T. Németh1,2, A. Seixas1,3, M. Cannone1,4, P. Dubajova1, G. Szendro1, K. Englas1,5
1Europe Region World Physiotherapy, Advocacy and EU Matters Working Group, Brussels, Belgium, 2Hasselt University, Rehabilitation Sciences and Physiotherapy, Hasselt, Belgium, 3Escola Superior de Saúde Fernando Pessoa, Physiotherapy, Porto, Portugal, 4Fondazione Centri di Riabilitazione Padre Pio – Onlus, San Giovanni Rotondo, Italy, 5Haapsalu Neurological Rehabilitation Centre, Haapsalu, Estonia
Background: World Physiotherapy preconises that autonomous physiotherapists should have the freedom to exercise their professional judgment and decision-making, within their knowledge, competence and scope of practice. Gathered data suggests that professional autonomy tends to be different in the public and private healthcare systems, when and where existing in Europe. However, clustered information regarding professional autonomy in Europe is scarce.
Purpose: The aim of the data collection was to gather evidence regarding professional autonomy within the public healthcare system in the Europe Region World Physiotherapy member organisations.
Methods: A structured online survey was sent to representatives of the Europe Region World Physiotherapy member organisations by the Advocacy and European Matters Working Group. The survey gathered specific information regarding the possible necessity and the content of the medical prescription and the possibilities to adapt the specifics of the prescription. Furthermore, the data highlights the legal authorisation to assess and diagnose as a physiotherapist. Subsequently, referral pathways to and from a physiotherapist are charted. The survey included additional qualitative questions to better understand the specific context in the member organisations.
Results: Of the 39 countries that received the survey, 38 participated and completed all answers. The medical prescription remains necessary to access physiotherapy services in 14 countries. In these countries, the prescription is a mandatory element for either access, a means of reimbursement or both. The content of the prescription varies greatly. Going from only the medical diagnosis to the treatment stipulations and the treatment frequency as mandatory elements. Although eleven countries indicate that patients can always self-refer to a physiotherapist, in the majority of countries a referral from a medical doctor usually initiates the treatment. In 19 countries the physiotherapist is legally authorised to assess and diagnose the patient, where in 6 countries both the assessment and diagnosis are not allowed. In the remaining countries, assessment is authorised but the diagnosis is not. Overall, eighteen member organisations graded their level of autonomy with 5 or more on a scale from 1 to 10. The professional autonomy aspects highlighted by the member organisations in need of improvement are mostly related to direct access, the ability to refer patients to other health care professionals and the legal authorisation to make a diagnosis.
Conclusions: The responses provide a good indication of the elements making up professional autonomy. The elements contributing to or prohibiting acting autonomously are charted. Follow-up studies can highlight trends and changes. Considering the different levels of satisfaction across the countries, specific advocacy strategies appear to be necessary.
Implications: The Europe Region of World Physiotherapy can use the results to assist member organisations through specific advocacy actions when targeting identified aspects from the survey. In addition, the information can be used by researchers as benchmark data and policymakers can benefit to further the physiotherapy profession.
Funding acknowledgements: The authors received no funding for this work.
Keywords:
Professional autonomy
Public health care system
Europe Region World Physiotherapy
Professional autonomy
Public health care system
Europe Region World Physiotherapy
Topics:
Professional issues: business skills, leadership, advocacy & change management
Globalisation: health systems, policies & strategies
Professional practice: other
Professional issues: business skills, leadership, advocacy & change management
Globalisation: health systems, policies & strategies
Professional practice: other
Did this work require ethics approval? No
Reason: This survey addresses professional autonomy in Europe Region World Physiotherapy member organisations. The information is public and responsible sharing of this data serves the public interest by strengthening the science that is the foundation of effective advocacy and public health practice. Sharing also fosters sound regulatory decisions, generates new research hypotheses, and increases the scientific knowledge gained from the contributions of the participants and the efforts of the researchers.
All authors, affiliations and abstracts have been published as submitted.
