“Smart. Sporty. But not smart enough to get into Medicine.” My Reasons For Leaving The Physiotherapy Profession

I was one of those 17 year olds who was really into sport and exercise as well as being academically gifted, but not THAT academically gifted. I was good with people, pretty hardworking (at school, anyway) and a good allrounder. In short, I was the sort of 17-year old male that ends up studying Physiotherapy because he couldn’t get into medicine!

But looking back, maybe I should have seen the writing on the wall in my first week as a Physiotherapy student?

Maybe I ought to have realised that my set of values was incompatible with the prevailing norms of the Physiotherapy profession at the time?

When I think back to the beginning of my (somewhat short) tenure as a Physio student and practitioner (1997-2005 all up), I recall a workshop on “being professional” in my first week of Physiotherapy study.

The facilitators exhorted us to live up to the high status we would hold in the community:

- be on time, tell the truth, seek the best interests of your patients etc etc.

“Yep, totally on board with all this” I thought.

- You need to do this because you’re going to be a professional, and part of the Physiotherapy profession.

“Well, that’s a bit weird. Isn’t this just what everyone should be doing, irrespective of whether they’re deemed to be “a professional?”

- Plus, you now also need to seek the best interests of the Physiotherapy profession. We are a profession that is going places and you need to be casting us in a positive light to the community.

“OK, that’s odd (and a little creepy). Shouldn’t we just be trying to help the patient and seeking their best interests?”

“Seek the good of the profession.” “Advance the cause of the profession.” This was my introduction to the kind of self serving bulldust that did me in as a Physiotherapist. Around about 8 years after that, I walked off the job from a private practice near Armadale, completely exhausted by the cognitive dissonance involved in doing that work day in, day out.

This is an article about why I left the Physiotherapy profession. It is a long story so you’re getting a dramatically condensed version.

This topic comes up a lot with my clients, many of whom are attracted to me because I have a Physio degree, and Physio experience. In writing this, I hope to clarify my own thinking, and to tell an aspect of my personal history which explains an oddity in my present existence: “Why isn’t Tim a Physio? He’s got the degree… Why is he working as a Personal Trainer?”

To begin with, I want to own my own contribution to why my Physio career imploded. When I look back on that era in my life, I can see I had many personal character flaws. My sins were many - omissions and commissions. Although I could work hard, I was often quite lazy. Though intelligent, I was mentally soft. I was highly conflict avoidant. I had a BAD habit of running away from my problems. I could go on…

Also, in the fourth year of my degree, my Tourette’s Syndrome flared up badly. I would be medicated - with degrees of side effects - until January this year. Plus, by my last year working as a Physio (2005) I had experienced panic attacks and had been diagnosed with Generalised Anxiety. The medications I had been on provided some stability, but they came with significant side effects, as is so often the case. 

I have some big regrets about the way I handled the implosion. I regret not being more proactive in learning about the physiology of anxiety (which helped me immensely in 2014). I bitterly regret becoming pretty sedentary between 2001 and 2013, forsaking all the joy and health benefits my training and sporting pursuits had brought me prior to that. I regret not trying out different sectors of the Physio profession which could have been a good match for me - the disability sector being one of them.

But at the end of the day, the single biggest factor which led to me bombing out of Physio (and letting my registration slide away) was the dodgy ethics in the prevailing commercial paradigm in musculoskeletal private practice.

When I worked as a Physiotherapist between 2001-2005, the interests of the patient were a distant second to the financial interests of practice owners. I was strongly encouraged to see people way more often than they needed to be seen (called “over servicing”), providing band aid solutions to their problems - with a massively inflated view of the effectiveness of “hands on” treatment - instead of looking at root causes and empowering people to take control of their issues. 

This was a deeply unethical system of people and ideas which exploited injured workers and road traffic victims for financial gain. One practice I worked for, which rhymes with “Strife-swear” promoted a policy of seeing workers compensation patients EVERY DAY for the first week after the initial consult, irrespective of the nature of the injury or how long ago the patient was injured. I

learned from an injured sheetmetal worker that his employer’s workers compensation premium had tripled after he became injured - this was the sort of collateral damage we turned a blind eye to. No hassle or downsides to us that employers should pick up the bill for our profiteering.

I referred to cognitive dissonance a few paragraphs above. This was the psychological damage of needing to believe your treatments, which often had pretty lacklustre results, were really helping and were heaps superior to natural recovery (“a tincture of time”). You needed to believe it to keep going, and to keep earning money. Because there was no obvious way to break the cycle and escape from the system. And, no, it was not simply that my treatments were lacklustre.

To my shame, I subjected myself to that cognitive dissonance for a long, long time with the encouragement of practice owners (and other Physios who had drunk the koolaid) who said things like, “we are here to provide pain relief while we walk alongside natural recovery”. True story. 

In fairness to the Physio profession, significant sectors of the public at the time did not have much of an appetite for taking charge of their own issues. Many, many people came to you saying “fix me!”. If you didn’t do the passive treatment, they’d find someone else who would. In this context, it can be hard to carve out a niche for yourself working with patients seeking empowerment. At the same time, there was a glut of Physios providing musculoskeletal care, and therefore we had little commercial power to insist to patients (and unethical practice owners) that we would be providing high value care - as opposed to superficial level manual therapies and nothing to address more causative factors.

So, I was a shell of who I had been and who I’d become in 2005 when I broke down, walked off the job and changed direction in my life.

I see some signs that things have changed now in the Physio profession, and others which indicate it has not.

But I’m happy doing what I’m doing as a personal trainer. I LOVE empowering people to take charge of their health through exercise. The scope of practice of a PT is broad enough for me to make a living from doing the sorts of things which I think are sorely needed, very powerful and cost effective.

The mental empowerment I have experienced through physical training has been immense. Every day I pinch myself that I get to spend my working life helping other people tap into that, too. Thanks be to God for this immense privilege!!

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