Reflections on 20 odd years as a Physiotherapist

By Natalie Whish-Wilson

I always find it difficult to know where to start in trying to share my 20 plus years knowledge of the interesting things I’ve learnt in my profession as a Physiotherapist. So instead of boring you (yet) with the details of my opinion on how to treat this or that I thought Id share my journey from a new graduate to where I am today.

My early experiences as a new grad working in a busy private practice should probably have turned me off the profession altogether. I was poorly mentored, saw a patient almost every 15 minutes, was expected to work weekends for sporting clubs unpaid (in order to generate clients) and had no time (or money) to attend professional development courses.

Having said that, Physiotherapy has been the perfect profession in that I have been fortunate to work in London, New York, Hong Kong as well as many Australian states. I have been hired more times by phone interview than in person thanks to a healthy demand for Physio services. I have been able to work in a variety of areas (this is so voluminous that I will save it for another blog) of the profession, altering my workload as necessary while having children.

So in eventually moving to Tasmania to live, I decided to draw on my experiences and do things my way, establishing In-Balance. The way I currently assess and treat clients is so far removed from that novice in Western Australia and most definitely shaped by the many fabulous thinkers and researchers that dominate in the Physio world.

One of the more important aspects of the way I treat is to take the time in an initial assessment to really have a good look and most importantly, listen to what clients are telling me about their problem and how it effects their life. I’m no longer in a hurry to just treat the symptom and hope that the underlying problem resolves incidentally. I explain to clients that the first session is really to get a handle on what is going on so I can formulate a plan of attack that (most importantly) is a fit with their goals. This forms the basis of what is more widely termed the bio-psychosocial model of patient centered care. Of course there are times when relieving pain is definitely a priority.

Back in my student days I suffered through Psychology and Neurology but they have both come back to bite me as I’ve travelled my path. For those of you that don’t know me, I’m constantly banging on about the brain and how it is the GPS and central command for the way we think, feel and perform. It is also the organ that produces pain and therefore I should be thankful for the fact that everyone has one - as it is one of the main referral sources for the Physio profession!

The other important aspect of my practice that has changed since my early years is that I view rehab as more than just a series of exercises to strengthen a particular muscle or assumed weakness. I have embraced Pilates as one of the many movement practices (there are other great ones such as Yoga and tai chi) that can change the way the brain strategizes and plans movement sequences for functional activities. I have seen the benefits of merely improving breathing in some patients to treat pain and change muscle activity and even instantly change strength or flexibility. More on this in another blog.

Finally I’d like to finish by saying that I’m indebted to the many patients I have treated over the years who have challenged me, enlightened me, frustrated me and delighted me. I often think back on those early years and wonder how any of my patients got better and would like to sincerely thank them in retrospect for allowing me to experiment on them with my newly acquired skills! These days you can be assured that I’m much more capable and I'm committed to lifelong learning in my practice. I am never bored, rather, fascinated by the amazing people I’m privileged to assess and treat. I'm forever thankful for the trust you place in me.