Woznica D1,2
1Polish Chamber of Physiotherapists, Warsaw, Poland, 2Medical University of Gdańsk, Physiotherapy, Gdańsk, Poland
Background: World Confederation of Physical Therapy (WCPT) aims at unification among regional physiotherapeutic market to foster similar regulations and impact on decision-making institutions connected with Health Care and independence. In European Region, physiotherapists (PT) are on the fourth place of most migrating professions. An aging society in Europe requires more and more effort to develop physiotherapy service, which is imported when debating about direct access generally available. Despite WHO statement on physiotherapy as autonomous profession, PT in Europe may not be independent fully.
Purpose: The aim was to compare basic and advance physiotherapeutic scopes of practice among European countries.
Methods: The survey was conducted on all 39 Members of European Region WCPT. Responses were however received from 29 countries. The Survey Questionnaire contained 6 main sections included Basic Scopes of Practice, and Advanced Scopes of Practice. Basic Scopes of Practice included professional autonomy, assessments, plan or implementation of therapy whilst Advanced Scopes of Practice concerned: dry needling, prescriptions, specialist medical procedures.
Results: Among respondents, scopes of practice was introduced by Ministry of Health in 28,2% cases, and by law in 59%. Twelve comma eight percent have no regulations at all. Basic scopes of practice differ most when comparing professional autonomy; 58,6% declare full autonomy to practice, 34,5% part autonomy. Two countries pointed no autonomy at all (6,9%). Another difference occurred when comparing “permission to provide functional diagnostic”. Seventy eight comma six percent respondents declared full permission compared to 18,4% who pointed answer “No”. Analyzing permission to “differential diagnostic” 75% Member Organization (MO) countries provide such, and 25% don't. Relative compatibility includes: estimating short- and long-term goals of PT as estimated by 94% respondents, issuing opinions about patient function (76%), and introducing health education (85%).
Analyzing advanced scopes of practice greatest divergences included: medicines prescription, conduction (permitted among 31% of respondents) as well as description (20,7%) of specialist medical examinations (USG, EKG, Botulinum injections, Spirometry). Spirometry was the most pointed procedures to conduct and describe by PT within their scopes of practice. Medical devices prescription is permitted within 21,4% countries. Procedures like dry needling is permitted within scopes of practice among 25,8% of respondents, nevertheless 29% declared it as “unclear” or “unregulated”.
Conclusion(s): There is lack of common practice rules among European countries in terms of PT service. Despite the introduction of regulations in most countries, lack of full professional autonomy is noticeable. Competencies tend to include prevention, health education instead of medical procedures such as functional diagnostic and differentiation. On the other hand scopes of practice oblige physiotherapists to issue opinions, assess and provide a documentation of PT procedures, giving unclear tool or partly permission to do so. Unequal basic scopes of practice might be a barrier to uniform advance one.
Implications: the study showed the need for further work toward the unification of PT professional rights and obligations in Europe.
Keywords: Scope of practice, Physiotherapy, Analysis
Funding acknowledgements: The present work was supported by the Polish Chamber of Physiotherapists.
Purpose: The aim was to compare basic and advance physiotherapeutic scopes of practice among European countries.
Methods: The survey was conducted on all 39 Members of European Region WCPT. Responses were however received from 29 countries. The Survey Questionnaire contained 6 main sections included Basic Scopes of Practice, and Advanced Scopes of Practice. Basic Scopes of Practice included professional autonomy, assessments, plan or implementation of therapy whilst Advanced Scopes of Practice concerned: dry needling, prescriptions, specialist medical procedures.
Results: Among respondents, scopes of practice was introduced by Ministry of Health in 28,2% cases, and by law in 59%. Twelve comma eight percent have no regulations at all. Basic scopes of practice differ most when comparing professional autonomy; 58,6% declare full autonomy to practice, 34,5% part autonomy. Two countries pointed no autonomy at all (6,9%). Another difference occurred when comparing “permission to provide functional diagnostic”. Seventy eight comma six percent respondents declared full permission compared to 18,4% who pointed answer “No”. Analyzing permission to “differential diagnostic” 75% Member Organization (MO) countries provide such, and 25% don't. Relative compatibility includes: estimating short- and long-term goals of PT as estimated by 94% respondents, issuing opinions about patient function (76%), and introducing health education (85%).
Analyzing advanced scopes of practice greatest divergences included: medicines prescription, conduction (permitted among 31% of respondents) as well as description (20,7%) of specialist medical examinations (USG, EKG, Botulinum injections, Spirometry). Spirometry was the most pointed procedures to conduct and describe by PT within their scopes of practice. Medical devices prescription is permitted within 21,4% countries. Procedures like dry needling is permitted within scopes of practice among 25,8% of respondents, nevertheless 29% declared it as “unclear” or “unregulated”.
Conclusion(s): There is lack of common practice rules among European countries in terms of PT service. Despite the introduction of regulations in most countries, lack of full professional autonomy is noticeable. Competencies tend to include prevention, health education instead of medical procedures such as functional diagnostic and differentiation. On the other hand scopes of practice oblige physiotherapists to issue opinions, assess and provide a documentation of PT procedures, giving unclear tool or partly permission to do so. Unequal basic scopes of practice might be a barrier to uniform advance one.
Implications: the study showed the need for further work toward the unification of PT professional rights and obligations in Europe.
Keywords: Scope of practice, Physiotherapy, Analysis
Funding acknowledgements: The present work was supported by the Polish Chamber of Physiotherapists.
Topic: Globalisation: health systems, policies & strategies
Ethics approval required: No
Institution: Polish Chamber of Physiotherapy
Ethics committee: Polish Chamber of Physiotherapy
Reason not required: it does not concern ethically incorrect issues
All authors, affiliations and abstracts have been published as submitted.
