When algorithms don't care: physiotherapy and the post-professional turn.

Abstract

Physiotherapy has long resisted the forces that restructured manufacturing, journalism, and finance. This resistance is ending. Drawing on Gilles Deleuze's prescient analysis of societies of control, this paper argues that physiotherapy - along with the orthodox health professions more broadly - is entering a post-professional era characterized by the progressive marginalization of practitioners in the coordination and delivery of care. Three concurrent forces drive this transformation: the atomization of bodies and health into commodifiable fragments under late-stage capitalism; the systematic unbundling of professional claims to goodness and expertise from both political left and right; and digitally mediated technological disruption that promises efficiency gains while hollowing out professional jurisdiction. Yet Deleuze's framework, written before the internet and artificial intelligence, requires updating. The paper proposes that we are now witnessing the emergence of a "society of indifference" - a post-neoliberal formation in which predictive algorithms replace individual choice altogether, offering consumers the benefits of personalization without the burden of decision-making. Using the case of Flok Health, the UK's first AI physiotherapy clinic, the paper demonstrates how this shift threatens not merely physiotherapy tasks but physiotherapists' agency itself. When artificial intelligence can autonomously assess, diagnose, treat, and discharge patients with musculoskeletal conditions, what remains for human practitioners? More troublingly, if the disciplinary infrastructure that sustained professional physiotherapy is progressively dismantled, how will populations' rehabilitation needs be met when algorithms and personal choice prove insufficient? The paper concludes by considering how physiotherapy might respond - not by defending professional territory, but by identifying and sharing the "intensities" that have sustained physical therapy practices for millennia.