Gone are the days when people would remain, not only in the same profession, but with the same company for their whole working life. Now, we change jobs with increasing rapidity.
Is this driven by the global economy and the fact that there are more opportunities? This is a significant for sure but there’s more to it then that.
In generations gone by the focus was on ‘hygiene’ factors. A term coined by the psychologist Frederick Herzberg.
Job security and enough pay were vital because economically, times were tough. World Wars caused serious turmoil as we grappled with uncertainty and fear. We moved from our homelands to areas of safety (and, hopefully, prosperity). Having enough money to feed and support our family was meaning enough.
And things were even harder in the years prior to the twentieth century. Most of us worked physical and laborious jobs. Most of us lived closer to the poverty line too.
But things have opened up since (in the developed world). We’re in control of Herzberg’s hygiene factors. Also, the job market has changed – with a greater emphasis on skill, intelligence and technology. The variety of work is (close to) endless.
Physiotherapy, although a young profession, has followed a similar trajectory. Our scope of practice was much narrower in the years gone by. Perhaps we’d land a job at a hospital and work our way up from a junior to a senior clinician. Then, retire some thirty or forty years later in the same role.
But now, job selection is more diverse. And with this, we’re seeing clinicians change jobs more than ever before. But is this for better or for worse?
Here, are a few factors why job shifting is commonplace:
- We have more security than older generations and have the ability to ‘test the waters’. We’re interested in experiencing different areas of the profession. This helps us to determine which one suits us best. Also, it’s important to find a good team fit (hygiene factor). Thus, freedom to look around can help us find this
- We move between roles because:
- They don’t align with our expectations (and we’re discouraged or disappointed as a result)
- We don’t find them meaningful
- We lack the support or guidance to grow
The first reason is perfectly acceptable – and advised even. Testing different roles also helps to broaden our skills.
But the second is not. And it’s one that we have to address. It ties into another aspect of Herzberg’s work:
Physiotherapists grapple with the profession because it takes an effort to uncover the ‘motivating factors’ within. Our profession is not as clearly defined or established as some others. Perhaps this is because of our relative youth. But if we take a closer look, we’ll find that most factors can be unearthed:
Achievement starts upon graduating and becoming a fully-fledged physiotherapist. Then, there are opportunities to achieve more through post-graduate degrees.
Further education shouldn’t be something we rush into. Yes, there is typically a two-year buffer between completing the bachelor’s degree and having the ability to study further. But at two years, we’re still infants. We haven’t learnt enough about the profession including where we want to specialise.
Perhaps, there should be a requisite number of hours of shadowing and observing experienced clinicians in our desired role. If we can get a better understanding (plus experience a few different settings) we’ll be able to make an informed decision about the correct pathway.
Also, we shouldn’t limit ourselves to post-grad degrees within the profession. What about combining our physiotherapy knowledge with a different set of skills like material engineering, communication or software design? Then, we have the scope to disrupt the industry and make a unique impact.
Research is another avenue where we can make a contribution to the betterment of the profession. A good starting point could be to take up a research assistant role before committing to something juicier like a PhD.
Recognition is closely tied with achievement. Once we’re qualified, we are recognised by our peers, as well as our patients, as experts in our chosen area.
Those in academia receive recognition too. Think to the famous names like McConnell, Mulligan and O’Sullivan.
Also, those who do something different and innovate are acknowledged. Whether it be spearheading a new service, like Telehealth. Or creating a new product.
And recognition is nice. It’s an indicator of our hard work and dedication. But it shouldn’t be something that we attach to our identity or self-worth.
Responsibility comes in different forms:
- We’re responsible for the wellbeing of our patients. First, we must do no harm. Then, our aim is to get them back to full health as fast as possible. A key factor too is empowering the individual. That is, ensuring they are in control (internal locus) and providing them with the tools to self-manage
- We’re responsible for supporting our colleagues. This includes younger clinicians – guiding them through the challenging early stages of the profession. Also, it means pushing one another to provide a better service
- We’re responsible for growing our organisation (whether hospital, private practice or other). This should come naturally with best practice principles and fostering talent within the team
- Finally, we’re responsible for the welfare of the profession at large. We serve as ambassadors and should constantly strive to improve what we do
Challenge can be elusive. But this is not the fault of the profession but rather a problem with self-perception. Countless times I’ve heard physiotherapists speak of their knowledge and skills as if it were common sense. The truth is, it’s not. Or, otherwise, no one would suffer for long from musculoskeletal pain (or the myriad of other conditions that we treat).
Clinicians lack challenge because they fail to challenge themselves. The management of people’s ailments is far from straightforward. There are so many factors (as well as so much individuality) that mastery of the profession is almost impossible.
The trouble is, we can do a good job and still remain in our comfort zone. It takes initiative and, well, discomfort to step outside. But it’s in our best interests (as well as our patients, colleagues and the profession) to do so.
We must ask ourselves, ‘Is what I’m doing enough?’. And if the answer is, ‘No’, we must change. What challenges us within the profession? Building rapport? Getting someone to do their exercises? The lack of team spirit within the clinic? Then, perhaps, we can focus on this area and turn it from a weakness to a strength.
Promotion doesn’t exist in the same sense as in other heirarchical professions. Physiotherapy is relatively flat. Sure, in the hospital system, there are various levels. And in the private practice setting, there are junior and senior clinicians. But these are achieved purely by accruing experience (rather than accomplishing other landmarks that demonstrate an increase in ability).
And while this can be viewed as a weakness – a lack of progression, that is. It’s refreshing too. There’s little pressure of losing one’s place in the system if a person decides they want to try something different (or travel indefinitely!).
Also, it forces us to somehow differentiate ourselves from the physiotherapists (and other health professionals) around us. This means pursuing a particular interest, like women’s health. Or finding another niche that needs our expertise.
The ‘flat’ structure also reduces status issues (“I’m better than you because I’m more senior”). We need to take advantage of this and build a stronger and more collaborative community (as opposed to one where we guard our knowledge).
Growth ties in with ‘challenge’. The reason many physiotherapists fail to grow is that they don’t continue to challenge themselves. Instead, they stay mired in their comfort zone.
The pathways aren’t so clear in physiotherapy when it comes to becoming a better contributor (clinician or otherwise). We have to make the running – through research or innovation, for example.
It’s time we, as individuals, take responsibility for our profession and drive it forward. Rather than complaining about its flaws or our competition, we must pour our energy into developing a robust profession that retains its talent.
This might come in the form of improved frameworks, within hospitals and private practices, that foster new graduates. The emphasis should be on sustainability and finding meaning (for the individual).
Or perhaps the university course itself needs tweaking with more focus on non-clinical skills, like business smarts and communication.
Whatever it is, the impetus comes from us. So, let’s get started. What can we do to improve our profession? Comment below!