Ginger Rogers Did Everything Fred Astaire Did Backwards and in High Heels

Abstract

Summary This article presents a slightly maverick view of the emergence and development of the profession, looking at the progress and evolution of physiotherapy as a 20th century phenomenon and an example of the status and ambitions of women. The occupation and history of physiotherapy are not gender-free and historical constraints on the construction of knowledge in and about physiotherapy and the development of a research culture are identified with regard to the reasons that the Founders of the profession were happy to trade autonomy for orthodoxy, to carry out ancillary and subordinate tasks and explain physiotherapy in terms of ‘the medical model' in exchange for recognition and patronage. Electrotherapy is used as an example of lack of coherence and entropy in knowledge in physiotherapy. Constraints of the current structure and culture of the NHS are also identified, in particular exclusion from decision-making structures and managerial perceptions that the therapy professions and other professions allied to medicine ‘serve' medicine. The main thesis is that the therapy professions have uniquely developed sets of intellectual capabilities and independent knowledge which are inseparable from professional autonomy and which management needs in order to deliver a high quality service. The discourse concludes with the need to provide valid evidence of present and potential contributions to the health of society in order to retain professional independence in the face of the management model being imposed on much of the NHS and carry it into the next century.