E d i t o r i a l

W a k e  u p  c a l l
elcom e to the graduates o f 1997 

and congratulations to you and your edu­
cators on your success. It is an exciting 
point in life to be contem plating your 
future but I wish that it w ere as sim ple as 
that. Just as we, the educators, had con­
vinced the students o f the im portance o f 
consolidating w hat they had learnt by 
starting off their careers in a teaching 
hospital u nder supervision because it was 
assum ed that such posts w ould be avail­
able, the situ atio n  has c o m p letely  
changed. Closure o f hospitals, reduction 
o f staff establishm ents and freezing o f 
posts are the order o f the day. It is true 
that posts do exist and the needs are en o r­
m ous in outer city and rural hospitals and 
clinics, but how  w ould these young inex­
perienced physiotherapists fare in isola­
tio n  w ith o u t su perv ision ? T he real 
tragedy is that it is not as if we w ere 
unaw are that this crisis was brewing. 
Indeed there had been m any lengthy 
w orkshops w here the problem s facing 
health care delivery in this country and 
m ore especially in our ow n profession 
w ere debated. H ow ever, we w ere unable 
to get our act together to put into place 
m echanism s fo r our young therapists to 
be directed and supervised w here they 
w ere really needed. In this situation what 
o th er em p lo y m en t o p p o rtu n ities are 
available for our young graduates? South 
A frican  trained  p h y sio th erap ists are 
sought after all over the w orld with 
attractive conditions o f service and rem u­
neration in desirable pounds or dollars. Is 
this w hat we are training for and can we 
afford it? Is this really w hat our young

professionals had in m ind w hen they 
em barked on this career? 1 hope not.

Positions in private practice in our own 
country are plentiful and conditions of 
service seem  positive and desirable, but 
once again there is the lack o f supervi­
sion and it is foolhardy to believe private 
practice can continue to provide the same 
physiotherapy practice as they did in the 
past. Let me explain.

It is no  secret that m e d ical aid 
Societies are pulling in the reins, as they 
are unable to support the ever-increasing 
dem ands fo r treatm ents, the need for 
w hich is often questionable and has not 
been substantiated. This is probably an 
understatem ent and 1 am sure that there is 
no read er w ho can n o t cite incidents 
where they are paying substantially m ore 
for considerably less to the point o f 
refusing or denying the need for recom ­
m ended services. I have been inform ed 
o f situations that will illustrate the point, 
which I am trying to make. A patient with 
a fractured fem ur w ho spent 3 or more 
w eeks in hospital was presented with an 
account fo r physiotherapy fo r R3 500.00. 
An interview  w ith the physiotherapist 
convinced me that she is an honest co m ­
petent therapist and she and her staff had 
done the job . The patient is a pensioner 
and the M edical A id is restricted. I 
believe that this patient should have been 
counseled giving som e indication o f the 
choices available fo r treatm ent and for 
what reasons and at w hat cost in consul­
tation, with the team , orthopedic sur­
geon, anaesthatist, nurses etc., and the 
fam ily o f course. D id she realistically

require breathing exercises tw ice daily 
once she was am bulant? W ould it not 
have been possible to involve friends or 
fam ily in the rehabilitation process and 
thus reduce the fees?

At this point in tim e it could not be 
m ore appropriate to publish Professor 
T eager's M olly L ev y  L ec tu re . “T he 
Changing Profession -  An International 
Perspective.” Its application to our p re­
sent situation is clear. I urge you all to 
read it very carefully. The problem s fac­
ing health care delivery are international. 
To quote from  his paper: “ If physiother­
apy is to fulfil its early prom ise as a 
dynam ic p rofession every p h y sio th er­
apist m ust have an open m ind and the 
readiness to change their practices.” The 
m ove from  hierarchical structures which 
are failing in favour o f inform al netw orks 
in w hich rew ards com e from  em pow er­
ing others, not by clim bing o v er them. 
Political and professional initiatives have 
to be taken to facilitate adequate health 
ca re p ro v isio n  at c o m m u n ity  level. 
Physiotherapists m ust develop appropri­
ate policies and training for the em ploy­
m ent o f support personnel to be able to 
provide effective and efficient services 
dem anded through a w ide range o f com ­
m unity based program s.”

In  conclusion we m ust rem ind our­
selves that the situation facing us today 
has been exacerbated by the fact that we 
have a back-log o f about 80% o f our p o p ­
ulation who have no physiotherapy ser­
vices available to them. The challenges 
are urgent and exciting -  w e can no 
longer procrastinate and our rew ard will 
be to find new  and innovative ways to 
provide physiotherapy and rehabilitative 
services fo r all in a way that dem on­
strates our worth.

ADDRESS: South African Society o f Physiotherapy, PO BOX 92125 
Norwood 2117 Fax No: 788-5628 E-Mail Address: muriel@ icon.co.za

REVIEWERS THANK YOU
I want to acknow ledge the prom pt reply o f acceptance to be a review er fo r our jou rn al As there had been no response from  a call for 
volunteers to review, the editorial com m ittee invited a num ber o f m em bers to becom e review ers. Should anybody else wish to becom e 
review ers please do not hesitate to respond and Y ES, we will assist to develop or im prove your skills. T hank you to those review ers 
o f the last two journals:
D Cohen J Lund
S D eC harm oy A M arais
K E rm an M M orrell
S H irshow itz M Papadoupolos
L H unter M Riley
L Jacobs J Sklaar
We intend to publish a list o f  review ers who have contributed annually.

SA J o u r n a l  o f  P h y s io th e ra p y  1998 V o l  54 No 1 3

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mailto:muriel@icon.co.za