Reflecting on Rehab: A Timely but Incomplete Guide

By Tom Flanagan

I love rehab. Whether it’s helping a person return to something high level, or helping someone be able to manage a few steps in their garden, being in a position to help someone regain their physical ability is incredibly fortunate.

It's weird for me to follow that statement up with a concern but…I think there’s a battle to have clinicians give equal priority to developing their rehabilitation skills alongside their diagnostic skills. Further to that, it seems the problem grows the further clinicians go into their careers. 

It’s easy to see why clinicians focus on diagnostic skills - you're unlikely to get a Datix for a weak rehab plan. But in rehab, that lack of accountability is a problem. We should be as accountable for effective rehabilitation as we are for accurate diagnosis.

Accountability isn’t the only thing missing - opportunities are too. The FCP roadmap was one of few frameworks physios have had to guide their development - and rehab wasn’t part of that conversation. Though understandable, the fact a ‘rehabilitation roadmap’ hasn’t been mentioned may be symptomatic of a profession that deprioritises rehab.

Of course there are ACP courses, but when completing my own ACP Masters, there was little mention of rehabilitation - apart from when someone put two pence in me and I started whinging.

I believe change is coming and AI is driving it. Its potential to support accurate diagnosis is huge, and I think it’ll change healthcare rapidly.

Maybe this is the shift I’ve been pining for: clinicians getting the time and space to really focus on their rehab skills. But even if the need for diagnostic expertise reduces, we still lack support to develop as strong rehab therapists.

So how do we get better at rehab? Before I try to answer that, here’s where I stand: I’m probably all right at it. Sometimes I get it right, sometimes I don’t. But I’ve made a point of surrounding myself with people who are really good at it. So what I share here comes from someone who’s above average, with great mentors.

I’m not going to pretend I have all the answers. Instead, I’ll share some of the reflection prompts my mentors have given me - the ones that continue to guide my growth. I’ll also add why I think they matter.

But before I dive in, I want to touch again on accountability. Rehab skills are hard to measure, and feedback is often missing, which makes it tough for leaders to promote accountability. For now, it’s mostly on the individual. Hopefully these prompts help with that.