Perseverance pays off for SA physios

 

Advocacy is often a long process before tangible change is seen—and after many years of consistent lobbying led by the South Australian branch of the APA, there is some great news for physiotherapists, especially given the financial challenges faced over the past few months.

The team in South Australia has successfully won a 12-year argument for an increase in payment given to treating physiotherapists by Return to Work SA (RTWSA, formerly known as WorkCoverSA).

As a result, from 1 July, there will be 15.2 per cent increase in the fee paid to physiotherapists for a standard consultation with injured workers. In addition to the standard indexation of all physiotherapy services by 1.6 per cent, the fee for standard consultation will increase further from $68 to $78.50.

In 2008, the APA advocacy team in South Australia began actively lobbying for a fair fee for physiotherapists treating RTWSA patients. Back then physiotherapists were given $42 for a 17.5 minute consultation, based on an outdated ‘Rhook’ measure of consultation. 

In 2013, RTWSA began using Medicare data to calculate the time and cost of standard consultations. This was met with disapproval from the advocacy team as Medicare claims make up a small percentage of physiotherapy billings.

Martin Van der Linden, APAM, is a member of the APA Occupational Health Group and the former South Australian branch president (2015–19). Martin was instrumental in working with the APA advocacy team infighting for this pay increase.

‘The goal of our lobbying with RTWSA for a number of years has been to guide them to setting the fee for a standard physiotherapy consult at a rate that is consistent with a rate that average private physiotherapy patients pay,’ Martin says.

‘One of the things that took a long time to convince RTWSA was that using Medicare data to calculate physio fees was not a valid methodology—because Medicare is not a large contributor to normal physio practice in Australia. In most clinics, they are a very, very small part of their practice and so we argued for a better methodology’.

Martin goes on to say that the insistence on using Medicare data as the only way of measuring average charge was a ‘significant flaw’, and that for many years the advocacy team argued for RTWSA to ‘conduct a survey of practices in the state and use that survey data to set a measurement of average charge to a private patient’.

For the past 12 years, there has been constant lobbying, conversations with governmental parties and steady, incremental steps towards granting physiotherapists a fair fee when treating RTWSA patients. 

This resulted in the independent survey indicating that, on average, a consultation was substantially longer than the 22 minutes that physiotherapists were being paid for.

On this big win, Martin says, ‘It’s been because of a very slow, very collaborative approach with the APA and RTWSA. Through this we’ve managed to build an effective and collaborative relationship with the decision-makers there—we feel that is something that is valuable for the Association.

'Sometimes advocacy requires us to go in all guns blazing and to fight really hard for something because we think it’s wrong. In other situations what we’ve learned is that a gentle collaborative approach can be effective as well.’ 

Brief timeline of events

  • 2009—Physiotherapists were paid $42 for a 17.5 minute consultation
  • 2009—Independent statewide survey of practices demonstrated the true time/cost for a standard consultation— resulting in an increased treatment time to $56 for a 22 minute consultation
  • 2010–11—APA developed relationships with WorkCoverSA through the physiotherapy reference group
  • 2013—WorkCoverSA began using Medicare data to set fee benchmarks
  • 2012–16—APA furthered relationships with WorkCoverSA (which became RTWSA in this period), collaborating on management tools/fee descriptors/ quality reviews/educational forums
  • 2016—APA won a restricted item providing six one-hour-long consultations for patients with complex pain
  • 2018—APA lobbied South Australian Treasurer Rob Lucas
  • 2019—RTWSA undertook its own independent survey of allied health practice fees and treatment times.
 

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