Physiotherapy has long held a respected place in Australia’s healthcare landscape: a university-trained allied health discipline focused on restoring movement, function, and quality of life. Yet over the past decade, questions are emerging about whether the profession has lost some of its shine — its distinct identity, professional status, and long-term career appeal.

A confluence of factors — increased competition from osteopathy and exercise physiology, funding and policy pressures, public confusion over professional roles, and declining workforce retention — suggest that physiotherapy faces significant challenges.

Competition and Role Confusion

The last ten years have seen rapid growth in allied health professions such as osteopathy, exercise physiology, and rehabilitation consultancy. While these professions provide valuable services, the expansion has blurred the boundaries between roles. Consumers, and even some healthcare providers, often struggle to distinguish between our professions which has resulted in confusion, which has resulted in:

1. Competitive pressure, with patients choosing services based on cost or convenience rather than clinical appropriateness.
2. Erosion of professional identity, as physiotherapy risks being perceived as “just another hands-on therapy” rather than a movement and rehabilitation science-based discipline.

The consequence of this is that physiotherapy may be forced to compete more as a commoditised service rather than as a specialised profession, which ultimately undermines its standing, perceived value and price point.

Reputational Damage: Lessons from ACFI

Government funding programs have sometimes inadvertently undermined physiotherapy’s professional brand. The Aged Care Funding Instrument (ACFI) “4B” pain-management item funded physiotherapists primarily for massage and electrotherapy — far removed from the profession’s broader scope and expertise in clinical reasoning, rehabilitation, exercise prescription, and mobility enhancement.

A 2022 study highlighted that physiotherapists in residential aged care were funded only for short massage or electrotherapy sessions, creating a perception that physiotherapy equates to massage rather than clinical rehabilitation.

Although ACFI has now been replaced (by the Australian National Aged Care Classification (AN‑ACC)) as of October 2022, the reputational legacy remains, and the funding precedent continues to shape stakeholder perceptions of the profession.

Pricing, Funding Streams and Market Pressures

A major factor in the diminishing shine of physiotherapy has been pricing and funding‐stream stagnation or decline, combined with escalating overheads and competitive pressure.

NDIS Pricing Cuts
Under the National Disability Insurance Scheme (NDIS) the professional fees for physiotherapy supports were reduced effective 1^st July 2025 to $183.99 per hour, and travel allowances have been halved. The Australian Physiotherapy Association (APA) has labelled these cuts “untenable” given rising operational costs and a five‑year price freeze preceding them.

These cuts have several immediate effects:

• They limit the ability of physiotherapy practices to raise their fees in line with inflation or growing costs, eroding margin and sustainability.
• They reduce attractiveness of working in NDIS‑funded physiotherapy, potentially driving clinicians out of the scheme or the profession entirely.
• They send a signal to consumers and funders that physiotherapy may be a lower‑value service compared to other disciplines whose pricing has at least held or increased.

Stagnant Funding in Other Streams
In other major funding streams — including Department of Veterans’ Affairs (DVA), WorkCover/state workers’ compensation and Medicare rebates — physiotherapy fees have not consistently kept pace with inflation, overhead cost increases (rent, staffing, compliance) or equipment/technology investment. This further compresses fee‑growth potential and puts pressure on private practices to find other revenue streams, reduce staffing or accept lower margins.

Competitive Pressure
Adding to these funding constraints, the overlap of service scopes means physiotherapists also face competition from professions whose growth has been more rapid, or who market themselves more aggressively to consumer dollars (e.g., exercise physiologists for chronic disease/exercise programmes, osteopaths for musculoskeletal/manual therapy). This competitive dynamic weakens the ability of physiotherapy practices to set premium fees, to differentiate their offering, or to command higher margins. The cumulative effect of funding cuts, stagnant fees and stronger competition has significant implications for the profession’s viability, attractiveness, and identity.

Workforce Scale
The size of the physiotherapy workforce also emphasises the scale of the challenge. At 30 June 2023 there were approximately 40,540 registered physiotherapists in Australia. With such numbers operating in diverse private and public settings, competition both within the profession and against allied disciplines is intense—and when fee growth is restricted, the business case for some practices becomes increasingly difficult.

Workforce Retention and Attrition

Physiotherapy is also facing a workforce retention crisis. According to the APA 2023 Workforce Census:

• 19% of physiotherapists intend to leave the profession within five years.
• 45% cite inadequate remuneration, 32% burnout, and 24% limited career progression as key drivers.
• Attrition rates among early-career physiotherapists are increasing, with only an estimated 40–45% remaining in the profession beyond ten years, down from previous estimates of ten years or more.

Declining retention threatens the profession’s collective knowledge, mentorship capacity, and long-term credibility.

Has the APA Kept Pace?

The APA has been active in workforce surveying, advocacy and raising pricing concerns (for example, about NDIS price reductions). However, given the outcomes — reduced pricing, continuing confusion of role, workforce attrition — the question remains whether the APA has been as effective as peer bodies in allied health (such as those representing occupational therapists or speech pathologists) in lobbying for fee‑protection, role‑clarification and professional equity. If physiotherapy is to reclaim its shine, the professional body must vigorously lead on pricing, scope and public advocacy.

The Final Word

Physiotherapy remains a core allied‑health discipline with significant potential: aging populations, chronic disease, falls prevention and rehabilitation all point to increasing demand. But the shine—the professional clarity, the premium positioning, the long‑career appeal—is under serious pressure. Role confusion, funding distortions, pricing constraints and workforce attrition combine to erode physiotherapy’s distinctiveness and value.

The opportunity remains: if the profession can clarify and communicate its unique scope, advocate effectively for fair pricing and funding, support workforce retention and differentiate itself in a crowded allied‑health market. The question is whether physiotherapy will reclaim its shine—or continue to drift toward being viewed as one of several interchangeable “hands‑on/rehabilitative” options.