For Mitchell Taylor APAM MACP, completing the Australian College of Physiotherapists Milestone 3 titling credential offered an opportunity to reflect on a career that includes working in the trilogy of
physiotherapy—clinical practice, research and education. 

The APA Cardiorespiratory Physiotherapist recently completed the evidence portfolio pathway, highlighting his experience and knowledge of cardiorespiratory physiotherapy in the
acute, subacute and, more recently, primary care setting.

The APA Physiotherapist title is a formal recognition of attainment of a highly developed level of competency in an area of practice and is the precursor to specialisation, conferred on physiotherapists who have attained the highest level of expertise in their field. Titled physiotherapists are known as Members of the Australian College of Physiotherapists and clinical specialists become Fellows.

Since graduating from the University of Sydney with first-class honours in 2012, Mitchell has continued to study with world-leading cardiorespiratory specialists across Australia, New Zealand and the UK to improve respiratory care. 

In 2015, he opened the private physiotherapy clinic Functional Lungs in Sydney and later expanded the footprint of cardiorespiratory interventions to Wollongong.

Mitchell is also a clinician and researcher within the respiratory medicine department at St George Hospital in Sydney. 

At the University of Sydney he is undertaking a Master of Research with a focus on improving the evidence base for physiotherapy management of bronchiectasis in primary care.

It’s a career path that could be described as serendipitous. ‘I really fell into cardiorespiratory physiotherapy. 

The last rotation of my new graduate year was a cardiorespiratory rotation and at the end of it I was invited to stay on full-time and take a key role in the education and supervision of the following new graduate year.

I was really enjoying the position and I always loved being involved in teaching and training,
so I took it and never looked back.’

After three years in an acute care setting, Mitchell began work in a community-based respiratory outreach program, where, during times of lesser demand, he was able to focus on preventive care and ‘look towards preventing morbidity rather than reacting to it’.

‘After successfully working one-on-one with a patient who had had 19 emergency department admissions in the previous calendar year and who only had one admission in the 12 months following,
I was driven to provide a service that focused on prevention and community- based interventions.’

However, opening and then operating a physiotherapy clinic dedicated to the prevention of cardiorespiratory morbidity was not straightforward. 

It came with challenges such as the need to ‘navigate referrals, marketing and establishing a valued place in the community’.

‘I didn’t personally know of anyone else focusing on cardiorespiratory physiotherapy within the private practice setting in Australia. 

I was fortunate to draw on the experiences of friends working in the musculoskeletal space. 

However, GPs and even respiratory specialists were not looking for this service as it was not something widely available in the area. 

Turn the clock forward eight years and we have more than 20 respiratory physicians regularly referring to the practice as well as receiving referrals from GPs and practitioners of many specialties, not to mention word-of-mouth referrals.’

The patient mix is varied.  

Patients range in age from infants to 90-year- olds, with a wide range of conditions including bronchiectasis, dysfunctional breathing, long COVID, phrenic nerve injuries, inducible laryngeal obstruction, neuromuscular diseases, lobectomies, asthma, gastrointestinal issues, pulmonary hypertension, interstitial lung diseases and chronic obstructive pulmonary disease.

Proudly referring to Functional Lungs as the biggest milestone of his career so far, Mitchell says that a desire to do more to ‘normalise’ preventive cardiorespiratory physiotherapy in primary care on a larger scale led to his doing the titling program.

‘With this goal in mind, I felt it was important to take two actions: to embark on the APA titling program to help generate a platform for cardiorespiratory physiotherapists to be recognised for their skills within the primary care setting and to establish an education program specifically for cardiorespiratory physiotherapists in private practice. 

We’ve had more than 70 physiotherapists take part in the course, nationally and internationally, which continues to inspire me.’

It was peer interest in Mitchell’s clinical work that led to the development of the education programs. 

‘I was having lots of discussions, calls and emails with therapists, physicians and patients from
all over the country so I could see that the community was calling for a platform for physios to expand their cardiorespiratory skills into primary care.’

While titling brought career reflection, its benefits extend beyond personal achievements.

‘I hope the integrated career pathway will help to establish a community-based awareness and understanding, not only of cardiorespiratory physiotherapy but of the range of specialisation pathways that physiotherapists often undertake as part of their careers.

‘Personally, I enjoyed taking the time to reflect on my career to date. 

Taking a helicopter view of my career was not something I had done before and it was great to think about the opportunities, mentors and challenges that have led me to where I am today.’

An investment of time is needed, says Mitchell of the titling credential, and he advises peers to consider how it will balance with family and professional interests. 

For Mitchell, the latter includes being an educator of the BradCliff Method, an associate member of both the Thoracic Society of Australia and New Zealand and the Australasian Society for Ultrasound in Medicine and deputy chair of the New South Wales branch of the APA Cardiorespiratory group.

‘Deconstructing your career requires time to reflect, understand and then demonstrate your achievements. 

This is a challenge for healthcare professionals because we are not often asked to exult in our achievements and I definitely found this a little difficult and unfamiliar. 

My advice is to enjoy the process and take it as an opportunity to reflect and grow rather than scrutinising yourself.’

When not working, his focus is on family. ‘I am fortunate enough to have recently become a father and am currently enjoying all the little things in life like smiles, walks and nursery rhymes.

‘Would I go on to specialisation? Yes, I believe I will at some point.

Right now, I am just over halfway through my master’s recruitment and time with my newborn is precious.

 However, as I continue to work towards normalisation of cardiorespiratory physiotherapy in primary care, I see embarking on specialisation as the next landmark in creating a pathway for professional and community recognition of the important role it can play.’

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