This blog is a team effort by myself and a physio in India called Sandesh Rangnekar, please go follow him. I have been watching Sandesh’s work for a while and he has that rare skill of being able to see through the bull sh*t and pseudoscience that most healthcare professionals put on social media in an attempt to gain followers. He also has a wicked sense of humour that can take down gurus a peg or two with his brutal yet honest views and opinions.
So a few days ago some of the more happy-clappy physio types posted a list of ‘why physios are heroes’. It had things like we are rays of sunshine in the darkness, we restore the quality of life, we give hope when all is lost, we smell of lavender, walk on water and the sun shines out of our arses.
Although we understand the sentiment this blog was a little overly optimistic, sickly sweet, and just too vanilla for us. So Sandesh and I decided to do a list of our own, giving a more ‘honest’ look at why we think physios are heroes. So sit down and buckle up for a big old spoon of reality!
No1: They take a lot of sh*t
With the rise of Insta-Google-Face-Tweet book, lots of patients come to see us with their heads full of bullsh*t, nonsense and pseudoscience due to some square-jawed, bicep bulging, buttock pouting celebrity guru.
Real physio heroes often have to sit quietly and calmly screaming on the inside as they listen to patients telling them some far-fetched non-scientific bollocks about what they saw some guru say on social media and how they need to to be fixed in a certain way.
Real physio heroes then have to carefully and tactfully try to unpick this crap from the minds of the poor patients infected with social media guru-itis. They try to explain things in a more simple, rational, honest way but often they are told that they clearly don’t know what they are on about as Dr ‘Bulging Biceps DPT, with his 100,000 followers does.
No2: They deal with a lot of sh*t
Even harder than trying to compete with the online celebrity guru is trying to deal with sh*tty advice patients get from their long-standing trusted local healthcare professionals.
Patients often come to see real physio heroes with low or unrealistic expectations thanks to some well-meaning information from their family doctor or local surgeon. For example, many patients are told that physio will be a quick, easy, simple fix, or that it probably won’t help but to just go and try it anyway!
Often the real physio hero has to try and manage these expectations before they can even begin to address the issues and trying to turn low or negative expectation around is a monumental, exhausting, and often thankless and fruitless task.
Also, many surgeons and doctors still try to tell us how to manage patients, often prescribing ‘aggressive hands-on physio’, or ordering outdated, ineffective treatment such as ultrasound, laser or shortwave diathermy. However, the real physio hero doesn’t put up with this, and will instead use their clinical reasoning and expertise to decide the best treatment plan.
No3: They don’t get paid well
There are wide differences in earnings between all healthcare professionals, with some being paid handsomely for what they do due to their skills, experience and training. But when you look at the average earnings of a skilled, experienced, well-qualified physiotherapist compared to other healthcare professions we are paid poorly, really poorly.
There are some ineffective bone idol physios coasting along doing the bare minimum possible and actually getting overpaid for giving out inner range quads, rubbing an ultrasound probe around, and putting on coloured pieces of tape in pretty patterns.
But most hard-working, evidence-based, decent physios are not paid enough for the level of clinical reasoning and responsibility and hard work they do. For example, there are some amazingly talented physios working alongside GPs and surgeons in first contact, primary care roles being paid a tiny fraction of what their colleagues are for doing exactly the same job.
No4: They work hard
Real physio heroes often start early and finish late, working 10-12 hours, 5-6 days a week, seeing patients back to back, whilst trying to give 100% attention, care, and compassion with little to no time to catch up on paperwork, emails, or even eat.
Most of these heroes also use their precious spare time to seek more knowledge and advance their skills, reading books, papers, and blogs, and attended courses. This is because most employers do not give them any support or time to do these things. Instead due to the increasing demand for services and growing waiting lists, most employers want their physios seeing patients and doing nothing else.
No5: They are busy as f**k
With waiting lists increasing, demands growing, and services under more and more pressure, appointment times are getting shorter and days are getting longer. This means real physio heroes are seeing more and more patients in the working day, with 20+ patients a day not being unusual for many. This makes it increasingly difficult to give good quality individualised care and treatment let alone build a therapeutic alliance.
However, the real physio hero doesn’t let this phase them, they attempt to give each and every patient their full attention and best efforts, listening attentively and patiently as patients complain about the inept and uncaring health care profession.
No6: They practice what they preach
Busy hard-working physio heroes also understand the importance of maintaining a healthy, physically active lifestyle and the role that exercise plays in keeping a healthy body and mind. Many lead by example doing regular exercise and eating well despite the pressures on their time and resources. This is hard work requires a lifelong effort and commitment.
Real physio heroes often find themselves listening to patients explain how they couldn’t find the time to fit in the 10-30 minutes of physical activity you asked them to do a few times a week, and how they couldn’t possibly understand how hard it is for them, even though most physios are exhausted at the end of a day and often still go for that run or do those deadlifts.
No7: They are lifelong learners
As well as committing to a lifelong healthy lifestyle real physio heroes are committed to a lifelong process of continuous learning. They realise that knowledge is forever changing and shifting and what they know today will be different or even obsolete tomorrow.
Real physio heroes look to challenge their understanding and knowledge from many areas and sources, recognising that there are many explanations of what they do and why it works. Real physio heroes are comfortable and confident with their uncertainty and are able to pass this onto their patients and others around them.
No8: They make a difference
Despite all the pressures and limitations on their time and resources, real physio heroes try to make a difference to all they see. Even if it as simple as getting someone to move a little more each day, or reduce the fear of a certain task or activity. Sometimes it’s just getting a patient to think differently about a problem or an issue.
Real physio heroes don’t exaggerate or feel the need to promote their results to everyone and anyone on social media. They understand that successful results are not quick and change is a slow and gradual process. They recognise that those who continually shout about and promote their quick fixes and successes often forget about or ignore their failures.
No9: They challenge bull sh*t
Physiotherapy is often stereotyped by patients and other professions as just some massage and silly exercises. Real physio heroes know differently and do all they can to change these assumptions. They question and challenge the many dubious claims and dodgy interventions they see being used in their profession.
Although this challenging is often perceived by many as being unprofessional or harmful, real physio heroes recognise that this is cognitive dissonance by those who can not differentiate their personal emotions and feelings from their ideas and interventions.
No10: They do it all with a smile
Despite all the challenges and difficulties that exist to provide good quality evidence-based physiotherapy day in day out, real physio heroes do all the above with a big smile on their faces. They recognise that although they may be frustrated, annoyed, exasperated, stressed, tired, even in pain themselves they don’t let it show to their patients.
Real physio heroes know the power of humour, banter and fun in the presence of pain and fear, and they know that if they can keep patients smiling then they are on the right path to successful outcomes.
Summary
So there are our top 10 honest reasons why physios are heroes. We understand and recognise that we all work in different environments and situations and that we all have our own unique pressures and stresses on our time and resources.
We understand that sometimes it’s hard to stay on the path of a real physio hero and it would be much easier and far more financially rewarding to take another path. We also recognise that it’s tempting to go along with the social media gurus giving out sexy looking, complex, yet ineffective treatments whilst natural history makes them look good.
Real physio heroes know to strive for more. Real physio heroes remain true to themselves and their principles. Real physio heroes know they can help people without the bullsh*t and bluster. Thank you to all you real physio heroes.
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Physio are less valued in the country am living in. Most of people recognize only the Medical Doctors than the Physio. Physio are less employed, and given little support, physio are the most health providers that give healthy services to patients per a day than Doctors.