COVID19 GOVERNMENT COMPENSATION MEASURES FOR BELGIAN PHYSIOTHERAPISTS IN PRIVATE PRACTICE: A NECESSITY IN THE CURRENT LEGAL FRAMEWORK?

Background: The complete social and economic lockdown in Belgium due to the COVID19 pandemic affected self-employed physiotherapists. Physiotherapy is considered a contact-profession and therefore it could not be exercised in safe conditions. The safe conditions could not be met due to the lack of available Personal Protective Equipment (PPE). Although tele-rehabilitation was legally authorised during the COVID19 pandemic, this did not prevent (temporary) mandatory closure of most of the private practices. Tele-rehabilitation was a new element in the legal scope for Belgian Physiotherapists. Tele-rehabilitation offered the possibility to accommodate certain patients however, it could not replace a full functioning practice. Closing a private practice implicates a complete loss of income for the self-employed physiotherapist while business expenses still continue.

Purpose: The purpose of the preliminary study was to identify the need for compensation measures allocated to physiotherapists providing services in the national health care system.

Methods: We did a descriptive analysis of available sources which included websites of the government, social insurers and professional physiotherapy association.

Results: On March 16, 2020 physiotherapy treatments not relating to life-threatening situations were cancelled due to lack of available PPE. To lighten the financial burden the government approved a nuisance premium for self-employed physiotherapists if the turnover for the reference period (March 14 to April 30) was at least 60% lower compared to the previous year. Furthermore, self-employed physiotherapists who closed their practices for a period of 7 consecutive days in the months from March until August were granted a monthly ‘bridging right’ premium. A third structural measurement was the possibility to postpone quarterly payment of the mandatory social contributions.
The solution for the PPE in the private practices was not structural nor well-coordinated. We found that some local governments provided health care workers with protective facemasks although the distribution was not simultaneously in all provinces. Some local initiatives led by schools, seamstresses and breweries made sure health care workers were able to obtain protective face shields, facemasks and rubbing alcohol.

Conclusion(s): On May 18, 2020 most private practices re-opened for non-life-threatening treatments. At that point self-employed physioterapists organised their services to ensure safe treatments for patients. Preliminary findings suggest that the structural financial compensations enabled most self-employed physiotherapists to bridge the period with no generated income from their practice. The uncoordinated process relating to the PPE and the overall lack of availability of PPE has largely affected a coordinated restart of Belgian private practices.

Implications: A follow-up study is recommended to map the impact of the COVID19 pandemic compensation measures for self-employed physiotherapists and provide more detail on why a number of private practices did not re-open.

Funding, acknowledgements: The authors received no specific funding for this study.

Keywords: COVID19, compensation measures, self-employed physiotherapists

Topic: COVID-19

Did this work require ethics approval? No

Institution: N/A

Committee: N/A

Reason: The study was a descriptive narrative review of current applied compensation measures for self-employed physiotherapists in Belgium.