I had  the pleasure of attending the Australian Physiotherapy Association (APA) ‘meet and greet’ new grads last week. With Shana-Lee on maternity leave, Craig up to speed, and myself trying to complete my PhD, we are on the lookout for new staff in the clinic. I really did not think that it would be too hard, but alas, it seems to be.

I met some really great soon to be graduates and we had a great chat. A great deal of our passionate discussion was focused around the new “elephant” in the room of clinical physiotherapy treatment. The elephant seems to have snuck-up over the last few years whilst I replaced my physiotherapy conference attendance with spine surgery and spine deformity conferences and surprisingly revealed itself when one of my senior research supervisors questioned my research into sagittal spine shape “because we don’t believe it’s important anymore”.  I had the pleasure of listening to, elephant promoter,  Prof Peter O’Sullivan at the recent APA conference and he is very convincing indeed. He passionately argues and brings case study evidence, empowering the elephant; that the biopsychosocial approach to physiotherapy treatment plays a critical role in the management of back pain and may be more effective than typical medical care; hands-on therapy, core control and stabilisation exercises, and structured movement instruction. 

I do not dispute that the PSYCHO-social approach to healing is essential, and recognised this about 15 years ago when I was the only physiotherapist attending a course in CBT (Cognitive Behavioural Therapy)  at Westmead hospital. However, I firmly believe that the PSYCHO-social component of physiotherapy healing needs to occur in the presence of excellent BIOMEDICAL skills. Prof O’Sullivan informs us that he has completed and developed expert manual therapy skills, and has conducted thorough research into the physiology and practice of exercise  stabilisation modalities. Note, that he did this PRIOR to recognising the superiority of PSYCHO-social management over traditional manual and exercise type therapy.

My advice to the new graduate is that you cannot hide from the need to develop expert clinical skills and do not be afraid to recognise the importance of the  “medicalisation” of patient care. You are blessed to work in a medical profession and are blessed to have spent time training and learning in hospitals where the sick, vulnerable, pained and dying have allowed you to observe and learn way more than you can be taught in any lecture theatre,  YouTube video clip, or tweet.

You are super intelligent and probably have a very high EQ. Do not let anyone take your critical analytical skills away from you. Observe, think, and learn, and then critically review everything! Learn the vocabulary of medicine at the level of a doctor, and the vocabulary of research at the level of a scientist, and the vocabulary of  diplomatic critical debate at the level of someone who respects and is respected. Then, in many years, at the end of your career, you might look back and recall ONE patient that you have helped. Maybe more, but one is enough.