They once dealt mostly with simpler problems like neck or back aches and a few orthopaedic, neurological and paediatric cases. Today, physiotherapists increasingly render their healing touch to nearly all branches of medicine, from plastic and general surgery to gynaecology, and even sports medicine.
Physiotherapy or physical therapy helps patients regain or maximise physical movement and functions through exercises and/or therapies using agents such as heat, wax and electricity.
Physiotherapists are an integral part of patient care, including in the ICU. “The scope of (a physiotherapist’s) work has increased,” says Dr Dharmendra Kumar, director, Pandit Deendayal Upadhyaya Institute for the Physically Handicapped, New Delhi. “Now people come with complex problems. They have started reporting to physiotherapists as soon as a crisis occurs.” Rajeev Mehta, head, department of physiotherapy and rehabilitation, Apollo Hospital, Delhi, agrees, “Physiotherapy complements every branch of medicine.”
Different departments in bigger hospitals such as the All India Institute of Medical Sciences (AIIMS) and Safdarjung have physiotherapy units attached. “The positive thing is that this has started happening,” says Dr Kumar. Physiotherapists are part of the deliberations when doctors discuss patients’ cases during afternoon clinics in hospitals, he adds.
“When we were students, we hardly had any exposure to cardiac patients,” says CK Dhawan, chief physiotherapist at AIIMS.
“Today, all post-operative cardiac patients get physiotherapy, which shortens their hospital stay. Earlier, we treated small children, not infants. Now, our work covers almost all disciplines… Physiotherapy is preventive, corrective as well as palliative.”
A lot of students now go for specialisations such as in cardio-thoracic, neurological, musculo-skeletal and paediatric conditions and sports physiotherapy at the postgraduate level.
“The career prospects are very bright in India because nowadays more and more people are becoming aware of physiotherapy,” says Dr Kumar. “We need good physiotherapists, especially in rural areas, where not many choose to go,” says Mehta.
There are wider job avenues today for qualified physiotherapists in hospitals, hospices, nursing homes, rehabilitation centres, private clinics, special schools, fitness centres, and non-government organisations working with the disabled and senior citizens.
However, as in many other fields, the proliferation of ill-equipped private colleges has led to a glut of inadequately trained physiotherapists. “People from sub-standard colleges then have to work at rock-bottom salaries,” says Mehta.
While there is no national regulator yet for the profession of physiotherapy, Delhi and Maharashtra have separate councils that require physiotherapists, as also occupational therapists, to register.
Mehta, however, asks aspirants to do their homework before enrolling for training. “Students must check the standing of the college and faculty — how’s the infrastructure, does it have proper labs, is it attached to a hospital?” Only if an institute ticks the right boxes, can it make you a good physiotherapist.
What’s it about?
Physiotherapy or physical therapy is an allied health science concerned with helping patients regain or maximise physical movement and functions through exercises and/or therapies, using agents such as heat, wax and electricity. “You are rehabilitating a person, not curing. This means getting the maximum out of whatever potential is left in the individual,” says Rajeev Mehta, head, department of physiotherapy and rehabilitation, Apollo Hospital, Delhi
The average day of a physiotherapist in a large tertiary-care hospital:
9 am: Start work in the OPD. Spend 30-40 minutes with a hemiplegia patient (one half of whose body is paralysed), teaching him to sit and make him do exercises. Teach exercises to the parents of a cerebral palsy patient so that the child can do them at home. Make a young patient, suffering from stiffness of the back (due to a spinal ailment), do exercises for mobility
1 pm: Lunch
2 pm: Clinic for outdoor patients, e.g. paraplegics. Give electrotherapy to a post
3.30 pm: Attend to patients in the wards and keep records
4.30 pm: Call it a day
In a central government hospital, the gross salary of an entry-level physiotherapist is Rs 25,000 a month (Pay band 2). The maximum gross salary is Rs 75,000 a month for someone with a chief physiotherapist’s rank, but this depends on experience. The entry-level pay in the private sector is about Rs 10,000 to Rs 15,000 a month
. Good communication skills
. Patience, especially when fielding queries from patients and relatives
. Physical stamina
How do i get there?
Take science at the Plus Two level. After this, go for a Bachelor’s in physiotherapy/ physical therapy. Depending upon your interest and career goals, you may specialise at the postgraduate level
Institutes & urls
. Pandit Deendayal Upadhyaya Institute for the Physically Handicapped, New Delhi
. Postgraduate Institute of Medical Education and Research, Chandigarh
. KEM Hospital and Seth GS Medical College, Mumbai
Pros & Cons
. You can make a paralysed person regain use of their limbs, which is like a small
. The work hours are flexible
. Low pay, at least initially
. On certain days, the effort spent on a patient can leave you exhausted
Physiotherapists are in demand everywhere
A senior practitioner on their expanding role in hospitals and elsewhere
In what areas do physiotherapists work today?
When I studied physiotherapy, it used to be a diploma course after BSc. Physiotherapy was then used in just a few disciplines — orthopaedics, neurology and some conditions of paediatrics, involving small children. Now, it caters to everyone — from little babies to the elderly, and even healthy people.
Physiotherapists give preventive treatment for scoliosis — abnormal curvature of spine in kids, for example. They work in fitness centres. Sports people, too, need physiotherapy. Now every sports team has a physiotherapist.
In a large hospital, there is a central rehabilitation unit and physiotherapists are attached with different departments like in orthopaedic, cardiology, cancer ward, general surgery ward etc.
There are physiotherapists in charitable dispensaries run by gurudwaras and temples as well.
What traits make a good physiotherapist?
You should have compassion and kindness. Do not come in to make money.
Which specialisations have the maximum demand for physiotherapists?
MPT in musculo-skeletal, neurological, cardio-thoracic and paediatric conditions and MPT in sports physiotherapy.
Can you elaborate on the difference in the work that physiotherapists and MDs in physical medicine and rehabilitation (those with an MBBS background) do?
They are physiatrists who examine, diagnose patients and also prescribe medicine. And if the patient needs physiotherapy, the physiatrist might refer him or her to a physiotherapist. The physiatrist can also instruct the physiotherapist to do whatever exercises or therapies the patient requires.
What are the high and low points of the work?
Physiotherapists are not paid so well and are not considered at par with doctors, though we also treat patients. On the upside, the work hours are good. There are shifts.
CK Dhawan, chief physiotherapist, AIIMS Interviewed by Rahat Bano