I had the good fortune to present recently at the AAOMPT conference in Reno, Nevada. The topic at hand related to how the modern scientific focus in physiotherapy is both strengthening our understanding of the mechanisms of manual therapy but weakening the standing of manual therapy compared to non-hands-on approaches. The topic did not need to be just about manual therapy though, as it relates to all aspects of modern physiotherapy practice. Where we do not have the in-depth knowledge of the genesis of our techniques and philosophies, and how this shaped multiple professions, we drift away from what it is that made us of value in the first place.
The relevance of historical study can also be seen through the lens of optimising future education, including profession-based, allowing us to understand how professions formed and where the value lies in our practices. In another lens the humanistic aspects of individualised care, including cultural perspectives, are often lost in controlled scientific approaches to healthcare. This presentation served to view how if we study the past, we can inform the future and understand the power in our knowledge and heritage.
The presentation, titled “Understanding the Historical Foundations and Power of Manual Therapy to Inform the Future Directions of OMPT”, explored the perspectives of physiotherapists (P), chiropractors (C), osteopaths (O), and physicians (M) on the history of their professions and critically, the impact that the study of history had on their professional journeys. It is clear that historical study of one’s own profession, and the reflection on the experiences of each individual within this study, provides substantial benefits, and a few challenges. It is interesting that osteopaths tend to know their history more than others also.
When discussing histories and lived experiences, there are key themes that arise which show us the power laying in histories often ignored. Key within these were many, but a few to note include:
Impacts – How will new knowledge on the historical genesis of manual therapy affect clinical practice?
-
- Confidence is expressed through the hands, more individual expression, more knowledge more confidence (P, O)
- Osteopathy may see what they have lost in the United States (C)
- Shift away from a primary pain focus in clinical practice (C), need the soft skills (M)
- History gives you the value, the love of your profession, more self-respect (C, O, P)
- Better understand the science of healing form the perspective of the patient, study all approaches (P, C, M)
- Regain and improve our professional identity if we regain our history (P)
- Hands-on approach allows for retention of the joy and myster of healing, more space to heal (O, P)
A quick synthesis shows us that if we study history, we will find confidence, soft skills in practice, self-respect, love for profession, value, professional identity, and the ability to increase the space for healing available to individuals. We do face challenges in that we will feel less pressure to focus our practice on the most modern, and most scientific approaches. This may not be a problem.
Further, if we consider the benefits to our practice from a historical lens, there are many: these themes relate to gaining better understanding of our hands-on practices between professions.
-
- Promotes understanding of the broader aspects of care, the profession, society, and the health of society (P)
- History loss in physiotherapy resulted in losing way as healthcare providers. Removed from the role of healers and lost the connection between patients and providers established by the laying on of hands (P)
- Permits understanding of biases that emerge in attitudes towards its use (C)
- Provides appreciation of similarities and differences in profession. Facilitates open mindedness and opportunities for growth as profession (P)
- Makes interactions with patients less mechanistic and allows examination of your scope of practice (C)
As we look ahead, we need to constantly be looking back. As we strive to create interprofessional patient centred care, historical viewpoints will generate impacts that have tremendous meaning. As we learn, share, and explore our narratives, the problems of the present can be solved by recognising we already solved many in the past.
-
- Lead to professions coming together outside allopathic system to share concepts, opportunities for influence (P, P, O)
- Make professions more collaborative, less threatened, and permit them to communicate and relate better to one another (P, O, O). Allow practiioners to be more open to alternative mechanisms (O)
- Promote respect between disciplines, mutual ownership, understanding manual therapy is appropriate for all to use (P)
- Sharing common ground permits practice to move forward (C), examine underlying theories and tenets, allow simplification of approaches and allow cross pollination of ideas to proved a broader base for clinical practice (C)
