Column: Dr Watkins On Physiotherapy & More
[Column written by Dr Kimberley Watkins]
September 8th marked World Physiotherapy Day, and this year the global profession of physiotherapy is making a pointed argument to health systems everywhere. When it comes to cardiovascular disease and stroke, physiotherapy is not a nice-to-have. It is essential care.
Cardiovascular disease and stroke remain the leading causes of death and disability worldwide, and one in four of us will have a stroke in our lifetime. Here’s the hopeful part: we already know what helps people recover, stay independent, and get back to the lives they love. Decades of evidence point to the same answer, again and again: physiotherapy-led rehabilitation works. The opportunity now is making sure that evidence translates into investment. The World Health Organization estimates that one in three people globally could benefit from rehabilitation, and closing that gap between what works and what’s funded is one of the most promising, achievable wins available to health systems today, including ours.
The evidence is not in question
The clinical case for physiotherapy-led rehabilitation is well established. Structured, exercise-based cardiac rehabilitation has been shown in contemporary meta-analyses to meaningfully cut cardiovascular mortality and hospital readmissions, while also improving physical function, general health, and mental wellbeing. For stroke, national and international guidelines consistently recommend regular, sufficiently intense physiotherapy, tailored to the individual, as a core part of care. The WHO’s own Package of Interventions for Rehabilitation names physiotherapists as a core workforce for delivering cardiopulmonary and neurological rehabilitation, stroke included.
In other words: this isn’t a question of whether physiotherapy works. It’s a question of whether it’s properly funded, staffed, and embedded in how care is delivered.
What the profession is asking for
World Physiotherapy’s global advocacy toolkit for this year sets out a clear set of asks for health systems, and they apply just as much to a small island system like Bermuda’s as to any larger jurisdiction:
- Embed physiotherapy across the full pathway — from prevention through to long-term rehabilitation rather than treating it as a service people only reach after everything else has been tried.
- Fund and scale cardiac and stroke rehabilitation programmes, with physiotherapists recognised as core providers, not optional extras.
- Invest in workforce planning, so that physiotherapy capacity actually keeps pace with an ageing population and a rising burden of chronic disease.
- Strengthen referral and access pathways, so people who would benefit from physiotherapy can reach it early, rather than falling through gaps between specialties.
- Recognise the economic case, not just the clinical one — investment in rehabilitation delivers measurable health and economic returns by reducing hospitalisation, disability, and long-term care dependency.
None of this is a radical ask. It’s a request that policy catch up with evidence that has existed for years.
Why this matters here, on a small island
Bermuda’s healthcare system does a great deal well, and our physiotherapists, doctors, nurses, and allied health colleagues work hard every day to give patients excellent care close to home. But every small island system shares a structural reality: we can’t host every specialist service locally, and for complex or highly specialised rehabilitation needs, patients sometimes have to travel off-island, away from family, work, and the familiar surroundings that support recovery. That’s simply the nature of serving a population our size — not a criticism of anyone doing the work.
The encouraging news is that this is exactly where physiotherapy shines. Effective rehabilitation doesn’t depend on expensive machines or large specialist hospitals, what actually drives recovery is consistent, tailored, sufficiently intense practice with a skilled clinician. That’s a model built for an island like ours. It means more of the recovery journey: for stroke, for heart disease, for the everyday chronic conditions so many Bermudians manage, can realistically happen right here, in our own community, close to the people who matter most.
That’s the opportunity in front of us this World Physiotherapy Day: not a shortfall at all, but a strength to build on. With the right investment in workforce, training, and referral pathways, Bermuda is genuinely well placed to make community-based physiotherapy a bigger part of how we help people recover their independence, their confidence, and their quality of life after a stroke or a cardiac event.
This World Physiotherapy Day, the Bermuda Physiotherapy Association joined physiotherapists worldwide in making that case with optimism: rehabilitation is essential health care, our island is well suited to deliver it close to home, and investing in it now means a healthier, more resilient Bermuda for years to come. Thank you to all our physiotherapists here in Bermuda for everything they are doing here in our community.
- Dr Kimberley Watkins
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