Semantics is the scientific study of meaning as expressed in language. It describes how language is used, often in advertising and politics, to have a desired effect on an audience.

More commonly, when we hear someone say, ‘Oh, that’s just being semantic’, what they’re implying is that there’s a trivial debate about word use, that someone is ‘splitting hairs’ or nitpicking.

Yet how we use and understand language and words has a huge impact on our lives.

 This is particularly relevant to the health system because we must understand how words and terms are received and understood.

For example, in Australia physiotherapy is classified as allied health. It can be argued, however, that the term ‘allied health’ is not properly understood and may mean different things to different people.

According to peak body Allied Health Professionals Australia—at the forefront of advocacy and working closely with governments towards its goal of effective, equitable and sustainable services for all Australians—allied health ‘encompasses a broad range of health professions working in a range of settings to improve community health and wellbeing’.

I’ve always had a problem with the word ‘allied’. It literally means being in close association, connected to or joined in an alliance.

I wish there was a stronger word, such as ‘integrated’. Allied health is essential, critical, vital and life-saving. It is healthcare, not an adjunct or associated care.

Why does this matter?

Consumers are best served when they clearly understand health terminology.

In Australia, our levels of health literacy—that is, how patients and health consumers access, understand and use health information to improve their health—is inconsistent.

Navigating and accessing the complex health system is a challenge for too many people. This complexity is driven by the Commonwealth/state and territory divisions.

Simply put, federal, state and territory governments have joint responsibility for funding public hospitals, but the states and territories also enact legislation relevant to the operation of their public hospitals and they license and register private hospitals.

The Commonwealth funds the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme, regulates private health insurance schemes and funds health programs specific to Aboriginal and Torres Strait Islander people.

Physiotherapists, along with other allied health professionals, work across all settings and schemes, which adds additional complexity to navigating and accessing the right healthcare at the right time.

Allied health in other countries

To make the waters muddier, ‘allied health’ is not a universally understood term, unlike general practitioner or nurse.

Around the world, there are various definitions, standards and interpretations of allied health.

In the UK, allied health describes a broad range of health professionals who are defined as not being doctors or nurses.

The list includes physiotherapists, dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, speech–language pathologists, art therapists, drama therapists and paramedics.

In the USA, where approximately 60 per cent of the healthcare workforce can be classified as allied health, the recognised professions appear to be more wide ranging.

Alongside physical therapists (physiotherapists), dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, radiographers, respiratory therapists and speech–language pathologists, you can find genetic counsellors, mental health counsellors, family therapists, athletic trainers, kinesiotherapists and health educators (such as asthma educators or diabetes educators) listed under allied health.

Canada is similar to Australia. However, the Canadians also include pharmacists, clinical sexologists, creative arts therapists, pastoral care clinicians and social workers under the allied health umbrella.

In 2021, the Parliament of India passed the National Commission for Allied and Healthcare Professionals Bill, noting that allied services broadly include physiotherapy; occupational therapy; ophthalmic sciences; nutrition sciences; medical laboratory and life sciences; medical radiology; imaging and therapeutic technology; trauma, burn care and surgical/anaesthesia-related technology; community care; behavioural health sciences; health information management and health informatics.

Of particular interest is the Allied Health Professions Council of South Africa, a statutory health body established in 1982 to control all allied and complementary health professions.

In South Africa, physiotherapists enjoy first-line practitioner status.

This is defined as ‘a practitioner capable of making a diagnosis and being able to treat… 'As first-line practitioners, physiotherapists also practise and work in association with the patients’ medical team and may refer patients for X-rays, refer to a specialist, write and issue sick notes and administer prescribed medicine’.

Sounds very much like the publicly funded first contact physiotherapy model the APA is working on.

My view is that Australia would benefit from increased health literacy messaging that helps consumers understand our complex health system.

We all share a responsibility for ensuring that terminology is both common and meaningful, a process that begins with strengthening understanding of the umbrella term ‘allied health’.