Twenty years ago, a television production company came to make a pilot documentary about us.
This was peak fly-on-the-wall TV. From Docs to airport staff shouting about liquids. Somebody decided physios might be next, and a camera crew spent four days filming us.
We may have got the nod because I'd had a semi-regular slot on a documentary about Harley Street. Arriving on a scooter, helmet off, hair everywhere, very much the Naked Chef idiom. Somebody thought: that's super cool, there's a series in that.
There was not a series in that.
Physio isn't dull. If you're in pain, frightened, unable to run or can't get your socks on, good physiotherapy is fan-bloody-tastic.
But try watching it.
Somebody asks questions. A man bends forwards. Somebody pushes on a body part. The man steps up. He steps down. For variety, he steps sideways. Then he's handed a stick-man drawing resembling something he could have found online in nine seconds.
Riveting.
The important bit is invisible. Knowing which questions matter. When to step up, step down or leave the bloody thing alone. Spotting the straightforward problem inside a dramatic story and the serious problem inside a boring one.
None of that has a visual. They never rang back.
Patients can't judge it either. They judge what they can see and feel.
How they were greeted. Whether anyone expected them. Whether the place feels good. Whether the physio looks like somebody you'd trust with a spine. Whether the whole thing feels worth what they've been asked to pay.
And this is where our profession has its priorities beautifully upside down.
We'll spend a decade arguing about titles, courses, modalities and who is sufficiently evidence-based. All of it invisible to the person paying. Meanwhile we leave the visible part to chance.
A corner of a gym. Shorts. Hand tattoo. A grown adult calling a 58-year-old accountant "bro."
None of this may affect clinical ability. It's also irrelevant. The patient decided what they thought somewhere between the door and the handshake and everything afterwards is filtered through it.
First impressions don't sit politely alongside treatment. They are treatment.
Arrive unconvinced and you arrive guarded, comply less and don't come back. The clinician never knows because people don't complain. They just leave.
Same with restaurants. You'll cheerfully eat a £16.50 burger cooked by a man with fingernails you'd rather not examine. Part of the charm. Pay £150 and you expect the kitchen, welcome and staff to look as though somebody gives a shit. That isn't snobbery. The experience has to match the promise and price.
And before anyone accuses me of lofty standards, it wasn't my clinical reasoning that put me on television. Nobody said, "Get me the geezer who's sound on differential diagnosis."
It was a bloke on a scooter. A signal. Entirely superficial, and it worked.
Professionalism is how we make the invisible bit believable.