Access matters

In May, I had the privilege of representing Australia as part of the World Physiotherapy delegation at the 79th World Health Assembly in Geneva, Switzerland. 

World Physiotherapy played an active role throughout the Assembly, ensuring that rehabilitation and the physiotherapy profession were represented in discussions on health system reform, workforce development and healthy aging. 

While much attention focused on pandemic preparedness, the economics of healthcare and expanding access to emergency care, rehabilitation emerged as a major priority. 

There was growing recognition that health systems must focus not only on reducing mortality and disease, but on improving functioning, independence and quality of life. 

Following Geneva, I travelled to Halifax, Canada, to meet with fellow founding member organisations of World Physiotherapy and contribute to discussions about the organisation’s future strategic direction. 

Conversations focused on the development of the next global strategy, Physio2040, and explored how physiotherapy can maximise its influence over the coming decades. 

One theme repeatedly emerged during these discussions: Australia continues to be viewed as a global leader in physiotherapy. 

This reputation has been built on innovations such as direct access physiotherapy. 

Fifty years ago, Australia became the first country in the world to allow people to consult a physiotherapist without first obtaining a referral from a medical practitioner. 

While this may seem routine today, it remains a significant achievement that transformed access to care and recognised physiotherapists as autonomous health professionals. 

Many other countries are now following a similar path. In 2018, Norway introduced broader direct access arrangements, enabling patients to access physiotherapy without a GP referral. 

The Norwegian Government has also invested in first contact musculoskeletal physiotherapy in primary care and provides financial incentives for physiotherapists to establish practices in regional and remote communities. 

Similar first contact physiotherapy models are expanding globally as governments seek solutions to workforce shortages, rising healthcare costs and increasing demand for care. 

Internationally, opportunities for physiotherapists to work as first contact practitioners are likely to expand well beyond traditional musculoskeletal pathways. 

Physiotherapists are increasingly serving as first contact practitioners in emergency departments, urgent care centres, aged care services, occupational health, pain management programs, women’s health and community rehabilitation settings. 

These models recognise that physiotherapists possess the skills to assess, diagnose, manage and appropriately refer patients with a wide range of conditions. 

First contact physiotherapy is helping to reduce waiting times, improve patient access, optimise workforce utilisation and support more integrated models of care. 

Momentum is also building here in Australia. 

The National Health and Medical Research Council recently awarded a Partnership Grant to the University of Sydney and the APA for the PhysioDirect-Aus project. 

This research will evaluate a publicly funded first contact physiotherapy pathway for musculoskeletal pain, with the potential to improve access to timely, evidencebased care while reducing pressure on GPs, emergency departments and hospitals. 

It represents an important step in building the evidence needed to inform future health policy. 

As we celebrate 50 years of direct access physiotherapy in Australia, we should take pride in the leadership our profession has shown. 

However, our work is far from complete. The next chapter is not simply about preserving what we have achieved. 

It is about building a healthcare system where every Australian can directly access physiotherapy when they need it, regardless of where they live or their ability to pay. If we achieve that vision, Australia will once again lead the world, demonstrating how physiotherapy can improve lives and create a more sustainable future for healthcare.

Rik Dawson APAM MACP
APA Titled Gerontological Physiotherapist
APA National President