Being a physiotherapist in a rapid changing context - Editorial

Sweden as many other countries has future challenges within health care. Elderly people are increasingly a larger proportion of the population, there are increasing numbers of people with NCDs (non-communicable diseases) and chronic diseases. Children, teenagers, and young adults live sedentary lives which might result in overweight, depression and diabetes at young ages. WHO calculates that over 70% of NCDs can be prevented [1].

In Sweden the social insurance system is generous and guarantees health care for everyone for free or at a low cost. The coming years the tax income for regions and municipalities will not be sufficient for providing the health services required. Thus, we can´t afford to let people fall ill in NCDs and other diseases, when we know it can be prevented. If we continue as we do now, i.e. not focussing on health promotion and NCD prevention, it will mean high costs for the society, it will affect the persons’ lives and living conditions and it is not evidence based practise. We have known the importance of physical activity as NCD’s prevention and treatment for years, but the health care systems still struggle to change focus from treating conditions to preventing and supporting persons to stay healthy. Quite often imbursement systems complicate or even make it impossible to change towards a more health promotive and preventive approach.

Physiotherapists are essential in the national and worldwide strive for universal health. And for that to happen physiotherapists need to put ourselves in a broader context, work together with other health professionals and act on societal level.

The Swedish Association of Physiotherapists, where I work as the CEO, adopted the vision in 2016, ‘Everyone should be able to live healthy life in movement’. It originates from one of 17 the sustainable development goals which the UN agreed on in 2015 [2]. All governments worldwide have committed to work towards to reach the goals 2030. For us as a professional body and union it has been our aim to be a part in future solutions, to be a partner on societal level and through that be the advocacy voice for the profession and our members. Together with the vision we added three key values, to point out how we would like to be recognised.

• In movement We are an association in constant movement and development

• Trustworthy We ensure our influence by always being trustworthy

• Together We build our success through intern and extern collaboration

Now four years later we think that the vision has served us well. Later this year the general meeting of the association will be held. The executive committee will base the intentions for the association for the four coming years on an even broader perspective with the 17 sustainable development goals as a solid surface. On top of that surface we can build our role on tremendous physiotherapy research and professional knowledge alongside with improvement knowledge and continuous improvement in the systems and contexts where we work every day. The context where we act is changing rapidly and we as a profession have an opportunity to take the lead for the changes that are needed. We as leaders have to be the change we want to see.

This year has certainly shown how rapid changes can occur. Covid −19  has in a few weeks fundamentally changed society as we know it, and maybe change our way of living forever. During this period physiotherapists have played important roles and shown how valuable our profession and knowledge is in all kinds of settings, at the ICU, at other departments in hospitals, in primary health care and in rehabilitation settings. In practically no time physiotherapy colleagues collected data to establish knowledge-based advice, changed workplaces, started new departments and wards for Covid-19 patients, shared knowledge generously, tried to find new ways to see patients digitally and outdoors. Physiotherapists were seen in press, national television and were acknowledged. And I was and am proud.

The IHI (The Institute for Healthcare Improvement) have described what is essential for strategic improvement; Will, Ideas and Execution. ‘You have to have the will to improve, you have to have ideas about alternatives to the status quo and then you have to make it real – execution’ [3]. Our profession has shown all of that during this period. Let us in our profession continue to be in movement, act trustworthy and work together. There will be an increasing need of physiotherapy in the future challenges – the door is open. Let’s go on!