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LeadershipDec 3, 2022

Physiotherapists must create' clear vision' so their profession can adapt to meet changing demands

Physiotherapists need to re-evaluate their role and develop a ‘clear vision’ on how the profession will meet people’s healthcare needs in the future, according to an open-access paper published online in the journal Physiotherapy on 1 December.

It was written by physiotherapist Sandra Hartley, a senior lecturer in the school of physiotherapy at Manchester Metropolitan University (MMU), along with her MMU-based co-authors Hanane Ryad and Gillian Yeowell.

The team recorded semi-structured interviews with 23 physiotherapists (15 females), many of whom were studying on a post-graduate programme at a university in north west England. Their main aim was to ‘gain an insight into physiotherapists’ perceptions of their current and emerging future role’.

‘The intention is to develop an understanding of the role of the physiotherapist, how it is affected by the changes occurring in healthcare, and how practice can continue to evolve to support the population’s needs in more sustainable and innovative ways,’ they note.

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Physios must become more adaptable, developing a breadth of skills and knowledge

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Respondents had a wide range of experience

Only three interviewees had been in the profession fewer than five years, nine had from six to 15 years under their belts, while the remainder (11) qualified at least 16 years ago. More than half of the respondents (13) worked in two specialist areas: musculoskeletal and neurology. Other areas represented were orthopaedics, rotational, respiratory, paediatrics, community and the military. 

Today’s healthcare professionals, the authors suggest, face ‘increased demands’ resulting from an ageing population, unhealthy lifestyles, and underlying health inequalities – which have become more apparent due to factors such as the Covid-19 pandemic

While applauding colleagues who have taken on new roles as advanced and first contact practitioners, for example, they point out that physiotherapists must become ‘more adaptable and multifaceted with the breadth of skills and knowledge to manage the complexities posed by the shift in population demographics’.

‘Therefore, although physiotherapists are ideally placed to embrace the future healthcare challenges, collective support amongst the profession for radical change in practice is needed including a re-evaluation of their role.’

Four key themes emerged from the interviews

  1. underpinning philosophy of practice that promotes holistic care and supports patient wellbeing
  2. an ‘evolving role broadening the scope of practice’, with many ‘agents of change shaping the profession’
  3. when ‘preparing the future workforce and their transition into practice’, graduates were said to be more adaptable and resilient
  4. however, more ‘affiliation’ is needed between universities and placement providers to enhance learning environments

‘Blurred boundaries’ concern

Some respondents felt that professional boundaries were blurring, moving physiotherapists away from traditional roles and into other professionals’ territories, the authors note.

‘Covid-19 was seen to have accelerated this. Although, it was generally felt that this had helped to develop both the physiotherapists’ skills and their scope of practice, there was also the feeling that physiotherapists needed to be mindful that they were not losing their distinct craft and, hence, their professional identity.'

The authors note: ‘Conversely, there were also concerns raised by some that blurring of professional boundaries could create the risk of stepping outside their scope of practice.’

An emerging role that re-envisages a holistic approach that incorporates health promotion as fundamental to this role seems essential to support physiotherapists’ transformation in practice [Sandra Hartley et al]


‘An evolving healthcare system requires new ways of working that are innovative and sustainable,’ the authors state. ‘To rise to the challenge, physiotherapists need to reflect on their role so a clear vision for the future can be co-created to ensure physiotherapists remain contemporary and continue to optimise their potential.'

Dr Hartley and her colleagues add: ‘An emerging role that re-envisages a holistic approach that incorporates health promotion as fundamental to this role seems essential to support physiotherapists’ transformation in practice.'

The article features selected quotes from the respondents. Examples from two respondents that feature in the Theme 1 category include the following:

‘Sometimes that conversation about that general health just needs to be in the context of what you’re actually there to treat them for … if they’re coming for the knee and they’re significantly overweight, it’s very valid to be talking to them about losing weight … it helps with general health as well, but if somebody has come in for something that is unrelated to their weight then it’s more difficult to steer the conversation that way.’

‘If you’ve just met that person at that one session, it would be really hard to say “you’re a bit overweight, so what are we going to do about that”. Whereas when you’re seeing the child and their families regularly, it seems to somehow just drop into conversations so naturally.’

The article is titled Future-proofing the Profession: Physiotherapists’ perceptions of their current and emerging role. To read the full version, which is currently ‘in press, visit: https://doi.org/10.1016/j.physio.2022.11.007


Author: Ian A McMillan
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