MIXED PRACTICE OF PHYSIOTHERAPY IN FRANCE: MOTIVATIONS OF PROFESSIONALS FOR THIS MODE OF PRACTICE AND IDENTIFIED OBSTACLES TO ITS DEVELOPMENT

¹French National Council of Order for Physiotherapists, Demography Observatory, Paris, France

Background: In France, the practice of physiotherapy is conditioned to the registration to the Order. The law recognizes only two modes of practice: liberal or salaried. However, some professionals choose to practice both.

Purpose: This study aimed to better understand the contours, the reality and the motivations of mixed practice by French physiotherapists.

Methods: A digital questionnaire was sent by the Order to all French physiotherapists via a specific electronic newsletter. The first part of the questionnaire aimed at collecting general information about the respondent. Next, the motivations of professionals practising or wishing to practise in a "mixed" way were explored. Lastly, the perceived obstacles to the development of mixed practice were collected for all the respondents, whether or not they had or wished to have mixed practice.

Results: A total of 77,029 physiotherapists received the newsletter informing them of the survey. Among them, 11,992 answered the entire questionnaire. In terms of gender, age and type of practice, the sample is representative of the population of physiotherapists. Of the 11,992 respondents, 1,180 (9.8%) of our sample reported mixed practice and 3,528 (29.4%) reported that they wished to have mixed practice. Finally, 7,284 respondents (60.7%) stated that they did not wish to change their practice pattern to move towards a mixed practice. It appears that mixed exercise and professionals wishing to engage in mixed practice is more common under 40 years of age and women. The 3 main motivations of employed physiotherapists who consider going to a mixed practice are: "to diversify the activity", "to escape from the routine" and "to be intellectually stimulated". These elements are common with those indicated by liberals who envisage a mixed practice and for whom the "collective project" and "teamwork" complete these motivations. Concerning the obstacles to mixed practice, the "minimum amount of social contributions" is the main obstacle identified by all categories. The "organizational difficulties" are also an omnipresent obstacle. The "regulatory framework" is more often perceived as an obstacle by respondents "wishing to engage in mixed practice" than by those already "in mixed practice" or "without mixed practice and not wishing to do so".

Conclusions: Considering the profile of mixed practice professionals, we can hypothesize that the frequency of mixed practice may increase in the future. We can also perceive a form of idealization of mixed practice among physiotherapists who do not practice it. There are very material elements that seem to hinder mixed practice.

Implications: The primary motivations for mixed practice are a source of wealth for the individual, the profession and the health care system. However, the identified obstacles must be removed in order to offer perspectives for individuals but also recruitment possibilities for institutions, especially those with a shortage of physiotherapists.

Funding acknowledgements: This work was unfunded.

Keywords:
Mixed practice
Demography

Topics:
Professional practice: other
Globalisation: health systems, policies & strategies

Did this work require ethics approval? No

Reason: This work does not involve the human person, and French regulations state that no ethical advice should be sought for this type of study.