Physiotherapy and priority setting – a focus group study in municipalities in Finnmark, Norway
Scientific article in Fysioterapeuten 1/2015.
Morten Nikolaisen, specialist in neurological physiotherapy (MNFF), MSc, PT, Department of Rehabilitation, Finnmark Hospital Trust (Kirkenes). firstname.lastname@example.org
Cathrine Arntzen, associate professor, ph.d., Department of Health and Care Sciences, UiT The Arctic University of Norway
Siri Moe, associate professor, dr. philos, Department of Health and Care Sciences, UiT The Arctic University of Norway
This scientific article is peer reviewed by the Fysioterapeuten’s guidelines, and was accepted 12.03.2014. Norwegian Social Science Data Services (NSD) approved this study. No conflicts of interest stated.
Purpose: The article discusses how municipally employed physiotherapists and private practicing physiotherapists in Finnmark’s municipalities describe and reason about prioritization and allocation of tasks. The objective of the study was to gain more knowledge about content and tradeoffs in physiotherapy services and see if professional practice and development are in line with current health policies.
Method: The study is based on five focus group interviews with physiotherapists (n=21).
Findings: The participants perceived municipal resources for physiotherapy as insufficient, and expressed that they had to perform demanding prioritizations with limited support from the local authorities. Due to long distances to travel, patients who needed home consultations were in danger of not getting physiotherapy. Traditional differences between private practitioners and municipally employed physiotherapists characterized prioritization and distribution of patient groups and tasks. In municipalities with fewer physiotherapists and a wider range of tasks, the differences were less apparent. Municipally employed physiotherapists were given new tasks without an increase in capacity in the physiotherapy services, and distributed their resources on more patients than professionally desirable.
Conclusion: Limited service capacity, variations in affiliation (private practicing or municipally employed) and prioritizations, plus long distances, causes differences in provided physiotherapy services depending on place of residence. This emphasizes the importance of municipalities attending to their overall responsibility for physiotherapy services.
Key words: physiotherapy, primary health care, rural health services, health priorities.