The convergence between behavioral neuroscience, strategic management and manual therapies: a new paradigm for adherence, clinical efficacy and sustainability in contemporary physiotherapy

Abstract

The current healthcare ecosystem, characterized by fierce competitiveness and the demand for measurable clinical outcomes, imposes a highly complex challenge on physiotherapists and rehabilitation managers: integrating the technical excellence of manual therapies with the sophistication of strategic management and the depth of behavioral neuroscience. This scientific article aims to analyze, from a technical, integrative, and dense perspective, how the fusion of these three domains of knowledge can redefine the standards of therapeutic adherence and economic sustainability of clinics. The adopted methodology consists of a systematic and critical bibliographic review of a broad spectrum, correlating classical management theories (Porter, Drucker), advanced concepts of neuroeconomics (Kahneman, Damasio), and clinical evidence on rehabilitation and chronic pain. The study is structured into seven thematic axes that explore everything from the neurobiology of patient decision-making to the application of key performance indicators (KPIs) in clinical management. The results indicate that the traditional care model is insufficient to engage the modern patient, requiring a "neuro-strategic" approach that acts simultaneously on pain modulation and the individual's choice architecture. It is concluded that ambidextrous leadership — technical and managerial — is the determining factor for the survival and growth of healthcare organizations in the 21st century.