So you are a Manual Therapist - but will you survive?

So you're a manual therapist health professional. Congratulations, it is an incredibly rewarding career.

There are 27543 physiotherapists and 4998 chiropractors (plus 9097 and 1894 students respectively) in Australia.

The graph shows the relative number of registered physiotherapists in Australia across 5 year periods.

Given the average practitioner takes about 5 years to develop reasonable competency in clinical practice, we can break down their working life into two major epochs of 20 years each, so 25-44 years and 45-65 years.

What becomes startlingly obvious, is that only a small percentage of physiotherapists transition from the first epoch (nearly 20K) into the second epoch (about 7K). It would seem that a lot have 'moved on' to other pursuits outside of the physiotherapy profession.

To what and why, have these physio moved are good questions? Perhaps a discussion for another day or people in this situation can enlighten us of their story in the 'Comments' section below.

However, for the moment I am much more interested in what made those that did stay in the profession, stay, and build on the skills they learnt in the first 20 years. Plus, if this is your chosen profession, and you are in the early stages, you might like to find out from those that did stay, WHY they did stay.

See, while hanging out with older folk might seem weird, I actually like it. Why? Well for one, when you do, you are getting to hear and see you will be talking about, doing, and thinking in 5 or 10 years time. In my mind it is better to know and act with awareness, than let it creep up. Want to know what your life will be like with young kids? Find some friends with young kids and hang out. You will quickly find there won't be any late night dinner parties, meals will be basic, discussions will focus on nappies, teething and lack of sleep.

So to help you plan your next 20 professional years, remained enthused and stay in the game, I asked a bunch of experienced practitioners, both in the private and public system, to explain what has kept them active, engaged and involved in their chosen profession. As it turns out, there are just a few things you need to know and these professionals said them over and over again. From this experienced crew, here is some sound advice for new and recent graduates to consider.

Theme 1 -  Variety

There was no doubt that Variety was the most commonly mentioned topic. I would strongly agree. Having had the chance to treat, teach, research, design tools and write about my profession, the shear variety of options has been a huge factor in maintaining excitement for physiotherapy. Here are some comments capturing the importance of seeking variety within your profession.

Jo Milios Physiotherapist - Men's Health

I started off in private practice working with the Fremantle Dockers in their very first year and in a busy practice where I was mentored for 2 years. Then I had an opportunity to purchase a practice as a 24yold.This was an exciting challenge that was stimulating and added depth to my career development. Initially MSK focused, I then trained in Hydrotherapy, Pilates, Yoga and most recently developed a Men's Health practice. In the last 5 years I have been working my way through a PhD and next year have an opportunity to present research at Cape Town's World Confederation of Physical Therapy... Anything is possible. Plan it. Do it. This career has endless doors to open...

Paul Tucker - West Coast Eagles Senior Physiotherapist

Variation in working life - I have always been involved with different sports throughout my career, regardless of working in either the public or private sectors

Felicity Kermode Clinical Director, Move Well Pty Ltd

The wide variety of job descriptions available in physiotherapy allows you to experience many different environments within the one profession. If you feel you might be getting stale in one job situation, a change is always possible. This can keep you fresh and energised and there is always something new to learn in physiotherapy.

Susan Herdman Professor Emerita Vestibular Rehabilitation

I could do so many different things - see patients, teach and research - and just kept changing my emphasis among the three (concentrated on 2 of the three at a time) over the years.

Melissa Cary - Titled Sports Physiotherapist

A country practice provides a lot of variety and challenges.

Alison Thorpe - Specialist Sports Physiotherapist FACP

Diversity in the range of positions that can be held as a sports physiotherapist. I have been fortunate to have had a range of experiences in the physiotherapy profession including team physiotherapist, clinician, educator, researcher and academic

Theme 2 - Staying Up to Date

Coming in a number two, was the theme 'staying up to date'. Now, while some may consider this to actually be a chore a demand or expense, it is actually a key part of staying engaged and motivated professionally (simply put this is why I created AAP Education - to provide much needed PD opportunities). Put in another context, investment legend Warren Buffett has a story about offering you a car, any car as your first car, cost no limit. What would you choose? The catch in the story is you only get one car in your lifetime. So how much effort are you going to put into keeping it running well? I see professional development in the same light. If you are willing to commit 4+ years to training for a profession that sets you up for life, doesn't it make sense to attend a course a year at least, to grow and nurture the initial investment in yourself? Here is what others say on the topic.

Paul Tucker

Working in an area I really find both challenging and rewarding, plus always attempting to stay cutting edge in the way I manage and treat.

Ian Cooper HOD, Physiotherapy SCGH

Research. I became interested in research late in my career and this has introduced a whole new set of challenges. The process is very stimulating and certainly improves your critical eye on everything we do as Physios.

Michael Shacklock  FACP Director, Neurodynamic Solutions 

Intellectually stimulating - continuous opportunity to improve performance and patient care.

Susan Herdman 

Research was the basis for what I did.... not expert opinion. It gave me greater confidence in what I did.

Alison Low  Specialist Sports Physiotherapist FACP

Keeping up to date with best, evidence based practice. This has allowed me to get rewarding results with my patients as well as reliably identify who may not do well with my physiotherapy skills and who to refer on. Continued participation in further education as a masters student, lecturer and more recently the Australian College of Physiotherapist's specialisation process.

Alison Thorpe

Attendance at a range of continuing education seminars and courses over many years. Recognition that learning is a life long journey and even as an experienced clinician, there are still great benefits in attending conferences and courses. The benefits of postgraduate education and specialisation enhance the critical process of evidence based practice and clinical reasoning.

Theme 3 - Making a Difference

For me personally, it is the interactions, the sharing and the helping of clients, that gets me up each day for work or drags me through the long nights of my PhD. Knowing that we have the skills and the compassion to help people and make a difference in their lives, is a very powerful and humbling combination.

Jo Milios

From the aged to babies, cancer patients, stroke victims, incontinent patients, teenagers with scoliosis, sports injuries, yoga classes, sporting clubs- the opportunity to connect and provide s valuable health service from all different walks of life has been satisfying, challenging and stimulating on so many different levels. Every individual has a story to share and connecting with people through health and mutual goals has been endlessly rewarding. People and their personal success stories help build a very widely enriching community.

Felicity Kermode 

Physiotherapy is a positive profession too - we really do help people and make people feel good.

Michael Shacklock

Job satisfaction - helping people.

Jenny Andrews - Private Practice Physiotherapist

Its a profession that empowers others to get on in their life

Gaetano Milazzo Consultant Physiotherapist

Working with people and promoting health and function

Susan Herdman 

I loved being able to help the patient's I had.

Cameron Tweedie LifeCare State Manager

I like helping people, and feel I can achieve this as a Physio and I like working with Physios, helping them help others.

Melissa Cary

I love caring for people and always more to learn about how to help people physically

Theme 4 - Employment, Stability & Rewards

Having a job, that provides rewards (satisfaction, money, stability) is an important part of our psyche. Certainly when treating workers' compensation clients, I see changes in mood, attitude and confidence as they fall out of and then get back into work. Work provides a purpose to life and having a profession that enables employment, diversity and challenges over a lifetime is pretty special. 

Ian Cooper 

Employment opportunities and progression - not referring to number of jobs available but the diverse nature of our profession and the many different paths available for me to explore. I was fortunate enough to commence my career in a large Teaching Hospital that exposed me to areas of Physiotherapy that I had not been made aware of as an undergraduate. Each step along the way brought new challenges different from the previous role(s). This certainly has contributed to my ongoing engagement in the profession.

Felicity Kermode

Australian physios are thought of highly all around the world so you can travel and work overseas within the physio profession, or just within Australia. It was essential that I was able to work in a profession that could allow for a passive income stream. Being an owner of a private practice (or practices) means you can take time off and still earn money, and its easier to achieve a life/work balance.

Melissa Cary

Opportunity to work part time which has kept the workload fresh and new over the years.

Michael Shacklock

Make a good income.

Jenny Andrews

It is a good mix of brain and brawn. You don't fossilize at a desk and you are constantly asking yourself why this does or doesn't work and how can I be more effective.

Jo Milios

Physiotherapy has provided me with a career path that means I have been employed without a break, for 22 years, missing only a few weeks with each of my 3 children, before being able to work part time, school friendly hours, and then gradually more hours as I desired over time. Physiotherapy is recession proof, a necessary health service and internationally respected, with a decent earning capacity of desired. I plan to work well into my 70's if I am able...

The transition from new graduate to experienced practitioner is HUGE on so many levels. AAP Education aims to smooth this transition by providing a heads up, to assist recent graduates navigating the hurdles and speed humps often found in their aspiring way.

A huge vote of thanks to the all the practitioners above, who kindly took the time to provide insights and words of wisdom for the benefits of others. Thank you.

Looking forward to hearing your comments about what has keep you in your profession.

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