# A Groundbreaking Insight Into Primary Care Physiotherapists’ Remuneration

## TL;DR

Greek primary care physiotherapists feel underpaid, leading to low job satisfaction and informal fees, with mixed preferences for new payment models.

## Contribution

This study identifies dissatisfaction with current physiotherapist remuneration in Greece and explores alternative payment schemes.

## Key findings

- 84% of physiotherapists believe their remuneration does not match their productivity.
- 58% report feeling forced to charge informal fees due to low pay.
- 25% prefer cost-per-case payments combined with co-payments.

## Abstract

Introduction

Physiotherapy in Greece, as part of primary health care (PHC), faces sound imbalances: reduced quality, productivity, and efficiency, along with rather inflexible remuneration schemes. This study is aimed at reporting the attitude and perceptions of Greek PHC physiotherapists toward their current remuneration and also at identifying any other preferable remuneration schemes.

Methods

A stratified proportional sampling study was undertaken, using an anonymous, electronic survey. The participants were 250 self-employed physiotherapists running their business in Central and Eastern Macedonia and Thrace, being also contracted with the National Organisation for Healthcare Provision (EOPYY). The sample size stands for 34% of the population with a circa 5% margin of error.

Results

Nearly 9/10 physiotherapists (84%) underline that remuneration falls short of their productivity, leading to reduced job satisfaction. Moreover, their remuneration does not motivate them to provide services of higher quality (46%), while 58% of them stated that they are forced to claim informal fees. There is no clear desire regarding the remuneration scheme, but nearly ¼ of physiotherapists revealed their preference for the cost-per-case philosophy combined with co-payments.

Conclusion

The majority of physiotherapists believe that their current remuneration does not reflect their productivity nor the quality of their services and, therefore, informal payments arise. The preference of physiotherapists lies between cost-per-case fees and patient co-payments, which, however, favors supplier-induced demand and access inequalities, respectively. Hence, policymakers should revise the current remuneration scheme and overcome its deficiencies without creating new ones.