Psychologically Informed Physiotherapists With Good Communication Skills: A Conversation With Romy Parker
Romy Parker, PhD, is a professor and director of the Pain Management Unit in the Department of Anaesthesia and Perioperative Medicine at the University of Cape Town in South Africa. She is an active researcher, as well as an experienced physiotherapy clinician working in chronic pain management as part of the Chronic Pain Management interdisciplinary team of Groote Schuur Hospital. Her research focuses on pain, with emphasis on developing and testing mechanism-based treatments relevant to a South African context. Parker recently spoke with PRF Correspondent Y V Raghava Neelapala, PT, MPT, a PhD student in the School of Rehabilitation Science at McMaster University, Hamilton, Ontario, Canada, to discuss her career journey, her current research projects, and the skills and knowledge that make for good physiotherapists. Below is an edited transcript of their conversation.
You were a physiotherapist initially, and later did your PhD in the field of psychiatry. Can you elaborate on your career path?
When I finished my physiotherapy training, I did a postgraduate qualification in sports science and worked in the field of sports injuries, particularly in rugby. After many years of working in that field, I got a bit tired of athletes who I thought just weren’t listening to what I had to say. So I then started working, strangely enough, in the field of rheumatology.
When I worked in rheumatology, that was really when I was challenged by the strangeness of pain, because I had patients with severe rheumatological disease. Their joints were destroyed, their knees were a mess, and yet they were living full, rewarding lives and hardly ever complained of pain. I had some patients with early rheumatological disease – who had no joint damage and were responding well to their drugs – and yet they were in pain all the time and were disabled. That was when I was challenged by this idea that there was pain, and then there were disease processes, which were not always directly linked to each other.
That’s when I started asking questions, and I went on to do my master’s in pain in Edinburgh at Queen Margaret University. Then I came back to South Africa and started working on my PhD in psychiatry. This was because my supervisor was a psychiatrist but also because we recognize that pain is about the brain, right? I was asking questions about pain in people living with HIV and AIDS, because at that stage we already had some quite good insight that pain in people with HIV was not related to disease, viral load, or opportunistic infections. So what was this high prevalence of pain in people with HIV about?
So that’s when I started my research career, really focusing on pain problems that are particularly relevant to my society in South Africa, to the millions of South Africans who don’t have access to expensive healthcare, who manage at a primary healthcare level. I started thinking about how we develop effective but sustainable treatment options for those patients. I have a particular passion for making sure that our treatments are effective but are also culturally relevant and sustainable for these resource-poor settings where the majority of people in my country are living and struggling.