Reform Physio Reform Physio

If not us, then who? If not now, then when?

Martin Ong’wen, Orthopaedic Manual Therapist and Movement Dysfunction Specialist, from Kenya, reflects on his impact at the #TheBigRs conference last year, the trip that followed and his latest thoughts!

Do not tire from doing the great things that you do.
There is a young soul out there who is listening.

I’m from the Luo tribe in Kenya and I love the physiotherapy profession. Back home we do have areas in the rural communities where we don’t even have treatment beds or X-ray, MRI and ultrasound machines. The profession in my country is quite young, which is a good and a bad thing all at the same time, allowing us to learn from the mistakes of others. The profession started as a diploma course a few decades ago and now we have just 2500 physios in Kenya and a newly formed governing body. However, we lack leadership – we don’t really have a body that is leading improvement in the profession and helping to build it.

So four years ago myself and a group of friends started investing our time into continuous education. I looked online for research and education but it was difficult to find as I travel a lot in order to educate and learn.

The Physio Matters podcast was that extra classroom for me. I had always been excited to learn when the next new episode was coming out so I could update my knowledge and evidence base. It was from there, that I was invited to speak at #TheBigRs conference in Oct 2018, one of the most humbling moments of my career.I thought you’re kidding me, but then I thought yes, let’s do it (as long as I receive my Visa in time).

The event was tremendous. Being in a room full of physiotherapists from different parts of the UK was the motivation I needed. Not because they were in large numbers. (Numbers don’t lie by the way, coming from a country where leaders are voted on based on numbers! Remember those can be manipulated a well) But because everyone in that room cared about all the other people that were not in that room that day. They cared about patients to begin with. They cared about other physios that cared about other medical professionals.

Everyone was so engaged in the necessary steps that could or will help steer the profession forwards. A lot was discussed. From how best to deliver an evidence-based approach, how the education system needs to make the shift towards the current evidence-based medicine that matters to the patient. We brainstormed how to involve policy makers and decision makers a well.

The contributions came from clinicians, educators and agitators in the profession that I look up to in high regard. I felt really small in the room but I got good encouragement from people as I had a chance to talk about my story.

I believed that what I was talking about, wouldn’t add much value to what they already knew. But then I realised there is always something to add. And if I don’t speak on how I feel, the world would lose out. The welcome I received was amazing both in person and on twitter. It was really humbling and encouraging.

After attending the #TheBigRs conference in October I then had a tour which included a visit to Connect Health’s clinics. What was humbling was the clinic in Nottingham where I attended a patient session which was driven by patients living with chronic pain and it made me think what it felt like to be in their situation. It was a really moving experience. It is very rare you see this type of session happening in Kenya. We don’t readily have access to clinical psychologists with a speciality in pain science. Having their perspective and experience in pain was amazing.

Client driven experience rather than medical model

Then in Nottingham I sat in on a consultation. The relationships between the patient and therapist was an amazing experience in the sense that the patient was in the driving seat. Having the patient in charge of the session rather than the provider, and then having someone who is clinically experienced to guide them through what recovery will look like was amazing for me to see.

A different type of employer who is more interested in the patient, than money making

I then attended a think tank event with Connect Health, whereby a group of therapists from different areas and clinics from different levels came together. We sat down and discussed ideas of how best to promote the service. What was so amazing for me was as an employer, Connect was asking and challenging everyone to be the best that they can be. That aspect of having a different type of employer who is interested in the patient as opposed to money making was so intriguing.  If someone was looking for an employer that is willing to let them grow and give them lots of opportunities, I think the best provider would be Connect Health.

I will continue to provide leadership for my profession in Kenya

Coming home I thought what is the way forward? Maybe we can look for different leaders.

I have written down a list of all the things that I can do back home to make small wins in terms of promoting and improving the profession. I am gathering a group of likeminded physios and talking with them about my experience – to encourage them there is a lot we can do to grow.

I can now give examples of 100 years of physio in the UK. The mistakes we can avoid, learning through experience and start working on the most efficient ways of improving the profession.

Another thing I have been doing is getting into rooms where decisions are being made. In my country, I’ve been going around almost single handed and it has been very challenging. I have considered giving up, but now I’m even more determined to knock on the leaders doors and start asking questions. They are discussing clinical guidelines, so I want to say, this is what I have to offer and this is what physio guidelines should look like.

I have lower back pain with sciatica. How do you know? I googled it.

Physiotherapy is a really hands on and engaging profession. The interactions we have with patients can be as simple as delivering simple coping strategies to sometimes wearing a psychologist’s hat.

We have lots of patients with misconceptions of what back pain looks like. Most doctors in Kenya don’t really explain what’s going on to the patients. So they are just given drugs and the patients never question anything. There are those that google it and then they have more wrong information and end up in your clinic. It becomes part of a very challenging environment in terms of how to educate them. Doctors are considered superior beings. It becomes a challenge to demystify them about their conditions.

In summing up, we have information that is beneficial for the world. Going to the UK and presenting gives me the motivation to keep doing what I’m doing. PTs around the world can come together regardless of their speciality, and if we bring our heads together and sit down in a room, we’ll have more meaningful ways of improving the profession rather than fighting one another.

My message to the physios out there and #TheBigRs crew – do not tire from doing the great things that you do. There is a young soul out there who is listening. If you don’t talk about what you know, how does the world learn about it?

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