive alternatives and a sense that utopia, or at least the hope of a better life, might be possible. This is a powerful argument that I don’t entirely agree with, but it did make me think about Roger Kerry’s recent blogpost ‘Physio will eat itself’, which followed my own question of whether we would disestablish physiotherapy as a profession if it were in the best interests of patients or the healthcare system as a whole (Link). Critiquing the systems and structures, objects and subject positions that make up today’s healthcare … [Read more...] about New physiotherapy – 7 ways to change the world
One of the biggest dilemmas facing the physiotherapy profession today is how to keep it alive. Given the unrelenting pressures to reform, cut costs, and redesign practice, it's hard to know whether to push the profession's stability, history and established culture, or to promote a radical new professional image. And faced with healthcare innovations that seem to be dissolving old certainties, it's hard to know whether we like it or not. Imagine, for instance, that robots were shown to be more reliable manipulators than physios, or that a low-cost assistant could do the work of post-op respiratory physiotherapy just as well as an expensively trained clinician. Would we promote it? In some instances, like this recent trial by a 'short-stay rehab unit based at a Nottingham care home' that 'managed to cut 90-day hospital … [Read more...] about Should we give up physiotherapy?
Last week I had the very great pleasure of teaching some critical thinking skills to postgraduate students at AUT University with my good friend Dr Barbara Gibson. The students were physiotherapists, nurses, case managers, occupational therapists and others, and few of them, in truth, knew much about critical thinking. So we concentrated on what is perhaps the most important, but also the hardest skill in thinking critically: questioning things that we otherwise take for granted. Because something is taken-for-granted it is, by definition, hard to see. They include things we unquestioningly support (like taking care of your own health, for instance); things that are custom and practice (patient assessments perhaps); popular attitudes (a dislike of cigarette smoking); and powerful ideas and influences (biomedicine). The reason … [Read more...] about Keys to critical thinking
Spend any time thinking about innovations in practice, research, education or ideas and you come up against the problem of how to break the mold. There are all sorts of barriers to overcome if you are going to be truly, radically, innovative. Many people find the idea of change unsettling, others might be skeptical that real change ever happens. Others may be perfectly happy with how things are and ask why we would want to 'fix' something that isn't broken in the first place. Then there are regulatory restrictions and customs and practices that purposefully place limits on what can be said and done in the name of physiotherapy, medicine, dentistry, etc. Innovation, by definition, means challenging conventions and proposing an approach that extends beyond the boundary fence that we rebuild and reaffirm around ourselves each day. … [Read more...] about Innovation in physiotherapy
The title of this post comes from a recent story on the CSP's website, celebrating the success of a physiotherapist, Lucy Cassidy, who took the main prize at this year’s Advancing Healthcare awards. Her prize was for the development of a virtual fracture clinic at Brighton and Sussex University Trust. In responding to the prize, Lucy commented that "It’s difficult to innovate in the NHS because of financial constraints, and entrepreneurship is often about trying to find a win-win situation with the private sector to support new services." This got me thinking about why it is that the public sector should so often be thought of as such a moribund place for innovation and creativity. Some years ago, I undertook a research project looking at 'bleeding edge' physiotherapy practices. A bleeding edge practice is one that takes … [Read more...] about It’s difficult to innovate in the NHS