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Physiotherapy | Physical Therapy - examined

From time to time in the Priory Clinic our clients ask us to outline the differences between physical therapy and physiotherapy.  After more than two decades of involvement with physical therapy and working alongside both professions, here are some of the differences we see.

An important point to mention at the outset is that roles that are filled in Ireland by physical therapists are filled elsewhere by physiotherapists.  So the way the professions have been organised differs from one state to the next.

Firstly there are the educational differences: traditionally physiotherapists were graduated from the mainstream universities and physical therapists were not.  That though has changed in the last number of years and it is now felt that academically the two qualifications are on a par. 

Secondly there is a difference in approach.  Physical therapy education focuses primarily on hands-on treatment, whereas electrical modalities have long been mainstay of physiotherapy.  That need not necessarily always be the case as some physiotherapists may eschew the traditional values and prefer to develop hands-on skills to more closely resemble a physical therapist.  Equally, there is nothing to prevent a physical therapist from using interferential, electrical, ultrasound or laser treatment to replace hands-on treatment.  So the differences are also greying in that area.

Thirdly, there is a different emphasis in approach; physical therapists are trained to make every consultation and treatment patient-centred.  This manifests itself in a few ways; a longer visit with more time spent on history-taking, more emphasis in discussing the injury or problem with a patient, more emphasis on looking at a bigger or ‘holistic’ picture.  Physical therapists also emphasise the importance of engaging the patient fully in the treatment plan and to do this they must first try to explain their diagnosis and agree a solution or treatment plan.  Of course nothing prevents a physiotherapist from embracing these values (if they did not already) and we always hope that physical therapists don’t let them slide.  But much about the hospital setting and waiting lists pressurises physiotherapists to conclude treatments without being allowed utilise a truly patient-centred approach.

From a health insurance perspective plans vary but these days it seems most main companies cover both treatments to the same extent.  Both physiotherapy and physical therapy also seem to qualify for tax relief as medical expenses.

There was talk in the last few years of regulating the practise of physiotherapy by law and much seemed to have been done.  This might have accentuated differences between the professions.  However, budgetary changes have cast doubt as to whether this can happen as planned.  Soundings from the EU and IMF as part of the financial bailout suggest they would prefer encourage competition suggesting a minimum of state interference through regulation.

Traditionally, GP’s would be more familiar with physiotherapists and may not be aware of, or even understand the distinction between both approaches.  However, it is fair to say that where both are qualified to same level, albeit in working with different styles, GP’s are comfortable supporting the decision of the patient as to which is best for them.

Then there is the fact that physiotherapists seem to be trained primarily for hospital-work and physical therapists for private practise.  This is important in practical terms because the range of problems seen in each environment is quite different.  Stroke victims for example are a significant part of a hospital client list but rarely appear in private practise.  The same can be said of those recovering from surgeries or respiratory disorders.  So the range of common problems within a hospital and outside are quite different.  People with back pain, which tends to be episodic and recurring rarely find the prospect of an emergency ward appealing and most first seek treatment outside.  So back problems and sports injuries will be a much higher percentage of the problems treated in private practise than they will within a hospital.  It stands to reason then that in developing a physical therapy course the emphasis is on making it fit-for-purpose and giving students the skills to treat the conditions they are likely to see.  Though physiotherapists will of course develop many skills and techniques in the effective treatment of back pain within an out-patient department. 

So you may well have the experience where having attended both professions you find little difference between them.  However, it is also probably fair to say that if a prospective student reflects on the relative merits of various courses and approaches, they are likely to undertake the course that mostly embraces the values they want to bring to practise.  Starting out, if you really want to be hands-on and want to work in private practise and have a recognised award, the physical therapy course would seem to make most sense.  Whereas if you are attracted by working in a hospital and treating the types of conditions common to hospitals, then physiotherapy would seem to be the option. Once qualified, there is nothing to prevent therapists from developing their skills; indeed most have a lifelong commitment to this kind of continuing professional development.

We have no doubt that members of public should feel perfectly safe with either approach.  Our experience is that other professions also make a major contribution and that an individual with say, a back problem could benefit greatly from osteopathy or sports rehabilitation.  It seems no one approach is a cure-all, no profession provides all the answers and that any one of a number of approaches could potentially solve the problem.  In this case, both physiotherapy and physical therapy are trained to be primary care specialists having the ability to diagnose when their approach is suited to the problem and equally both are taught to refer patients elsewhere as appropriate. 

It is uplifting to witness the mutual respect between the professions.  It is also true that they compete with each other and that such competition can cause friction but the hope is that the patient and public are the winner and the health status of the community is enhanced through the provision of choice in the care of soft-tissue injuries.

To discover if Physical Therapy is right for you, talk to one of our therapists now about your symptoms / pain /discomfort.  We’ll help you decide which therapy will be most effective to get you back to optimum physical condition as soon as possible. Use our free phone number 1800 254 642 now!  or send us an enquiry and we’ll call you back at a more convenient time.

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The Priory Clinic | 17-18 Priory Hall | Stillorgan | Co. Dublin | Ireland | Tel: 1800 254 642 | Fax: 01 283 5756 | Email: .(JavaScript must be enabled to view this email address)