As you may be aware, I just returned from a whirlwind trip to England. I had 4 different teaching ventures, and got to mingle with physiotherapists, veterinarians, and hydrotherapists. It was a great trip, but a common theme emerged, that fits in with the dozens of e-mails that I get in a day, and conversations that I have had all over the world with various animal rehab / physio practitioners. And that is…
Acceptance is slow to establish, and veterinarians don't always refer, or don't refer when they should, or don't refer the kinds of cases that they should!
The problem is universal! And it doesn't seem to matter whether you are a veterinarian or a physiotherapist… So here are some of my thoughts on the issue.
Why are we all experiencing this?
What should we do?
Inter Professional Collaboration is not taught in vet school. It is drilled into us on the human-side of medicine, however, we have had decades of multiple professionals working in unison for the goal of betterment of the patient. Now, that is not to say that human medicine is perfect in this regard… not at all… however, we at least know that we are supposed to get along in the sandbox, and that the patient is at the centre of our decision making. I don't mean this idea to be inflammatory to the veterinarians out there, however I do think that this plays a part in resistance to non-veterinary professionals working in the field, and also factors into inter-veterinarian relationships as well. Why won't the vets down the street refer to your rehab services if it is in the best interest of their patient? Perhaps the time has come to add classes on inter professional collaboration in vet school. Want to read more on this topic… check out the Free Stuff page on www.FourLeg.com. I have an article there that a rehab vet and I did as part of a presentation at the Canadian Physiotherapy Association Congress in 2012.
Case Studies and Case Series need to be presented in veterinary journals. Aren't we all a little sick of hearing "Show me the evidence that this works?" My reply is always to point out that all of the basic fundamental scientific research that backs up what we do in humans (manual therapy, modalities, and even exercises) can find it's roots in animal research. However, that doesn't always satisfy the nay-sayers. My thoughts are that we need CLINICAL research & reports out there. If you have even done Masters or PhD-level research as a clinician, then you too have felt the frustration of having to dissect your original research idea into a minuscule measurable piece of the original. What I learned from doing my Master degree was that plenty of scientific research simply does not have a clinical application. So, I would propose that more of us write up case reports for submission. While this kind of evidence is low on the empirical research scale / scoring system… it IS the stuff that allows scientific researchers to spring from (i.e. to get them to do research that matters), and it is what clinicians like to read in a scientific journal. So why not start there??? We should all think about doing this!
Balls! Or rather, the lack thereof is a real threat to the physical therapists engaged in animal rehabilitation. Physical therapy is a female dominated profession, and we tend to put our families first (sometimes taking years away from professional practice), try to be peace makers (appease the other person / party), and not stand up for ourselves (hoping we'll be noticed, instead of standing up and saying "Here I am, this is what I know and do, I'm bloody brilliant at it, and you need me!"). I'm delighted that there are more men in the PT profession. It is a highly technical and intellectually demanding profession, and I would find it fascinating to know where the profession would be (or could go) if more men were involved! If you have a chance, the book Lean In by Facebook CEO Sheryl Sandberg is a great read on this subject! In having taught both vets and physios for over a decade, I will maintain that it is MUCH easier for the physiotherapist to learn how to apply the physio skills and knowledge to the animal patient, than it is for the veterinarians to learn to practice the profession of physiotherapy in a 2 week course. I am not saying that they shouldn't try… but it will take more than a 2 week course to learn the application of physiotherapy as a professional skills set (and one reason why my website was created). So… back to physio-balls (fun play on words there!). The PTs / Physios need to stand up for themselves, and I would hope that the pro-physio vets would help initiate political processes to start allowing PTs / Physios to legitimately practice - as professionals… because, I feel strongly that THAT is how the practice of animal physiotherapy will grow! I remind everyone involved, that vets did not create this field of practice… the physios did… an for knowledge translation and transference, the physios need to be heavily involved moving into the future.
Support for the Technicians. I do have concerns that our vet techs are not adequately supported in practice. If the our technicians do not have a vet or PT that can help to direct therapies (especially for complex cases), or help sort out cases that are not quite so straight forward, or offer additional teaching / training / mentoring, or provide advanced level manual therapies, then their successes could suffer. And that's not a win-win situation. Now, there are some exceptions to this finding… where a technician has gone on to take multitudes of continuing education to expand upon his/her rehab training basics… but this requires either the technician to self-direct their learning (and often have to pay for it out of their own pockets), or have an employer who is willing to pay for continuing education in rehab-related (or rehab-adjacent) areas. So I wonder if perhaps a technician would better enjoy working in a practice with other rehab practitioners. Additionally, the general practice vets need to have a better understanding of what is rehab, what is appropriate to refer, and why more advanced rehab-specific assessments, direction of therapy, and respect for rehab practice is needed in order for a rehab service to fully succeed.
Ground Swelling. I believe that the general pubic will be our greatest ally in moving us forward - politically, clinically, and from a business perspective. So, to that end, it is to the public that we have to market. I don't mean taking out advertisements, I mean provision of information. Blog posts, replies on dog-owner chat groups, magazine articles, newspaper articles, lectures, courses… etc. Educate the public and they will start to demand the services that we offer! Looking for more marketing ideas? Check out my e-book: The Marketing Manifesto for Canine Rehab Practice e-Workbook. It's available for purchase on FourLeg.com as well… because I think we all need more education in professional marketing!
So now it's your turn! Give me feedback on this blog post. Tell me your thoughts on the subject. Pass along your tips. Lets grow this thing together!
Cheers to your success!