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This post is a guide only and should not be taken as medical advice. It does not replace assessment and recommendations from a registered and regulated healthcare professional.
Contents
🔹 Prologue - Cleaning the House, Selling the House, and Staying in It (🔗link)
🔹 Chapter I – Quality Control | “Are You Still Good?”Why competency checks matter, and how other professions do them better. (🔗link)
🔹 Chapter II – Credentialing | “The Title that Doesn’t Entitle”How we can make APA Titling meaningful and externally recognised. (🔗link)
🔹Chapter III – Branding | “What’s the Flavour?”Fixing the physio lucky-dip: labelling our services so patients know what they’re getting. (🔗link)
You are here👇
🔹 Chapter IV – Public Recognition | “The Public and the Public Purse”Why the public still doesn’t get us, and what happens when they do. (🔗link)
🔹 Chapter V – Retention | “Keep the Good Ones”How recognition, pay, and purpose drive the longevity of experienced clinicians. (🔗link)
🔹 Epilogue - Diplomacy Failed. This Is My Fart in the Wind. (🔗link)
We keep saying, “Physios are under-recognised.” But the real question is: by who?
Because patients don’t actually care about our title. Not really.
They care about:
How quickly we can help them.
How well we explain what’s going on.
Whether we appear like someone who knows what they’re doing.
And right now, the answer to that last one isn’t always obvious.
We could be magicians… or massage therapists… or maybe just a wizard with a wobble board.
We are experts in the assessment, diagnosis and management of musculoskeletal pain and dysfunction.
We are trained to spot serious medical pathology masquerading as musculoskeletal pain. We are skilled in recognising rheumatology conditions, even when they’ve been missed by others. We go to operating theatres with our surgeons. We sit down with GPs. We write referrals that radiologists actually appreciate. We create plans, track progress, and discharge when we’re done.
We are the experts in ACLs, rotator cuff tendinopathy, patellofemoral pain, persistent pain management, falls prevention, prehab, post-op care, and more.
We could — and should — be taking pressure off GPs, reducing unnecessary imaging and surgery, and saving the taxpayer hundreds of millions a year.
Instead, our entire profession has been reduced to a verb.
“Try physio.” “Get some physio.”
As if we’re Paracetemol. As if we’re a Shrug with a Medicare item number.
“You’ll find some Physio in Aisle 3 next to the Hail Marys, and the Placebo Pills”
Oh c’mon! Just give us the Medicare Rebates already
Diagnostic imaging is a classic example of where Physios can help — really help.
Let’s be clear: this isn’t about being “better than GPs.” Our General Practitioners are drowning. Overloaded. Swamped with admin, squeezed for time, and managing an impossible number of fronts at once. As the RACGP and AMA have been shouting from the rooftops:
We don’t use nocebic language. We treat the patient, not the scan.
We know that imaging often doesn’t change management, we tell the patients that - they understand it, because by that point in the clinical conversation the know they can manage their condition.
More importantly, when we do send off for diagnostic imaging, we take the time to explain what the report actually means — in context, with a plan.
And that saves the system money and patient stress.
Ask Any MSK Radiologist
If you want to know how good we are at imaging, don’t take our word for it. Ask any experienced MSK Radiologist the difference between these two referrals:
🩻 “Knee pain”
vs.
🩻 “3/12 history of anterior knee pain, exacerbated by hiking and a sudden big step-down. Now anteromedial pain post-basketball. Full ROM, unable to squat. Suspecting PFJ joint surface injury.”
It’s night and day.
The second one doesn’t just sound more competent — it helps the Radiologist do their job better. It guides the scan, informs the report, and gives the patient the best chance of an accurate diagnosis.
That’s the level we bring.
And that’s the level we could bring more often, if we were empowered to do it.
The Australian Government Only Understands One Thing: Submarines
If you’re wondering why this blog is about to compare cost savings to nuclear submarines…
Here’s the quick — and very Aussie — context:
After blowing $835 million stabbing France in the back, the Australian Government just gave the USA a literal cheque for $500 million as a deposit for up to eight (yes, 8) AUKUS nuclear submarines, which will cost Australian taxpayers $368 billion (yes, $368,000 million) over 30 years.
“Mon dieu! First you cancel our submarines, now you write le chèque to Uncle Sam? This is not très diplomatique!”
Critics called it the biggest transfer of wealth in Australian history — and it’s still unclear if we’ll even get the subs.
The build timeline? Decades. By the time they arrive, underwater vessels may not even be manned.
So now, every time someone floats a new funding idea — whether it’s healthcare, housing, or climate action — the Australian public is righteously asking:
“Yeah, but how many submarines is that worth?”
Just enough for a 4-$ub Soft-Serve Cone at Maccas
So fine. Let’s give it to them the way they want it.
$300 million/year: GP time and consults saved on MSK (15% of GP workload).
$100 million/year: Better-directed imaging (less ultrasound for MRI pathology).
$150 million/year: Avoided surgeries via high-quality MSK management.
Conservative Running Total:
~$1.9 billion/year
(And that’s lowballing every line item.)
The Submarine Comparison
Australia is spending $368 billion over 30 years for up to 8 nuclear submarines via AUKUS.
That’s $12.3 billion per sub.
At $1.9 billion/year in potential savings from full-scope Msk Physio care…
We could “pay off” a nuclear sub every 6.5 years — without spending a cent more.
Eight submarines? Fully paid off in ~52 years. (Which is actually faster than the government’s projected build timeline.)
And that’s not theoretical money — that’s money we’re already spending, bleeding through a thousand paper cuts of low-value care, unnecessary surgery, underfunded prevention, and repeat imaging with no outcome change.
Diplomacy’s Done. This Is My Insurgency
The APA has played it smart. They’ve run the numbers. They’ve tried diplomacy. They’ve played a straight bat. (apologies to non-cricket-ing readers)
But sometimes, diplomacy isn’t enough.
The APA can play the diplomacy game. But not me.
I did my time in Afghanistan. One thing I learned? In the long game, in harsh environments, insurgency can beat diplomacy.
Gratuitous Veteran photo: Yours Truly on a Afghan hilltop in 2007, surrounded by insurgents. Spoiler alert: they won.
This Blog Series, it’ll probably be a fart in the wind - but so be it.
This manifesto — this is my one-man insurgency. For the patients who deserve better. For the clinicians delivering more, but getting less. For the system that keeps reaching for the wrong lever. For the profession I’ve bled for, studied for, and fought to raise the standard of, but not with bullets. With data, lived experience, and a clinical standard the public should be able to expect — and funders should be proud to back.
Coming next: Chapter 5 – Retention | “Keep the Good Ones”How recognition, pay, and purpose drive the longevity of experienced clinicians. (🔗link)
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