This is the third in a series of workplace analysis pieces. The first is here
If you haven't guessed, I am a physical therapist working in orthopedics.
Like I've mentioned, lots of things that I do, post-op total knee replacement management, management of chronic pain, management of dizziness and concussion are what you'd expect. It's a mix of rehabilitation science, some tactics borrowed from the mental health field, and a generous dash of just being a decent, empathetic person. What's funny over the years has been watching wellness culture (an extension of the woo-turn of the counterculture) bleed into a practice that I took on as a quest to build a skillset that I could use to heal people without needing to be tied to equipment or resources (i.e. capital).
In a quest to escape the awful work-life balance of, say, a large chain practice (think billable unit quotas, upwards of 20 clients per day, mountains of documentation, extremely brief appointments) lots of small practices have evolved into this model where, they treat patients, but are also something else -- life coaches, or a crossfit gym, or a yoga studio. In essence, they hook you with PT care, then roll you into a weekly massage session with reiki, or guided workouts, or personalized pilates sessions. Add a splashy web page about "our strong community" or "come join our tribe of passionate movers," and they're pulling a funny trick, healthcare as a lifestyle, as pursuit of perfection, as fulfillment. These are often cash pay, to avoid the hell that is billing insurance or medicare/medicaid, and serve middle-upper class folks nearly exclusively.
I'm not against the idea of just plain having a place to work out, or some therapeutic support or athletic coaching, or a group of friends who like what you like. In ideal communism, shouldn't we all have our physical/mental/emotional selves cared for?
What I hate about this is model is that it sells dependence. Without my expertise, you won't be living optimally. Without my community based on optimal living, you won't feel understood. It doesn't foster self efficacy with regards to taking care of yourself. I work hard to support my patients, but also to help them feel that they can understand their injuries and take action to make it better, and have a good heuristic to estimate how they're doing when they need outside help. Without that it destroys self-efficacy. It's just coming to see the guru.
Furthermore, I think this approach is profoundly disabling to political action both on the part of the patient, who gets on a never-ending hamster wheel of pursuing performance and self actualization, and on the clinician, who never sees a member of the working class and never gets exposed to the grinding brutality of physical work. It immunizes you against radicalization. If you're too busy working on yourself, or treating only rich people, you're insulated from the material lived realities of the oppressed and exploited. Like any post-60's self improvement-cum-religion, it kills the possibility for connection, action, empathy and solidarity.
That said, I haven't done pro-bono clinic service since starting my new job. 50-hour weeks tend to do that to you. This is in contrast to my student days where I fit in a lot of pro-bono clinic time, as well as outside activism. So fuck me, right?