What Makes A Good Physio?

I often see blogs and images that promote the traits, virtues, and qualities of good physiotherapists. They often say things like good physios are kind, empathetic, caring rays of sunshine, that give hope when all is lost. Although I understand the point and sentiment of these posts they are simply not realistic.

Having been a physio now well over 20 years, I have met all kinds of physios with all kinds of skill, knowledge, and enthusiam. From the disinterested dinosaur coasting along doing the bare minimum possible to get through the day not giving a fuck about anything or anyone. To the motivated, ambitious, energetic bunny who wants to help anyone and everyone to the best of their ability.

So I thought I would take a more honest and ‘realistic’ look of what I think are the traits of a good physiotherapist that is beyond the sickly sweet obvious stuff. So buckle up and hold tight, and get ready for a big old serving of some brutal honest reality!

No1: Good physios can deal with a lot of silly bullshit

With the rise of Google-insta face-tweet book, lots of patients go to see physios with their heads stuffed full of pseudoscience, nonsense and silly bullshit thanks to some pea brain, ignorant, social media guru with a bazzillion followers. Often the good physios sit quietly and calmly while screaming on the inside as they listen to patients telling them some ridiculous far-fetched non-scientific bollocks that they saw or heard a guru say on the internet.

Shit physios dont care about this and will just ignore it or even agree with the silly shit. Good physios however carefully, tactfully, and compassionately try to unpick this bull-crap from the minds of their patients, trying to explain things in a more simple, rational, honest and evidence-based way, often only to be told that they clearly don’t know what they are on about because Dr ‘Social Media Guru’ DPT, CSCS, OMT with his bazillion followers says differently.

No 2: Good physios can change peoples minds

Even harder than trying to compete with an idiot online is trying to manage the shitty advice patients get from their friends, family, or even their trusted local healthcare professional. Patients often come to see physios with low or unrealistic expectations due to some misinformation gained from their family doctor or local surgeon.

For example, many patients are told that physio will be a quick, simple, easy process and they will be better in a few weeks when they’ve had a complex painful chronic condition for years. Or conversley they are told the opposite, that physio won’t help them for something it can quite easily help with!

Again shit physios dont care, but the good ones will spend extra time and energy trying to manage these ill-informed unrealistic expectations which is often a difficult, time consuming, and thankless task.

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No3: Good physios dont do it for the money

There are huge differences in the wages of all healthcare professionals, with some being paid very handsomely for what they do due to their extended skills, experience, training, and the risks of what they do. However, when you look at the average earnings of a good, experienced, well-qualified physiotherapist compared to other healthcare professions they are paid poorly, very poorly.

There are now many physios working in extended roles and positions of great responsbility and risk who get paid a fraction of what other professions working in the same roles do. Don’t get me wrong, the lazy disinterested dinosaur physios who are coasting along doing the bare minimum possible I think are getting overpaid for what they do. But the hard-working, evidence-based physios simply do not get paid enough for the level of time, experience, and responsibility they have.

No4: Good physios work hard

Some physios works up to 12 hours a day for 5-6 days a week, seeing patients back to back giving each one their full attention, care, and compassion with little to no time to catch up on paperwork, emails, or even eat. Good physios also use what little precious spare time they have to seek more knowledge and advance their skills further by reading books, papers, and attending post graduate courses at the weekends.

Unfortunately most physio employers do not give their physios any financial support, time, or even incentive or encouragement to do these things. Instead due to the increasing demand and growing pressures on servies, most physio employers want physios to see patients and do very little else.

No5: Good physios work really hard

With waiting lists increasing and all healthcare services under more and more pressure, appointment times are getting shorter and shorter and the working days are getting longer and longer. Many physios can see more than 20 patients a day which is not only mentally and phyiscally exhausting, it makes it increasingly difficult to give good quality individualised care and treatment let alone build a therapeutic alliance with patients.

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However, the good physios do attempt to give each and every patient they see their full attention and best efforts, listening attentively and tailoring their approaches to suit the perosn in front of them. This often means they work harder and longer than others again without any recognition or rewards.

No6: Good physios practice what they preach

Good physios really understand the importance of maintaining a healthy, physically active lifestyle and the vital role it plays in keeping both a healthy body and mind. Good physios lead by example by doing regular exercise despite the pressures on their time and resources.

Often good physios find themselves listening to others explain how they can’t find the time to fit in a few minutes of physical activity, even though they have worked 12 hours and only had 30 minutes for a pee and some food and still go for a run or do those deadlifts at the end of a clinic.

No7: Good physios are lifelong learners

Many shit physios havent picked up a journal since they graduated and couldn’t care less about the changes in research or practice. However, the good physios have committed themselves 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.

The good physios 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. Good physios are comfortable and confident with their uncertainty and are able to pass this on to their patients and others around them.

No8: Good physios make a difference

Despite all the pressures and limitations on their time and resources, good physios try to make a difference in all they see. Even if its as small as getting someone to move a little more each day, or by reducing their fear of a certain task or activity a little bit.

Sometimes this difference can be just getting a patient to think differently about a problem or an issue.

Good physios also don’t exaggerate their results or feel the need to promote their success to everyone and anyone on social media with stupid before and after pictures. Good physios understand that successful results are often not quick or easy and change is a difficult slow and gradual process.

Good physios recognise those who continually shout about and promote their few quick fixes and successes often forget about or ignore their many failures.

No9: Good physios challenge stupid bullshit

Physio is often stereotyped by patients and other professionals as just some massage and silly exercises. Good physios know different and they question and challenge the many dubious claims and dodgy interventions they see being used in their profession.

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Although challenging bullshit is often perceived by many as being unprofessional or harmful, good physio recognise that pseudoscience, misinformation, and silly shit is far more unprofessional and harmful.

No10: Good physios have a laugh

Despite all the challenges and difficulties that exist to providing good quality evidence-based physiotherapy, good physios do the best they can as often as they can with a smile on their face. Good physios recognise that although it can be incredibly difficult and stressful for them to do a good job, they know that they have to put their patients first.

Good physios also recognise that some banter and humour is essential in this oh so serious and oh so uptight world of physiotherapy with its many prudes and pearl clutchers in positions of authroity

Summary

So there you go, thats what I think makes a good physio beyond being nice, caring, kind and all that other condesceding crap.

I understand that sometimes it’s hard to stay on the path of a good physio and it would be much easier and often far more financially rewarding to take another path. I also know it’s very tempting to get dragged into the world of social media algorythum and gurus, posting sexy-looking, complex, yet ineffective treatments, and other silly bullshit for likes and follows.

But please recognise that being a good physio is far far more than being popular on social media and that good physios will always remain true to themselves and their principles.

So thank you to all the good physios out there, you rock.

As always, thanks for reading…
Adam

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  1. Nice one Adam….. thinking I was losing it ’til I read this, a timely reminder that “there are other lunatics out there doing a bit more than they need to”………

  2. I agree with pretty much all your points, apart from No.4. Just because you work 10-12 hours a day, 6 days a week does not make you a good physio, just an inefficient one. And someone who is at risk of being a very one-dimensional, dare I say boring, individual who is prone to stress and burnout.
    Getting a good work-life balance is essential, and I would say makes you a better physio as you will enjoy your time at work more and be more inclined to put the effort when you are there. Working long hours does not make you a hero, in fact the opposite.

    • I think you are missing the point Matt… many physios don’t choose to work these hours, especially in the U.K. Rather these are imposed on them by employers due to waiting lists and service demands!

      • Hmmm. How many physios work unsociable hours, and 14 hour shifts without a meal break AND their actions can be the difference between life and death? Our job is a doddle compared with other NHS staff !

  3. I love it. I have just wasted an hour of my life checking out ‘osteo strong’ – another con someone asked me about. I would love to hear your thoughts on this one.

  4. Could relate to almost every one of them ! Made me laugh !!!! but also made me proud to call myself a physio !

  5. As Dumas observed in The Three Musketeers, “Heroes or madmen [are] two classes of imbeciles greatly resembling each other.”