In a world where health challenges from accidents, aging, and chronic conditions are on the rise, the role of physical therapists, also known as movement therapists or physiotherapists, has become increasingly crucial. Not just in Mongolia, but globally, the demand for these professionals is growing day by day. These specialists help restore lost mobility, alleviate pain, and improve overall physical functioning. They also play a key role in the rehabilitation of musculoskeletal joint disorders, post-surgical recovery, and sports injuries.

In this exclusive interview, we speak with A.Oyungerel, a physical therapist at the Chingeltei District Health Center, who has been practicing physiotherapy for nine years. We discussed the profession’s importance, challenges, and the growing demand for trained physical therapists in Mongolia.

Could you provide information about the characteristics and importance of the profession? It seems that this profession is often confused with occupational therapy.

People often do not distinguish between these two professions. Therefore, it seems they understand them as one and the same. In rehabilitative medicine, there are three main types of assistance: physical therapy, occupational therapy, and speech therapy. Physical therapy addresses issues such as brain injuries, spinal cord injuries, stroke, joint stiffness, and paralysis. It is for people with musculoskeletal disorders caused by diseases, accidents, or injuries. Physical therapists provide assistance and services to individuals with disabilities related to their mobility systems. Apart from the physical appearance, our role is to help people regain their ability to perform tasks like walking, standing, sitting, running, and maintaining balance. This helps the patient live independently, without relying on others, and participate in social interactions freely. Globally, physical therapists usually work in three main areas: exercise therapy; electrotherapy, or what we commonly call physical therapy; and aquatic therapy. 

Occupational therapists, on the other hand, work to help individuals develop skills to live independently, starting from strengthening the fine motor skills in the hands to improving daily activities such as brushing teeth, using a spoon to eat, drawing, or putting on shoes.

The demand for physical therapists seems to be high at the Chingeltei District Health Center. With that, your workload must be heavy?

Our clinic has four physical therapists. One of them is a volunteer physical therapist from the Japan International Cooperation Agency (JICA), who started working with us in 2023. The others work at the rehabilitation and traditional medicine department of the Chingeltei District Central Hospital. As for me, I work alone at the Khailaast branch outpatient clinic, so my workload is relatively heavy. I also participate in preventive health screenings and community outreach events to raise awareness about our profession.

How many patients do you treat per day? What age group mostly seeks this type of services?

There is a standard for how many patients a physical therapist should treat per day. On average, a therapist spends about 30 minutes with each patient. Therefore, a therapist is expected to treat about 16 patients a day. However, in practice, I treat even more people and provide consultations. Most of my patients are between 35 and 60 years old. Recently, we have seen an increase in younger patients, particularly adolescents, who come in for back pain. This is mostly due to their desks and chairs at school not being suitable for their body types, as well as long hours spent playing on computers and smartphones. As a result, there has been a rise in back pain among teenagers. The treatment duration depends on the degree and type of spinal curvature, and how severe it is.

Does the number of clients increase with more slippery conditions due to winter?

Yes, it definitely does. During the cold season, the number of people who get injured from slipping and falling increases significantly. As a result, the number of clients seeking our services at the clinic also rises accordingly. Elderly individuals, in particular, are more likely to suffer injuries from such accidents.

While the demand for your profession is high, it seems that few children and young people are interested in studying it. Why is that?

The profession of physical therapy began to be formally taught at the Mongolian National University of Medical Sciences; since then, 14 classes of physical therapists have graduated. However, there is still a shortage of therapists in this direction across the country, and not all hospitals have enough qualified professionals. This reflects the high demand for this field, but also highlights the lack of sufficient staffing in many health institutions.

Do people seek advice from you for preventive purposes?

Absolutely. People do seek advice, but there is a general lack of health literacy among the public. Most people don’t realize the importance of prevention and often don’t pay attention to it until they personally experience pain or illness. Usually, people come to see a physical therapist only after a family member has suffered an injury or they experience pain themselves. 

In other words, individuals seek preventive advice only after they see the consequences firsthand. We work with public organizations, district social welfare departments, and primary healthcare centers to offer educational sessions and provide advice to the public. It’s important to note that physical therapists are not just for people with injuries or pain; healthy individuals can also consult with us for preventive purposes. Regular physical therapy can help prevent future complications. By strengthening muscles and boosting immunity, you are effectively healing yourself. Unlike medication, which can have side effects with prolonged use, physical therapy has no adverse effects.

What are the most common conditions that patients seek treatment for in your department?

The majority of our patients come to us due to neurological and musculoskeletal disorders, sports injuries, and complications after surgery. For example, patients suffering from stroke, back pain, knee pain, injuries following trauma, or those who have had joint replacement surgery are common among our clients. When a patient comes to us, we assess their physical condition and based on this evaluation, we create a personalized treatment plan, which we then implement.

The demand for therapists in this field is high, but there is a shortage of professionals, so there have been discussions about the government's attention to this issue. For example, the government has started subsidizing tuition fees for students in this field. Has this had an impact on increasing the supply of professionals?

Yes, support for human resources in the physical therapy and occupational therapy fields began in 2022. For new entrants, if a student scores above 501 points on the entrance exam and has a GPA of 2.8 or higher, the government covers 100 percent of their tuition fees. This initiative has certainly contributed to increasing the number of students pursuing this field, and it is believed that it will help address the staffing shortage.

This type of therapy is primarily based on rehabilitation therapy. What are the benefits of undergoing this type of treatment?

As mentioned earlier, rehabilitation therapy is made up of three core professions. These three professionals often work together, but there are cases where they also work separately. Recently, respiratory therapy has been considered a part of rehabilitation treatment. Respiratory therapy became more widespread after the COVID-19 pandemic. Those who contracted COVID-19 often experience changes in lung function, and respiratory therapy is used to restore it to normal. The goal is to improve lung capacity. For example, if a person previously couldn’t climb two flights of stairs without shortness of breath but now struggles with fatigue after climbing just one, it means their lung capacity has decreased. Therefore, respiratory therapy is used in stages to gradually improve lung capacity. However, the number of patients receiving respiratory therapy at our center is relatively low—about one to four people per season. This number increases during the winter months.

When people suffer from bone fractures, they often turn to traditional massage therapists. However, many times, treatment by unqualified individuals worsens the condition. How do you see this?

Traditional medicine has been around for over 5,000 years, and it includes various methods and treatments for bone fractures. A traditional healer can provide more detailed explanations regarding this. When it comes to bone fractures, radiologists use X-rays to finalize the diagnosis. To prevent complications such as joint stiffness or muscle contractures due to bone fractures, physical therapists follow the recommendations of injury and rehabilitation specialists when providing treatment. Massage therapy belongs to the field of traditional medicine, while physical therapy is based on Western medicine. Massage therapists often perform point therapy or open channels.

In contrast, physical therapists focus on improving a patient’s ability to perform daily activities. For instance, for patients who have lost the ability to walk, a physical therapist will assist them in taking their first steps. We support and help them regain their movement abilities. There are many differences between these two approaches, and generally, they belong to different scientific traditions. 

By D.CHANTSALMAA