Profession told to promote its cost effectiveness

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Issue: 20 June 2007

Physiotherapists need to gather evidence of their cost effectiveness, and communicate it to employers and service users, if the profession is to move higher in the 'food chain' of health care professionals.

This was the message from Anthony Delitto, professor and chair in the physical therapy department of the University of Pittsburgh, in his keynote address.

Professor Delitto said it was a difficult time for all health care systems around the world.

'I'm happy to make the assumption that there is no one here that has a healthcare system that is in good health,' he said.

Most were riddled with unnecessary inefficiencies and expense, inflated prices, inequalities and disparities.

This had an adverse effect on physiotherapy he said, particularly in countries with a reimbursement system.

Because of decisions made on little data, physiotherapists were reimbursed at a fraction of the rate of doctors – which affected their status as a profession.

In turn, this affected the number of high-level applicants for physiotherapy education.

To counter this, the profession needed to reconsider its strategy, and make sure that decisions made at high level were not arbitrary, but based on good data. There was good evidence of the cost effectiveness of physiotherapy, he said.

For example, research published in the Wall Street Journal had shown that effective physiotherapy interventions for low back pain were half as expensive as interventions by physicians.

'Rational people would surely understand such substantive proof,' he said.

Professor Delitto said physiotherapists missed an opportunity in taking that evidence to decision makers.

However, he added that physiotherapists needed to consider removing themselves from areas of care where they could not prove their cost effectiveness.