CSP Founders’ Lecture · Chartered Society of Physiotherapy · 21 November 2025
Keynote lecture
Overview
The Chartered Society of Physiotherapy’s annual Founders’ Lecture, taking up a question that unsettles every health profession: how do we make sense of a technology that challenges fundamental assumptions about what constitutes professional practice?
The talk opens with the disorienting evidence — AI systems now match or exceed primary care physicians on diagnostic accuracy, are rated more empathetic than human clinicians, and reason ethically with notable consistency. Rather than treat this as a threat to be defended against, the lecture works through and rejects the instinctive “sanctuary strategies” — denial, retreat, resignation — that position practitioners as spectators of something happening to them. A violinist isn’t special because they do things violins can’t; they’re special because of how they use violins.
The central argument is context sovereignty. Language models are stateless (no memory between sessions), static (knowledge frozen at training), and contextless (no understanding of your expertise, patient populations, or clinical reasoning). As models become more capable, their connection to context — not raw capability — becomes the bottleneck. The professional context a practitioner brings is therefore not a comforting refuge but a structural necessity: by controlling the context, you control the meaning of the interaction. The question shifts from “What can only humans do?” to “What contributions do humans make?”
The lecture develops this through three principles — persistent understanding, individual agency, and cognitive extension — and grounds it in concrete applications across professional development, evidence-based practice, and the cultivation of evaluative judgement, or “taste”. It closes by looking ahead to the next shift, patient context sovereignty, where patients arrive with their own persistent AI agents, and the therapeutic relationship becomes a negotiation between clinician-plus-AI and patient-plus-AI. Context sovereignty is not a solution you complete or a tool you use — it is ongoing work you commit to doing, and meaning-making in an ambiguous moment has always been the work of professionals.
Slides
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