Working as a physiotherapist: 5 Pros and 5 Cons
5 Pros
1. Collaborative multi-disciplinary professional environment
Physiotherapists (‘physios’) enjoy working in multidisciplinary teams (with doctors, nurses, OTs, other AHPs etc), promoting shared knowledge and expertise.
2. Wide range of clinical responsibilities
Physios have a wide range of healthcare tasks, from taking medical histories, examining patients to performing procedures and giving treatment.
In hospital, they focus on the rehabilitation of the patients, attending (or leading) MDT meetings, and informing other NHS staff when the patient is ‘physically fit for discharge’. This is more than being ‘medically fit for discharge’.
3. Crucial role in patient care
Physios have a significant impact on patient outcomes by diagnosing and treating a wide range of conditions, teaching health promotion, prevention and providing valuable education. In hospitals, they see the patient every day if they can.
Also, senior doctors, nurses and other AHPs (especially OT), have a lot of confidence in them.
4. Growing demand in the NHS, with diverse working environments
Physios benefit from a rapidly expanding career with increasing popularity, creating more job opportunities. They can work in diverse environments in the NHS: GP, hospital, mental health, community – gaining exposure to almost all medical and surgical disciplines.
5. Good working conditions
- Reasonable pay. Most physios begin their careers with a reasonable NHS Band 5 salary, ranging from £28,407 to £34,581 per year. Some start at Band 6.The training is relatively short (3 years at university) so it doesn’t take too long to get to a decent salary.
- Enjoy a good work/life balance. Physios usually work regular hours – mainly Mon-Fri 9am-5pm (no nights). Some work weekends (those specialising in neurology/surgery, cardiology/CT surgery, MSK). This promotes overall wellbeing, and a good work/life balance
- Career flexibility. Physios benefit from the other good NHS working conditions, e.g. maternity leave, part-time working, good pension etc
- Able to work outside the UK. Physios are able to work in other countries, unlike some other health professionals
- Able to work in private practice. This can be very lucrative.
5 Cons
1. Supervision and limited autonomy
While physios work closely with doctors in hospitals, they work under the supervision of a senior doctor. This can mean less autonomy in decision-making and patient management compared to doctors. However, as hospital physios often make the final discharge decision (with OTs), they have areas of autonomy where they do feel they are leading.
2. Lack of career structure, with appropriate pay rises
Even though at the start of their careers, physios pay is reasonable, the career structure after that is relatively flat, without good pay rises linked to promotion etc. They can usually achieve Band 6 within a year of qualifying. After that most stay on Band 7. Band 8 at the top of the pay scale is often for roles in management with little patient contact.
3. Lack of educational development
Because of the flat career structure, they are less able to specialise, by getting extra training. So even though they are encouraged to do CPD, and go to conferences etc, this doesn’t always lead to career development.
4. Image in the eyes of the public (and within hospital)
The public may see them as important health professionals, but with limited areas of knowledge (e.g. for physical problems such as sport injuries). Their range of skills, and detailed knowledge of anatomy, is not always appreciated.
Also, within a hospital, physiotherapists (and all AHPs) are rarely represented on hospital boards. They normally report to the hospital’s senior nurse. This limits their power to ‘change big things’ or ‘change the system’.
5. Physically and emotionally demanding work
The work can be both physically and emotionally demanding. And, when this is combined with the frustration of not being able to carry out the requested task (‘please get this frail elderly lady home today’), because of factors beyond their control (‘no nursing home bed, no carers available in community’ etc), burnout is an issue.
Older physios will tend to move away from front-line hospital work as lifting heavy patients, becomes too much for them.
Reviewed by Xavier Leggo, Student Physiotherapist
