Policy statement: Regulation of the physical therapy profession

The World Confederation for Physical Therapy (WCPT) advocates for regulation of the physical therapy profession through recognised and valued systems. These systems should assure protection of the public through mechanisms includingresponsible self-governance of physical therapists.

Models of professional regulation vary between countries and are influenced by many factors, including the system of government, the health system and the history of the profession.  In order to be effective, any system of regulation must take into account the economic, political and cultural context in which the system is being implemented.

WCPT recognises that physical therapists may be regulated through a legislated system that includes licensing or registration by the profession or an external regulatory authority. Alternatively, in some countries, the profession is regulated by physical therapists meeting membership criteria for the professional organisation.

Physical therapy is an internationally recognised health profession which should only be practised by qualified physical therapists.[1] Where required by state or national legislation, they are entitled to hold a valid registration/licence to practise physical therapy and/or use the title physical therapist.[2] In the absence of regulatory legislation, physical therapists are recognised through their eligibility for membership of the WCPT member organisation in that country.

WCPT encourages member organisations to work towards a system of regulation that focuses on the public interest. Such a system will promote trust and confidence in the profession. The system can achieve this through mechanisms that ensure only physical therapists, who are duly educated and competent, are able to use the title physical therapist or physiotherapist.[2]

Effective regulation is characterised by four key elements:

• assurance that educational programmes have met the professional entry level education standards for practice
• continuing assurance of standards of professional competence or proficiency
• standards of professional ethics and conduct
• the maintenance of a register of licensed/regulated/recognised physical therapists

These four key elements are inter-related and represent the pillars that underpin regulatory approaches that serve the public interest.

In many cases, effective regulation can be achieved by embedding standards of professional education, performance, conduct and competence within the system of regulation. These standards, together with mechanisms to monitor and foster practitioner compliance and manage non-compliance, provide the means by which the profession can protect the public interest.

WCPT encourages member organisations to ensure that a mechanism is in place by which the public can report or make a complaint about a licensed/regulated/recognised physical therapist to an appropriate authority. Contemporary complaint mechanisms include dispute resolution methods such as mediation and conciliation rather than only “command and control” methods or more punitive approaches.

WCPT encourages member organisations to work towards regulation systems that:

• define the qualifications required for licensure/regulation/recognition to practise physical therapy
• restrict use of the titles physical therapist and physiotherapist,[2] and their abbreviations, to licensed/registered/recognised physical therapists
• set and monitor standards of competence to practise physical therapy
• establish processes to assure the competence of applicants seeking recognition to practise the profession
• establish processes to assure that licensed/registered/recognised physical therapists maintain competence, such as continuing professional development and requirements for practice
• set and monitor standards for the practice of physical therapy by recognised/registered/licensed physical therapists
• establish processes to deal with complaints regarding licensed/registered/recognised physical therapists
• establish processes to deal with the findings of investigations into complaints relating to licensed/registered/recognised physical therapists
• are based on cooperative discussions with the regulatory body, ensuring the impartiality and independence of the regulator, whilst developing, securing, implementing and maintaining engagement with high standards of education, practice and professionalism 

WCPT encourages member organisations to support systems of regulation where requirements to practise physical therapy are:

• the same for all applicants regardless of nationality, race, ethnicity, politics, gender, sexual orientation or social status
• based upon fair, objective and transparent criteria related to professional education, experience and/or assessment of competence
• not more burdensome than necessary, in ensuring that only competent physical therapists are able to use the title physical therapist or physiotherapist[2]
• not used for the sole purpose of restricting the supply of physical therapists in the country concerned
• are communicated in plain language
• include responsible self-governance of physical therapists

WCPT encourages member organisations to advise their members of the WCPT guidelines for the development of a system of legislation/regulation/recognition, such as a Physical Therapy Practice Act.

Glossary

Accreditation — is a type of quality assurance process which utilises all aspects of review and assessment according to pre-defined standards. Accreditation may be applied to physical therapy education programmes or a programme of physical therapy delivery.

Competence — is the proven ability to use knowledge, skills and personal, social and/or methodological abilities, in work or study situations and in professional and personal development. (In the context of the European Qualifications Framework, competence is described in terms of responsibility and autonomy.)[3]

Licence/registration — is an official authorisation issued by the authority on an annual or otherwise specified time frame to practise the profession of physical therapy and is based on the declaration by the physical therapist that he/she will continue to meet competencies required to be licensed/registered.[4]

Regulation of the profession — cluster of laws, regulations, directives or rules set by the authority to legislate the physical therapy profession. The regulation can also be in form of self-regulation set by the physical therapy profession (WCPT member organisation).[5]

Standards of practice — are a collection of documents describing the professional consensus on the practice of physical therapy for physical therapists working in any occupational setting. Standards reflect the collective judgement of the profession at a given point in time.[6]

References

1. World Confederation for Physical Therapy. WCPT guideline for physical therapist professional entry level education. London, UK: WCPT; 2011.  (Access date 22nd September 2011)
2. World Confederation for Physical Therapy. Policy statement: Protection of title. London, UK: WCPT; 2011.  (Access date 22nd September 2011)
3. Office for Official Publications of the European Communities. The European Qualifications Framework for Lifelong Learning. Luxembourg: European Commission Education and Culture; 2008.  (Access date 23rd March 2010)
4. World Confederation for Physical Therapy. WCPT guideline for the development of a system of legislation/regulation/recognition of physical therapists. London, UK: WCPT; 2011.  (Access date 22nd September 2011)
5. European Region World Confederation for Physical Therapy. European Region World Confederation for Physical Therapy Glossary of Terms. Brussels, Belgium: ER-WCPT; 2010.
6. Chartered Society of Physiotherapy. Rules and Standards.  London, UK: CSP;  [cited 2010 23rd March]; Available from: http://www.csp.org.uk/director/members/practice/rulesandstandards.cfm.