The aim of the data collection is to update the professional autonomy evidence within the public healthcare system in the World Physiotherapy Europe Region member organisations. The survey gathered specific information on the possible necessity and the content of the medical prescription and the possibilities to adapt the specifics of the prescription. Furthermore, information on the legal authorisation to assess and diagnose as a physiotherapist was sought. Subsequently, referral pathways to and from a physiotherapist were charted. The survey included two additional qualitative questions to detail the specific member organisations’ context.
A structured online survey was sent to representatives of the World Physiotherapy Europe Region member organisations by the Advocacy and EU Matters Working Group.
Out of the 45 countries that received the survey, 36 participated and completed all answers. Thirty-two countries reported that medical referral is necessary to access physiotherapy services. However, 16 countries highlighted that a medical prescription was only needed in specific situations, such as first appointments or longer rehabilitation pathways. In 17 countries the necessity of the medical prescription pertains to access and reimbursement of physiotherapy services. The content of the prescription ranges from only the medical diagnosis to the treatment stipulations and treatment frequency as mandatory elements. In 19 countries however, the specifics on the prescription can be adapted in consultation with the prescriber. Although 4 countries indicate that patients can always self-refer to a physiotherapist, in the majority of countries a prescription from a medical doctor usually initiates the treatment. In 15 countries the physiotherapist is legally authorised to assess and diagnose the patient, where in 3 countries the assessment and the diagnosis are not allowed. Overall, 23 countries graded their satisfaction with the legal level of autonomy in the public health system with 5 points or more on a 10-point scale. The professional autonomy aspects highlighted in need of improvement are direct access, the ability to refer patients to other professionals and the legal authorisation to diagnose.
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.
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.
Public healthcare system
Europe Region of World Physiotherapy
