Dear Dhara

Physiotherapy exists in Brazil since 1919. Physiotherapy There are several colleges as well as some graduate courses in physiotherapy.

Physical therapists currently working in public hospitals and / or private sectors.

The Minister Eliana Calmon the Superior Court of Justice held that it should not require physical therapy clinics in the work of physiotherapists and occupational therapists are supervised by doctors, which obviously does not prevent, in the frames of physiotherapy clinic, these professionals can work together in order to provide a more complete service to their patients

In Brazil the physiotherapist can and should exercise their profession with entire freedom.

INDIA, there are policies to start up a setup, but most of the medical practitioners never follow that. for starting up a Big unit (Hospital / multispeciality clinics) need to get permission from Health ministry, whereas starting up a small clinics doesn't need any approval, for Physio's they have to have a good licence to practice. (certificate from the IAP / University state that you are eligible to practice Physiotherapy).

Hello nelson and jayanti..

Thanks for your input..

So your govt allow growth and development of field.

We are also looking forward for a favourable decision

Arun sir, I know that we can have licence from IAP but “Clinical Establishment Act Standards for Physiotherapy Centre CEA /Physiotherapy Centre- 023” states something different..

Healthcare and treatment in Jordan is generally good and there is an extremely high level of medical care. Beside health facilities in Jordan are amongst the best in the Middle East, this has come about as a result of the Kingdom's stability and to a range of effective development plans and projects which include health as a major concern. The private sector is encouraged by the government to ensure preventative, tertiary and rehabilitative care. Going back to your question. In Jordan, it is not allowed for PT to open clinic without professional physician or a Ph.D holder.

Arun, it is an absurd myth that a PT in India would need a certificate from the IAP to practice. Please bear in mind that the IAP is just an association, not a council. It is not 'elected' (but 'selected') and has been de-recognised (suspended) by the WCPT. IAP simply cannot be compared with international professional associations like the CSP (England and Wales, UK), APTA (US), CPA (Canada), or the APA (Australia). I have many times publicly questioned the existence and functioning of this body, I strongly reckon, it is a laughing stock and denounce it.

Dhara, healthcare legislation and practicing rights differ in different counties. Just because PTs are autonomous primary contact health practitioners in the UK, US (etc), that doesn't automatically qualify Indian PTs to do so. Thankfully, PTs live a better life in few Indian states (Maharashtra, Delhi), well comparatively. Without a shadow of a doubt, the government needs to rise from its deep slumber and heed on the definitions given by the WHO, ISCO.

Gourav sir, I totally agree with your view regarding functioning of IAP..

thanks for ur input..

In Germany physiotherapy treatment is available in a clinic environment only after prescription of a physician. Of course in private sector direct access exsits partially, but is not far spread to be used in-patient.

Australian Physiotherapists have been independent and first contact practioners for a long time. We still work closely together, but if a medical doctor makes a referral that the physiotherapist doesn't agree with the referral will be set aside, with the therapist's' clinical reasoning guiding treatment. Having well developed and high level clinical reasoning skills is essential, and until they are taught and assessed in the physiotherapy schools, the profession can not move on.

So, in Germany n Australia PT Rx, in majority of cases done after a referral..

Thank you Eduard and Irmina..

In Lebanon we do not have yet the Direct Access policy. Patients must be referred to physical therapy by a written referral. The physical therapist decides on the plan of treatment and informs the referring physician about it.

We are preparing the physical therapists to the direct access.Academic institutions have introduced the DPT program as a first step for direct access. Once we have a significant number of doctors of physical therapy, we will prepare two laws: 1- To have the DPT as the degree for entry level in physical therapy

2- Get the law for direct access.

I hope I answered your question.

Claude sir, Thank u for ur input..

I hope you will soon have these laws in your state..

Dhara, this is a very interesting question and international comparison! In Sweden, PTs are autonomous practitioners and no doctor's referral is necessary. We have had direct access to physiotherapy for many years. Clinics/practices vary in size from 1-20 PTs, sometimes more, and are organized either within the public healthcare system or as private practices. Patient fees are very low and subsidized by the government, whether you're publically or privately employed. All PTs must have a license to practice, issued by the National Board of Health and Welfare.

I hope the Indian government will change its policy. But practicing autonomously also puts a lot of responsibility on the PTs, so diagnostic competences, clinical skills and thorough clinical reasoning capability are necessary and must be taught to PT students!

In Poland, if you want to use public physiotherapy, you must have a referral from GP to doctor with a specialization in rehabilitation, then the specialist directs the PT.

In the private sector there is no regulation, more and more private insurance companies cover the costs of private physiotherapy.

Polish regulations focus only on the basis of the public funding of physiotherapy. There is no law on the principles the profession of physiotherapist

Hi Suanne, thank u for your input.. Its good that your Govt. allow s independent prectice..

Hi Wojeciech, Thank u for input.. Here very few insurance companies cover the cost of PT Rx.

Gourav, I just want to correct you regarding WCPT. There is an awareness that there are ongoing issues with IAP but they have not been derocognised/suspended from WCPT.

Gillian Webb, Chair AWP, WCPT.

Thank you Dr. Webb for the correction.

In our country we are seen as Independent practitioners and don't need a physicians referral before we can see a patient.

Dear fahamida thank you for your input..

All practising physiotherapists need to be registered by the Physiotherapists Board, Supplementary Medical Professions Council of Hong Kong. Same requirement for private physiotherapy clinics.

Anthony sir thank you for your input..

So, in hongkong you just require registration not compulsory reference..

Registration plus declaration of no criminal offences both local and overseas

No compulsory reference is required.

For patient consultations, we need medical referral except in sporting emergency.

In sporting emergency, physiotherapists can provide all the required treatment without medical referral.

That is good..

Thank you..

In the US we are required to be licenced by state after passing PT Board exams. We technically have direct access through our practice act, but insurance usually requires a doctors referral to cover services. The US is moving to a DPT degree for PT's but there are still therapists grandfathered in as MPT's or BA's. THe DPT degree change is happeng to allow direct access. We do and evaluation after recieving an order and send the MD a Plan of Care (POC) that then must be signed within 30 days to continue to work with patients that are federally insured with Medicare or Medicaid. The POC includes diagnoses, PT diagnoses, treatments, and goals. Then we must send the MD a reevaluation every 30 days.

Thank you for sharing valuable dear Cara..