Less is more: the hidden power of subtraction

In physiotherapy, we’re driven to add – more techniques, more tools, more ways to expand our practice. Sound familiar? It should. The idea that ‘more is better’ is deeply ingrained in our society. 

Research shows a strong bias toward solving problems by adding rather than subtracting. When asked to improve a piece of writing, few participants chose to remove words. And when refining a recipe, most people add more ingredients.  It’s how we are wired – but what if the real power for progress in our practice and patient outcomes lies in subtraction? 

Finding success in less

Success often comes not from piling on more, but from removing what no longer adds value. This principle applies broadly to many aspects of our life and work, where our constant pursuit of more can overshadow the benefits of simplification. 

How often do you find yourself adding something new to your practice – whether it’s a new technique, a piece of equipment or a treatment approach? Are you sure it’s necessary? Now think about how often you remove elements of your practice.

Probably much less. You’re not alone. Removing is often seen as a negative – a step backwards or even laziness – in a profession that values innovation and growth. But what we really want for physiotherapy is professional progress, not growth. 

Sometimes progress comes from adding, sometimes from taking away. We must balance our adding with a mindful approach to subtraction. 

Hidden value

Subtraction is hard to notice. How do we highlight what is no longer there? For instance, a treatment plan with fewer, more focused exercises may be more effective, but is this improvement obvious? Unlikely. The benefits of subtraction are often invisible, making it easier to overlook their value.

Yet when we subtract, we create space. Space to focus on what truly matters, refine our skills, and deliver care that is not just abundant but effective.  Subtraction might involve eliminating outdated practices that no longer serve your patients effectively, streamlining treatment plans to avoid overwhelm, or reducing the techniques you use to focus on a few that more consistently deliver the best results.  This isn’t easy. We are conditioned to think that adding equals success. But subtraction could bring transformative changes not just for your patients, but for you as well. Could the constant addition be contributing to clinician burnout and stress? By focussing on what truly matters, you can work more efficiently and find greater satisfaction in your role. 

Take action

It’s time to recognise subtraction as a powerful tool. Start today by identifying one area of your practice where removing or simplifying could make a real difference – and measure the impact. Embrace subtraction not as a step backward, but as a big strategic step forward, unlocking hidden value for more effective and satisfying practice.