Reclaiming the art of physiotherapy

Lawrence Baker implores physios to remember the fundamental skills of coaching and behaviour change when providing advice and exercises to patients

Lawrence Baker
Lawrence Baker’s career in the West Midlands has spanned 36 years – 30 within the NHS and now in private practice

I have spent most of my career working in the NHS with some excellent, committed, and skilled therapists. I believe this to still be the case after leaving the NHS. So why, now in private practice, do many of the patients I come across seem so disillusioned with physiotherapy?

There is some discontent that they have only been able to get a telephone appointment or that they have simply been provided with exercises after a brief face-to-face with someone. I feel and understand their frustration.

I know the NHS and its workforce are under a tremendous amount of pressure. We have a shortage of physiotherapists and squeezed services, with large waiting lists especially since the pandemic.

There is also an incredible amount of fantastic work still happening around the UK.  But I implore my colleagues not to forget the fundamental skills of coaching and behaviour change when providing advice and exercises to patients. 

We have to understand where patients are starting from and manage their expectations of what modern physiotherapy is. We know the evidence base has moved on, but many patients do not, and their expectations are a huge part of the success in any treatment.

One of my private patients questioned whether a physiotherapist needs a three- or four-year degree education programme to follow an algorithm on the phone and then send off exercises in the post! We must refrain from algorithmic, one size fits all approaches. Let’s ensure physiotherapy remains personalised, we coach patients through the behaviour change required, we manage their expectations and, when we do provide exercises, they are relevant, functional and adequately dosed.

I love the profession I have been part of for many years and I am determined to ensure that patients continue to receive the best care they can, from whichever sector it is being delivered. 

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