The 2023 Workforce Census provides a snapshot of where the physiotherapy profession is currently at, says APA President Scott Willis.

While some findings are surprising, the survey provides objective data on what practitioners want in terms of career pathway, remuneration and job satisfaction.

Scott says the key points are improving remuneration and job satisfaction, reducing the attrition rate and providing new graduates and early career physiotherapists with mentoring and support so that they stay in the profession.

‘We need to use this data effectively to assist not just our new graduates and middle-stage physios but also our business owners and our managers within the public sector.

‘Everyone within the profession needs to take a look at it so we can work out ways to improve our retention rate.’

The gender pay gap is real

A key finding of the workforce census is a gender pay gap that widens with experience, especially at the expert level.

While Australian physiotherapists earn on average $95,405 per annum, men earn about $5000 more than women.

As experience increases, so does the gap and by the time they reach the level of highly developed and expert skills, male physiotherapists are earning 11–15 per cent more than their female counterparts (click to see Figure 1 below).

Figure 1

Men are also more likely to take on leadership and management roles.

One possible reason for this disparity is the time women take out of the workforce to have babies and care for young children. .

They may not be able to keep up with the professional development hours required to maintain registration or they might miss opportunities to advance their career.

Scott says that to retain parents who take time off to care for their children in the workforce, the profession as a whole needs to change the way it approaches parental leave.

‘It’s not just up to the parents to plan their parental leave.

‘I think everyone needs to start talking about it—the physiotherapist, the practice partners and the workplace,’ Scott says.

As for remuneration, Scott says that while the overall average was higher than he expected, the remuneration for highly developed and expert physiotherapists was too low.

He says there are many factors that play into physiotherapy fees, including location—physiotherapists in regional areas may not be able to charge as much as their city-based counterparts—experience and quality of service.

Third-party funders and compensable schemes—including Medicare, aged care, the Department of Veterans’ Affairs, the National Disability Insurance Scheme, insurance organisations and other players—also have a huge impact on what physiotherapists can charge for fees.

‘There are minimal ways that you can increase wages because of our compensable schemes.

‘We need to do a lot more work with the compensable and private health insurers and really the whole profession to improve remuneration for mid-to-end-stage career physiotherapists because that’s how we will reduce the attrition rate,’ Scott says.

Job satisfaction is generally high

Three in four physiotherapists have high job satisfaction and this increases with experience.

The key drivers are the ability to make a positive impact, a flexible work–life balance and financial security (click to see Figure 2 below).

Figure 2 

Physiotherapists working in cancer care and in women’s, men’s and pelvic health are the most satisfied with their jobs.

On the other hand, less than two-thirds of those working in gerontology, disability and occupational health report job satisfaction.

On the flip side, poor remuneration and unmet expectations are the biggest causes of dissatisfaction.

More than three-quarters of the students and graduates who indicated dissatisfaction with their career said it was because the remuneration did not match the expertise and skill level required, while almost two-thirds indicated that the job was not what they thought it would be.

Other reasons included lack of experience with complex cases and lack of skills to work autonomously, as well as a dearth of mentoring from more experienced clinicians.

‘One of the things we have really tried to hone is our APA mentoring program framework so that some of the mentors and mentees can then mentor others as they come along, passing on their knowledge to the next crowd coming through,’ Scott says.

While three-quarters of physiotherapists surveyed planned to remain in the profession for the next five years, one in five intended to leave, with the majority citing inadequate remuneration, mental burnout and lack of career progression as the key reasons (click to see Figure 3 below).

Figure 3

Among those at the end of their careers, many planned to ‘ease into retirement’ by moving to part-time work or taking on locum work in rural areas.

Rural concerns

The census showed that almost 70 per cent of physiotherapists work in metropolitan areas, 16 per cent in regional centres and 14 per cent in rural towns.

Only one per cent of physiotherapists work in remote communities.

Rural and remote physiotherapists are much more likely to be generalists—around 30 per cent compared to 10 per cent of the total number of respondents surveyed.

Distance from family and friends was the major barrier to working in regional, rural and remote areas (click to see Figure 4 below).

Figure 4 

Other factors included leaving existing social networks, the financial costs of moving and personal and family commitments such as sports and access to schools as well as partner’s work, access to other health services and lack of career opportunities.

Almost half of the physiotherapists surveyed said that more financial support and higher remuneration would assist with a move to a rural

Professional support, mentoring and training to develop rural-specific skills were also important factors, especially among less experienced physiotherapists.

Scott says that doing clinical placements in regional and rural areas can encourage physiotherapists to come back to those areas once they graduate, as has been seen in other health professions including medicine and nursing.

Business and beyond

For physiotherapy practices, workforce supply issues and competition from emerging disciplines are the biggest factors affecting business viability.

More than 30 per cent have workforce supply issues and nearly 20 per cent are concerned about retaining employees.

Practice owners also cited the financial burden of managing multiple funding streams and the red tape associated with compliance, and changes to the healthcare system as affecting their business viability.

Why we needed the census

The 2023 Workforce Census marks a significant step forward in enhancing the reach and effectiveness of advocacy and policy efforts within the profession.

This new initiative aims to provide a comprehensive picture of the current state and future needs of the physiotherapy workforce, a crucial component of Australia’s healthcare system.

Physiotherapists play an essential role in managing a wide range of health conditions across all stages of life in a variety of healthcare settings.

As Australia’s population continues to age and the prevalence of chronic diseases and injuries grows, the call for physiotherapy services will increase.

Physiotherapy ranks among the top 20 professions in demand in Australia, highlighting the need for a well-developed workforce that can sustain and improve the country’s healthcare services.

Developing such a workforce necessitates a deep understanding of the profession, including factors related to sustainability, supply and the changing needs within the sector.

However, this kind of data is fragmented and incomplete, limiting our advocacy and policy reach.

To address these gaps, the APA’s Policy and Government Relations team launched the 2023 Workforce Census in October 2023. It was conducted through an online survey open to all APA members for a period of three weeks. Members were invited to provide insights on several strategic policy and advocacy areas, with the primary objectives being to:

• understand the workforce composition
• measure employment conditions and remuneration in physiotherapy
• determine future intentions regarding staying in or leaving the profession
• identify potential reasons for leaving
• outline business priorities and challenges
• address issues and challenges faced by physiotherapy students.

Offering a detailed snapshot of the profession, the census report serves as an invaluable resource for policymakers and enables stakeholders to address current challenges with innovative and forward-thinking ideas, underpinning further strategy development and workforce planning.

Data gathered from the census will be analysed and published biennially, with the next survey scheduled for 2025.

This regular collection and analysis of data will support a key objective of strengthening comparative analysis for strategic oversight.

The APA extends its gratitude to all members who participated in the survey.

Your responses have significantly contributed to filling critical data gaps in our understanding of the profession.

As well as enhancing the APA’s advocacy efforts, this information provides a foundation for informed decision-making and planning, ensuring that the profession remains responsive to the changing healthcare landscape and can continue to meet the healthcare needs of Australians effectively.

The 2023 Workforce Census is a landmark initiative for the APA.

Gaining a comprehensive understanding of workforce demographics, employment conditions, future intentions and challenges faced by the profession puts us in a strong position to advocate for and implement policies that will support the sustainable growth and development of the physiotherapy workforce in Australia.

As the data collection continues biennially, the insights gained will become increasingly valuable, guiding the profession towards a future in which our workforce is adequately equipped to meet the healthcare needs of all Australians.

>> Click here to read the APA’s 2023 Workforce Census report.