Situation of Physiotherapy in Spain
Physiotherapy and rehabilitation are two terms that, although they are not the same, are closely related to each other. Well, the first is integrated into the second, bringing together the methods and techniques of physical therapy that are part of the recovery process that a patient goes through to recover a state of functionality similar to the one he had prior to the pathology.
Indeed, and as we have already mentioned in other entries of this blog, this directly relates to physiotherapy with each medical discipline in which the patient needs to go through a period of rehabilitation.
In Spain, physiotherapy is a discipline recognized by the Ministry of Health as one of those that provide the rehabilitation service in primary care. It is a sector that includes more than 60,000 health professionals according to the INE.
Since it was recognized as a specialty of the ATS in 57, through the creation of the diploma in 1980 or the implementation of the degree in 2008 until today, physiotherapy has been consolidated in our country as a fundamental discipline in health sciences.
But where does it come from?What is its real role?What relevance does it have in the health sector?What are its biggest challenges?
We intend to answer these questions in this article from our physiotherapy blog. Want to know more? Keep reading!
Physiotherapy and rehabilitation: brief historical context
«The specialty that concerns us and that in recent times has attracted the attention of clinical centers belongs to a group of didactic subjects that until now have not been gathered in a single body because they are not characterized by an organ system as is the case with laryngology, ophthalmology, etc. Nor by the special way of being of the conditions they treat (…), but by the exclusive domain and management of a specific therapeutic technique. Referring by this to the so-called physiotherapeutic methods (…). «Therapeutics without medicines» or «art of healing without medicines».
This is how Max Herz expressed the tendency he observed towards physiotherapeutic practice in his book “Manual de Iatro-gimnasia” in 1907.
The truth is that Dr. Herz’s vision did not go astray if we think about what happened next. But, as Raposo Vidal and collaborators pointed out in their 2001 article, during the dawn of the 20th century physiotherapy in Spain took shape in the hands of those known as practitioners and in the daily tasks of midwives and nurses. So it was, until in 53 the figure of the Health Technical Assistant (ATS) was created and later its specialty in physiotherapy.
After this, he speaks of a time of obscurantism in which the work in physiotherapy and rehabilitation of the ATS went unnoticed until 1969, the year in which the creation of schools that taught the discipline, the celebration of congresses and the publication of the first National Journal of Physiotherapy give rise to the foundation of the Spanish Association of Physiotherapists (AEF).
The AEF was mobilized to modernize and value a discipline that needed to gain a foothold among the most preeminent branches of health sciences and its effort resulted in the creation of the diploma in Physiotherapy in 1980.
From then until today, the discipline has evolved with years of research and effort to become one of the most important health disciplines, becoming a university degree in 2008 and becoming its own faculties, with the academic field in one hand and the impulse of professional, community and national associations, in the other.
Relevance of physiotherapy in Spain
It would be extraordinary to say that all the effort that we have told you in the previous point has been enough to place physiotherapy in its rightful place. It would be extraordinary to say. But the reality is that a lot of work is still needed to help take the sector to higher levels.
In Spain the figure of the physiotherapist is recognizable in a sports and / or traumatological field. He is observed as a specialist in musculoskeletal injuries and the population usually resorts to them when suffering from a related ailment.
Its role in the National Health System (SNS) is more widespread, being able to find physiotherapists in the rehabilitation units of any clinical field such as pulmonology, cardiology, oncology, etc. Although the specialties are not officially recognized by the Ministry of Health. Currently about 5000 physiotherapists work in the NHS.
There is also a need to educate the general public about the real competences of physiotherapists and the specializations that the disciplin has.
It would seem that we need vision to continue modernizing the sector in terms of addressing pathologies, such as the creation of an online health center or the implementation of a digital physiotherapy or telerehabilitation service, which guarantees assistance to any patient, anywhere.
Greater challenges of physiotherapy in Spain
What has been said so far suggests that the sector is at a crossroads and that it has problems on several fronts that do not seem to have an effective long-term solution. Next, we are going to tell you about the biggest problems of current physiotherapy:
Saturation of rehabilitation services and job insecurity
As we have already mentioned, more than 5,000 physiotherapists currently work in the SNS, which in itself is a breach of the WHO indications. The international organization suggests that the professional/patient ratio should be 1/1000. But in our country it remains at 0.1/1000 inhabitants.
In some mutuals, each professional sees close to 40 patients a day, which is disastrous for professionals, who end up exhausted, and for patients who do not receive adequate assistance.
Added to this is the fact that many live in private clinics where they work 9-hour days as false self-employed workers and sometimes even without a contract.
One of the biggest current problems in physiotherapy is the labor intrusion to which the sector is subjected from other pseudoscientific disciplines that represent a dangerous practice for the entire population and patients.
Some chiromassage, acupuncture and other complementary therapies centers seek to supply the competencies of a health profession such as physiotherapy and should be prosecuted and punished as a danger to public health.
Recognition of specialties and skills
We have already discussed in our physiotherapy blog the subject of specialties in the sector and why they should be recognized by the competent authority of our country with the aim of providing a better service to the population.
Recognizing the specialization and shielding the competencies of the physiotherapist in exercise and in clinical practice would have a positive impact not only in terms of quality of care, but also in terms of management and organization.
And you, what do you think are the biggest challenges of current physiotherapy?