Sadly, it seems we cannot escape the fact that many physiotherapists now believe that part of the answer to the problems now facing the profession can be resolved, at least in part, by telling people to lose weight, stop smoking, and get more exercise. The need to feel part of the move towards population-based primary health care has induced many traditional and orthodox health professionals to scratch their heads and ask what their social function will be in the future. It seems reasonably clear that traditional sources of work, like the specialist care that once took place in large hospitals, and the routine self-limiting, acute musculoskeletal disorders that made up significant … [Read more...] about Stop telling people to lose weight and get more exercise
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 … [Read more...] about It’s difficult to innovate in the NHS
One of the biggest growth areas for physiotherapists in the coming years years will be the management of chronic illness. The numbers of people now living with conditions that were once relatively rare is quite staggering, and they are becoming more complex. A report released last week by the Australian Health Policy Collaboration (link) has once again highlighted the need for us to take a society-wide approach to managing the threats posed by conditions like heart disease, diabetes, cancer and respiratory illnesses, through a concerted effort to tackle the 'upstream' causes: alcohol consumption, sedentary behaviour, high salt intake, smoking, etc. Obesity, diabetes, hypertension and … [Read more...] about Do you need a four-year degree to tell someone to stop smoking and do more exercise?
A lot of really interesting attempts to change the way health care is being delivered are foundering because people can't work out how to fund them. There are certain pockets of money available: seed grants and step-change funds that get projects started, but often these are term-limited and there is rarely any chance of ongoing funding. One of the unspoken principles underpinning a lot of new models of health care (including primary care, health promotion, inter professional practice, patient-centred care), is that they will cost less, (or at least they will shift the responsibility for payment onto the individual and away from the state.) But few people have yet worked out ways to … [Read more...] about New: Money
If you were to design a health care system from scratch, and began with the people you wanted to form key alliances with, who would you choose? Doctors, nurses, occupational therapists, podiatrists...? In the past, the choice might have been easy. Health care was strictly hierarchical and doctors were at the top of the pyramid. No health professional could become established without the patronage of the medical profession. But is that still true today? Health care consumers now have much greater choice when it comes to health providers and they are exercising their choice in innovative and interesting ways. Over-the-counter remedies, alternative and complementary therapies, … [Read more...] about New: Alliances
Physiotherapists don't generally think our profession is 'political.' We mostly work on people's bodies, in one-to-one sessions, and few of us use our social standing as respected, orthodox health professionals to campaign for community causes. There are no physiotherapy-specific models of population health, and subjects like primary health care and health promotion are only just beginning to appear in undergraduate curricula. So while physiotherapists are experts in the assessing and treating the body-as-machine, and we are increasingly interested in people lived experiences of health and illness, we are less aware of the social determinants of health. Social determinants are those … [Read more...] about Social determinants of health – are we doing enough?
One of the most important functions of critical thinking is to go 'against' the prevailing wisdom: to go against convention; to think the impossible or the unreasonable; to entertain the possibility that our present way of thinking is neither the best or most appropriate way. One way to do this is to look back to a time when people thought otherwise and to ask whether we are necessarily smarter today, or just different. This is not easy to do. Thinking against conventional wisdom immediately puts you in a minority position and opens you up to the easy dismissal of the comfortably popular. But that's exactly why critical thinking is so important, because it is directed at tomorrow, not … [Read more...] about Childhood obesity, play and critical thinking