Championing physiotherapy’s future

The Physiotherapy Board of Australia plays a central role in protecting the public by setting standards, codes and guidelines for practice and by responding to notifications and conduct concerns. 

Beyond these core regulatory functions sits another critical responsibility: supporting a sustainable physiotherapy workforce that can continue to meet the needs of the Australian community. 

The Board’s work to address workforce shortages and improve community access to safe, high-quality care is far from an afterthought. 

A sustainable health workforce is one of the three key themes of Ahpra’s recently launched National Scheme Strategy 2031, on equal footing with effective harm prevention and a culturally safe health system for Aboriginal and Torres Strait Islander Peoples. 

This area is only likely to become more important as demand for physiotherapy services grows alongside rising chronic disease rates, an aging population and the ongoing reforms to the National Disability Insurance Scheme. 

Access in rural and remote areas also remains a significant challenge, with only 19 per cent of physiotherapists currently practising outside metropolitan areas. 

The Australian Physiotherapy Council, in collaboration with the Board, has introduced a range of new pathways for internationally trained physiotherapists to become registered in Australia. 

Last year the number of physiotherapists in Australia passed 50,000 for the first time, with over 40 per cent of first-time registrants being trained internationally. 

However, while streamlining pathways for international physiotherapists to live and work in Australia is an important part of the solution, it is equally important to support physiotherapists who are already registered and working in communities across the country.

Workforce retention 

The Board has worked in partnership with Ahpra and the APA over the past two years to conduct research into retention and attrition within the physiotherapy workforce. 

This included surveying registered physiotherapists about their intentions to remain in practice and the factors influencing this decision. 

More than 7500 physiotherapists completed the survey, making it one of the largest and most representative surveys of physiotherapists ever conducted in Australia. 

Follow-up interviews with selected participants provided further context and more indepth responses to the key questions. More than 80 per cent of survey respondents said they planned to stay in the profession, with around half of those saying they saw their entire future in physiotherapy. 

It is encouraging that a large majority of registered physiotherapists plan to keep practising. Physiotherapists play a crucial role in supporting and improving the health of the community – a sentiment respondents share, with more than half of those planning to stay in the profession saying they find their work fulfilling and meaningful. Other anchoring factors included having a positive working environment, career advancement and feeling embedded in the local community. 

This was reflected in specific responses by participants: 

• ‘I am passionate about the area to make a difference in women’s lives.’
• ‘My skill enables me to contribute to my community.’
• ‘I’m probably still in the profession because of the kind of mentoring and peer support I received when I started.’ 

Financial and career factors driving attrition 

Of the respondents, 10.3 per cent said they planned to leave the profession, with another 9.4 per cent unsure of their immediate future. Almost all these respondents intended to leave within five years. 

Among those either planning not to renew their registration or who are unsure, the most common reason outside of retirement was unsatisfactory remuneration, followed closely by a lack of opportunities for career advancement and the work no longer being professionally satisfying. 

Responses included: 

• ‘The high stress load isn’t commensurate with government pay, so I am exploring other avenues of work.’ 
• ‘There’s not enough challenge and there’s not enough structure to sort of continue to improve to become more senior.’ 
• ‘The workload and conditions, including physical environment, lack of staffing and lack of funding for leave cover, have me reconsidering whether this is a field of work I want to continue with in the long term.’ 

Supporting professional development and advanced practice 

Looking at the factors that are keeping physiotherapists in the profession helps the Board reinforce what is working, just as the converse point to areas for improvement. 

A sense of achievement, mental stimulation and making a meaningful contribution were all cited highly by those planning to stay in the profession, with their opposites each acting as leading reasons for those planning to leave. Several participants specifically cited scope of practice as a key issue for consideration: 

• ‘There’s been very little progression in the scope of practice in the last 20 years.’ 
• ‘An increase in our scope of practice to treat patients independent of GPs… would make a physiotherapist want to stay in physiotherapy for 40 years.’ 

Next steps 

This research will help guide how the Board, the APA and employers can support workforce retention. 

These studies highlight the fact that addressing challenges in the physiotherapy profession requires more than simply increasing supply. 

Targeted strategies that strengthen both intrinsic and extrinsic dimensions of work are essential for improving retention and making service provision more equitable. 

Possible approaches could include greater recognition of postgraduate qualifications and advanced clinical expertise, development of further leadership opportunities and enhanced access to flexible working arrangements. 

This might mean increased availability of roles in research and education, broader use of telehealth services and more adaptable scheduling, eg, staggered working hours. 

All National Boards, including the Physiotherapy Board, have recently introduced fee relief for parental and other types of leave to reduce the regulatory burden for practitioners who need time away from practising. 

The Board also supports physiotherapists being able to practise to the full extent of their professional capabilities, where it is safe and appropriate for individual patients and circumstances. 

Physiotherapists with additional training and qualifications can achieve recognition via credentialing pathways overseen by the Australian College of Physiotherapists. 

These pathways allow physiotherapists to use certain titles relating to their areas of practice. More information is available in the Board’s Statement on the use of titles. 

The Board is also investigating a proposal to increase scope of practice, enabling physiotherapists to be endorsed to prescribe medicines after completing a Board-approved program of study. 

Work to progress this proposal continues, in concert with the development of a joint prescribing framework for registered health professions. 

The full research article containing the survey results is available in the Australian Health Review, while results from a further paper covering interview responses are available in Physiotherapy Theory and Practice.