This blog is a joint effort by myself and a physio based 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 waves of bull shit and pseudoscience that most healthcare professionals put out on social media in an attempt to gain followers, look clever, and sound important. He also has a wicked sense of humour that can take down a guru a peg or two with his brutal yet honest views and opinions.
So a few days ago some of the more happy clapper physio types posted a list of ‘why physios are heroes’. It had things like we are rays of sunshine in the darkness, we help restore the quality of life, we give hope when all is lost, we smell of lavender, walk on water and the sun shines brighter when we bend over… Although we understand the sentiment this was a little overly optimistic, a bit sickly sweet, and just too vanilla for us. So Sandesh and I decided to do a list of our own, giving some more ‘honest’ reasons why we think physios are heroes, so sit down and buckle up for a big ol’ spoon of reality!!!
No1: They take a lot of shit
With Instacrap, Facepalm, Twatter, You-Turd, and not forgetting Dr Google, lots of patients come to see us with their heads full of pseudoscience and other bullshit due to some square-jawed, white-toothed, bicep bulging, buttock pouting celebrity health guru. The real physio hero often has to sit calmly and quietly listening to patients telling them some far-fetched non-scientific twaddle about what they think their problems are, and how they need to to be fixed thanks to these online fuckwads.
The real physio hero listens patiently whilst screaming inside, and then slowly, carefully, tactfully tries to unpick this shit from the minds of the poor patients infected with guru-itis, trying to explain things in a more simple, rational, honest way. Sometimes this works, but often it doesn’t and the real physio hero is told that they clearly don’t know what they are on about but Dr ‘Bulging biceps, I’ve 100,000 followers fucktard’ DPT does.
No2: They take an awful lot of shit
Even harder than trying to deal with the online celebrity guru is trying to deal with the shitty advice patients get from their trusted local healthcare professionals. Patients often come to see us with unrealistic expectations thanks to some well-meaning advice from their family doctor or local surgeon. Often patients are told that physio will be a simple, easy, quick fix, or more often that physio won’t help but go and try it anyway.
Often the real physio hero has to try and manage these expectations and often they get a lot of flack because of this. Patients are often sent to physio by our colleagues with low or negative expectations, such as when a surgeon tells them to go and ‘try’ some physio ‘just in case it works’ but they will book them in for 6 weeks anyway to do their injection or operation. Having to try and turn this negative expectation around is a monumental, exhausting, and often thankless and fruitless task.
The real physio hero has to also deal with prescriptive referrals from doctors and surgeons for crappy interventions like ultrasound, acupuncture, and massage. Often these things are not needed or helpful. Physio is an autonomous profession yet many surgeons and doctors often assume they should tell us how to manage patients, and unfortunately, many physios accept this and act as subordinates to doctors and surgeons. This is both annoying and pathetic.
However, the real physio hero doesn’t put up with this shit, and will instead use their clinical reasoning to decide what is the best treatment for a patient, but because some sharp-suited, smooth talking, well-paid doctor has said differently, it’s very hard for the tracksuit wearing, not so well paid physio to challenge.
No3: They don’t get paid well
There is a huge difference in earnings between all healthcare professionals, with some clearly deserving to be paid handsomely for what they do. But when you look at the average earnings of a fully qualified physiotherapist compared to other autonomous healthcare professionals we are paid poorly, really poorly.
Don’t get me wrong there are some bone idol numb-skull physios getting overpaid for simply giving out inner range quads and rubbing an ultrasound machine over their patients. But in my opinion, most decent physios are not paid enough for the level of work, clinical reasoning, and responsibility they are given. I see some amazingly talented physios working alongside GPs and surgeons in first contact, primary care roles being paid a fraction of what their colleagues get for doing exactly the same job. This needs to be challenged and changed. If we expect the standard of physio to improve we need to reward the heroes who are giving it.
No4: They work hard
Of course there are lazy coasters out there doing the bare minimum, but 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% care, attention, and compassion with little to no time to catch up on paperwork, emails, or even eat.
Most of these physio heroes will also use their rare and precious spare time to further seek knowledge and advance their skills, reading and attended postgraduate courses. However, most employers these days will not give physios the time or finances to do this due to the increasing demand for their services and growing waiting lists most employers want their physios seeing patients and doing nothing else.
No5: They are busy yet patient
With waiting lists increasing, demands growing, and services under pressure, appointment times are getting shorter and shorter, meaning physios are seeing more and more patients in the working day, with 15-20 patients a day not being unusual for many. This makes it increasingly difficult to take a good history, listen effectively, build a therapeutic alliance, and give good advice and treatment.
However, the physio hero doesn’t let this phase them, they continue to give each patient their full attention and best efforts, listening attentively and patiently as a patient explains how the ineffective, inept, and uncaring the current health care profession is and how it just doesn’t understand their problems. This often means most physio heroes run late and end up working extra for nothing.
No6: They practice what they preach
Although busy and hard working the real physio hero understands the importance of maintaining a 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.
The real physio hero often finds themselves nodding and smiling politely when they hear patients telling them that it must be so easy for them to stay fit and in shape, and how they couldn’t possibly understand how hard it is for them, even though most physios heroes are exhausted at the end of a day and still go for that run or do those sets of deadlifts. They also tend to smile even wider when they hear patients explain that 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, yet somehow managed to find the time to watch tv or browse social media for hours and hours.
No7: They are lifelong learners
As well as committing to a lifelong healthy lifestyle the real physio hero is 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 will 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. The 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 try to make a difference
Despite all the pressures and limitations on their time and resources the physio hero try’s their hardest to make even the smallest difference to all they see. Even if it as simple as getting someone to move a little more each day, or reduce a 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 promote their results to everyone and anyone on social media. They understand that successful results are not guaranteed and change is a slow and gradual process for many things they see. They recognise that those who continually shout about and promote their successes often forget about or ignore their failures. Real physio heroes don’t.
No9: They challenge the bull shit
Physiotherapy is often stereotyped by patients and other professions as just some massage and silly little exercises. Real physio heroes know differently and do all they can to change and refute these accusations. They question and challenge the many dubious claims and dodgy interventions they see being used in their profession.
Although direct and upfront with this challenging and often perceived by many as being unprofessional and rude the real physio hero doesn’t let this deter them. They recognise that this is a common fault by those who can not differentiate their personal emotions and feelings from their ideas and interventions.
No10: They do it with a smile on their faces
Despite all the challenges and difficulties that exist to provide good quality evidence-based physiotherapy day in day out, the real physio hero always does their best 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 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.
So there you go, 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 true physio hero and it would be easier and more financially rewarding to roll over and do whatever patients wanted. We also recognise that its tempting and sexy to go along with the fucktard gurus giving out their shitty ineffective treatments whilst natural history occurs in the background making them appear to be miracle workers.
But 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 bullshit and bluster that surrounds this profession of ours. Please stay a real physio hero.
As always, thanks for reading…
Adam and Sandesh.