Some people go through life feeling they have never quite found their niche, while others know early and instinctively exactly what they are destined to do. "When I was at secondary school, I had the chance to learn about physiotherapy through a career talk arranged by the school," recalls Eleanor Chan, who has been department manager (physiotherapy) of the United Christian Hospital since 1993. "I had always wanted to help others and was very impressed by the kind of work, so after that it was an easy decision to become a physiotherapist."
Ms Chan's first career step was to complete a professional qualification at the Hong Kong Government Physiotherapy School, which has now become part of the Department of Rehabilitation Science in the Hong Kong Polytechnic University. The course provided all-round knowledge of the subject, as well as clinical practice and bedside teaching. "That was very important because we were trained for the profession in both the theoretical and practical aspects," she says.
Ms Chan points out that working as a physiotherapist allows more patient contact, and she sees this as one of the great benefits. "I love interacting with people and this job allows me to rehabilitate patients with results which can be very rewarding," she explains.
Broadly speaking, physiotherapy is concerned with the assessment, diagnosis and treatment of disease and functional disability through physical means. It entails working on the muscles and joints to cure various physical problems caused by improper posture and movement, trauma, or complications resulting from medical conditions. The profession also involves offering a wide range of services for people suffering from acute or chronic illnesses which require intensive and extensive rehabilitation. "In addition, physiotherapists attend patients in clinical specialties such as the accident and emergency department, the intensive care unit (ICU) or the spinal unit in a hospital, as well as in rehabilitation centres or elderly homes in the community," Ms Chan explains.
She says that most patients start off by describing aches and pains they have, but emphasises that any assessment of these must be objective and involves a careful examination of signs and symptoms for each case. "Feeling pain is a warning, so we need to note down every detail. For example, we investigate whether the patient feels more pain at morning or night, at work or resting. All these little details contribute to the physiotherapy diagnosis."
In a typical case, the physiotherapist first conducts an interview covering the patient's medical history, and then proceeds to an objective physical examination. This makes use of certain quantifiable measurements to complete the diagnosis and to monitor later progress. Based on the various findings, a treatment plan is then worked out from the available options and is implemented.
"In Hong Kong, for example, integrating acupuncture in physiotherapy has proven to be effective," Ms Chan says. "We are privileged to have this kind of east meets west approach and have the training to work out the best combination of treatments." When necessary, patients are also instructed in correct practices, preventive care, appropriate exercises, and steps towards self-management in handling their problems.
After working initially at the David Trench Rehabilitation Centre, Ms Chan subsequently moved to Canada to take a degree conversion course in rehabilitation medicine at the University of British Columbia. In 1987 she was sent to Australia for further training related to the subsequent setting up of the physical rehabilitation unit at the Prince of Wales Hospital. Two years later, she was promoted to senior physiotherapist providing clinical teaching for students.
"After more than ten years of practical work, I enjoyed having the chance to train others. Together with my academic studies, this has given me a comprehensive understanding of the profession," she says. In 1993, she completed the core programme run by the Hospital Authority for senior managers and joined the United Christian Hospital the same year. Working at management level, Ms Chan wants to contribute as much as possible. "In the past, I helped patients to recover, but the scope was limited as I could only deal with one person at a time. Then I taught students who would be able to treat more patients after qualifying. Now, being a department manager, I can take part in implementing policies which will be able to help even more people."
Looking ahead, she believes that certain reforms will be needed for the profession to move forward. "For example, the implementation of direct access to physiotherapy services will benefit the public in terms of convenience and cost effectiveness," she says. "This is the international trend within the profession and, in line with the health care reforms in Hong Kong, will be a beneficial move for all parties concerned."
- One attraction of the profession is the chance to treat
people from all walks of life
- Physiotherapists provide a wide range of patient services
in different clinical and community settings
- Treatment begins with an objective assessment of the causes
of a patient's problems
- Every diagnosis requires quantifiable measures also used
to monitor progress