Marilyn Moffat during her trip to Dubai in April 2008
Marilyn Moffat during her trip to Dubai in April 2008

Around the world with Marilyn Moffat: reflections on the President's two years of travelling

Two years into her WCPT Presidency, Marilyn Moffat talks to Simon Crompton about how her global travels have broadened her mind – and encouraged an increasing sense of closeness in the WCPT family

What has impressed you most as you’ve travelled the world over the past two years?

Although we often think of countries as being different, the more I travel the more I am ever reminded of the many similarities amongst us. Some of the problems being faced by countries with well-established physical therapy professions are often so very similar to those facing countries with emerging professions.

Can you give any examples?

Physician control over physical therapy is almost omnipresent. Whether it is physician-owned physical therapy services or physiatrist-dominated prescriptive requirements, the problems imposed on physical therapists are inappropriate in this day and age.
 
Difficulty also exists in getting educational programmes established where none exist. And upgrading of those programmes that do exist often presents major problems to local physical therapists as a result of lack of support and at times opposition from bureaucratic and government agencies.
 
Many countries are faced with a shortage of appropriately trained physical therapists, making provision of services to large populations extremely trying. There are only one or two countries where an over-supply of physical therapists seems to exist, and from my perspective, this is a reflection of their health systems and the limitations that are placed upon the types of environments in which physical therapists may practice.

What have you observed about variations in practice?

You see high quality services being provided whatever the working environment and resources available. But there is a lot of variation in practice. In some locations, I have observed an overemphasis on modalities like heat, ultrasound, and electrotherapeutic agents. While these agents have their place in our practice, I have a great concern when they are mainstays of practice and not ancillary to our practice.
 
The central interventions in our practice are therapeutic exercise and functional training in self-care, in home management, and in work, community, and leisure activities. Our manual skills, use of devices and equipment, airway clearance techniques, integumentary protection techniques, and the electrotherapeutic modalities, physical agents, and mechanical modalities are all adjuncts to getting our patients and clients moving, no matter what the diagnosis is.

You’ve been running your own course on physical therapists as exercise experts with aging adults as you’ve travelled. How’s that gone?

I have been so pleased by how well these courses have been received. It has been a wonderful opportunity for me to share this information, which I think many physical therapists have found will enhance their practice.  My keynote speech looking at our roles in the management of diseases of civilisation has also sparked interest. It is so important that we all understand that we have a role in preventing lifestyle-related diseases like obesity, diabetes, cardiovascular disease, and pulmonary and tobacco-related conditions, as well as treating people affected by them.

How did you choose where to travel?

In almost every instance, I have been invited by the member organisation. I don’t want to impose myself on anyone. The member organisation to which I travel provides travelling costs since a main goal of mine has been to rebuild WCPT’s reserve fund and to leave the organisation on a totally solid financial footing.
 
I have also attended three regional meetings (the Africa Region meeting in Abuja Nigeria, the Asia Western Pacific Region meeting in Mumbai India, and the Europe Region meeting in Athens Greece) so far and plan on attending the other two regional meetings during the next year. These regional meetings enable me to see a lot of people from many countries at one meeting.

How important is that personal contact with physical therapists around the world?

Very. Because when talking to physical therapists and governmental officials directly to ascertain the specific issues that they face, I get a far more accurate impression of what is really happening. I can probe issues more deeply. I can also see the extent to which WCPT structures and policies are working, and where they are not. My travels have made me increasingly aware of how effective the regional structure can be for bringing people together. But I can also identify concerns, which may mean we need to look at new areas or develop new positions in the future.

Where are you planning to visit next?

Next year, I will be going to the North America/Caribbean Region meeting in Suriname and the South America Region meeting in Chile. I will also be attending meetings in Qatar, Switzerland, Dubai, India, and Japan. I’d also like to make sure that we have increasing contact with China and Russia, because I think it is important that WCPT’s guidelines and positions on education of physical therapists be at the forefront in those countries. Neither of those huge countries currently has physical therapy services and education across the board as we know them. While there are some programmes in those countries, we would really like the key people in those countries to know that WCPT should be the first resource they seek when developing physical therapy education programmes.
 
I will continue to make myself available whenever I possibly can. I am still teaching full time and practising on a regular basis, so I must juggle all responsibilities as best I can. Travelling for WCPT has made me very proud to be representing our wonderful global family of physical therapists, and the more I travel, the more I know how close that family is.
 
Marilyn Moffat’s destinations…
Sao Paulo, Brazil - October 2007 (90 minute presentation)
Helsinki Finland - April 2008 (40th Anniversary Meeting of the Heads of the Nordic countries, one day course and keynote address)
Dubai - April 2008 (keynote address)
Barbados - April 2008 (WCPT update, one day course, meeting with Minister of Health)
Athens, Greece - May 2008 (Meeting of the European Region, WCPT update)
Tel Aviv, Israel - May 2008 (Keynote address and one day course)
Geneva, Switzerland - May 2008 (Conference on Regulation of the Professions)
Abuja, Nigeria - August 2008 (Africa Region Meeting, one day course and keynote address)
Daegu, Korea - October 2008 (One day course and keynote address, met with head of city)
Amsterdam - November 2008 (KNGF Congress and site visit)
Cairo, Egypt - January 2009 (Opening remarks, keynote address, half day course on bone health, met with university administration)
Mumbai, India - January 2009 (Asia Western Pacific Region Meeting, two day course and keynote address)
Bogata, Columbia - March 2009 (Keynote address, one day course, presentations on evidence-based exercise with special populations)
Kuala Lumpur, Malaysia - March 2009 (Keynote address and one day course)
Bahrain - April 2009 (Keynote address and two day course)
Singapore - May 2009 (Keynote address, one day course, presentation on global PT education)
New York City - Armenian World Medical Conference, Physical Therapy Specialty Group - July 2009  (Global PT education)
Bermuda - September 2009 (Two day course and one day course)
London, England - Nov 2007, April 2008, Nov 2008, April 2009 (Executive Committee Meetings)
 
Marilyn Moffat's travels across the world in the past two years