UBC Reports | Vol. 54 | No. 1 | Jan. 3, 2008

The False Hope of the Next Big Thing

The values inherent in the field of physical therapy remind us that there is no substitute to the basic work of maintaining a good lifestyle.

By Elizabeth Dean
Professor, Department of Physical Therapy

Physical therapy is the quintessential non-invasive health care profession. Its values are consistent with the profound tenets of Hippocrates that include ‘First do no harm’ and ‘The function of protecting and developing health must rank even above that of restoring it when it is impaired.’ A holistic health approach is consistent with contemporary definitions of physical therapy and its 100-year tradition of health education and prescription of physical activity and exercise.

Lifestyle conditions are leading causes of chronic illness and disability in high-income countries and increasingly in middle- and low-income countries. These conditions include ischemic heart disease, smoking-related conditions, high pressure and stroke, and diabetes and obesity. The next ‘big thing’ in the profession of physical therapy is aligning contemporary practice more closely with its underlying values to impact the social and economic burdens of these conditions, in addition to their impact on individuals and their families.

In addition to being members of the fifth largest health care profession, physical therapists are uniquely suited to impact these lethal conditions because, compared with other health care professionals, they spend prolonged periods of time with their clients/patients -- this pattern of care enables effective teaching and follow-up to be implemented. The translation of existing evidence-based knowledge into practice is paramount in the 21st century.

Effective lifestyle behavior change is a multi-dimensional challenge that may explain its relative failure compared with adherence to invasive care recommendations related to drugs and surgery. Effective teaching and effecting lifestyle behavior change must be the priority in physical therapy. Consistent with the recommendations of the Romanow Report and the Kirby Report on health care in Canada, physical therapy needs to be as important a response to 21st century health care priorities as it was to the needs of survivors of the world wars and the polio epidemic. Putting into practice the 2,500 year-old ethical and cost-effective tenets of Hippocrates will be a giant step forward in addressing the health priorities of our time.