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The importance of advocacy
Marcus Dripps

In the critical advocacy role that the APA plays there are always a number of issues that affect physiotherapists and their patients which are considered professional priorities.

In broad terms these are often related to the domains of either, scope of practice or funding.

In the scope of practice domain, the issue of prescribing rights for physiotherapists is front and centre in 2015.

Funding advocacy can be more complex. At times we are advocating directly for funding for physiotherapy services. An example of this is working with state-based compensation schemes regarding fees and policies which affect the delivery of physiotherapy services. On other occasions, it is about indirectly advocating for physiotherapy services, for example for an advanced practice role in the public sector.

Often our advocacy is for the benefit of our patients, rather than for the funding of physiotherapy services. Examples of this include lobbying government for changes to rebates on imaging items under the Medicare Benefits Schedule or for funding of physiotherapist-referred patients to medical specialists.

The intent of this advocacy activity is to strengthen the role of physiotherapists in different settings and sectors of care, strengthen the physiotherapy industry, and improve the patients’ journey through the Australian healthcare system.

From time-to-time, however, we come across an issue that is not restricted by funding, is within the scope of practice of many physiotherapists, but, for some reason is not widely embraced by our profession. Every now and then this issue is one where widespread use by physiotherapists would improve our patient’s journey and outcome, strengthen the role of the physiotherapy profession in the Australian community and improve our external reputation.

In my opinion, the most obvious example of this is physiotherapists providing certificates of work capacity in a compensation setting.

While the rules vary in different compensation schemes and states, in most jurisdictions physiotherapists can provide some types of certificates of work capacity. As physiotherapists, our understanding of musculoskeletal and other conditions positions us well to give advice to employers about what our patients can safely do. We have expertise about principles of progression in an exercise setting, many of which translate into an industrial setting. The health benefits of work are quite well understood, and we know that being engaged in meaningful work is good for our patients. In areas like sports physiotherapy our focus from the day of our initial examination is often centred on return to the sporting field, and we work with coaches and athletes to maximise the speed of recovery.

So why do many physiotherapists elect not to provide certificates of work capacity for injured workers?

I would argue that physiotherapists having a greater engagement in certification of injured workers would increase the standing of the physiotherapy profession in the Australian community, improve patient outcomes and provide opportunities for greater engagement with compensation schemes and other funders of physiotherapy services.

In time we should advocate for greater rights in issuing work certificates, including writing a first certificate to trigger the commencement of a claim.

If we don’t take this type of opportunity, we are certifiable.

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