Recently, Deputy National Rural Health Commissioner Faye McMillan sat down for an interview with rural physiotherapist, Dan Searle. In this interview we learn about what led Dan to become a physiotherapist, his unique experiences as a physiotherapist and rural allied health professional, and how he feels the COVID-19 pandemic has affected his work and the broader allied health community.
Faye McMillan
Dan has agreed to have a chat with me today about himself and his experience of being a rural allied health professional. So, thank you Dan for agreeing to have a yarn with me.Can I start by asking you; originally, what drew you to become a physiotherapist?
Dan Searle
Yeah, well, I guess I have to go right back to high school to answer that. And I think like a lot of young boys growing up in the country, I was pretty passionate about sport and involved in sport. And I thought I was good at sport. But I guess I was a realist to know I was never gonna play a sport at an elite level. So I thought the next best thing would be is if I could find a way to be involved with sport at an elite level and physiotherapy seemed like a good option.
And at 16 years old, so when I was coming into year 10, I actually lost the majority of my eyesight through a genetic condition that I didn't know was in the family. So, it happened very suddenly over a couple of months out of nowhere, basically went from fully sighted to down to less than a couple of percent. That really changed my world and changed how I thought about everything and really made me re-evaluate what was going to happen with regards to finishing school, leaving home, a career and things like that. I luckily did manage to get in contact with some people that had gone through physiotherapy as vision impaired people and, whilst I'd not been contemplating that as being an option after losing my sight, I realized there was still the potential that I could explore something like that.
And what was really good for me in that time, that huge change and huge adjustment, I got to work with some occupational therapists through Guide Dogs and through Vision Australia. And I saw that the little skills and education and advocacy work that they did for me made such a huge difference to my independence and my ability to be able to complete schooling, and how grateful I was for their help and support.
I think that really made me just refuel that passion that I did want to do something in health and it wasn't necessarily that idea around sport that originally drew me to physiotherapy, but I thought the idea that I could help and I could give back to people was something that really continued to drive me into physiotherapy. And then I was lucky enough after completing school, after that big adjustment to the way I learned and engaged with education after my site loss, I learned to use a screen reading computer program on my computer and learned to touch type. I ended up doing my year 12 over a couple of years rather than just over the one year and was lucky enough to get an early entry place to study physiotherapy at Charles Sturt UNI in Albury.
So that was really what sort of helped fuel my passion. And then once into that course, I quickly realized there was so much more to physiotherapy than I'd probably, maybe naively, thought but that really excited me because there was so many more options and I really liked Charles Sturt’s placement within that focus on Regional Health. And most of my placements were out in regional areas. And I saw how much difference the Allied health professionals and physiotherapy, where I was working, could make to people’s lives and that's sort of what drew me to that field and has kept me passionate about it until this point.
Faye McMillan
Thanks, Dan. And hearing you talk about your love of sport, you've continued that and you've also made that part of your life through elite sport, which you are an elite sports person, that recognition of your cycling pursuits and that you not only use your own skills as a physiotherapist, but other allied health professionals to bring in your sport capabilities and allow you to continue to work as an allied health professional. What is it that you love about your profession though?
Dan Searle
What is it I love? I love the relationships that you form with people over a long period of time. So, doing a bit of work at the moment that, like most of my work, is for myself within my own space. Part of the motivation that took me to working for myself was that I like that I can have longer appointments that I can get that time to build relationships with my patients and really dig down deep into what motivates them and what they want to be able to get back into and engage with. And I think there's many times when I can relate to patients if they've got pain or if they've had an injury or a long-term disability, I can really relate to that idea. That sense of loss and maybe disconnection from their community, from their hobbies, from their work, things like that, having had to overcome some of that stuff myself.
And I really like that I get to be a part of their journey and help empower people to give them back their lives and some sense of control of their lives. And it's really weird but I guess in many respects the highlight is often when patients come to me, if they've been seeing me for a while and say, “I don't think I need another appointment”, when I see that excitement that they feel like they've got back some control of their life that they feel like they've lost. That's really exciting for me and reminds me of where I've come from and the fact that I couldn't have done it without the support of a lot of great people around me, and I'll be forever grateful for that and it always takes a team or a community of people around you to help you thrive, to be the best person you can be. So, I just love being a part of people's team and helping them to get back to the things that are really meaningful to them.
Faye McMillan
I know we're going a little off script now, but using what you've said and what we've already spoken about with the multidisciplinary teams and you spoke about being part of those systems that provide people with the opportunity to reengage or reimagine their lives. What does being part of a multidisciplinary team mean for you?
Dan Searle
Yeah, well, I know within best practice care today, we talk about that biopsychosocial model of care, which realistically was something that was discussed in the 1970s, but it's still not always practiced as well as it can be. So, we know that in order for a person to be functioning at their best, we need to be considering the sort of biomedical factors, the psychological factors and the social factors. So, it's awfully often, within Western medicine especially, there's a heavy focus on the biomedical aspects of a person's care and their treatment. So, you know, looking at the tissues, looking at medications, looking at surgeries, things like that, and maybe we forget to sort of look at some of those other things and the structures that might exist within their life and within society generally that are going to have a significant impact on their health. So, for me, I find it really important to engage in those things and see where there might be opportunities to make big wins with the patient and things that they can control and might not realise that they have some control over. Like looking at whether or not they're engaging with their community still? Are they getting good quality sleep? Do they know about the benefits of exercise? Do they know how to engage in exercise? Do they appreciate the impact of whether or not they have a job, whether or not they feel like they're contributing to society?
And I'm not necessarily suggesting as a physio that I have the answers to all those skills, but if I can help to open up those conversations with patients, then I like that. That gives me the opportunity to engage with other health professionals and bring them into that person's care. So, I do a lot of work directly with psychologists, especially with some of the people that I work with, with disabilities or persistent pain because we really know that there is that huge link between somebody’s stress and mental health, and their psychological health and their physical health. So, you can't just be treating one and expect the other one to spontaneously recover as well. You've got to be always working on them all at the same time. So, where I can, I do some pain education directly with the psychologist. So, I think that's really exciting that I have the opportunity as a physiotherapist to be working directly with a psychologist and, for both of us, that gives us the opportunity to see how the other works and what the others are looking at in terms of a patient and looking at in terms of their health and we're both learning from each other and it gives that patient the opportunity to have that experience where someone's considering both their physical health and their psychological health right then and there together. So, any opportunity I can get to work within that multidisciplinary space I think is good for my ongoing professional development, but ultimately the most important thing is it's beneficial to the patient.
Faye McMillan
Which probably leads us nicely into the next question, which is how has COVID impacted on the way you practice? But also how we've seen allied health step into spaces that probably we hadn't been in for quite a while.
Dan Searle
Yeah, well, you know it's been a massive challenge, but I think it's exciting and there are some good things that came out of it in terms of that flexibility and agility we've seen within the workforce how there are greater capabilities of people to be able to work from home. And I know, having grown up in a rural area all my life, the challenges with accessing health professionals from a rural town or regional space have just been a nightmare for a number of years, this predates COVID. But if we're now looking at those telehealth models, I hope it continues into the future and I hope it gives greater opportunities for people out in those regional communities to be able to access more easily doctors, nurses and allied health professionals. Of course, that relies on some level of IT or computer literacy and relies on people having a good Internet connection, which is not always the case within some of these settings.
I think for me as a physiotherapist it has been a unique and exciting challenge. As part of my job I really like to, as I spoke earlier, put an emphasis on education as a part of the consultation. I think people probably do come with an expectation that you're just going to put your hands on them, do some stretches, do some massage and send them away and tell them to do their exercises and that's it. So, I think that gives me the opportunity to challenge that model of care, that ‘what more can I be doing?’ How can I be engaging with the other factors within a person's life and how can I tap into what motivates them and what can I do to help give them back control of their life? So even now I have seen that, once things have opened up a bit more, I am still getting the occasional request for a telehealth consult because some people have found it more convenient that they can call me or telehealth consult with me from their own space and from people that are outside of a space that they might be able to drive in and come and see me.
So, it's not always going to work within physiotherapy because the reality is there are oftentimes when you do need to get your hands on people, and you do need to help them with moving. And there are safety concerns around getting them to do particular movements or exercises themselves. But I think it does open up some new ways for us as physiotherapists to explore the role of education and empowering our patients to get some control over movement and their bodies and things like that.
Faye McMillan
Well Dan it, I think, resonates with so many practitioners around; making sure that people have choice and sometimes that means that I can come in and other times it means I don't. What do you love about being a rural practitioner? I mean, you've obviously made a conscious decision to be a rural practitioner. What do you want? What is it about being rural that you enjoy?
Dan Searle
I think you're not just a health professional and I think, if you're in that sort of large metropolitan area, you're probably known for being a particular thing, and you're probably really good at one thing, and that's what people come and see you for. And as a doctor within a regional setting or a GP, not that I'm comparing myself to that, you become this almost specialist generalist so you can get such a broad range of different presentations and that really keeps your job so interesting that you don't know what you're going to get and sometimes they go “Oh, there's the physio.” I'm not sure that that's really my space, but I can try and direct you to someone that might know what to do. But sometimes people don't necessarily have someone else to go to.
So, if the physio, or whoever is the most qualified health person they can find, then you're it sometimes and that's really nice. But I guess the other thing I was saying that I’m not just a health professional, I really like that. You know, I'm art of a community, so I love that I go to park run and there's some of my patients are there doing park run and they're excited to tell me that they're out doing exercises and doing the exercises that we spoke about together or that's the first time they've been for a walk in months and that's really nice that they feel like they can come up and chat to me and I'm not just a physio. I am a member of the community and part of the triathlon club and the cycling club and canoe club and things like that. And you run into patients or people that then know you through someone else who's come and seen you and want to chat to you about what's going on with them and stuff like that. And I think that's really nice that you get that within that rural health setting.
Faye McMillan
I like that. I'm part of the community. I form part of the jigsaw puzzle that makes up a whole picture, and that's really nice. Dan, can I ask you what you think your unique skills and attributes are that you bring to physio, or physiotherapy? What do you think makes you special?
Dan Searle
So I think the reality is losing my sight at 16 years old and having to overcome that adversity and the acquisition of the disability at that critical age in a young man's life I think is the thing that has made me who I am today. And I’m definitely not for a second suggesting it didn't come without its challenge and there weren’t times when I didn't hate the world, but it's really got me to where I am now and I think that gives me that really unique perspective. Sometimes patients probably get very frustrated with the physios when we're telling them to get up and do this and go for a walk and I think the fact that, I like to think, I practice what I preach, that I wouldn't ask a patient to do something that I wasn't willing to do myself. And you know I think it's important for me in my clinic space. I've got photos on the wall of me participating in some of my tandem cycling things and some of my pictures traveling around the world and things like that, and my Guide Dog is in the corner with me.
So, they all know that I'm vision impaired but they equally know that that is not stopping me from living my life and doing the things that I enjoy doing. So, I think that really gives my patients that perspective and they go “Oh yeah. Well, if he's doing that, then I can do it too.” And then there are always challenges with how to do things. But I think I can relate back to, well, I tried this and this didn't work. So, then I tried this so I can work with them to sort of brainstorm different ways to get through it, and I think I can really, genuinely empathize with people’s struggle and when they feel like they've lost some control over their health or feeling that sense of disconnection from their community and the things that they love doing. I think I can really relate back to that and hopefully find strategies with them to overcome those things and relate it back to my own experience.
Faye McMillan
Bringing in your services that's, I think, a genuine gift to the people you work with that, as you say, sometimes that empathy of I've been in, not your shoes, but a very similar environment of challenges. And I'm not just speaking from a place of privilege. I've had opportunities. So, I think that's really great.
Dan, what would you say to someone who is thinking about becoming a physio or thinks that they'd like to work rural?
Dan Searle
I get so excited when I hear other people thinking about a career in health and I think, for the most part, people that go into health are doing it because they’re just genuinely caring people and want to help. And I think it is such a rewarding career. And for me, as I said earlier, that opportunity to build those direct relationships with people and be a part of their recovery and be a part of them getting back and engaging with the things they enjoy is really extremely rewarding and, within that rural health setting, you really are a part of a whole of community that people know you and respect you and you get to give back. And I think that's really exciting.
And no matter sort of what area of, well physiotherapy I guess is the area I know best, but no matter what type of physiotherapy you want to go into, whether it's Paediatrics or sport or Women's Health or neurological or disability, whatever it is, there's still so many opportunities within rural health and you will just get such a great chance to be a part of the community and form really special long term relationships with the community that you're working with. And there is plenty of opportunity for jobs out there. Sadly, there is still a great need for more health care and more preventative health within a rural setting as much as anything. So, it’s very rewarding and there will always be careers out there in health, I think.
Faye McMillan
Dan, thanks for having conversation with me. ‘Heroes in health’, as much as allied health professionals don't see ourselves in those roles. I think that we stand aside alongside of our colleagues in providing care with our communities that meets their needs, where and when they need it. So, I'm very honoured that you sat down and had a chat with me today and I look forward to when we get to next see you in the tandem cycle and posting about allied health physiotherapy, and all of the abilities that our communities have in facing the exciting prospects of the world, so thank you.
Dan Searle
Thank you for the opportunity.
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