One size fits some

As a profession, we face change.  Physiotherapy services are under immense pressure, and in response we challenge ourselves as a profession, how we work, where we work. But are there some aspects of our workplace practices that haven’t evolved, and should they? 

We should all be aware of reasonable adjustments for disabled people: this is enshrined in law. With growing awareness around neurodivergence, more people are seeking diagnosis and support in adulthood. But not everyone receives or seeks a formal diagnosis, meaning some may be managing individual challenges quietly within conventional practices. 

Patient centred, physiotherapist-standardised? 

Physiotherapy emphasises individualised patient care, but do we apply this principle to ourselves? Beyond reasonable adjustments, are we flexible enough to embrace diversity in our workforce in ways that support our strengths? Can we make small changes that empower all physiotherapists to work in ways that best suit their abilities, enabling our workforce to operate more authentically and effectively. In services under immense pressure, striking the right balance where inclusivity drives efficiency is key. 

How can we be more inclusive? 

We recognise that patients have varying communication needs and readily adjust to provide the best care. But do we extend this same consideration to our colleagues? In the UK, for instance, making eye contact is considered a basic indicator of engagement. Yet, for some, this can be a challenge. 

One physiotherapist shared: ‘I have always struggled with eye contact. I was told this was how I had to communicate with patients, so I pushed through with this for years and always felt really uncomfortable. 

‘Recently I explored support through 'Access to Work' and now inform patients upfront that I do not always make eye contact but assure them I am listening and engaged’. 

This approach represents a small shift but demonstrates the value of adjusting professional norms to suit individual needs. 

Consider rotations, recognised as essential for building solid foundations as physiotherapists. Rotations expose us to diverse experiences, but for some, the challenge isn’t in the knowledge and skills of the specialty, but in navigating a specific work environment. 

For example, an individual may thrive in a ward setting, but struggle with the structured diary of outpatient clinics. 

When this happens, how can we support the physiotherapist to succeed? Make small changes to reduce environmental barriers, or removing environmental barriers altogether by recognising speciality skills can be developed in other clinical settings...the best option will depend on the individual and the service: after all, of one size doesn’t fit all.

It is time to consider if some of our ‘traditional practices’ supports a diverse workforce. Small, thoughtful changes could enhance productivity, job satisfaction, and patient care. 

While our primary mission is to serve population health, embracing a more individualised approach for physiotherapists could foster an environment where everyone thrives and we are not only patient-centred in our care, but physiotherapist-centred in our workforce delivery.