The physiotherapist's role in contemporary health care in Ireland: responding to 21st century indicators and priorities

Two key factors will determine the demand on the physiotherapy profession in contemporary Ireland in the future. Firstly, the shift towards primary care, with a focus on prevention and health promotion and secondly, the chronic conditions that will dominate illness care for the foreseeable future are incontestable given lifestyle profiles and changing life expectancies. For physiotherapists to become effective first contact primary care providers, their role must change from one exclusively geared towards illness, disease and disability to one that provides greater emphasis on the health and wellness, and prevention of 21st century health concerns, specifically, lifestyle related diseases. Modifying lifestyle practices (risk factors) such as tobacco use, excessive alcohol consumption, poor nutrition, weight gain and physical inactivity is listed as a major priority by the Health Services Executive (HSE), given that an escalating number of children, as well as over half Irish adults have one or more manifestations of lifestyle related conditions. Research has shown that a successful assault on lifestyle conditions is more likely achieved by addressing lifestyle rather than primarily focusing on symptom reduction, indicating that health assessment and risk factor modification, undoubtedly, warrant being 21st century physiotherapy competencies. Based on historical precedent and evidence, this article highlights how physiotherapists, by exploiting interventions such as health education, physical activity and exercise, can play a major role in prevention and in some cases, reversing the tide of lifestyle related conditions. Furthermore, the current transition to primary care, with a focus on prevention and health promotion, will facilitate Irish physiotherapists to affect public health practice in every person and patient. Physiotherapy in Ireland could lead the way globally by serving as a model of change.