The fight has only just begun
In the last 12 months, we have arguably seen the largest attempt to influence physiotherapy scope and practise than ever before. This hasn’t come from innovation in practice or emerging models of care, but rather the increasing influence of funding bodies in shaping our profession.
We have witnessed an emergence of funders making decisions that influence our capacity to practise within our full scope. In many cases this has happened without adequate consultation and is often not in alignment with high-quality evidence.
Early last year, the National Disability Insurance Agency (NDIA) set a pricing schedule that would put physiotherapy providers at significant financial risk and reduce physiotherapy options for participants. We were able to put these recommendations on hold and are currently working productively with the NDIA to develop a revised pricing schedule that is fair, allows physiotherapists to work appropriately with people with disabilities, and ensures survival of the market for both physiotherapists and participants.
‘We have witnessed an emergence of funders making decisions that influence our capacity to practise within our full scope...’
The federal budget in the first half of 2018 outlined plans to incentivise general practice to employ physiotherapists to meet rural workforce gaps. While the principle of increasing access for rural Australians is a direction we strongly share, the model proposed was one we clearly opposed. By working with the Department of Health, we are continuing to advocate for a workforce incentive program that strengthens existing physiotherapy businesses, rather than putting them into direct competition with their GP colleagues.
In November, the government announced it would not continue to fund physiotherapists with limited registration to provide pain management services under the Aged Care Funding Instrument. If implemented, this decision would have severely limited access to safe, timely pain services for elderly patients in a range of setting and locations. In collaboration with other peak bodies, we successfully had this decision overturned.
Towards the end of 2018, you would have seen the culmination of the large body of work that ensured Pilates-informed exercises, prescribed by physiotherapists as part of an individualised program, would continue to receive private health insurance rebates in one-on-one, group and class settings. This advocacy has been in response to the recent government legislation changes affecting rebates for natural therapies.
We need to be very clear that these types of efforts by funders to alter the face of physiotherapy practice will only continue. In the cases listed above, we had tangible wins for the profession, underpinned by good evidence, robust data, an excellent response from our membership, and a clearly articulated financial alternative.
But the question is, how do we actually stay on the front foot and actively change the conversation from one of being reactionary, to one of leading change?
What are your thoughts on how we future proof the profession against the threat to scope and practice by funders and decision-makers? I would value your thoughts.
Email your suggestions to firstname.lastname@example.org.
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