Dutch physical therapy push ahead with professional autonomy

The introduction of direct access to physical therapy services in the Netherlands in 1996 has proved so successful that, five years on, almost half of patients come to physical therapists without referral. This is among the achievements that delegates to the WCPT Congress in June will have the opportunity to learn about from Dutch delegates.

Before 2006, evaluation and treatment by a physical therapist in the Netherlands were only possible following referral by a physician. It is WCPT’s official view that all patients should have direct access, without referral, to physical therapists, and the Netherlands is one of the most recent countries to introduce this policy. 

Now, following the successful introduction of direct access (also known as self-referral), the Royal Dutch Society for Physical Therapy (KNGF) says it is seeking to further extend professional autonomy by making it possible for physical therapists to refer patients on to medical and other specialists, and prescribe medications. It has begun talks with government on these issues.

“The government here, as elsewhere in the world, is very concerned about rising health care costs,” says Victorine de Graaf, KNGF’s Senior Professional Advisor. “We’re trying to demonstrate to them that giving physical therapists power to refer on will save money. Studies in Scandinavia, where this policy has already been introduced, show a decrease in costs, because people are referred to consultants only when they really need it.”

The KNGF believes there are other aspects of Dutch physical therapy that are progressive, and make it of great interest to congress visitors. Hans Redeker, Manager of Strategy and Development at KNGF, says the society is very proud of the number of high quality clinical guidelines available to support physical therapists in the Netherlands. Because these are multidisciplinary in outlook, they firmly establish the place and status of physical therapists within the team. They also provide a firm basis on which the government can decide which services to fund, and which not.

One of the big current professional issues in the Netherlands is the introduction of new performance indicators for professionals working in general practice, in private clinics.  “We have developed and tested them in cooperation with government and the insurance companies, and now we are trying to implement them,” says Hans Redeker. “It’s the moment of truth. Implementing them for the whole nation isn’t easy, and there are some technical and logistical issues.”

He believes that Dutch physical therapists at the WCPT Congress will enjoy meeting international colleagues, and discussing some of these issues with them. “You will be visiting a nice country with kind people, and we are looking forward to meeting everyone,” he says.