Why Allied Health’s Biggest Problems Are Actually Healthcare Problems

I got back from the Patients' Choice Awards with two feelings that don't sit together very well. I felt completely out of place, and at the same time I felt like I should absolutely have been there.

The out of place part was simple enough. Physiotherapy was barely in the room, and across the whole night I met one other physio. But the reason I felt I should be there was exactly the same reason, because a room where nobody shares your assumptions is the only place you get a genuinely fresh perspective on your own.

The problems I spend my days on, the ones I coach on and the ones we go around in circles about in our Facebook group, were not problems for anyone there. Not because they don't care, but because they have their own to solve, and most of them have honestly never had a reason to think about why it's so hard to run a small community healthcare clinic sustainably. When I explained it to a few people who were closer to the scene, they looked at me and said, "I never thought about that," and of course they hadn't. Why would they?

That was the moment it caught me. For one night, in a room where healthcare in Australia was properly represented, allied health looked small, and our problems looked small with it. Somehow we have made them enormous, and the size we've given them ends up shaping how we run our businesses. I kept wondering how that was possible.

They are frustrated too, just about very different things

Then I spent time with some GP friends, and with people fairly high up in general practice and medical centres, and I realised they are frustrated too, just about very different things. Short appointment times. A funding model that makes preventative care almost impossible to deliver, even though they believe in it as much as we do, and have for some time.

That's the bit I want you to sit with. It was never about which profession should own preventative healthcare. It's that every profession should be practising it, and the models most of us inherited simply weren't built for it. Theirs wasn't. Ours, if I'm honest, was closer, and that's a privilege we treat as normal. A physio can hold a relationship with someone's movement and function over years rather than the next six months, and the only reason that's possible is that private practice makes it possible.

So the conversation I think we actually need to have is about healthcare model design, right back to basics. How do you build a private practice, whether it's single modality, multidisciplinary or medical, that is sustainable as a business, produces great patient outcomes, and can sustain a team at the same time? That is what I've always believed allied health needed, and it turns out it's what most of private healthcare needs too.

There was a voice in my head on the way home that went something like, Winnie, how naive were you to only ever think about your problems in your industry, and how judgemental to assume it was a model and system problem that belonged to our corner alone.

They're stuck because of tradition, and so are we

Our pricing, our consult lengths, how much we overgive as a profession because that's how it's always been done. It's the same trap in a different room.

What I came home with, apart from the award, was a shorter list of problems and a longer list of things I'd been overthinking. Things that feel normal to us and are not normal to anyone else. Expectations we imposed on ourselves and then blamed on patients. Traditions we kept simply because that's the way things have always been run, so we ran them that way too.

It is good to know we're not the only ones struggling, and it's better to know the struggle is smaller than we've been treating it.

Healthcare was never about one profession or one level of care. It's a team, and that team now needs to be assembled inside a model that is good for patients and sustainable to run. I think we're better placed than most to help design it.

What have you been treating as a physio problem that might just be a healthcare problem?

Winnie

If rebuilding your own model rather than inheriting it is the work in front of you, here is how I work with clinic owners.

Winnie Wu is a physiotherapist, clinic founder and strategist. She runs Movement Laboratory and Papaya Clinic in Sydney, and The Clinic Project, a strategic education platform for women allied health clinic owners.