New: Reflection
There's a phrase that I've come to use over and over again in recent years whenever I've presented at conferences or talked to people about the research I do, and I use it because it beautifully encapsulates what I think is perhaps the main problem now facing the physiotherapy profession.
It comes from a book written by a New Zealand doctor who is part European and part Māori. His name is Glenn Colquhoun, and he's written some fantastic books about health care, using poetry and prose to express his ideas (see this link to his work).
In one slim volume titled 'Jumping Ship,' Colquhoun describes his experience coming to terms with his Māori heritage. He spent a few years in the far north of New Zealand with his elderly Māori aunt, learning the language and customs, and finding out about his heritage, and part of his journey of discovery involved some wonderful meditations on the tensions that alway seem to exist between indigenous peoples and their colonial brothers and sisters.
The phrase that Colquohoun used in the book that so captivated me was this:
‘The most difficult thing about majorities is not that they cannot see minorities but that they cannot see themselves.’
The reason this has stuck with me for so long is that it speaks to me directly about the past, present and future of physiotherapy.
Despite all the rhetoric about our profession being a Cinderella profession, or that we're struggling for public recognition and government funding, we are, unquestionably, part of a significant, powerful orthodox health care machine. We embody a biomedical practice philosophy that is both exclusive and hegemonic, and we are one of the largest, most respected, and highest subscribed professional programmes in the developed world.
So I have no qualms in arguing that physiotherapy is majoritarian. Partly as a result of this, and partly because our practice philosophy is so exclusive, we really struggle to see ourselves.
Physiotherapists think that the public doesn't understand what we do. I believe that the public understands us perfectly well actually, and part of the reason why they are increasingly turning to other therapists and rehabilitation specialists is because they have worked out what we do, and are increasingly calling for something more. No, our problem is not that the public doesn't understand us, it's that we don't understand ourselves.
Reflective practice, like critical thinking, is considered by many within the profession to begin and end with the individual practitioner: "Use a reflective 'model' and do your reflective summaries and you'll be alright." But the Critical Physiotherapy Network is a champion for a much bigger idea of critical reflection. This is a critical reflection that encourages us to identify our professional culture; it's history, its practices, its beliefs and values; and to question whether those that worked so well for us in the past will continue to work well for us in the future.
There is no doubt in my mind that seeing ourselves more clearly, may be one of the most powerful transformative changes to take place within the profession over the next half century. I only hope we have the courage and wherewithal to let go of our majoritarian instincts and learn some professional humility and introspection.
Reference
Colquohoun, G. (2004). Jumping Ship. Auckland: Four Winds Press.