As physiotherapists, we’ve long championed the value we bring to Australia’s health system. From early intervention in childhood development to pain management in working-age adults or falls prevention and reablement in older Australians, our reach is broad, our evidence strong and our outcomes tangible. 

But value alone is no longer enough. 

The outcome of the NDIS 2024–25 Annual Pricing Review, reducing the price limit for physiotherapy services after six years of frozen rates, has understandably raised concern across the profession. 

For many, it has reinforced a difficult truth: that even when the clinical value of physiotherapy is clear, our economic sustainability cannot be taken for granted. 

This moment invites us to look beyond the NDIS. 

It challenges us to consider what’s happening across the broader landscape of physiotherapy. 

Are the systems we work within— funding, workforce, regulation—evolving in a way that will sustain our ability to deliver high-quality care in the future? 

In aged care, new care minute requirements and regulatory reforms are reshaping service models but often with limited emphasis on the preventive and restorative potential of physiotherapy. 

In primary care, funding mechanisms still tend to favour brief, episodic encounters—despite strong evidence for physiotherapy’s role in managing chronic conditions, improving function and reducing downstream costs. 

In private practice, too, we see growing constraints: rebate structures that may not fully reflect the complexity of care delivered, increasing administrative demands and rising operating costs. 

We see these pressures and gaps clearly in women’s health, where recent investments in birth trauma and menopause clinics in New South Wales, and endometriosis and pelvic pain clinics across Australia, are welcome but incomplete. 

Despite strong Level 1 evidence supporting physiotherapy as first-line management for pelvic pain, urinary incontinence and pelvic organ prolapse, there remains a critical gap: funding for access to pelvic health physiotherapy. 

These issues are not isolated. Collectively, they point to a quiet but significant shift, one in which the economic underpinnings of physiotherapy practice are being tested. 

This is not a question of whether physiotherapy has value. 

That case has been made and will be on display at APASC25 in Adelaide in October. 

Physiotherapy’s value proposition continues to be strengthened by research, policy engagement and lived experience. 

The challenge now is ensuring that we can continue to deliver that value to all who need it. 

To do this, we need to broaden the conversation. 

Yes, our clinical outcomes matter. But so does our viability. 

We need to ask: are our funding models fit for purpose? Do they allow for the time, training and complexity involved in modern practice? Do they support access in rural and remote areas? 

Do they enable career development and workforce sustainability? We also need to be ready for the future. Healthcare reform is underway, whether through Medicare modernisation, aged care transformation, digital innovation or the evolving architecture of disability support. 

Each of these shifts will bring both challenges and opportunities. 

Our role in the system may grow but only if we are recognised, resourced and in a position to play it. 

That means continuing to articulate not just what we do but how we do it and what it takes to do it well. At APASC25, we will be asking: how do we maintain a workforce that is energised and equipped to meet rising demand? 

How do we ensure that our services remain accessible, equitable and evidence-informed? 

How do we protect the foundational conditions that allow physiotherapy to thrive? These are complex questions. 

But they are also an opportunity to reassert the importance of physiotherapy in a health system under pressure and to influence the conditions that will carry our profession forward. 

Join us in Adelaide this October. Be part of the conversation. Help shape what comes next.

>>Rik Dawson APAM MACP
APA Titled Gerontological Physiotherapist
APA National President