Schweizer Physiotherapie Verband

Research by WCPT reveals global picture on direct access to physical therapy

Research by WCPT has for the first time provided authoritative information about the extent to which patients can directly access physical therapists without referral by a third party. Papers based on the research have been published in the journals Physiotherapy and Physical Therapy, and are available to view as open access. 

In the research, 72 out of WCPT’s 106 member organisations responded and 40 of these said that direct access and patient self-referral were permitted in their countries - either because it was permitted by legislation, or because professional practice allowed it in the absence of legislation.  

Direct access to physical therapy, or self-referral as it is known in some countries, first occurred in Australia in the 1970s. WCPT believes it should be up to the profession in each country to decide whether to pursue direct access, in the context of their own educational standards. 

“Progress across WCPT’s member organisations has been varied, and the issue is now a high-profile advocacy issue for many,” says Tracy Bury, WCPT’s Director of Professional Policy. 

“Some member organisations have already reaped the benefits of advocacy initiatives and legislative change, and many more strive to make the changes and are keen to learn from their international colleagues.”

The research found that, of the 40 countries where direct access was permitted, 19 said it was available in both public and private settings and 17 said it was only available in private settings. Fifteen member organisations reported that direct access occurred in private settings even though it did not appear to be supported by legislation or professional practice.

Member organisations were asked whether physical therapy qualifying education equipped physical therapists for direct access. Sixty-nine percent of respondents said that it did, and 31% said it did not.

“Although WCPT has produced guidelines for physical therapist entry level education, they remain aspirational for some WCPT members, while others exceed them,” said Tracy Bury.  “Education plays a vital part in equipping physical therapists with the requisite competencies to accept patients who self-refer.”

Co-author Emma Stokes, WCPT’s Vice President, said the study is the first global map of patient self-referral. “We now know that physical therapy professional autonomy is greater in countries where patients/clients can self-refer to physical therapists,’ she said. “In countries where physical therapists wish to move to direct access, they need to ensure that the physical therapy community is prepared educationally and professionally for the responsibility increased autonomy brings.”

“The research provides information on barriers and facilitators and case studies on what assisted in moving the profession towards achieving patient/client self-referral and this information will be helpful, we hope, for member organisations’ advocacy initiatives. Global data is helpful for negotiations with policy makers and also, possibly, insurance companies.”

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