Not All Physios Are Equal
"Aren't all Physiotherapists the same?"
One of the most difficult tasks I have with prospective new clients is convincing them that I am different to other Physiotherapists that they have seen in the past. This is generally because people simply don't know that there are different types of Physiotherapists out there with different levels of recognised experience and skills.
So who should you see and when should you see someone else?
The General Physiotherapist
This is the physiotherapists you will most likely come across in most private practices. They have graduated with a Bachelor Degree in Physiotherapy or a Graduate Entry Masters in Physiotherapy. They range from the recent graduates to very experienced physiotherapists who never bothered to get their experience recognised.
Pros: They are fine for simple conditions and can be quite experienced (but that is hard to tell)
Cons: They may lack the experience to deal with complicated problems or get to the root cause of recurring injuries
The Titled Physiotherapist
This is the Physiotherapist who has gone on to do a Post-Graduate Masters degree in their chosen field - usually in Musculoskeletal or Sports Physiotherapy. Alternatively, they may have had their prior experience recognised. They will usually have at least 3 years experience behind them in their chosen field and have demonstrated a commitment to learning more about Musculoskeletal or Sports Physiotherapy. The training to become a Titled Physiotherapist is usually at least 1 year full time study. Some General Physiotherapists attempt the study to become Titled Physiotherapists but find it isn't for them - that is ok, it isn't for everyone. You need a certain ability to read the research, be able write scientifically and demonstrate your skills at a certain standard in written and verbal examinations. The process of gaining your Titled status should make you a better quality Physiotherapist.
Pros: They are more experienced and have advanced training in more complicated conditions which has been recognised by a formal examination process
Cons: For the very complicated, chronic cases, they may still lack the specialist knowledge on how to manage these patients.
The Specialist Physiotherapist
This is the Physiotherapist who is recognised by their peers as having a certain standard of knowledge, experience and ability. The process to become a Specialist Physiotherapist is at least 2 years long and requires written and verbal examination. The training process itself is quite intensive and will make you a better Physiotherapist even if you do not go on to complete your exams. There are currently only 7 Specialist Musculoskeletal Physiotherapists in NSW - Antony is hoping to be the 8th.
Pros: They are the most experienced and proven at dealing with complicated cases in their field of study. If they don't know how to manage a case, they will know the right people to refer to. They should possess the ability to evaluate any new physiotherapy research, technique or theory and determine how it integrates into the world of Physiotherapy.
Cons: Whilst they are Specialists, they will not know everything. Innovative physiotherapy practices are evolving all the time. Specialists are not always the "end of the line"
How should the Physiotherapy System work?
Ideally, you would see a general physiotherapist for most acute (less than 3 weeks old) conditions. They are equipped to handle most cases that present to them. However, if after a few treatments you do not seem to be getting better, then having a Titled Physiotherapist to review your case is appropriate. They can then report back to your (general) physiotherapist about their opinion on what is wrong and how to proceed. If the problem continues to be difficult to treat, then referral to a Specialist Physiotherapist may be required for an opinion.
The system is very much like the medical model. You see your GP for problems but get referred to specialists for the cases that need specialist care. In the Physiotherapy world, the Titled and Specialist Physiotherapists are often your second opinion providers.
So what is Antony's story?
Antony believed for a long time that it would be ok to be a great general physiotherapist. At the time, there was no real perceived benefit from undergoing post-graduate study. However, the desire to influence, mentor and shape the profession meant that formal recognition of Antony's skills would be required. He achieved an average mark of 87% in his Masters Degree and is currently studying in the specialisation process. Simply undergoing the specialisation training has impacted on his knowledge, skills and ability - it won't matter if he undergoes his exams or not, he has become a better Physiotherapist for the training.
What should you do?
Antony's recommendation is to see your physiotherapist 3-5 times. If you do not see measurable improvement in that time, it may be worthwhile seeking an opinion from a Titled or Specialist (or Specialist-in-Training) Physiotherapist to guide your condition.
Thanks so much for this information! I’m been trying to find physiotherapists in Victoria, BC and decide which one would be the best for me. This has been very helpful 🙂
I don’t presume to diargsee with your doctors, but when I pulled my plantaris, my doc had me back in three days my next scheduled run (with cycling from the day I saw him no days off).. Because you’re a fore-foot runner your situation may be different, but four to six weeks for a pulled muscle (especially a small one like the plantaris) seems ridiculously long. Either way, here’s to wishing for a speedy recovery. Good luck.