"Nobody Can Give Me a Goal!"
I'm in the throes of my fieldwork project for my MPH degree now. I'm conducting a health needs assessment for a neighboring town. It is a great learning experience! I'm looking at overall population trends, current health status, emerging populations, access to care and services, disparities in care and outcomes, services already in existence, and trying to find the gaps where services need to be focused.
Is this an area that needs a physio's attention? Absolutely! The ability to function, gain community access, additional care needs and health status are all areas we understand clearly and where we can have a huge impact (well, should have a huge impact) on policy and service provision. I've worked for more than two decades delivering care to individuals. Now I get to help a whole population. That is exciting to me.
Part of my work is interviewing providers to determine who does what, how they get referrals and what barriers they face in ensuring the best outcome for their clients. I was chatting with one provider last week who mentioned another physio service. I knew which practice he was talking about and questioned why that service was a barrier when it should have been an ally?
The physio in charge of the service in question doesn't accept referrals with regard to people with a certain presentation. "Nobody can give me a goal to work toward with them!" is the rationale behind the refusal. Huh? Silly me, I always thought the goals came as a result of a good evaluation. All of the published evidence on this particular presentation also states that the single most important intervention is physiotherapy!
There are still many practitioners who work in a very compartmentalized way. This is obviously one of them. This approach is simply not going to work with the changes the NHS is undergoing. More importantly, it is not an approach with the patients' best interest in mind.