Physiotherapy plays important role in multidisciplinary team in prevention of disease, intervention, health promotion..

This has been also stated by following..

Charted association of uk

Australian physiotherapy association

Canadian physiotherapy association

And so on..

Plz see the link..

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207975/

Hi Sai,

You seem to be falling into the same conceptual trap that many health professional groups fall into here. I don't subscribe closely to WHO definitions because they are usually extremely broad and non-committal to try and be 'all things to all people'. Self-empowerement is a rare thing - and not key to health promotion anyway. It could be argued that it is key to 'good' health education though. Community/population empowerment is far more key to health promotion.

Many health professional groups purport to be in an 'ideal position' to address health promotion issues; but rarely, beyond the rhetoric, are they in a position at all. Take nursing (my discipline), for example. The largest healthcare discipline in the world, yet one of the least visible in the health promotion world. I can't see Physical Therapists being much different.

Part of the problem is that health professionals often use the terms health education and health promotion interchangeably - when they are clearly different things. That affects the evidence-base and the way that the wider health promotion and political community regard such disciplines. Another problem is that health services, that contain these health professionals, have often not really reorientated in any meaning way. My evidence lies in the attached invited article of mine, in Health Promotion International, to 'celebrate' 25-years of the Ottawa Charter. Have a read of it Sai - and see if it resonates with you.

If you go to the thread of a question I asked in RG a little while ago (more than 150 responses) about 'what is the difference between health promotion and health education' - that might assist as well.

P.S - I've just noted Sai that someone has down-voted your question. Just to say that it was not me. I welcome the chance to discuss this on-going issue with health professionals.

Physiotherapy plays important role in multidisciplinary team in prevention of disease, intervention, health promotion..

This has been also stated by following..

Charted association of uk

Australian physiotherapy association

Canadian physiotherapy association

And so on..

Plz see the link..

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207975/

Says:-

Thanks Dean for the lovely article, it was very informative.

In my opinion, Health Promotion is a small word that holds a huge meaning. HP can be made possible in almost every field in today's hectic World. What is important here is how the individual fields uses it. Taking Physical Therapy into account here, HP is possible in every stream of it. Orthopedics, Cardiology, Neurology, Pediatrics, Sports, Woman's Health, Geriatrics, Rehab, etc are different streams in which HP is possible. However, the real problem comes in implementing such promotional activities. Inadequate knowledge in health policies, lack of funds, improper selection of the target audience, lack of interpersonal relationships between the promoter and public, lack of coordination between the promoter and organizations (Ex: Social Workers') are some factors that hamper the HP activities.  Sometimes, one has to overcome demotivations also, such as I have received a negative voting for this thread.

If one can address these factors properly and eliminate it, HP will happen automatically. 

Thanks Dhara, yes, it is indeed a  multidisciplinary approach. Thanks for the link too.

Could anyone show the way on how to avoid the above said factors that affect health promotion?

I believe that HP will continue to flounder unless it is adopted by all disciplines as part of the care model, not a separate add on,  though this is a tall order. Within my narrow window of experience, community and university based outpatient PT in the US, pain was adopted as the "5th vital sign" , should HP status be the "6th" ? The advantage that PT's have in HP is their  frequency of contact, 2-3x a week for a number of weeks and then an oppurtunity to continue this contact, as we do, electronically on a regular basis after discharge. 

Hi Andrew,

Good suggestion, having HP as the 6th vital sign - although I would argue that you are morel referring to 'health education' here. Good idea to have HE as the 6th vital sign.

Says:-

Lovely suggestion Andrew. Most of us lacks that 6th sense (these days), so it's better to make it a rule!

Thanks  Dean, want to make  sure I get it, is it too simple to say that HE targets self empowerment while HP is community/pop targeted? If so can they exist separate from each other? Maybe a better question is can one exist if the other does not?

thanks to all

No problem Andrew.

That is quite an accurate interpretation. Health promotion is generally a political/policy approach to community/population empowerment - but there are different levels of HP. Similarly, there are different levels of health education; ranging from giving someone a health information leaflet - through to 'empowerment' approaches. That said, where I differ with your interpretation is that very few people 'self-empower'. Whatever the barriers are for them to enjoy better health - they usually stay in place unless 'others' advocate for them or long-term, well-resourced strategies are put in place to change their personal circumstances. The essential difference is probably individual versus whole community targeting - but it's still not as easy as that. At the individual level of empowerment, I prefer McDonald's use of the term 'empowerment'; that is 'power handed down to individuals by more powerful health professionals'. 

They could exist independently - but it's a conceptual 'quagmire'. It has ben argued that you can heave health promotion without health education i.e. screening programmes, media campaigns etc - but it can't be the other way around. Giving health leaflets out to the general public is still an attempt to influence the public health - albeit a very limited and flawed one. 

I asked a question a little while ago on RG - 'what is the the difference between health promotion and health education?' It's had close to 200 responses - and might elaborate further Here is the link to it:

Thanks much,

clarity 

Hi all-

I have read these discussions with interest.  I have been a professor of public health (Community and Family Health) for 20 years and will be teaching an undergraduate course in the Fall on Health Methods, Communication, and Advocacy.  I am at the University of South Florida where we have a great reputation for social marketing and health communication.  As I am preparing my methods info, I really searched for the differences per se between health communication and health education.  In health education we tend to see communication as a method or strategy but truly I have found it to be the backbone I believe of the fields.  I have agreed with the posts about the differences between health promotion and health education as health promotion is much more broad introducing community and environmental efforts.  Any more thoughts on the issue with health communication and health education would be appreciated.  

Hi Karen,

Whereas I do see a clear difference between health education and health promotion - I'm not sure that it is easy to do the same thing between health communication and health education. I asked a similar question to the one I linked to Andrew's previous question - which was about the nature of health communication - as the link provided here. It's a tricky one. I'm more inclined to think that health communication does umbrella more under health education - but a wide and extensive health literacy programme within a community may well be regarded more along the lines of a health promotion approach. 

https://www.researchgate.net/post/Health_communication-health_promotion_by_another_name?_tpcectx=profile_highlights

Just realised Andrew that I didn't link you to the question correctly. Here it is!!

https://www.researchgate.net/post/What_is_the_difference_between_health_promotion_and_health_education?_tpcectx=profile_questions

Dear All

At the Department of Health and Rehabilitation Sciences,UCT a module is being offered To undergraduate students Both in 2nd and 3rd year including students from multiple disciplines.Within This teaching module,we aim To teach students regarding aspects of health promotion, community bases rehabilitation, advocacy, empowerment strategies etc...looking At health/social and other policies/acts and How It impacts on rehabilitation. The teaching module is called Disability and Primary Healthcare and was established about 4years ago. Students from OT,Physiotherapy,Speech Therapy,Audiology and nursing are required To translate classroom concepts into clinical practice within communities under the supervision of clinical educators. It is a good opportunity for multi-disciplinary approach To rehabilitation teaching skills in health promotion and prevention.

Hi Sai,

Thank you for your question which has stimulated this interesting conversation.

As far as should health promotion be mandatory in physical therapy - I have experience leading a physiotherapy program in an Australian university and found that introduction to health promotion philosophy assisted students to embrace a holistic approach to both individual and community health. I agree with Dean's comments that health promotion is far more often achieved in rhetoric than reality. Introducing students to health promotion philosophy and if possible immerse them in health promotion experiences may provide a first step towards developing physiotherapists who are capable of facilitating improvements in the health of communities. As an example, students coming to appreciate the importance of collaboration with a broad range of partners (beyond traditional allied health and medical disciplines) to embrace working with schools, government departments and NGOs may assist achievement of meaningful improvements in community health. For physical therapists collaboration with  planning authorities to facilitate development of healthy housing projects could be an example of improving community health.

As societal needs evolve so too should physical therapist programs - in which case I would suggest health promotion should be mandatory in physical therapy education and therefore physical therapy.

I agree that health promotion has a place in a variety of healthcare disciplines.  Implementing broad range community strategies are not easy however and take knowledge and resources.  Thanks Dean for your reply about health education and health communication.  Any other comments about the similarities and differences between these two would be greatly appreciated!

Good response Narelle. I think that health promotion should be mandatory in all health service/professions education. Population health, public health and community development should be 'front and centre' considerations - regardless of the 'main setting' of the discipline i.e. hospital-based. At the end of the day, the hospital-setting should be at the 'heart of the community' (not an impersonal, separate, technical and medicalised setting) with all health professionals striving to practice in a multi-disciplinary/multi-agency collaboration - so that all benefit. 

Hi everyone:

As an occupational therapist I can tell you we in the profession have been emphasizing health promotion, prevention and wellness for many years now.  I co-edited the first textbook on the topic in 2010 related to OT.  And the ACA is emphasizing primary care now.  I would say our sister PT profession (and all health professions) should be involved which would also lead to expanding some great inter professional research and collaborations !  

That's good to hear Michael. However, I've been emphasising health promotion to nursing for close to 15-years and written many articles and books on the topic. Prior to my interest in the area, nursing had been targeted since the early 1990s to be active in health promotion. The thing is - nothing much has changed and I suspect that for most disciplines allied to medicine, that the same is true. Emphasising is different to it actually being an integral and effective part of routine clinical practice. 

I totally agree with you Dean.  While the literature speaks more to health promotion than ever, we have a long way to go to put it into practice.  The US is very reimbursement driven, especially in the therapies, and health promotion is sadly not reimbursed.  My workshops discuss the integration of health promotion into what is already done, to at least get people thinking.  Other countries that have universal health care actually DO health promotion often and usually well.  I think that is part of the lack of 'putting it into practice'.  

Hi Michael and Dean,

I agree the putting into practice can be a hurdle. I have been privileged to work in a Primary Care setting in Victoria, Australia that mandated 20% of health professionals' time was spent implementing bone fide health promotion activities. This was achieved via a multi-disciplinery team led by a staff member with a university qualification in health promotion and a deep understanding of health promotion as improving community health. This highlights the importance of  embedding health promotion education in pre-entry university health professional programs so that health professional graduates are well equipped to put high quality  health promotion strategies into practice.

Then keep up the good work Michael - especially in such a 'tough' environment. I don't think that it is any secret that I have been quite critical of the US system for integrating health promotion as at least an ethical duty. A highly medicalised litigious public health system puts quite a few barriers in the way. It's good to know that people like yourself are attempting to 'buck the trend'. 

Hi back Narelle,

That sounds commendable support by the service. It would be nice to think that such intervention will visibly reflect a 'difference' in health promotion practice by emerging health professionals. I shall be keeping an interested eye on developments in Victoria. 

Says:-

Thank you all for your wonderful comments. Happy to receive such varied inputs. I feel we are slightly deviating from the main question I asked.

Here it is, once again: --> As health care providers, Physical Therapists are in an ideal position to address health promotion issues with their patients; yet, little is known about actual health promotion practice patterns or the confidence of physical therapists in engaging in such activities. I am keen to know about re-orienting the health services. How PT's can collaborate with other organizations (ex: Social Workers) to promote health.

ANY ANSWERSSSssss..???

I worry so much about the role physiotherapist play in our societies as it should play a major role in educating the public about how physical health can not be separated from social, mental, physiological, economical or any form of health one may give a name to. The system, locally in US, has made us look like exercise instructors using the practical aspect of instructing patients on exercises to do, as directed by an authority and not why. Having thought deeply about that, I decided it is time to introduce PT practice with a public health approach. It is a waste of resources to not use all the knowledge ae acquire in training to only say nothing about how people can improve their quality of lives.

There is a need to change the approach and direct access for our services will demand that we educate our patients. This will influence outcomes.

Sai, Adoniah, Dean - how about developing an interdisciplinary survey of OT, PT and nursing to explore the extent that those professions utilize health promotion in practice from various countries?  

Says:-

Thank you all for your wonderful and thoughtful comments. Putting all your comments together, over all, health promotion seems like a less explored zone (in terms of Physical Therapy). Some of us (here) do promote health, but not on a larger scale. May be, we lack skills in selecting our target audience? I don't know.

As I pointed out earlier, the real problem comes in implementing health promotion activities. Inadequate knowledge in health policies, lack of funds, improper selection of the target audience, lack of interpersonal relationships between the promoter and public, lack of coordination between the promoter and organizations (Ex: Social Workers') are some factors that hamper the HP activities.

If we can address these factors properly, then health promotion becomes an automatic process. This is where collaboration plays a major role. Collaborating with potential partners/ organizations will help in stabilization of the promotional activity with adequate knowledge and/ or funds and the health promotion specialists (or) health promoters can move out (to promote) in a selected orbit, just like the Earth revolves around the Sun. Once such a trajectory is devised, and the target audience/ population is selected, health promotion can be easily achieved.

Responding to Mr. Michael A Pizzi's offer:-

I personally would love to collaborate. Please email me your hypothesis (if any) to [email protected]  We can discuss in detail.

On the whole, I really enjoy reading all your comments. Thanks once again to all of you!

It is a good thing that we are concerned about an issued that is not new but old and the basics of any healthcare practice. Schools are the beginning of this approach and it is in school curriculums that effort should be made to incorporate health promotion programs. My school, the University of Zimbabwe's curriculum has it well established and PT's there practice health promotion as to my knowledge.

In today's practice, evidence based practice is the norm and we need studies to show outcomes. I agree with what Sai said, and Michael, please send me the same at [email protected] and we go from there. Without published articles we will go nowhere. We need to do research and publish results.

Hi Michael,

It would be a good idea to collaborate. I've seen and had similar requests to compare HP activities between discipline 'allied to medicine'. However, at the end of the day, from what I can see the barriers and practices are quite similar between them all. As long as a 'medical model' dominates - then those wider discipline will continue to practice 'limited' health education - and not really aspire to broader health promotion approaches. 

Sai - you suggest "Inadequate knowledge in health policies, lack of funds, improper selection of the target audience, lack of interpersonal relationships between the promoter and public, lack of coordination between the promoter and organisations" are the main problem, and it is certainly some of these things; there are many more that hamper and constrain health professionals. They are huge undertakings in themselves and you suggest that, if they are resolved, then HP will be an automatic process. You are more optimistic than me. 

Says:~

I am always optimistic when it comes to Health Promotion Dean. It would be nice, if you could highlight some more options/ factors other than what I said.

Hi I am Douglas from SA, our physiotherapy curriculum at the university of the witwaterserand, Johannesburg, SA, covers health promotion as a subject. The focus of this subject is to equip students on role of physiotherapy in HP. The ottawa charter list three core effective tools to be used in HP, namely, advocacy, mediation and enablement. These three core tools are taught to our students and have to be practically applied in their PHC block in urban and rural settings.

Hi All,

It has been interesting reading everyones comments! Health promotion and prevention does need to become a priority for physiotherapists. With increasing rates of obesity and diabetes and an increased focus on prevention of NCDs worldwide, physiotherapists have a part to play. NCDs are attributed to 3 main risk factors: poor diet, smoking and physical inactivity. Physiotherapists are seen as 'exercise specialists' and there is some evidence that physiotherapists can increase physical levels and are willing to do so. Here at the University of Canberra 'Health Promotion' is included as part of the cirriculum. It is interesting to consider Dean's comments on health education versus health promotion. I do think that more focus needs to be placed on behavioural techniques to increase intrinsic motivation within our training.

Kind regards,

Nicole  

Good to see that some of my comments resonate Nicole. For the most part, I would argue that most health professionals allied to medicine - such as physiotherapists, occupational therapists etc - are in a good position to facilitate effective behavioural health education programmes to their clients - as long as they are targeted, well-resourced, longitudinal, and evaluated. If we take the true 'health promotion' context into consideration (and interesting to note that it is a standard component of the undergraduate curriculum) - then 'to what extent are such health disciplines involved in wider politically-orientated population health programmes?'

Hi all-

I am wondering if more service learning type courses need to be developed for programs where students can receive actual practice in "doing" health promotion such as policy development, working with the legislative process, being part of environmental changes?  

I think the health worker derives immortal joy when he/she acts as health enabler. Client/patients builds it as habit or must-do if enabled to have health. Surest way is through health promotion. In Physical therapy and other related forms of care, Health Promotion is critical need and making it mandatory is matter of emphasis.  Chukwuekezie

hi everyone,

i've read with interest the posts on this topic.  It's been great to hear about what is going on internationally.  I would agree that HP should be embedded within all health care programs as well as PT, and that is what we do in our programs. 

To add to the suggestion of carrying out some investigation of AHP HP practice, we have recently carried this out.  We established AHP self reported health behaviours and their confidence around tackling HP in practice.  The results would support the discussion around the challenges of implementing HP in clinical  practice - it is multi-faceted and doesn't have an easy solution, but nevertheless, that just means we keep trying and hopefully sharing exmaples of good practice!

Lyndsay 

Hi all-

It might be interesting to develop a course with practice components in health promotion and require it across the health disciplines-including medicine, public health, nursing, PT, etc.  Scheduling such an offering can be problematic however with advanced educational technology this should not continue to be a barrier.

Correct Karen - at the end of the day, health promotion should be one of the core businesses  of all health practitioners. Especially with foundation undergraduate allied health professions education programmes, including medicine, offering core subjects to all health professions in their curriculum (such as with many UK-based Health Faculties) - then 'everyone should be working from the same page'. 

Thank you all for your excellent and erudite comments! I appreciate all of your efforts in making this topic an interesting one. 

One big question that I am seeking an answer for is:

How to re-orient health services?

Health services combining forces would be beneficial both financially and academically. Ultimately it is the people/ patients who will gain the maximum benefit if two health care providers collaborate and work for the same cause.

Any suggestions, with examples? 

Hi Sai-

Yes, this is the model found in our Moffitt Cancer Center where patients are treated by a multidisciplinary team including physicians, allied health care providers, social workers, and more.  What one has to be careful of however is that the patient has follow-up by someone throughout the process and is not left to navigate the system on his or her own.

Hi Sai - that is a 'huge' question. A main aims of the Ottawa Charter - most would agree that health services have hardly re-orinetated beyond a traditional biomedical focus for decades. It doesn't matter how much we all say ' it would be a good idea' - it doesn't shift that much. Attached here is an article in Health Promotion International who approached me to write it for a special 25th Anniversary of the Ottawa Charter supplement. It is on 'developing personal skills' - but you will see the links between it and re-orientating health services - as pats of the Ottawa Charter that are perhaps the least progressed - and the possible reasons as to why

Says:~

Thanks for your answers Karen & Dean.

Karen ~ A multidisciplinary approach will definitely enhance patient care in a Hospital setup. What is more important is how such an effort is carried out in the community/ society. I feel, HP should focus more on 'prevention' than 'cure'. Health promotion should primarily focus on preventing any form of illness/ disease, while, health education should emphasize on putting an end/ cure. However, we need to see the areas this fits into.

I do agree with you that there shouldn't be any conflict in decisions in the teams collaborating.

Dean ~ Thanks for the 25th Anniversary article. I loved it!

Hi Sai-

I follow the definition of health education which as a combination of learning experiences designed to facilitate voluntary adaptations of behavior change conducive to health-not really focused on a cure per se but behavior change.  Health promotion adds the important environmental and policy changes also often necessary.  Health education is a component of health promotion and does focus on prevention.  I think I understand what you are saying but prevention really is the premise.  Regardless of definitions however, I do hope more health promotion is incorporated into healthcare curriculum.  We are trying here!

Karen - an accurate interpretation of the distinct differences (but also the inter-relatedness) of the worthy disciplines of both health promotion and health education 

I have used health promotion through 'picturing' (use of colour pictures) disease and physical ailments of interest. My area of passion, since 1983, is dealing with TB and AIDS. I have addressed students, patients, carers, community members, traditional doctors, faith community leaders, politicians, uniformed forces, commercial sex workers, drug-addicts, out of street youths, trade union leaders, civil servants, nurses, medical doctors and other groups by engaging them with colour pictures.

The colour pictures do the 'talking' while the participants or audience lead the discussions. All I do is facilitate with a bit of scientific knowledge and the upbringing of an African in a world of TB and AIDS. If need be we discuss the colour pictures in the vernacular.

You will be surprised how these simple village folks can become powerful 'movers and shakers' when they are empowered through colour pictures. The Botswana HIV/AIDS Anti-retroviral therapy (ART/ARVs) programme is such an example. The community sensitisation programme and mobilisation to accept  ART/ARVs, "the poisons from the West" as it was believed in those days was through colour pictures. Removing the myths of HIV/AIDS as witchcraft was through colour pictures.

"Seeing is believing...a picture is worth a thousand words...seeing is very different from being told! Can you picture the before and after effects of physical therapy. the colour pictures talk.

In short, Health Promotion should be made mandatory in physical therapy.

Edwin

Says:~

Thank you all for your valuable inputs. Keeping in mind the gap between Health Promotion and Health Education, I feel, Health Literacy is a key component in deciding the impact/ effect of Health Promotion. Creating health literacy is a huge task and it is the duty of the health promoter to identify the level of literacy his audience has. This is where, may be, the collaboration helps. Collaborating with or re-orienting health services (ex: PT + Nurses / PT + Social Worker) will enhance the service provided and also be beneficial to both the promoter and the public.

Any further comments on this, are most welcome!

Excellent point of view!

Currently, the level of health literacy is seen as a predictor of outcomes in health and well-being, essential in evaluating the impact of programs on health promotion, prevention of disease and disability associated with chronic diseases and an aging population. Meanwhile, inadequate health literacy is a barrier to health care, in that it can make users less cooperative, less active in the practice of preventive measures and unable to make informed decisions, or even cause them to make decisions that adversely affect their health.

Health literacy is essential for the provision of health care cost-effective, safe and high quality health services, possibly with better health outcomes. Simple instructions written formats, visual aids and illustrations, repeating after the explanation, avoid technical terms, acronyms and abbreviations, among others, are some of the measures presented, as well as the development of a defined action for professionals involved in health promotion.

Regarding the original question, there is no doubt that Health Promotion should be made mandatory in Physiotherapy!

Good recent points. Health literacy is certainly an important, current, topical concept that would be highly desirable to achieve. However, I also see it as as 'a white elephant in the room'. In it's current form, it mainly relates to 'how to make medical information more accessible and understandable to wider populations'. important for many, I agree, but not all health care, and particularly preventative intervention, is about overcoming medicalised structures. 

Thank you all for your lovely inputs. I would like to cordially invite you all for the Health Promotion course due to take place in May, 2015.  This course will answer most of the questions answered here. I hope, we can use this as a platform to move ahead and find more suitable researches and exploration in the field of Health Promotion.

For more details, pls visit - http://www.wcpt.org/congress/courses/254

Best of luck with your course and please let us know what transpires so we can keep communicating about this issue.

Hi All

I think this is a really interesting topic. I think because of what physical therapists are capable of we really are in a good position to help in health promotion and that it should be mandatory. Here in the University of the Philippines, physical therapy students are exposed to their role in health promotion in communities early on in the curriculum in various courses. They undergo a course called Community Health and Development and later on in internship go on to immerse themselves in the more rural areas of the country where they help in educating people and health promotion through creation of different programs. As interns on their last year the students are also given the chance to work closely with other health care professions like occupational therapists and speech pathologists. I agree with what other people have mentioned in the thread that health promotion should be a multi-disciplinary endeavor. Although physical therapists are in a good position to promote health, I don’t think that it is something a single profession can handle on its own. Working closely with other health care professions, there are a lot of aspects of health promotion we know and a lot of other aspects that the nurses, OTs, SPs and other professions know about too. Having a really integrated program I think makes more sense. I think that is especially true in my setting where physical therapy, although a really important profession, is not that recognized in the country in areas outside of rehabilitation. There are many misconceptions about it and we are still growing as a profession here in the Philippines. I think by working together with other health care providers, our voice would be much louder and in effect we could be more actively involved in health promotion and disease prevention.

Hi all-

One of the important groups to involve is public health educators.  These professionals work hand in hand with other health professionals and are skilled in theory-based communication strategies along with the development, implementation, and evaluation of public health interventions.

Hi all,

I believe that health promotion should be included in Physical Therapy. Here in the Philippines, the profession started as one that was known to focus on rehabilitation and health restoration. Considering the evolution of Physical Therapy, I believe that this could be one of the avenues where the profession can further grow and redefine itself (of course, while still being within its scope of practice). I have encountered literature supporting the role of physical therapy in health promotion and some of those have identified barriers to wellness our profession can help address. Some of you mentioned that despite this knowledge, the application of this in practice is a bit lacking. This is particularly true here in our country. Some institutions here have actually started to adapt this, including the one I am currently affiliated with. It is exciting to think of working with a lot of other disciplines concerned with both people with and those without disabilities towards health promotion. It would be wonderful if all physical therapy institutions here would follow through because of the potential benefits for the country’s current health status and the public’s awareness about the profession and what it has to offer.

I think a mixed curricula as you state would be very advantageous for the field and for the overall health of patients.  A therapist can work towards the cure better by educating the patient and having the patient participate actively in his or her own recovery.

Hello Sai

Should health promotion be made mandatory in Physical Therapy?  

Absolutely.  The question is how to best facilitate this.  I would think the most effective route is to build and retain muscle mass, as this is the best prophylactic at the least cost.  If the patient had or has an exercise pursuit they enjoy or would like to pursue we should attempt to rehab with a primary focus on facilitating any activity they would reliably pursue - as opposed to insisting a lifestyle change to any activity they have little interest in participating in.

I think the current generation of new PTs will have that skill and interest in their repertoire (unlike us older generation who are too conditioned to practicing by what is reimbursed, and wellness and prevention is not paid for).

First, wellness is a required to be in the curriculum, per our current accreditation standards in the US.:  7D34 Provide physical therapy services that address primary, secondary and tertiary prevention, health promotion, and wellness to individuals, groups, and communities.  http://www.capteonline.org/AccreditationHandbook/

It is also included in the CPI, the instrument used to evaluate students in their clinical internships.

Lastly, as a profession, the APTA House of Delegates (USA) has previously passed two motions supporting the PT's role in advocating for and providing wellness and prevention services. So, it is a priority of the profession, and is tied into the professional core values and ethics.

Some training will vary by school. Some schools have more time spent on health education practices than others, or fitness screens, or community-based approaches, based on their curricular philosophy and their faculty's interests. But it is in there in some capacity in each program now.