Being a Good Physiotherapist Is No Longer Enough

Most young physiotherapists start their careers with a simple assumption. If you are clinically competent, work hard, and care about patients, things will eventually work out. Progress will come. Opportunities will show up. Someone will notice.

It’s a reasonable belief. Physiotherapy education trains you to think that way. You study, you pass, you qualify, and then you expect the system to reward effort and competence in a fairly linear way.

But very early on, many physios begin to feel a quiet disconnect between what they were told and what they are experiencing.

They are doing the work. They are safe clinicians. Patients are improving. Colleagues trust them on the ward or in clinic. And yet, their career feels strangely static. Same band. Same responsibilities. Same sense of waiting.

This is often the moment when frustration creeps in, not loudly, but steadily. You start wondering whether you are missing something obvious. You look at peers who seem to be moving faster and you can’t quite work out why. On paper, you’re not behind. In practice, it feels like you are.

What nobody explains clearly enough is that clinical competence, while essential, is no longer the factor that moves careers forward. It gets you in the door, but it doesn’t decide what happens next.

In modern healthcare systems, especially in places like the NHS, competence is assumed. Everyone around you has passed exams. Everyone has a degree. Everyone can assess, treat, document, and communicate. By the time progression decisions are being made, those things are no longer differentiators.

What starts to matter instead are things that are rarely written down. Visibility. Trust. Reputation. How people experience working with you. Whether decision-makers can picture you carrying more responsibility. These judgments are human, informal, and often formed long before an interview panel ever sits down.

There is a phase in many physiotherapy careers that no one names and no one prepares you for. It sits somewhere between qualifying and progressing. You are no longer new, but you’re not yet moving. You are capable, but not clearly positioned. You are waiting, often quietly, for the system to recognise you.

This phase is where many good clinicians get stuck, not because they lack ability, but because they are still playing by rules that no longer apply. They keep their heads down, do the work, and assume that time alone will do the rest.

Sometimes it does. Often it doesn’t.

Most career decisions are not made purely on CVs or application forms. They are shaped through conversations, shared work, familiarity, and trust. Someone mentions your name. Someone remembers how you handled a difficult situation. Someone feels confident recommending you because they’ve seen how you think, not just how you treat.

By the time a role is advertised, a picture has often already formed.

This doesn’t mean the system is corrupt. It means it is human. And pretending otherwise doesn’t protect you, it just leaves you confused when effort doesn’t translate into movement.

This is the gap my upcoming book explores in depth. Not from a motivational angle and not from a place of bitterness, but from clarity. It looks at how careers actually move in real systems, why hard work sometimes stalls, and how young professionals can learn to navigate opportunity without losing their integrity or becoming cynical.

The aim isn’t to tell you to abandon clinical excellence. That still matters deeply. The aim is to show you that excellence needs context. It needs positioning. It needs an understanding of how decisions are really made.

If you’re a young physiotherapist who feels capable but unseen, this isn’t a personal failure. It’s a structural blind spot that no one talks about enough.

This blog is only a glimpse of that conversation. The book goes much further.

And if it makes you slightly uncomfortable, that’s probably a good sign.

while waiting for my book launch, have you tried some of my E- books guides

check: https://selar.com/m/adebolabadiru