A candid conversation between me and a patient about robotic surgery led us to this very question:
Will computers ever replace physiotherapists?
Before giving away the answer, this is a good time to revisit the role of a physiotherapist in the continuum of care. There are 5 major components in how we provide physiotherapy:
- Examination: the process of obtaining history and performing tests and measures to gather information about the patient and the symptoms.
- Evaluation: the process where clinical judgements are made based on data gathered during the examination.
- Diagnosis: the end result of evaluating examination data.
- Prognosis: the determination of the level of optimal improvement that may be achieved through intervention and the amount of time required to reach that level.
- Intervention: skilled interaction using physiotherapy methods and techniques to produce changes in the condition which are consistent with the diagnosis and prognosis. The progression of intervention is determined by re-examinations performed during the course of intervention.
Within each component mentioned above, there is an emphasis on clinical judgements using clinical reasoning. Simply put, clinical reasoning is what you pay a physiotherapist for: it’s when a physiotherapist uses cognitive skills to process information, reach decisions, and determine actions, i.e. why we do what we do. In this case, the “what we do” can be a joint mobilization, education on posture, therapeutic ultrasound, or core stabilization exercise. Some may argue that when they go to see a physiotherapist, they are paying for the physiotherapist to provide treatments, but behind each treatment, there are clinical judgements being made from the point the patient walks in to the clinic to the point the patient steps out of the clinic. Clinical reasoning also involves other “human qualities” such as ingenuity and creativity that computers won’t be able to provide in the near future. After all, physiotherapists are clinicians, not technicians, and until clinical reasoning is no longer required in the way physiotherapy is provided, it’s nearly impossible for computers to replace physiotherapists.
For physiotherapist assistants though, the answer is a very possible “maybe”. Robots, one day, may very well be “physiotherapy technicians” who are programmed to carry out specific treatments preset by a physiotherapist, similar to the way physiotherapist assistants do now, like applying therapeutic ultrasound or monitoring the form when a patient performs exercises, but whenever a clinical judgement is needed, a human physiotherapist is still needed to be present and be able to “make the call” in real time using clinical reasoning.
At our clinic, we understand and value the importance of our clinical reasoning throughout the course of treatment, that’s why we don’t hire physiotherapist assistants to provide any physiotherapy treatment at all because every patient we see is unique.
Richard Kung, Registered Physiotherapist
Doctor of Physiotherapy, Bachelor of Science (Kinesiology)