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HEALTH, HEALTH EDUCATION AND PHYSIOTHERAPY PRACTICE: IN BRIEF
How, then, are we to effect attitudinal and organizational change? How are we to overcome these various obstacles to the establishment of good practice? As Whitehead (1989) laments, 'The over-riding impression ... is one of health educators attempting to swim upstream, against the current of forces which have operated to damage health or undermine educational efforts . . .'. Her report of lay participation, however, provides an encouraging example of what is surely good practice of the kind in which physiotherapists could become increasingly involved, given opportunities and encouragement to do so by their managers. Furthermore, Whitehead's account of community-based health education illustrates that change, although a difficult process to manage, is possible, given the initial commitment among professional health workers. And this is the crucial point. In order to establish and maintain good practice, we, as physiotherapists must be genuinely committed to this ideal; we must find the energy to examine and evaluate our knowledge, skills and attitudes on a regular basis and be receptive to new perspectives. Where possible we must initiate and manage change within both the educational and clinical context and, perhaps most importantly, we must work to dismantle inter-professional barriers.
If these applications are summarily dismissed as the incoherent ravings of an inveterate idealist, it is difficult to find a rational argument which might serve to combat such a reaction. The only hope lies, perhaps, in directing the reader to Mary Warnock's writings on educational practice and, in particular, to her valuable observation that, 'It is the function of an ideal to be unattainable. It is no argument against adopting an ideal, therefore, to show that it is impossible to attain it' (Warnock, 1977). To aim for the establishment of physiotherapy practice based on Aristotelian principles does not, therefore, imply a naive belief that this aim will ever be fully realized; rather, it demonstrates a genuine commitment to those principles and a serious intention to strive towards their realization.
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