COVID-19 forced many allied health professionals to change the way they provide patient care drastically – and fast.

Physiotherapists, being in direct contact with their patients, are arguably one of the most vulnerable when it comes to business continuity. So, one of the most significant challenges faced was to influence client perception of quality care without hands-on contact. 

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Peter Flynn, physiotherapist and Director of two Physio Fit clinics in Adelaide, facilitated online treatment and encouraged staff to work from home during the pandemic. One positive to come out of this situation, he said, was highlighting the benefits of physiotherapy outside the confines of manual therapy.

"Our business model had to pivot fast to continue to serve the community over the past few months due to COVID-19.

"At the height of the crisis, we faced a complete move to online consultations. We had to create entirely new systems of delivery, ways to provide this treatment and then upskill our team on how to deliver it to create the most benefit in the lives of our clients," said Mr Flynn.
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The challenges and opportunities of working through a pandemic were technology-related and navigating the perception of telehealth for treatment delivery.

"Many people were able to move to Zoom, but this didn't comply with security regulations for healthcare. We were fortunate that the cloud-based system we use, Cliniko, worked day and night to create and integrate a platform for telehealth delivery.

"Moving to online consultations brought challenges, as patients didn't understand the effectiveness of these consults.

"We worked hard to produce two to three pieces of video content each day to educate the people in our community about how we can continue to help them to reach their goals via telehealth.

"The reason most patients couldn't imagine doing physiotherapy consultations online is that there would be no opportunity to perform manual therapy, such as massage and mobilisations, which is what many people believe achieves their rehab goals."

In fact, research very strongly supports that the most critical part of rehabilitation is progressive exercise-based therapy, explained Mr Flynn, much of which can be delivered online.

"There is great evidence for moving away from manual therapy. This will be a great step forward in challenging physiotherapists to continue to grow and evolve."

Another constructive development the pandemic brought to light was the realisation that physiotherapists can work from home to support their clients. 

"From an employer perspective, it is an opportunity to create a viable online arm of the business that will stay long after COVID-19.

"It also allows us to offer more flexible work arrangements for our team. Working from home was previously unheard of in physiotherapy – now we can offer employees flexible work arrangements in future."

In response to the challenge physiotherapists faced during the pandemic, Mr Flynn created Telehealth Mastery, which is an online professional development course that assisted 200 clinics Australia-wide to develop exceptional online client experiences.

"This was vital to the success of moving physiotherapy consultations to the virtual space as most patients weren't ready for it. Clinicians needed to provide a professional experience right from the start.”

The investment in technology, development of online content and training for staff, who now understand video editing, is a bonus for the clinics and the public, said Mr Flynn.

"We can now provide a large amount of free online content to help people in our community to live pain-free active lives."

At the peak of the pandemic in Australia, Mr Flynn took the decision to manage risk between clinics.

"We completely separated the team members from each clinic, ensuring there would be no cross-contamination risk should COVID-19 present in one location."

Mr Flynn also set up a volunteer enterprise, Frontline Healthcare Initiative, to support doctors and nurses during the pandemic by offering free allied health services.

"The idea for this initiative came because we had seen such a decline in our own businesses and wanted to give back in a meaningful way to those doctors and nurses on the frontline against COVID-19.

"We were able to organise over 50 physiotherapists, psychologists, osteopaths and podiatrists from around Australia to come together to offer free online services to doctors and nurses throughout the COVID-19 crisis."

While the crisis has calmed down in Australia with a progressive return to the norm, besides social distancing and increased hygiene, the future of physiotherapy is changed, said Mr Flynn.

"There's no doubt it's changed what physiotherapy looks like forever. We are excited to now be able to offer online consultations to people who prefer the convenience of not having to come to the clinic, or for those who live rurally and don't physically have access to these services."

So, what does the future look like for physiotherapy post-pandemic? Mr Flynn said the biggest challenge is moving towards evidence-based care with an emphasis on education about the benefits of health and fitness. 

"We still see too many claims made by health professionals in general that don't fall in line with the evidence and perpetuates the myth that people must be dependent for the rest of their life to avoid pain - even overusing scans to incite fear."

There is also a shift away from the preoccupation with manual therapy and towards online consultation, which benefits those who otherwise could not access treatment. 

"Part of the reason many struggled to make the shift to online consultations was that they had perpetuated this dependence mentality around manual therapy and, when this was taken away, it was incredibly hard to then convince their patients otherwise.

"Online rehab to gain strength and functional capacity is the way to go. We have an opportunity to educate and genuinely help more people through the virtual world, and COVID-19 has opened this up for us. It's what we do now that will determine the future of our industry moving forwards."

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